ITS Used In Europe for PMS Treatment

What is Dong Quai?

Dong Quai or Angelica Sinensis is also called female ginseng although it belongs in the celery family. This herb has been used for centuries as a spice and medicinal herb in Asia especially in China, Japan, and Korea.

In traditional Chinese medicine, dong quai is still used to strengthen the chi. It is a tonic commonly prescribed for problems with female reproductive health. Specifically, this herb is used, in traditional medicine, to treat mild anemia, fatigue, high blood pressure, painful menstruation, and menopausal problems.

The herb known as dong quai can be prepared from the roots of the Chinese A. sinensis or the related Japanese plant A. acutiloba. The American and European relatives of these plants (A. archangelica and A. atropurpurea) are also medicinal herbs but they are not used for female reproductive problems.

In the late 1800s, dong quai reached Europe as a female tonic. Since then it has been used to treat the symptoms of premenopausal syndrome (PMS), menstrual cramps and menopausal symptoms.

The major bioactive phytochemicals in dong quai include flavonoids, coumarin, plant sterols, polysaccharides, and ferulate.

While it was once believed that dong quai contained phytoestrogens, researchers have found no evidence of such compounds and no proof that the herb has any estrogenic properties.

Dosage

Dong quai is available in multiple dosage forms including dried herb (for tea), tablet, softgel, capsule, liquid, and tincture.

For PMS, the recommended dosage is 600 mg daily. This dose can be taken as 200 mg pills or 30 drops of the liquid extract of the herb 3 times daily.

However, dong quai is usually combined with other herbs. In the treatment of PMS, it is commonly used in combination with chasteberry, black cohosh, and Siberian ginseng.

On the other hand, the essential oil of dong quai should be avoided because it has been shown to contain small amounts of known carcinogens.

Safety and Drug Interactions

Dong quai is generally considered as safe. There are very few side effects associated with dong quai. The most common ones are mild gastrointestinal discomforts.

However, dong quai makes the skin photosensitive (extra sensitivity to sunlight). Therefore, make sure to avoid direct sunlight and use sunscreen while taking this herb. It can also trigger a form of allergic reaction that appears as skin rashes.

The combination of dong quai with St. John’s wort should be avoided in the herbal treatment of PMS because both herbs make the skin more sensitive to sunlight.

Due to the lack of safety studies, dong quai is not recommended for children as well as pregnant and nursing women.

The most important drug interactions with dong quai involve blood thinners or anticoagulants. Because of its anticoagulant property, dong quai can increase the risk of severe bleeding when combined with blood thinners such as aspirin, coumadin, and heparin.

In addition, care should be taken when combining dong quai with herbs with anticoagulant properties.

Herbs that can increase the risk of bleeding include ginkgo, ginseng, garlic, ginger, licorice, turmeric, skullcap, and feverfew. Since some of these herbs are also used in PMS therapy, you may need to speak with a healthcare professional before combining them with dong quai.

Dong Quai and PMS

Dong quai is usually prescribed for women experiencing the hot flashes of menopause. For this purpose, it is believed to act as a phytoestrogen (plant estrogen) with mild estrogenic properties.

Because most of the symptoms of menopause are caused by reduced production of estrogen, it was believed that dong quai serves as a form of herbal hormone replacement. However, there is no consensus about the estrogenic effect of dong quai.

While some studies found that dong quai acts like an estrogen replacement in the body, some other studies concluded that the herb actually blocks estrogen in the body.

Currently, the prevailing conclusion in the medical community is that the evidence is weak for the efficacy of dong quai in the management of menopausal complaints. In addition, most researchers reject the notion that dong quai contains estrogenic compounds.

And that is a good thing for women with PMS because one of the major causes of PMS is the high level of estrogen (compared to progesterone level) during the luteal phase of the menstrual cycle.

However, the absence of estrogenic compounds in dong quai does not help PMS symptoms; it simply means that dong quai cannot contribute to PMS.

So how does dong quai help with PMS? There are two possible ways by which this herb can provide relief for PMS symptoms.

Dong Quai: Muscle Relaxant

First, dong quai has an antispasmodic property. Specifically, it is believed to modulate the contractive rhythm of the uterus. Therefore, the herb may help with cramps.

Cramps are one of the common physical symptoms of PMS. Herbs that help relax the muscles are usually prescribed to help reduce PMS cramps. Such herbs include valerian and cramp bark. Dong quai is another herb that acts as a muscle relaxant.

In this role, dong quai will not only provide relief for cramps but also fatigue and aches associated with PMS.

Dong Quai: Adaptogen

The other important medicinal effect of dong quai is its adaptogenic property. As an adaptogen, dong quai helps women cope better with stress.

The adaptogenic property of dong quai is quite important and it is one of the reasons why it is commonly referred to as female ginseng. By reducing stress, dong quai does more than help restore calm and banish headache; the adaptogenic effect of the herb also means that it helps with hormonal balance.

The link between stress and hormonal imbalance is important in PMS. When stressed, the level of the adrenal hormone, known as cortisol, rises.

Unfortunately, cortisol is synthesized from progesterone. Therefore, stress lowers progesterone levels.

Because progesterone is needed to counterbalance estrogen, a lower level of the hormone leads to the dominance of estrogen. The high estrogen level and lower progesterone level promoted by stress is quite ideal for the development of PMS symptoms.

By reducing stress, dong quai lowers cortisol level. By extension, it promotes the right balance of progesterone and estrogen to help provide relief for PMS symptoms.

There are other advantages to maintaining this healthy estrogen-progesterone ratio during the luteal phase of the menstrual cycle. For example, keeping estrogen level down during this period reduces the neurotransmitter imbalances triggered by the hormone in the central nervous system.

Therefore, don quai can make some contributions towards relieving emotion-type PMS symptoms resulting from low levels of neurotransmitters such as serotonin and dopamine.

In this role, dong quai can help with PMS-related depression and mood changes.

In Conclusion

There are precious few studies done to investigate the efficacy of dong quai in the treatment of PMS symptoms. In addition, these few available studies are generally poorly designed.

Therefore, most of the evidence for the use of dong quai for this purpose comes from the testimonies of women who took the herb for their PMS symptoms. And they reported that dong quai helped with some symptoms.

It is not recommended that dong quai should be the sole herbal treatment for PMS.

From reports, it is clear that the herb performs better when combined with complementary herbs such as black cohosh and even other natural supplements such as calcium, magnesium and B vitamins.