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How Chasteberry Supports Women’s Health

Vitex agnus-castus, also known as Chaste Tree or Chasteberry is a powerhouse herb in women’s health. Indigenous to Central Asia and the Mediterranean, it has been used for thousands of years for menstrual irregularities, premenstrual syndrome, premenstrual dysphoric disorder, breast tenderness, infertility, and more. The Latin root: agnus castus means “chaste lamb” purportedly alluding to the ancient culinary use of Vitex (also “monk’s berry”) to curb libido in monks!   

Historical uses aside, what we DO know about Vitex is that it contains glycosides, flavonoids, essential oils, essential fatty acids (oleic and linolenic). It works at the level of the brain to decrease prolactin levels, increase progesterone levels, and bind opiate receptors — which might be how it improves anxiety, food cravings, physical discomfort associated with premenstrual syndrome (PMS). Vitex is approved by the German Commission E for use in menstrual cycle irregularities, premenstrual disturbances, and mastodynia (breast pain).

3 Reasons To Consider Taking Chasteberry

Do you have PMS?

There are multiple studies that validate chaste tree for gynecological problems including PMS. One well-designed study of 170 women compared Vitex to a placebo pill during three consecutive menstrual cycles and women who got the herb reported 52% improvement in symptoms compared to just 24% in the placebo group. Specific symptoms looked at in this study were irritability, mood changes, anger, headaches, breast fullness, bloating and ALL had significant differences between Vitex and placebo pills1.  

Heavy Bleeding

Many women suffer from heavy bleeding during their periods.  This can be especially true for women who have a copper containing intrauterine device (IUD). One prospective study of 84 women looked at Vitex compared to mefenamic acid (an anti-inflammatory medicine) to reduce heavy bleeding in IUD users over the course of 4 menstrual cycles. Researchers found that women in both groups had significant improvement in symptoms, 52% in the anti-inflammatory group and 46% in the Vitex group2. I look forward to seeing additional studies with more subjects and that include a placebo group to fully understand the role for Vitex.

Irregular Periods

Many women have irregular periods and are often prescribed progesterone to help regulate their period, either in the form of birth control pills or sometimes progesterone alone.  Since we know that Vitex increases one’s one progesterone production, it makes sense that we would use it to help regulate an irregular period. Additionally, chaste tree works by decreasing prolactin, which for some women is the culprit in causing too few periods. I always lean towards supporting your body’s ability to make its own hormones over prescribing additional ones, especially if the ones we give are synthetic progestins. After all, synthetic progestins (the type of progesterone in birth control pills) can cause side effects such as weight gain, bloating, acne, moodiness, hair loss: not what you are looking for when suffering already from period problems!

Chasteberry and Infertility: A Word of Warning

Some people take Vitex for infertility due to irregular periods since it increases progesterone. Adding progesterone during infertility treatments is quite common. The studies on Vitex for infertility are mixed, leaving us without firm conclusion that it will help you get pregnant. While historical use supports this approach, there is no safety data on Chaste tree during pregnancy or lactation. For these reasons, I do not recommend starting it specifically for fertility and I DO recommend stopping the herb if you become pregnant.  

How to Take Chasteberry

Chasteberry does take time to see full impact, so stick with it for at least three months before deciding if it is working for you.The dose is usually 200-500 mg a day of dried fruit or 20-40mg/d of extract standardized to agnuside or casticin. At Blum Center for Health, we use Chasteberry Plus, at the dose of 1 tablet in the morning and 1 in the evening, with or without food.  Because Chasteberry has an impact on your body’s hormone production, it is wise to avoid if you have a hormone sensitive cancer, are pregnant, or are nursing. It could potentially impact hormonal birth control. It could interfere with dopamine-related medicines, such as some medicines used in Parkinson’s and some antipsychotic medicines. Side effects are not common but include GI upset, headaches, fatigue, increase in menses, hair loss. Rarely women with a history of depression may see a worsening of their symptoms.  Before starting herbal remedies, if you are taking other medications or have any hormone related health issues, remember to always check with your doctor, or come and see me at Blum Center.

Live in our neighborhood and want to learn more about using herbs for women’s health? Make an appointment with Dr. Fitz!  In her practice at Blum Center for Health she takes a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. For more information, call 914-652-7800.

Meet Dr. Fitz:  Bronwyn Fitz, M.D. is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.

