What Is It?
Dong quai has been used in Asia for thousands of years as a tonic for the female reproductive system. In fact, it ranks just below ginseng as the most popular herb in China and Japan, although its effectiveness has yet to be substantiated by conventional Western standards.
Dong quai is derived from the gnarled root of the Chinese perennial Angelica sinensis and the root of the native Japanese A. acutiloba. Both species have eight-foot hollow stems graced by umbrella-shaped clusters of white flowers. When in bloom, the blossoms resemble Queen’s Anne lace, a botanical cousin. Common names for the herb include angelica, Chinese angelica, dang gui and tang kuie. Interestingly, European and American angelica species (A. archangelica and A. atropurpurea) are used medicinally as well, but for a different constellation of symptoms altogether, none of them gynecological.
Dong quai helps to promote uterine health and regulate the menstrual cycle. Some researchers contend that active ingredients called coumarins are responsible for its effectiveness. Coumarins dilate blood vessels, stimulating the central nervous system and increasing blood flow throughout the body. They may also relax the smooth muscles of the uterus, which would help to explain the herb’s traditional use for menstrual cramps.
Other experts claim that dong quai’s powers should be attributed to its phytoestrogens, which are weaker than the estrogens produced by the body but do manage to bind to estrogen sites on human cells. Potentially negative effects of a women’s own estrogens–such as breast cancer risk–may be offset in this way. More long-term studies of dong quai are needed, however, to fully assess how it affects the body, a task made all the more challenging because dong quai tends to appear in combination products. It’s commonly added to herbal decongestant mixes for sinus problems, for example, and to special “women’s formulas” for PMS (premenstrual syndrome) and menstrual cramping.
Specifically, dong quai may help to:
Relieve PMS and menstrual irregularities. Dong quai’s reputation as a female tonic rests largely with its ability to reduce the symptoms of PMS (premenstrual syndrome) and regulate the menstrual cycle. Countless women have used it to treat amenorrhea (irregular or absent periods) and menorrrhagia (heavy bleeding or prolonged periods). The herb’s long-standing popularity for reducing menstrual cramps has been ascribed to its anti-inflammatory and antispasmodic actions.
Reduce the pain of endometriosis. Dong quai works well in combination with chasteberry to restore the hormonal imbalances that can cause the often severe pain of this disorder. When taken together, the herbs can also relax the uterine muscle.
Minimize menopausal symptoms. In combination with herbs such as black cohosh, chasteberry, and Siberian ginseng, dong quai appears to be useful for controlling hot flashes and reducing vaginal dryness. The herb’s phytoestrogens may help by compensating for menopause-related drops in natural estrogen levels. However, in recent studies involving postmenopausal women, dong quai proved to be no more effective than a placebo in relieving such common menopausal symptoms as hot flashes and vaginal dryness. In one study, the herb and the placebo both reduced the frequency of hot flashes by 25% to 30%. This type of disappointing result may simply highlight the importance of taking dong quai in combination with other herbs.
Nourish body fluids, counter fatigue, and lower blood pressure. As a rich source of vitamin B12, dong quai may play a role in stimulating red blood cell production. It may therefore indirectly boost energy and lessen fatigue by increasing the number of red blood cells transporting oxygen throughout the body. When used in conjunction with other herbs, dong quai also mildly dilates blood vessels, facilitating the heart’s pumping ability and possibly lowering blood pressure as a result. Chinese doctors have long prescribed the herb for high blood pressure and circulatory problems. Note: Dong quai has also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for dong quai.
–When buying the pill or liquid form of dong quai, look for extracts standardized that contain 0.8% to 1.1% liguistilide.
For PMS, menstrual cramps, menstrual irregularities, and endometriosis: Take 600 mg daily, either in the form of 200 mg pills three times a day, or 30 drops (1.5 ml) of fluid extract three times a day.
For menopausal discomforts: Take 600 mg daily in the form of 200 mg pills three times a day. Be sure to check out our Dosage Recommendations Chart for Dong Quai, which lists therapeutic dosages for specific ailments at a glance.
Guidelines for Use
Women taking dong quai for menstrual complaints may want to consider using products that combine dong quai with other menstrual-regulating herbs, such as Siberian ginseng, licorice, and chasteberry. When attempting to regulate a menstrual period, try taking this kind of a mixture for three months and then taking a break for a month before starting again.
When treating PMS symptoms, confine your use of dong quai to the days you’re not menstruating. However, when treating menstrual cramps only (and not PMS symptoms), start taking dong quai two or three days before you expect your period and continue until your period is over.
