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Dong Quai supplement
Traditional Herbal Medicine

Dong Quai: Benefits, Dosage, Forms & Research

Traditional Herbal Medicine

This content is for informational purposes only and does not constitute medical advice. Consult your healthcare provider before starting any supplement. Full disclaimer

TL;DR — Quick Answer

Dong quai is a foundational herb in Traditional Chinese Medicine for menstrual health and blood circulation. As a standalone supplement, Western clinical evidence is limited — the one rigorous RCT (Hirata et al., 1997) found no benefit for menopausal symptoms when used alone. It is traditionally combined with other herbs in TCM formulas.

Key Facts

What it is
Root extract from Angelica sinensis containing ferulic acid, ligustilide, polysaccharides, and coumarins
Primary benefits
  • Traditional use for menstrual regulation
  • Blood circulation support (anti-platelet effects)
  • Anti-inflammatory and antispasmodic properties
  • Used in TCM formulas for gynecological complaints
Typical dosage
1-4g dried root or equivalent extract daily (often in multi-herb formulas)
Evidence level
Preliminary
Safety profile
Safe with Caution

What the Research Says

Dong quai occupies an unusual position in herbal medicine — it is one of the most widely used herbs in TCM but has limited Western clinical evidence when used alone. Hirata et al. (1997) conducted the only rigorous Western RCT, studying 71 postmenopausal women given dong quai or placebo for 24 weeks. The study found no significant difference in vasomotor symptoms, endometrial thickness, or vaginal maturation between groups. Critics note this study tested dong quai as monotherapy, which contradicts traditional TCM practice where it is always combined with other herbs. Traditional formulas like Si Wu Tang have some clinical evidence from Chinese-language trials but lack the methodological rigor of Western RCTs.

Benefits of Dong Quai

  • Menstrual regulation — dong quai has been used for centuries in TCM formulas for dysmenorrhea, amenorrhea, and irregular cycles; its antispasmodic and vasodilatory effects may reduce menstrual cramping
  • Blood circulation — ferulic acid and ligustilide in dong quai have demonstrated anti-platelet, vasodilatory, and mild blood-thinning properties in preclinical studies
  • Anti-inflammatory — ligustilide has shown anti-inflammatory effects in laboratory models, potentially reducing uterine prostaglandin-mediated pain
  • Synergistic use in TCM — dong quai is most effective as part of traditional formulas like Si Wu Tang (Four Substances Decoction), where herb combinations create synergistic therapeutic effects not seen with dong quai alone
Did you know?

Dong quai occupies an unusual position in herbal medicine — it is one of the most widely used herbs in TCM but has limited Western clinical evidence when used alone.

Forms of Dong Quai

FormBioavailabilityBest For
Standardized Root ExtractModerateWestern supplement use — standardized to ferulic acid or ligustilide content
Dried Root Slices (for decoction)ModerateTraditional TCM preparation — boiled in water as a decoction, often combined with other herbs
Granule or Powder (in TCM formula)ModerateMulti-herb formulas — the traditional and most evidence-supported method of use in TCM

Dosage Recommendations

General recommendation: 1-4g dried root or equivalent extract daily; best used as part of a traditional herbal formula

Timing: Between meals in divided doses; follow TCM practitioner guidance for formulated preparations

Dosage by Condition

ConditionRecommended DoseEvidence
Menstrual regulation (in TCM formula)3-6g dried root in multi-herb decoctionPreliminary
Dysmenorrhea2-4g root extract dailyPreliminary
General blood tonic1-3g daily in divided dosesPreliminary

Upper limit: 6g dried root daily; higher doses may increase bleeding risk due to coumarin content

Side Effects and Safety

Safety profile: Safe with Caution

Potential Side Effects

  • Photosensitivity — dong quai contains furanocoumarins that can increase sun sensitivity
  • Increased menstrual bleeding — due to blood-thinning and vasodilatory effects
  • GI upset — bloating, diarrhea, or stomach discomfort
  • Skin rash (rare, possibly related to photosensitivity)

Drug & Supplement Interactions

  • Blood thinners (warfarin, heparin, aspirin) — dong quai contains coumarins with anti-platelet activity; significant bleeding risk if combined
  • Hormonal medications — while dong quai's estrogenic activity is debated, caution is warranted with hormone-sensitive conditions
  • Prior to surgery — discontinue 2 weeks before surgery due to bleeding risk
  • Photosensitizing drugs — additive photosensitivity risk
Check Dong Quai interactions with other supplements →
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Frequently Asked Questions

Does dong quai work for menopause symptoms?

As a standalone supplement, the evidence is not favorable. The Hirata et al. (1997) RCT found no benefit over placebo for menopausal hot flashes. However, this contradicts how dong quai is traditionally used in Chinese medicine, where it is always combined with other herbs in formulas tailored to the individual. If you are interested in dong quai for menopause, consider consulting a licensed TCM practitioner for a multi-herb approach.

Is dong quai a phytoestrogen?

This is debated. Early in vitro studies suggested weak estrogenic activity, but the Hirata et al. (1997) clinical study found no changes in estrogen levels, endometrial thickness, or vaginal cell maturation. Current consensus is that dong quai does not have clinically significant estrogenic activity when used at standard doses. Its traditional effects on menstrual health are more likely mediated through anti-inflammatory, antispasmodic, and blood-flow mechanisms.

Can I take dong quai with blood thinners?

No. Dong quai contains coumarins and has demonstrated anti-platelet activity. Combining it with blood thinners like warfarin, heparin, or even aspirin can significantly increase bleeding risk. Case reports have documented elevated INR values in patients taking warfarin with dong quai. Always disclose dong quai use to your doctor, and discontinue it 2 weeks before any surgical procedure.

References

  1. (). Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertility and Sterility. DOI
  2. (). Danggui to Angelica sinensis root: are potential benefits to European women a lost in translation?. Journal of Ethnopharmacology. DOI