Zusammenfassung
Extrakte aus der getrockneten Frucht des Mönchspfeffers (Vitex agnus-castus = VAC) enthalten dopaminerge Substanzen, die die hypophysäre Prolaktinsekretion hemmen. Die prämenstruelle Mastodynie, aber auch – wie in jüngster Zeit wissenschaftlich belegt – die fibrozystische Mastopathie werden durch Prolaktin in ihrer Entstehung gefördert, sodass viele Patientinnen, die unter Stresssituationen oder Tiefschlafbedingungen vermehrt Prolaktin ausschütten, diese Mammasymptomatik entwickeln, die durch VAC günstig beeinflusst wird. Diese sogenannte latente Hyperprolaktinämie kann auch zur Corpus-luteum-Insuffizienz und damit zur Sterilität führen. In diesen Fällen kann die Agnus-castus-Therapie fertilitätsfördernd wirken.
Summary
The status of chaste tree (Vitex agnus-castus) in gynaecological endocrinology Extracts of the dried fruits of the chaste tree (Vitex agnus-castus, VAC) contain dopaminergic compounds which are inhibitory to pituitary prolactin release. The development of premenstrual mastalgia as well as of fibrocystic breast changes involves an action of prolactin. Hence, treatment with VAC is helpful to prevent these mammary gland symptoms. Prolactin is also involved in the function of the corpus luteum and patients with a latent hyperprolactinemia often suffer from a corpus luteum insufficiency where treatment with VAC extracts may also be helpful to improve fertility.
Schlüsselwörter
Vitex agnus-castus L. - Mastodynie - prämenstruelle Symptome - Corpus-luteum-Insuffizienz - Prolaktin - Dopamin
Key words
Vitex agnus-castus
- premenstrual mastalgia - corpus luteum insufficiency - prolactin - dopamine
Literatur
-
1
Wuttke W.
Raus K.
Gorkow C.
Efficacy and tolerability of the Black cohosh (Actaea racemosa) ethanolic extract BNO 1055 on climacteric complaints: A double-blind, placeboand conjugated estrogens-controlled study.
Maturitas.
2006;
55
(S 01)
83-91
-
2
Wuttke W.
Jarry H.
Christoffel V et al..
Chaste tree (Vitex agnus-castus) – pharmacology and clinical indications.
Phytomedicine.
2003;
10
348-357
-
3 Gorkow C. Wuttke W. März R W. Evidence of efficacy of Vitex agnus castus preparations. In: Loew D, Blume H, Dingermann T, Hrsg. Phytopharmaka V: Forschung und klinische Anwendung. Darmstadt: Steinkopff; 1999: 189-208
-
4
Halaska M.
Beles P.
Gorkow C.
Sieder C.
Treatment of cyclical mastalgia with a solution containing a Vitex agnus-castus extract: results of a placebo-controlled double-blind study.
Breast.
1999;
8
175-181
-
5
Wuttke W.
Splitt G.
Gorkow C.
Sieder C.
Behandlung zyklusabhängiger Brustschmerzen mit einem Agnus castus-haltigen Arzneimittel – Ergebnisse einer randomisierten, plazebokontrollierten Doppelblindstudie.
Geburtsh u Frauenheilk.
1997;
57
569-574
-
6
Kubista E.
Muller G.
Spona J.
[Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles].
Rev Fr Gynecol Obstet.
1987;
82
221-227
-
7
Kumar S.
Mansel R E.
Hughes L E et al..
Prediction of response to endocrine therapy in pronounced cyclical mastalgia using dynamic tests of prolactin release.
Clin Endocrinol (Oxf).
1985;
23
699-704
-
8
Suginami H.
Ito T.
Hamada K et al..
[Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine].
Nippon Sanka Fujinka Gakkai Zasshi.
1986;
38
728-734
-
9
Wuttke W.
Pitzel L.
Seidlova-Wuttke D.
Hinney B.
LH pulses and the corpus luteum: the luteal phase deficiency (LPD).
Vitam Horm.
2001;
63
131-158
-
10
Freeman M E.
Kanyicska B.
Lerant A.
Nagy G.
Prolactin: structure, function, and regulation of secretion.
Physiol Rev.
2000;
80
1523-1631
-
11
Dogliotti L.
Mansel R E.
Bromocriptine treatment of cyclical mastalgia/fibrocystic breast disease: update on the European trial.
Br J Clin Pract Suppl.
1989;
68
26-32
discussion 49–53
-
12
Nazli K.
Syed S.
Mahmood M R et al..
Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia.
Br J Clin Pract.
1989;
43
322-337
-
13 Schwibbe M. Wuttke W. EEG and psychological effects of lisuride in women with premenstrueal tension. In: Calne D B Horowski R McDonald R J Wuttke W, eds. Lisurides and Other Dopmanine Agonists. New York: Raven Press; 1983
-
14
Milewicz A.
Gejdel E.
Sworen H et al..
Vitex agnus castus-Extrakt zur Behandlung von Regeltempoanomalien infolge latenter Hyperprolaktinämie. Ergebnisse einer randomisierten Plazebo-kontrollierten Doppelblindstudie.
Arzneimittelforschung.
1993;
43
752-756
-
15 Wuttke W. Gorkow C. Jarry H. Dopaminergic compounds in Vitex agnus castus. In: Loew D Rietbrock N, Hrsg. Phytopharmaka in Forschung und klinischer Anwendung. Darmstadt: Steinkopff; 1995: 81-91
-
16
Jarry H.
Leonhardt S.
Gorkow C et al..
In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay.
Exp Clin Endocrinol.
1994;
102
448-454
-
17
Ono M.
Nagasawa Y.
Ikeda T et al..
Three new diterpenoids from the fruit of Vitex agnus-castus.
Chem Pharm Bull (Tokyo).
2009;
57
1132-1135
-
18 Christoffel V. Spengler B. Jarry H et al.. Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus. In: Loew D Blume H Dingermann T, Hrsg. Phytopharmaka V: Forschung und klinische Anwendung. Darmstadt: Steinkopff; 1999: 209-214
-
19
Artymuk N V.
Kondratieva T.
Tachkova O.
Vitex agnus castus extract administered for luteal-phase defect treatment.
J Reproduktionsmed Endokrinol.
2010;
7
362
-
20
Gerhard I I.
Patek A.
Monga B et al..
Mastodynon® bei weiblicher Sterilitat.
Forsch Komplementarmed.
1998;
5
272-278
-
21
Schellenberg R.
Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study.
BMJ.
2001;
322
134-137
-
22
Prilepskaya V N.
Ledina A V.
Tagiyeva A V.
Revazova F S.
Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome.
Maturitas.
2006;
55
(S 01)
55-63
-
23
Atmaca M.
Kumru S.
Tezcan E.
Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder.
Hum Psychopharmacol.
2003;
18
191-195
-
24
Bogorad R L.
Courtillot C.
Mestayer C et al..
Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors.
Proc Natl Acad Sci U S A.
2008;
105
14533-14538
-
25
Courtillot C.
Chakhtoura Z.
Bogorad R et al..
Characterization of two constitutively active prolactin receptor variants in a cohort of 95 women with multiple breast fibroadenomas.
J Clin Endocrinol Metab.
2010;
95
271-279
-
26
Daniele C.
Thompson Coon J.
Pittler M H.
Ernst E.
Vitex agnus castus: a systematic review of adverse events.
Drug Saf.
2005;
28
319-332
Prof. Dr. Wolfgang Wuttke
Department für Endokrinologie
Universitätsmedizin Göttingen
Robert-Koch-Str. 40
37099 Göttingen
eMail: ufkendo@med.uni-goettingen.de
Online
http://dx.doi.org/10.1055/s-0030-1262411