When treating hot flashes, you’ll have to take dong quai daily for at least two months before noticing any changes.
If you take an anticoagulant (blood-thinning) medication or a nonsteroidal anti-inflammatory drug (such as ibuprofen), check with your doctor before trying dong quai. For information on interactions with specific generic drugs, see our WholeHealth Chicago Drug/Nutrient Interactions Chart.
Possible Side Effects
Dong quai may have a mild laxative effect.
Menstrual bleeding may increase when taking dong quai.
Stop taking dong quai if a skin rash or photosensivity develops.
Don’t take dong quai if you’re pregnant or nursing.
Limit your exposure to the sun when taking dong quai, especially if you are fair-skinned; it contains substances called psoralens that can react with sunlight to cause a rash or severe sunburn.
If you have diarrhea, check with your doctor before taking dong quai.
Endometriosis 200 mg of standardized extract or 1/2 tsp. liquid extract 3 times a day
Menopause 400-800 mg a day of standardized extract in 2-3 divided doses, or 1/4 to 1/2 tsp. liquid extract 3 times a day
Perimenopause 400-800 mg a day of standardized extract in 2-3 divided doses; or 1/4 to 1/2 tsp. liquid extract 3 times a day
PMS 200 mg 3 times a day or 20 drops liquid extract twice a day
David Edelberg, M.D.
One of the most revered and popular of the traditional Chinese herbs, dong quai is best thought of as a sort of female tonic for energizing the reproductive system and balancing delicate hormones. Countless Asian women have relied on the yellowish-brown, gnarled root of the native Chinese flower (Angelica sinensis) for these purposes. Dong quai is useful for perimenopausal and menopausal symptoms, such as hot flashes and vaginal dryness. Younger women may also find it eases menstrual discomforts, stabilizes irregular menstrual periods, and tones up the reproductive system in general.
HOW IT HELPS PERIMENOPAUSE
As a plant estrogen (phytoestrogen), dong quai can help compensate for some of the natural estrogen that becomes scarce as a woman enters menopause. This herb is extremely gentle and mild, and probably doesn’t work “just like hormones,” as it’s only 1/400th the strength of such widely used animal-based estrogens as Premarin. It’s more likely that dong quai works by enhancing the effect of a woman’s own estrogen by blocking some of her estrogen receptor sites. In this way, dong quai can help a situation caused by too much estrogen (relative to progesterone) or by too little total estrogen, both of which happen in perimenopause.
WHAT TO LOOK FOR
Be sure read labels carefully so you don’t confuse the different types of Angelica. There’s the famed Angelica of Chinese medicine known as dong quai. And then there’s Angelica Archangelica (also called Angelica Radix) thought to be named after the Archangel Michael. The latter is being explored for symptoms altogether different from gynecological ones, namely indigestion, gas, and bloating.
Look closely and you’re liable to find bits of raw dong quai, a traditional spice, floating in your favorite Chinese soup. The root is traditionally boiled or soaked in wine to prepare soothing teas. But for easing your menopausal symptoms, you may want to rely on more standardized forms. Look for: Capsules containing the fluid extract, perhaps the most convenient way to take dong quai. Injectable forms, which are available in some countries, but not in the United States.
Some pretty reliable research indicates that dong quai is most effective when taken along with other menopause-regulating herbs. It probably bolsters their effects in ways we have yet to learn. My own preference lies with one of the readily available combination products that teams dong quai with chasteberry (Vitex), black cohosh, Siberian ginseng, and other “female-healthy” herbs. It’s interesting to note that in traditional Chinese herbal formulas, dong quai is always used in combination with many other herbs. Look for blends containing such herbs as dong quai, black cohosh, or Siberian ginseng. (These are often billed as “Women’s Formulas” and contain relatively smaller doses of chasteberry.) These may also contain additional herbs like kava, dandelion root, and burdock that can help with additional symptoms Another benefit combination products is that you also get to reduce the number of bottles you need to open and the number of pills you have to swallow.
Most women only start feeling some relief from perimenopausal symptoms after taking dong quai daily for two months or more, so be patient.
If you’re on blood thinners, talk to your doctor before taking dong quai because the herb could dangerously increase the risk for bleeding. Sunlight and dong quai are a poor mix; the herb contains compounds (psoralens and bergapten) that can increase your sun sensitivity, causing a sunburn or rash. Although the kind of dong quai most people take rarely poses a problem, for safety’s sake, don a hat.
David Edelberg, MD