Chastetree berry is a very common supplement used by women with PCOS. Does it work? If so, how?
In order to better understand this interesting but complex herb, I thought I'd make this a series spread across several posts. I'm starting with the hormones affected by chastetree berry: luteinizing hormone (LH), estrogen, progesterone, and prolactin. Today I'll focus on LH.
Luteinizing hormone is the hormone that causes ovulation. It is also the hormone that promotes development of the follicle into a corpus luteum, the intermediary step between egg and embryo.
Luteinizing hormone is interesting in that what constitutes a"normal" level depends on what stage of a menstrual cycle you are referring to. Levels are low at the beginning of a cycle, they ramp up to a peak just before ovulation. After ovulation, they drop back down again. This graph shows a typical LH cycle in a woman who does not have PCOS.
In PCOS, there are two key variations on normal LH function to consider. First of all, when levels are supposed to be low, they tend to be high. Secondly, at the point they should be surging in order to induce ovulation, they are too low to do so. Here is a graph of LH function that is common to women with PCOS.
As you can see, restoring good LH function is not a matter of raising or lowering LH levels. It's a matter of restoring cyclicity…in other words, making sure LH is high when it should be high, and making sure it's low when it should be low. When you read information about vitex, or LH, in your own research, you should be looking for the word"normalize", rather than"raise" or"lower".
As I mentioned in the first part of this series, vitex has its strongest effect on four hormones: estrogen, progesteron, luteinizing hormone (LH), and the one this post is dedicated to, prolactin.
Prolactin is primarily associated with lactation. It is also important for sexual arousal, sensing orgasms, and libido. So it's safe to say, you have to have good prolactin metabolism in order to successfully conceive and carry a pregnancy through to nursing!
One of the most important, and often overlooked, influences on prolactin function, is medication. I am most familiar with psychotropic medications because of my specialty, and I believe, with the very high incidence of anxiety, depression, and sleep disorders in women with PCOS, it is incredibly important to use these medications with discretion in order to not interfere with fertility, or successful PCOS management in women who are not in pursuit of conception.
Before considering any supplement, make a list of all the medications you've ever been prescribed and show them to a registered pharmacist. Ask them if any of those medications have any potential for disrupting prolactin function. And if you come up with a"yes" for any of them, ask for a list of alternatives that you and your prescribing physician can use to adjust your treatment plan.
When prolactin is out of balance, funny things can happen. You can produce milk when you're not supposed to (I once had a male client who started to lactate, and it turned out to be a symptom of a pituitary tumor.)
You might not be able to produce milk when you want to. Many, many, many women with PCOS find, much to their dismay, that they get pregnant, and cannot feed their babies. I am shocked at how many medical colleagues with PCOS write me to share that until they heard us mention this at inCYST…they never knew it could be a problem. And they themselves could not nurse their babies!!!
This lack of awareness and the incredible importance of healthy prolactin function to the overall health of mother and baby, is precisely why, our first outreach outside of dietitians, with inCYST, has been with lactation consultants. They understand this physiology best, and they are the most likely to pick up on problems as soon as they become apparent.
Bottom line, PCOS is not just about infertility. It is about successful reproduction, which includes being able to successfully create the next generation of healthy people.
But I digress. Back to prolactin.
Prolactin is controlled by the hypothalamus, the part of the brain we at inCYST are obsessed with learning and teaching about. The hypothalamus also regulates estrogen, progesterone, testosterone, cortisol, thyroid, and growth hormone. You can see why it's your BFF as a woman with PCOS. If you have problems with one of those, you likely have problems with more than one.
Most medical treatments address each of those hormone imbalances as if they are separate, requiring a separate medical treatment…better yet…a separate medication. So by the time you've made the specialist rounds, you've been given a birth control pill, an antidepressant, a sleep medication, a lipid lowering medication (since some of these hormones are made of cholesterol, when they're out of balance…cholesterol will be, too).
We like to think we start where the problem starts. Giving the hypothalamus what it needs to work efficiently. And the number one chemical you can focus on, which should help all of these functions, which I call our"Recipe for a Happy Hypothalamus (SM)"…is DHA, one of the fish oils.
1. DHA makes it harder for the hypothalamus to feel stress. Stress is a very selfish thing. It steals energy away from other things your body might need it for. With enough DHA in the system, the hypothalamus can put its energy into healing the functions that are NOT related to stress, mainly reproduction, sleep, and mood.
2. DHA increases dopamine receptor density. Prolactin is dopamine-controlled, meaning the more receptors there are to communicate with the dopamine that is there, the less prolactin your body needs to make.
An interesting aside--dopamine imbalance is common in people who crave and/or binge on sugar. So if you've got cravings AND your prolactin levels are not right…you just might be DHA-deficient.
I have one more post coming on chaste tree berry that will summarize important findings and recommendations.
But, with regards to prolactin, what I will say is that two very important things you can, and should, do, to move yourself back into balance, are:
1. Make sure your medications are not the source of the problem, and 2. Make sure your food choices are promoting healthy dopamine function.
Even if you DO decide to try an herbal formula, it is much more likely to work for you, if you provide it with an environment that allows it to do what it does best.
