HerbPreliminary Evidence

Dong Quai

Angelica sinensis

Known as 'female ginseng,' this Chinese herb is traditionally used for menstrual and menopausal complaints. Human evidence is limited and mixed, and it carries notable safety cautions.

What is Dong Quai?

Dong quai (Angelica sinensis) is a fragrant root used for centuries in Traditional Chinese Medicine, where it is considered a premier 'blood tonic' and is nicknamed 'female ginseng' for its traditional role in women's health. It is rarely used alone in TCM, more often appearing in multi-herb formulas for menstrual irregularity, cramps, and menopausal symptoms.

Known Health Benefits

Traditional use for menstrual cramps and irregular cycles
Often used in formulas for menopausal symptoms
May support circulation ('blood tonic' in TCM)
Mild antioxidant and anti-inflammatory activity

How It Works

Dong quai contains ferulic acid and ligustilide, which have antioxidant, anti-inflammatory, and smooth-muscle-relaxing (antispasmodic) properties that may underlie its traditional use for menstrual cramps and circulation. It contains phytochemicals with weak estrogen-modulating activity, though whether it is meaningfully estrogenic in humans is debated. Coumarin constituents contribute to its blood-thinning potential, and furocoumarins are responsible for photosensitivity.

What Research Says

High-quality human evidence is limited and inconsistent. A frequently cited randomized trial found dong quai used alone was no more effective than placebo for menopausal hot flashes, and it did not show estrogenic effects on the endometrium in that study. Some trials of multi-herb TCM formulas containing dong quai report benefits for menstrual and menopausal symptoms, but the contribution of dong quai specifically is hard to isolate. It remains in the preliminary evidence tier.

Active Compounds

Ferulic acid, ligustilide, polysaccharides, coumarins

Forms & Bioavailability

Dried root (decoction)Capsules and tabletsTinctureComponent of TCM formulas (e.g., with peony, rehmannia)

Ferulic acid and ligustilide are absorbed orally, though ligustilide is volatile and unstable, so preparation and freshness affect potency. Traditionally dong quai is decocted and combined with other herbs, which practitioners believe modulates its effects and tolerability.

Dosage Guidance

Use CaseDosage
Menstrual / menopausal (traditional)Within a TCM formula per practitioner
Capsule (standalone)Per product label

Always consult a healthcare provider for personalized dosing.

Potential Side Effects

May cause photosensitivity (skin sensitivity to sunlight), digestive upset, and increased bleeding tendency. Contains compounds that can be estrogenic.

Who Should Avoid It

  • Pregnancy (may stimulate the uterus) and breastfeeding
  • Hormone-sensitive cancers (breast, uterine, ovarian)
  • Bleeding disorders or anticoagulant therapy
  • Upcoming surgery (stop in advance)
  • Before significant sun exposure (photosensitivity)

Pregnancy & Lactation

Contraindicated during pregnancy because of potential uterine-stimulating and blood-thinning effects. Avoid during breastfeeding due to insufficient safety data.

Known Drug Interactions

Significant interaction with warfarin and other anticoagulants/antiplatelets (bleeding risk). May interact with hormone-sensitive conditions and photosensitizing drugs.

Evidence Classification

Preliminary Evidence

Based on in vitro studies, animal models, pilot trials, or traditional use documentation. Clinical evidence is limited.

Frequently Asked Questions

Does dong quai help with menopause and hot flashes?

Evidence is weak. A well-known randomized trial found dong quai alone worked no better than placebo for hot flashes. It is traditionally used within multi-herb formulas, and any benefit may depend on that combination rather than dong quai by itself.

Is dong quai safe to take with blood thinners?

No — this is an important caution. Dong quai contains coumarin compounds and can significantly increase the effect of warfarin and other blood thinners, raising bleeding risk. Avoid combining them unless supervised by a clinician.

Why does dong quai cause sun sensitivity?

Dong quai contains furocoumarins, compounds that can make the skin more sensitive to ultraviolet light, increasing the risk of sunburn. Use sun protection and be cautious about sun exposure while taking it.

References

  1. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Fertil Steril (1997)View study

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This entry is for educational purposes only. It is not medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement regimen, especially if you take medications or have health conditions.