Real-World assessment of effectiveness and tolerability in utilization of herbal medicinal products for gynecological complaints with regard to Co-Medication

Little is known about the effectiveness and tolerability of herbal medicinal products (HMPs) when they are utilized concomitantly with synthetic drugs. Therefore a sample (n=1658) was taken from the pharmaco-epidemiological database PhytoVIS consisting of real-world outcomes reported by women treating their gynecological complaints with HMPs [ 1 ]. We focused on Vitex agnus-castus L. (VAC) (n=197) or Actaea racemosa L. (CR) (n=223) because their therapeutical benefits and safety have already been clinically proven [ 2 ] [ 3 ]. The vast majority of women using only VAC (n=177) or only CR (n=113), experienced a good effectiveness (~92%) and only a minor share did not benefit (~9%). When VAC was taken alongside other drugs the effectiveness was still high (91%, n=78), and only a few (9%, n=7) did not perceive any symptom relief. In these cases adverse events did not occur. Similar results have been observed with CR. When it was utilized concomitantly with other drugs (n=110), most women (96.4%, n=106) perceived the effectiveness as good. Only a few (3.6%;n=4) complained about undesired events. Interestingly, the number of combined medications did not affect the perceived effectiveness ( p =0.119; r =-0.114) or tolerability ( p =0.279; r =-0.079) of VAC or CR. Our results show that the perceived effectiveness and tolerability of CR and VAC is independent of whether they are taken as monotherapy or combination therapy. In addition to comedication, other factors e.g. daily dose, duration & frequency of use or concomitant diseases should be investigated, as these could also have an influence on the perceived effectiveness and tolerability. Publication History Article published online: 05 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany