Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms

INTRODUCTION

Menopause is a natural growth transition stage in every woman.¹⁾ During menopause, the activities of estrogen and progesterone secreted by the ovaries dramatically decrease.^2,3) Women experience physical, mental, social, and psychological changes during menopause, which results in cardiovascular diseases, osteoporosis, bone fracture, and even Alzheimer disease in the long term.^4-6) Menopause with complications such as severe hot flash, sudden sweats, fatigue, and dizziness, as well as physiological complications, leads to osteoporosis, ovarian atrophy, decrease in sexual hormone levels, increase in weight, and depression. Thus, acquiring good knowledge about effective treatments to reduce mental and psychological problems of menopausal women is of high value and importance.^7-10)  Use of various alternative or complementary treatments to reduce the undesirable symptoms of menopause is widely accepted nowadays. Among such treatments, phytoestrogens are used as hormonal therapies in menopausal women; these can have less side effects because of their herbal origin.¹¹⁾ Phytoestrogens are found in soybean, beans, cereals, and vegetables and have an estradiol-like function.¹²⁾  Administration of herbal medicines has been popular since a long time for the cure of irregular menstruation, menopausal complications, and menstrual pain. In Iranian traditional medicine, several herbal medicines have been suggested to be effective in alleviating menopausal symptoms. Vitex agnus-castus extracts (panj-angosht in Persian) is a native plant of the Mediterranean countries has a long history in traditional medicine. Botanical studies, cultivation, and pharmacognosy of Vitex started in Iran in 1991, and medicinal products were introduced in 1996.¹³⁾ Rates of complication, including mild upset stomach, rash, and itching, are low; complications are seen in approximately 2% of users.^14-17) Vitex has numerous uses in traditional medicine, and primary studies have demonstrated its effectiveness in decreasing menopausal complications.^18-20) The fruit of this plant is administered as treatment for menopausal complaints. Currently, in European and American countries, the use of the Vitex fruit for its therapeutic effects on women with reproductive problems, premenstrual syndrome, infertility, and hyperprolactinemia is common. Despite the lack of clinical trials designed to study the effects of this plant on menopause-related symptoms, pharmacological evidence denoting its dopaminergic activity, closeness to opioid receptors, and ability to increase melatonin secretion support the effectiveness of Vitex for reducing menopausal symptoms.