Vitex and Progesterone Cream

By Amy Day, ND

Question: "I have started taking vitex almost over a month ago. And I also just started using natural progesterone cream. I have PCOS and didn't menstruate without some treatment. I noticed since I have started using the both the above I have menstruated twice this month and now after 2 weeks I'm spotting again! Is that normal? Any suggestions? I am freaking out! Please respond as soon as possible."

Answer: It must feel strange to go from having no periods to having two per month. The good news is that you know your body is really responding to these natural therapies. To help you get your cycle to normalize, let's first help you understand the actions of the treatments that you are using. Vitex and progesterone cream have related but separate effects on the menstrual cycle.

Vitex is like a master regulator. It encourages the pituitary in the brain to produce the hormones that orchestrate the whole cycle. It helps to tell the ovaries when to produce estrogen and progesterone, and when to ovulate. After ovulation, the ovaries naturally increase production of progesterone for the second half of the cycle (i.e., luteal phase). So vitex encourages the body to produce its own progesterone.

Progesterone cream may be given as a therapy when trying to augment the natural production and stimulate the body to cycle. I'm not sure what dose or timing you were using, but in order to mimic a natural cycle, progesterone cream is usually given for two weeks on and then two weeks off, only using it during the luteal phase. Though it is a relatively safe hormone, it needs to be dosed carefully and used properly. When using progesterone in this way, you should have one bleed per month, right after stopping the cream.

Since you are responding so strongly, it sounds to me like you may not need both of these therapies at once. I most often start with herbal support to encourage the body to learn its own rhythm, adding in hormones only as needed. Vitex can take a few months to get its rhythms working optimally so it's best to give that a little more time on it's own before deciding what else you might need.

How Much Should You Take?

Everyone is unique, so the amount and form you need won't be the same as for someone else.

Chasteberry can be taken daily for up to 18 continuous months, unless pregnancy occurs. It can be taken once or twice a day. It may take 2-7 months before any results become evident.

As a general guideline, your daily dose could be 175 mg. or more of standardized vitex extract, standardized to contain 0.6% agusides (or 60 drops of tincture, standardized to contain 0.6% agusides).

It's not the same as taking progesterone. You don't take it, stop it, and then expect a withdrawal bleed a few days later as you would if you were taking progesterone or synthetic progestins.

Vitex agnus castus is exceptionally safe. In one study, chaste tree berry was given up to 9 years with very few side effects. But it's advisable to not take it if you are pregnant.

Please note: The quality of botanical supplements is unreliable. Don't buy any herbal or botanical product unless it has a "standardized" amount of the active component listed on the label. A "standardized" product has a consistent amount of active ingredients from one bottle to the next. If you buy a product that is not standardized, you have no clue as to what you are actually getting and are probably wasting your money.

If you're taking hormone replacement therapy, oral contraceptives or dopamine agonists, let your doctor know if you're taking this extract.

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