 

References:

  1. Schellenberg R BMJ. 2001 Jan 20;322(7279):134-7.
  2. 2. Yavarikia P, Shahnazi M, Hadavand Mirzaie S, Javadzadeh Y, Lutfi R. J Caring Sci. 2013 Aug 31;2(3):245-54.
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Herbs As Medicine: What You Need To Know

Herbs are used medicinally all over the world. For instance, morphine comes from the Poppy plant, aspirin comes from Willow Bark, digitalis comes from Fox Glove, taxol an important cancer drug, comes from the Yew tree. The list goes on.

It is ironic that doctors in the U.S. don’t learn about the healing powers of plants given that many powerful medicines are derived from plants. As a traditionally-trained Ob Gyn I was taught to prescribe a lot of medicine —  hormones, antibiotics, non-steroidal anti-inflammatories (NSAIDs), to name a few.

The problem is that many of these medicines have pretty hefty side effects.  NSAIDs are prescribed widely for menstrual pain and heavy bleeding, but prolonged use can cause GI bleeding. The three month injectable progestin shot, medroxy progesterone acetate (aka: “Depo”) works very well to prevent pregnancy, but at the expense of bone density.  It is well established that Depo users sustain a decrease in their bone density while taking the shot, but long term outcomes were not known until relatively recently.  According to a 2015 Cochrane review, we now we have evidence that postmenopausal women who took Depo in the past have increased risk of bone fractures.  

After practicing in the traditional model for many years, and being concerned about these types of side effects, I began to wonder, “what other choices do we have?”  This quest for more options to offer my patients led me to pursue an Integrative Medicine Fellowship, where I received extensive training in herbal medicine. I can tell you for certain that herbs are a wonderful addition, and sometimes replacement, for traditional pharmaceuticals.

3 Ways Herbs Outperform Standard Medicines

  1. Lower dose and less toxicity — The medicines I listed above — morphine, aspirin, digitalis and taxol — are all made from an active ingredient that has been isolated, extracted, purified, and packaged in a highly potent form. With high potency, comes increased risk of toxicity and side effects.  When you consume an herb in its natural form (root, leaf, bark) you are often getting lower doses of the active ingredient, which are often less toxic.  Still, even herbs can have side effects and can interact with other herbs and medicines that you might be taking.  It is important to be well informed about these potential side effects and interactions.
  1. Herbs are multi-faceted — Most medicines have one active ingredient whereas each plant has multiple active ingredients that work synergistically. There can be hundreds of distinct compounds in the plant that potentially contribute to its medicinal properties.  Sometimes these compounds work together to make the herb more efficient.  

For example: Red Yeast Rice, the fermented product of a fungus, Monascus purpureus, is known to contain monacolin K, which is lovastatin, a commonly prescribed cholesterol lowering drug. Many studies have proven that Red Yeast Rice also lowers LDL cholesterol by 30%. Some wonder how Red Yeast Rice, which has relatively low doses of monacolin K, can result in such great clinical outcomes when compared to the typical dose of lovastatin.  

Likely the answer resides in the fact that monacolin K is not the only compound in it.  Red Yeast Rice contains eight other monacolins, plus other plant compounds with beneficial health effects such as sterols, isoflavones and monounsaturated fatty acids.  

A word of caution: it is important to do research to find a reputable brand of herb to take because there is also the unfortunate practice of cutting herbal products with both active drugs (Red Yeast Rice can be spiked with lovastatin), heavy metals, or the opposite problem of not having enough active ingredient.  Working with a good Herbalist or Healthcare provider who is trained in herbs is essential.

  1. Less Side Effects — There are numerous examples of herbs that have fewer side effects than conventional medicines. St. John’s Wort (SJW) is a perfect example.  We often recommend SJW for mild depression. It has been extensively studied and found to be safe and efficacious. There is even a Cochrane Review (traditional medicine’s gold standard of evidenced-based medicine) that evaluated 29 studies of over 5,000 patients and concluded that SJW is more effective than placebo, as effective as other antidepressants with fewer side effects.  A word of caution, however: SJW can interfere with some medications (like birth control pills, antidepressants, coumadin, digoxin, cancer therapies, immunosuppressive agents) so ALWAYS check with your provider before taking it.  

Herbs are worthwhile additions to your medicine cabinet. Unfortunately, herbs are not well understood, particularly in places like the United States, where traditional medicine is the norm. Over the next few months I will be writing an informational series highlighting some of my favorite herbs for women’s health. Keep your eyes peeled!

Live in our neighborhood and want to learn more about using herbs for women’s health? Make an appointment with Dr. Fitz!  In her practice at Blum Center for Health she takes a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. For more information, call 914-652-7800.

