Safety and efficacy of chastetree (Vitex agnus-castus) during pregnancy and lactation.
BACKGROUND
There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbs used during pregnancy and lactation. This is one article in a series that systematically reviews the evidence for herbs commonly used during pregnancy and lactation.


OBJECTIVE
To systematically review the literature for evidence on the use, safety and pharmacology of chastetree, focusing on issues pertaining to pregnancy and lactation.


METHODS
We searched 7 electronic databases and compiled data according to the grade of evidence found. RESULTS In pregnancy, there is poor evidence based on theoretical and expert opinion and in vitro studies that chastetree may have estrogenic and progesteronic activity, uterine stimulant activity, emmenagogue activity and prevent miscarriages. In lactation, theoretical and expert opinion conflict as to whether chastetree increases or decreases lactation.


CONCLUSIONS
Given its relatively common use amongst women of childbearing age, it is likely that some women may consume chastetree while unknowingly pregnant. Complementary and alternative medicine, midwifery and medical practitioners should be aware of this fact when prescribing chastetree to women of childbearing age, particularly when the patient is planning a family. Key words: Chastetree, vitex agnus-castus, pregnancy, lactation, breastfeeding, systematic review.
Dugoua
Jean-Jacques
JJ
Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University ofToronto, Toronto, Canada. jeanjacques.dugoua@utoronto.ca
Seely
Dugald
D
Perri
Daniel
D
Koren
Gideon
G
Mills
Edward
E
D000022:Abortion, Spontaneous / Q000517:prevention & control; D000818:Animals; D019317:Evidence-Based Medicine; D005260:Female; D005638:Fruit; D041743:Herb-Drug Interactions; D006801:Humans; D007774:Lactation / Q000187:drug effects*; D008598:Menstruation / Q000187:drug effects; D008600:Menstruation-Inducing Agents / Q000009:adverse effects* / Q000737:chemistry / Q000633:toxicity; D010120:Oxytocics / Q000009:adverse effects* / Q000737:chemistry / Q000633:toxicity; D048789:Phytoestrogens / Q000009:adverse effects* / Q000737:chemistry / Q000633:toxicity; D028321:Plant Preparations / Q000009:adverse effects* / Q000737:chemistry / Q000633:toxicity; D011247:Pregnancy; D011960:Receptors, Estrogen / Q000187:drug effects; D011980:Receptors, Progesterone / Q000187:drug effects; D018570:Risk Assessment; D014590:Uterine Contraction / Q000187:drug effects; D020950:Vitex / Q000737:chemistry
D008600:Menstruation-Inducing Agents; D010120:Oxytocics; D048789:Phytoestrogens; D028321:Plant Preparations; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone