Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial

Menopause. 2009 Jan-Feb;16(1):156-63. doi: 10.1097/gme.0b013e31817fa9e0.


Objective: To evaluate the effectiveness of a phytotherapeutic intervention comprising a combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus (Chaste tree/berry) in the management of menopausal symptoms.

Design: A double-blind, randomized, placebo-controlled, parallel trial was performed over 16 weeks in 100 eligible late-perimenopausal or postmenopausal women experiencing hot flushes and other menopausal symptoms. Herbal combination therapy or placebo tablets were administered twice daily. The primary endpoint was hot flush episodes. Secondary endpoints included Greene Climacteric Scale scores, Hamilton Depression Inventory scores, and Utian Quality of Life Scale scores.

Results: Ninety-three women completed the study. Data analysis on an intent-to-treat basis found no significant differences between the two groups for any of the endpoints. Analyses performed at interim data time points revealed no significant differences at week 4, 8, or 12 for daily weighted flushes or scores on the Greene Climacteric Scale or Hamilton Depression Inventory. However, significant improvements across the treatment phase were observed in both the placebo and active treatment groups for these endpoints. No significant change was found for either group on quality of life.

Conclusion: The herbal combination of H. perforatum and V. agnus-castus was not found to be superior to placebo for the treatment of menopausal symptoms. The herbal combination was well tolerated with no significant adverse events noted in the short term. Robust findings from quality studies such as this are important for informing the community, healthcare providers, and regulatory authorities.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / drug therapy
  • Depression / drug therapy
  • Double-Blind Method
  • Female
  • Hot Flashes / drug therapy
  • Humans
  • Hypericum / chemistry*
  • Menopause / physiology*
  • Middle Aged
  • Phytotherapy*
  • Placebos
  • Plant Extracts / therapeutic use*
  • Quality of Life
  • Vitex / chemistry*


  • Placebos
  • Plant Extracts