Vitex Agnus-castus for the treatment of cyclic mastalgia: a systematic review and meta-analysis

Background. Cyclic mastalgia (CM) is premenstrual bilateral and diffuse breast pain that presents cyclically affects women in their reproductive years. It may associate with latent hyperprolactinemia due to the insufficient inhibitory effect of dopamine on pituitary gland. Vitex agnus-castus (VAC) known for its dopaminergic activity possible actions CM hyperprolactinemia. However, treatment VAC remains unclear.Materials methods. To perform a systematic review meta-analysis clinical trials report efficacy ofVAC patients, literature search was performed major research databases.Results. This includes 25 studies (17 randomized control plus eight nonrandomized trials). effective relieving intensity lowering increased serum prolactin level age patients (18-45 years) or without syndromes. Typical dosage 20-40 mg/day duration 3 months. A conservative included only six (n = 718: - 356, placebo 362) revealed moderate size (SMD 0.67, 95% CI 0.5­0.85) favoring over placebo. Seven demonstrated be noninferior alternative pharmaceutical therapies CM, including agonists, nonsteroidal anti-inflammatory drugs, serotonin reuptake inhibitors, hormonal contraceptives. safe associated mild reversible adverse events. risk bias most unclear information.Conclusion. option CM. More high-qualityclinicaltrialsareneededto strengthentheevidencebase.