Document Type : Original Article
Authors
- . Seyedeh Fatemeh Dalil Heirati
- . Giti Ozgoli 1
- . Roya KabodMehri 2
- . Faraz Mojab 3
- . Shamim Sahranavard 4
- . Malihe Nasiri 5
1 Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Reproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
3 Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Traditional Pharmacy, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
BACKGROUND: Sexual dysfunction in women is a common disorder. Yet, there is no consensus
on its treatment. Few studies have shown that Vitex agnus‑castus improves sexual dysfunction in
postmenopausal women; the present study was conducted to evaluate the effect of V. agnus‑castus
on the female sexual function in the reproductive age.
MATERIALS AND METHODS: This was a double‑blinded randomized control clinical trial on the
women of reproductive age referred to the gynecology clinic of Al‑Zahra Medical Center in Rasht, Iran,
from February 2018 to December 2019. The intervention group received Agnugol tablet containing
3.2–4.8 mg dried extract V. agnus‑castus (51 participants) and the control group received a placebo
tablet (51 participants). All participants received one tablet daily for 16 weeks. The participants were
asked to complete the Female Sexual Function Index questionnaire at the beginning of the study and
after 4, 8, 12, and 16 weeks. Data were analyzed in SPSS statistics (version 21) using Chi‑square
test, t‑test, Mann–Whitney U‑test, analysis of variance, and mixed model to examine the differences
between the groups.
RESULTS: The results showed that the difference between the two groups was not significant in
each domain, but there was a significant difference in the overall sexual function mean score so
that the intervention group had a higher score than the placebo group after 16 weeks (P < 0.05).
CONCLUSION: In the present study, it was observed that the consumption of V. agnus‑castus during
16 weeks was more effective than the placebo in improving sexual dysfunction. Further studies with
larger sample sizes are needed to be able to decide on the prescription of this drug in the clinics.
Keywords
predictors of female sexual dysfunction: A protocol for a
systematic review. Syst Rev 2014;3:75.
2. Sadock B, Virginia A, Ruiz P. Kaplan & Sadock’s Synopisis
of Psychiatray. 11th ed.. North American: LWW; Tenth, North
American Edition; 2015.
3. Ghiasi A, Keramat A. Prevalence of sexual dysfunction among
reproductive‑age women in Iran: A systematic review and
meta‑analysis. J Midwife Reprod Health 2018;6:1390‑8.
4. Safarinejad MR. Female sexual dysfunction in a population‑based
study in Iran: Prevalence and associated risk factors. Int J Impot
Res 2006;18:382‑95.
5. Tabatabayi A, Sajjadian I, Motamedi M. Effectiveness of
acceptance and commitment therapy on sexual function, sexual
self‑consciousness and sexual assertiveness among women with
sexual dysfunction J Res Behav Sci 2017;15:84‑92.
6. Weinberger J, Houman J, Caron A, Anger J. Female sexual
dysfunction: A systematic review of outcomes across various
treatment modalities. Sex Med Rev 2019;7:223‑50.
7. Bhagavathula AS, Elnour AA, Shehab A. Pharmacovigilance
on sexual enhancing herbal supplements. Saudi Pharm J 2016;24:115‑8.
8. Mari A, Montoro P, D’Urso G, Macchia M, Pizza C, Piacente S.
Metabolic profiling of V. agnus‑castus leaves, fruits and sprouts:
Analysis by LC/ESI/(QqQ) MS and (HR) LC/ESI/(Orbitrap)/
MSn. J Pharm Biomed Anal 2015;102:215‑21.
9. Csupora D, Lantosc T, Hegyid P, Benkőf R, Violae R, Gyöngyig Z,
et al. V. agnus‑castus in premenstrual syndrome: A meta‑analysis
of doubleblind randomised controlled trials. Complement Ther
Med 2019;47:102190.
10. Delaram M, Sadeghian Z, Parvin N, Kazemiyan A, Shams S.
Comparison of analgesic effect of agnogol with mefenamic acid
in the treatment of primary dysmenorrhea. J Res Develop Nurs
Midwife 2015;12:1‑7.