Meet Dr. Fitz:  Bronwyn Fitz, M.D. is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine. In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.

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Do You have Estrogen Dominance?

Estrogen Dominance

In Functional Medicine we often refer to the relationship between estrogen and progesterone as the “dance of the hormones” or the “hormone orchestra.”

Ironically, what sounds like a beautiful evening at the ballet often plays out each month as a real hand-banging, body-slamming cacophony!

So what gives?  Why is it that we often feel out of control, and sometimes out of body, for days at a time?

The answer could be Estrogen Dominance.

Here are typical symptoms that can be attributed to a relative excess of estrogen in relationship to progesterone:

  • irregular bleeding
  • mood swings
  • depression
  • water retention/bloating
  • painful breasts
  • hot flashes
  • heavy periods
  • painful periods
  • fatigue
  • brain fog
  • sleep disturbance

How did we get here?  Unfortunately, there are many roads that lead to estrogen dominance.  Let’s start at the beginning.

The Typical Menstrual Cycle

During a typical menstrual cycle, the first half of the month, known as the estrogen dominant phase, progesterone is relatively low and estrogen levels steadily rise. Due to some nifty feedback loops that involve the brain and other hormones, ovulation occurs at around Day 14, and an egg is released from the ovary.  During this second half of the menstrual cycle, estrogen levels fall somewhat and progesterone levels rise significantly. This is when progesterone takes the lead in our hormone tango.

5 Roads that Lead to Estrogen Dominance

  1. Irregular Ovulation — One road that leads to estrogen dominance is if ovulation doesn’t occur and progesterone doesn’t have the opportunity to take that lead. We see this type of problem in young girls who haven’t started ovulating regularly, and in peri-menopausal women who are close to the end of their ovarian reserve, and also aren’t ovulating normally.
  1. Any Type of Stress — Often stress can lead to skipped ovulation. Typically we think of extreme episodes of stress such as a severe illness, anorexia/malnutrition, intense athletic training. But commonly, your average woman who goes through a stressful time will notice that her period becomes irregular. Even long standing, chronic stress can take a toll on your female hormones.
  1. Foods and Food Packaging — In this day and age of genetically-modified, pesticide-laced, prepackaged food to go, we are constantly exposed to xenoestrogens. These are toxic chemicals that act like weak estrogens in your body. These nasty chemicals can be found in pesticides, plastics that our food comes wrapped in, that “to-go” coffee lid, even the lining of your canned goods and drinks.
  1. Cosmetics and Household Products — Other examples of endocrine disruptors are phthalates and parabens that are used in hygiene products, cosmetics, and fragrances. This is where women are potentially very vulnerable considering how many bath, haircare, cosmetic, nail, feminine hygiene products we use daily. These just add to your total estrogen “load” that your body sees on a regular basis and that your liver has to metabolize and detoxify.  It turns out that optimal liver function is very important in estrogen metabolism and clearance.
  1. Your Gut Flora — The gut microbiome and your gastrointestinal function is another major player in this hormonal dance that is now looking more like a square dance with all its moving parts. It turns out that the bacteria that reside within our GI tract plays a very important role in helping us eliminate our estrogen by-products once the liver has packaged them up nicely for excretion. Sadly, the average American diet, full of high fructose corn syrup and other inflammatory foods often keep our livers working over-time just trying to detoxify lunch, let alone efficiently remove spent hormones from our systems.  Obesity itself is a problem since estrogen is stored in fat cells.  The fact that 2/3 of Americans are overweight or obese points to how prevalent this form of estrogen exposure is.

As you can see, there are many, many influences that lead to Estrogen Dominance. It’s not just “the way you are.”

The great news is there is something you can do about it.

First, you don’t need to treat Estrogen Dominance with birth control pills!

While birth control pills may help alleviate symptoms, they do not solve the root problem, In fact, taking birth control pills to treat estrogen dominance could possibly lead to more longer-term problems. (There are other excellent uses for birth control pills, such as actual birth control, and it is important to understand a woman’s goals for her health when deciding how to treat her.)

As a fellowship-trained Integrative Medicine and Functional Medicine doctor, I attack this problem of Estrogen Dominance from many angles.  The truth is we have so many ways to help women feel better, without the use of medicine and surgery.  We can, and should, use food as medicine, weight loss, botanicals, mind-body modalities for stress management so that women can actually heal themselves.

About Dr. Fitz:

Dr. Bronwyn Fitz is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine.  In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.