Herb

    Dong Quai

    Angelica sinensis

    TL;DR

    Dong quai is a TCM formula herb, and the one good placebo-controlled trial of it alone found no benefit for hot flushes. It is also a photosensitiser and interacts strongly with warfarin.

    Ideal For

    • People working with a qualified TCM practitioner using multi-herb formulas

    Avoid If

    • You take warfarin or any anticoagulant
    • You are pregnant or breastfeeding
    • You have heavy periods or a bleeding disorder
    • You expect it to relieve hot flushes on its own

    Frequently Asked Questions

    Overview

    Dong quai (Angelica sinensis) is among the most-used herbs in Traditional Chinese Medicine, where it almost never appears alone - it is a component of multi-herb formulas prescribed for menstrual irregularity, anaemia and menopausal complaints. Western supplements typically sell it as a single herb for hot flushes, and that use has been tested: a 24-week randomised, double-blind, placebo-controlled trial of dong quai monotherapy in postmenopausal women found no difference from placebo in hot flush frequency or in endometrial thickness and vaginal maturation, indicating no meaningful oestrogenic effect either. Some multi-herb formulas containing dong quai have shown benefit in small trials, but attribution to dong quai is impossible. Chemically it contains ferulic acid, ligustilide and coumarin derivatives; the coumarins explain both the antiplatelet activity and the well-documented warfarin interaction, while furanocoumarins cause photosensitivity. Ligustilide has smooth-muscle relaxant activity that plausibly underlies traditional use for menstrual cramps, but this has not been isolated in controlled trials.

    How It Works

    • Ligustilide relaxes uterine and vascular smooth muscle in preclinical models
    • Ferulic acid provides antioxidant and mild antiplatelet activity
    • Coumarin derivatives inhibit platelet aggregation and interact with warfarin
    • No demonstrable oestrogen-receptor agonism in the controlled human trial

    Quick Facts

    • Traditional female tonic
    • Supports menstrual regularity
    • Reduces menstrual cramps
    • Mild blood circulation effects
    • Combines well with other herbs

    Benefits & Outcomes

    No linked outcomes yet. Research is ongoing.

    Health Concerns Addressed

    Hot Flashes

    symptom
    Not supported
    Effectiveness 1/5

    The single best trial says no. Dong quai used alone does not relieve hot flushes, and its warfarin interaction and photosensitivity make it a poor speculative choice.

    Supporting Research
    9 studies

    Dong Quai (Angelica sinensis) in the treatment of hot flashes for men on androgen deprivation therapy: results of a randomized double-blind placebo controlled trial

    Score: 7/10
    2010
    rct
    n=22

    Al-Bareeq RJ, Ray AA, Nott L +2 more

    A randomized double-blind placebo controlled trial was conducted involving 22 men receiving luteinizing hormone-releasing hormone agonist therapy for prostate cancer with bothersome hot flashes.

    View source

    Does Dong Quai Have Estrogenic Effects in Postmenopausal Women? A Double-Blind, Placebo-Controlled Trial

    Score: 8/10
    1997
    rct
    n=71

    Hirata JD, Swiersz LM, Zell B +2 more

    Dong quai produced no significant difference from placebo in hot flush frequency, endometrial thickness or vaginal cell maturation.

    View source

    A systematic review of herbal medicinal products for the treatment of menopausal symptoms

    Score: 7/10
    2003
    systematic_review

    Huntley AL, Ernst E

    The aim of this study was to evaluate the benefit of herbal medicinal products for the treatment of menopausal symptoms by performing a systematic review of randomized clinical trials.

    View source

    Systematic Review of Complementary and Alternative Medicine for Menopausal Hot Flushes: Chinese Herbal Medicine Including Dang Gui Buxue Tang

    Score: 7/10
    2008
    rct
    n=100

    Haines CJ, Lam PM, Chung TKH +2 more

    Hot flush severity decreased in both groups, with no statistically significant advantage for the herbal formula over placebo.

    View source

    Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women

    Score: 6/10
    2010
    systematic_review

    Kelley KW, Carroll DG

    Clinical trials comparing the above single-ingredient agents with placebo or active treatment were selected.

    View source

    Estrogenic Activity of Standardized Extract of Angelica sinensis and Matricaria recutita in Menopausal Women: A Randomized Trial

    Score: 5/10
    2006
    rct
    n=55

    Circosta C, De Pasquale R, Palumbo DR +2 more

    The combination reduced hot flush frequency and intensity substantially more than placebo.

    View source

    Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study

    Score: 5/10
    2007
    rct
    n=50

    Rotem C, Kaplan B

    The women receiving Phyto-Female Complex reported a significantly superior mean reduction in menopausal symptoms than the p

    View source

    Potentiation of warfarin by dong quai

    Score: 5/10
    1999
    case_study
    n=1

    Page RL, Lawrence JD

    A 46-year-old African-American woman with atrial fibrillation stabilized on warfarin experienced a greater than 2-fold elevation in prothrombin time and international normalized ratio after taking dong quai concurrently for 4 weeks.

    View source

    Interaction between warfarin and Chinese herbal medicines

    Score: 6/10
    2015
    systematic_review

    Chua YT, Ang XL, Zhong XM +1 more

    This phenomenon has brought along with it increasing reports on herb-drug interactions, beckoning the attention of Western physicians

    View source

    Safety Information

    Potential Side Effects

    Photosensitivity, bloating, loose stools, and increased bleeding tendency.

    Contraindications

    Anticoagulant therapy; bleeding disorders; hormone-sensitive cancer; pregnancy; heavy menstrual bleeding.

    Drug Interactions

    • Warfarin (documented INR elevation and bleeding)
    • Antiplatelet drugs including aspirin and clopidogrel
    • Photosensitising medications

    Pregnancy & Breastfeeding

    Pregnancy: likely_unsafe

    Breastfeeding: likely_unsafe

    Dosage Guidelines

    Dosage Used in Studies

    3-15 g

    Best Time to Take

    Divided doses with meals, within a practitioner-designed formula

    Best Form

    Practitioner-prescribed multi-herb TCM formula rather than single-herb capsules

    Bioavailability

    Contains coumarins and other compounds. May have estrogen-like effects. Increases photosensitivity - use sunscreen. May thin blood. Discontinue 2 weeks before surgery. Evidence for menopausal symptoms limited.

    Forms Compared

    Traditional format, used within formulas

    The single-herb format tested and found ineffective for hot flushes

    Concentrated; coumarin content and interaction risk unchanged

    Food & Timing

    With food.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.