11. Rafieian-Kopaei M, Movahedi M. Systematic review of
premenstrual, postmenstrual and infertility disorders of Vitex
agnus castus. Electron Physician 2017;9:3685‑9.
12. Van Die M, Burger H, Teede H, Bone K. V. agnus‑castus extracts
for female reproductive disorders: A systematic review of clinical
trials. Planta Med 2013;79:562‑75.
13. Jarry H, Leonhardt S, Gorkow C, Wuttke W. 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;102:448‑54.
14. Meier B, Berger D, Hoberg E, Sticher O, Schaffner W.
Pharmacological activities of V. agnus‑castus extracts in vitro.
Phytomedicine 2000;7:373‑81.
15. Wuttke W. Dopaminergic action of extracts of Agnus Castus.
Forsch Komplementmed 1996;3:81‑91.
16. Allahtavakoli M, Honari N, Pourabolli I, Arababadi M,
Ghafarian H, Roohbakhsh A, et al. Vitex Agnus Castus extract
improves learning and memory and increases the transcription
of estrogen receptor α in hippocampus of ovariectomized rats.
Basic Clin Neurosci 2015;6:185‑92.
17. Upton R. Chaste Tree Fruit, V. agnus‑castus: Standards of Analysis,
Quality Control, and Therapeutics. United States: Santa Cruz, CA:
American Herbal Pharmacopoeia; 2001. p. 2001.
18. Jarry H, Spengler B, Porzel A, Schmidt J, Wuttke W, Christoffel V.
Evidence for estrogen receptor β‑selective activity of V. agnus‑castus
and isolated flavones. Planta Med 2003;69:945‑7.
19. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova‑Wuttke D.
Chaste tree (V. agnus‑castus) – Pharmacology and clinical
indications. Phytomedicine 2003;10:348‑57.
20. Zeinalzadeh S, Dabbaghmanesh M, Akbarzadeh M,
Mohagheghzadeh A, Sayadi M. Investigation of the effect of
Elaeagnus angustifolia flower capsule on sexual satisfaction and
levels of androgenic hormones in 18‑40 year old married women
with low sexual desire referring to selected clinics of Shiraz
University of medical sciences, 2012. Biomed Res 2017;28:7443‑50.
21. Akbarzadeh M, Zeinalzadeh S, Zolghadri J, Mohagheghzadeh A,
Faridi P, Sayadi M. Comparison of Elaeagnus angustifolia extract
and sildenafil citrate on female orgasmic disorders: A randomized
clinical trial. J Reprod Infertil 2014;15:190‑8.
22. Yakubu M, Akanji M. Effect of aqueous extract of Massularia
acuminate stem on sexual behaviour of male Wistar rats. Evid
Based Complement Alternat Med 2011;2011:738103.
23. Rani A, Sharma A. The genus Vitex: A review. Pharmacogn Rev
2013;7:188‑98.
24. Eltbogen R, Litschgi M, Gasser U, Nebel S, Zahner C.
V. agnus‑castus extract (Ze 440) improves symptoms in women
with menstrual cycle irregularities Planta Med 2014;80:SL19.
25. Zamani M, Neghab N, Torabian S. Therapeutic effect of Vitex
agnus castus in patients with premenstrual syndrome. Acta Med
Iran 2012;50:101‑6.
26. Mirzaii‑Najmabdi K. Effect of V. agnus‑castus on sexual function
in menopausal women. J Womens Health Care 2016;5:9.
27. Lucks B, Sørensen J, Veal L. V. agnus‑castus essential oil and
menopausal balance: A self‑care survey. Complement Ther Nurs
Midwife 2002;8:148‑54.
28. Roemheldhamm B. Chasteberry Am Fam Phycian 2005;72:821‑4.
29. Dalil Heirati SF, KaboudMehriR, Mojab F, SahranavardS, OzgoliG.
Effect of V. agnus‑castus plant on sexual function in women of
reproductive age. Irain J Obstet Gynecol Infertil 2020;23:62‑47.
