The chemical composition and the effects of Vitex agnus-castus at the cellular and organismal levels

Vitex agnus-castus(VAC) is a medicinal plant that has been used in various gynecology conditions. This review synthesizes current evidence by integrating phytochemical standardization, mechanistic pharmacology, clinical effectiveness, and safety. The most studied standardized hydroalcoholic extracts are ZE 440 and BNO 1095. Pharmacological studies reveal dopaminergic D2 receptor activity, prolactin inhibition, opioid receptor modulation, anti-inflammatory and antioxidant properties, and cytoprotective signaling in oxidative stress models. Clinical trials consistently demonstrate that VAC diminishes the severity of PMS symptoms, alleviates cyclic mastalgia, and reduces prolactin levels in specific subsets of women, whereas evidence regarding its efficacy in menopause is limited and inconsistent. Safety profiles in randomized trials are positive. Nonetheless, comprehensive long-term safety data, pharmacokinetic profiling, and standardized exposure–response assessments are still insufficient. Overall, VAC represents a well-substantiated phytotherapeutic option for treating PMS. Future priorities encompass standardized extract reporting, biomarker-associated clinical designs, and stringent safety studies in vulnerable populations.