30. Noone PA. The holmes‑rahe stress inventory. Occup Med (Lond)
2017;67:581‑2.
31. Fleming T. PDR for Herbal Medicines. 2nd ed. United States:
Medical Economics Company; 2000.
32. Duke J. The Green Pharmacy Herbal Handbook: Your
Comprehensive Reference to the Best Herbs for Healing.
New York: St. Martin’s Press; 2000.
33. Nathan M, Scholten R. The complete German commission e
monographs: Therapeutic guide to herbal medicines. Ann Intern
Med 1999;130:459.
34. Mohammadi KH, Faghizadeh S. The validity of the Persian
version of the Female Sexual Function Index‑FSFI as a sexual
function index of women. Pyesh 2008;3:269‑78.
35. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
et al. The Female Sexual Function Index (FSFI): Amultidimensional
self‑report instrument for the assessment of female sexual
function. J Sex Marital Ther 2000;26:191‑208.
36. Wiegel M, Meston C, Rosen R. The female sexual function index
(FSFI): Cross‑validation and development of clinical cutoff scores.
J Sex Marital Ther 2005;31:1‑20.
37. Colloca L, Jonas WB, Killen J, Miller FG, Shurtleff D. Reevaluating
the placebo effect in medical practice. Z Psychol 2014;222:124‑7.
38. Bradford A. Listening to placebo in clinical trials for female sexual
dysfunction. J Sex Med 2013;10:451‑9.
39. ShifernJ. Overview of sexual dysfunction in women: Management.
2020; https://www.uptodate.com/.This topic last updated: Jul
16, 2020.
40. Jiannine LM. An investigation of the relationship between physical
fitness, self‑concept, and sexual functioning. J Educ Health Promot
2018;7:57.
41. Yoseefzadeh S, Sadeghi S, Rakhshandeh H, Daghar S,
Mazloum SR. The effect of date palm pollen capsule on orgasm
and sexual satisfaction in menopuseal women: A double‑blind
controlled clinical trial. Iran J Obstet Gynecol Infertil 2017;20:43‑51.
42. Amiri‑Pebdani M, Taavoni S, Seyedfatemi N, Haghani H.
Triple‑blind, placebo‑controlled trial of Ginko biloba extract on
sexual desire in posmenopausal women in Tehran. Iran J Nurs
Midwifery Res 2014;19:262‑5.
43. Sarwer DB, Durlak JA. Afield trial of the effectiveness of behavioral
treatment for sexual dysfunctions. J Sex Marital Ther 1997;23:87‑97.
44. Gorodeski G. Aging and esterogen effects on transcervicaltransvaginal epithelial premeability. J Clin Endocrinol Metab
2005;90:245‑51.
45. Brown D. Vitex agnus castus clinical monograph. Q Rev Nat Med
1994;2:111‑21.
46. Ibrahim N, Shalaby A, Farag R, Elbaroty G, Nofal S, Hassan E.
Gynecological efficacy and chemical investigation of V. agnus‑castus
L. fruits growing in Egypt. Nat Prod Res 2008;22:537‑46.
47. Seely D, Dugoua J, Perri D, Mills E, Koren G. Safety and efficacy
of chastetree (V. agnus‑castus) during pregnancy and lactation.
Can J Clin Pharmacol 2008;15:e74‑9.
48. Shayan A, Masoumi SZ, Shobeiri F, Tohidi S, Khalili A. Comparing
the effects of agnugol and metformin on oligomenorrhea in
patients with polycystic ovary syndrome: A randomized clinical
trial. J Clin Diagn Res 2016;10:QC13‑6.
49. Ahmadnia EH, Karamat A. Therapeutic interventions conducted
on improving women’s sexual satisfaction and function during
reproductive ages in Iran: A systematic review. J Mazandaran
Univ Med Sci 2017;27:146‑62.
50. Reyhani M, Kazemi A, Keshvari M, Farajzadegan Z. Sexual
expectations and needs of middle‑aged women: A qualitative
study. J Educ Health Promot 2018;7:49.