Dong Quai Benefits: What the Science Actually Says

Dong quai (Angelica sinensis) is a root used for centuries in traditional Chinese medicine, mainly for women's complaints such as menstrual cramps and menopausal symptoms. The short answer to "what is it for?" is this: tradition attributes many uses to it, but modern science has not yet confirmed clear benefits. In a double-blind, placebo-controlled trial with 71 postmenopausal women with hot flushes, taken on its own for 24 weeks, dong quai was no better than placebo at relieving menopausal symptoms, nor did it produce oestrogen-like responses in endometrial thickness or vaginal maturation ¹. A recent systematic review of 30 randomised trials on oral herbal supplements for menopausal symptoms identified two trials that used black cohosh and dong quai and concluded that they showed no measurable effects ².

This does not mean the plant is useless or dangerous in itself — it means that, contrary to what many pages promise, there is no proof that it "regulates hormones", "balances the cycle" or "treats" symptoms. This article explains what dong quai is, what studies actually measured, why results are so inconsistent, who should avoid it and how to read a supplement label.

What is dong quai and what does it contain?

Dong quai is the root of Angelica sinensis (Oliv.) Diels, a plant in the Apiaceae family (the same as carrot). It is both a food and a medicinal ingredient in China, where it is also known as danggui ³. The root contains a complex mix of compounds: organic acids (such as ferulic acid), phthalides (such as Z-ligustilide), polysaccharides and other metabolites ⁴.

It is important to understand that dong quai is not "one active compound" — it is a plant material with dozens of constituents, whose composition varies with variety, growing location and processing (for example, smoke-drying or roasting, with or without wine, in Chinese tradition) ³. This variability is one of the reasons why comparing studies with each other is so difficult.

What is dong quai used for? What tradition says and what trials show

Traditional Chinese medicine uses dong quai mainly for female reproductive problems: dysmenorrhoea (menstrual cramps), amenorrhoea (absence of menstruation) and menopause ³. The 2013 review of the root also describes traditional uses such as "replenishing blood" and regulating irregular menstruation, as well as traditional applications in gynaecological, cardio-cerebrovascular and nervous system complaints ⁴.

The problem is translating those promises into measurable results. Let us look at what clinical trials show, by area:

• Hot flushes and menopause: in the 1997 trial with 71 postmenopausal women, dong quai alone did not outperform placebo over 24 weeks ¹. The 2026 systematic review, which analysed 30 randomised trials of non-soy herbal supplements, reports that most studies found improvements, but the two trials that used black cohosh and dong quai showed no measurable effects ².
• Combined formulas: in a placebo-controlled trial with 55 postmenopausal women who refused hormone therapy, a preparation with Angelica sinensis and chamomile (5 chewable tablets per day, between meals, for 12 weeks) showed a significantly greater reduction in the frequency and intensity of hot flushes compared with placebo (90–96% vs 15–25%, p < 0.001) ⁵. Another double-blind trial with 50 pre- and postmenopausal women tested a multi-herb formula including dong quai and recorded, in the active group, a 73% reduction in hot flushes and 69% in night sweats after 3 months, significantly greater than placebo ⁶. These results cannot be attributed to dong quai alone — the formulas contained several plants and the trials were small.
• Other areas: research on dong quai includes reviews on cardiovascular and cerebrovascular diseases ⁷, ischaemic stroke ⁸ and Alzheimer's disease ⁹, but these are mainly preclinical and mechanistic studies, with some clinical research, not proof of clinical benefit in healthy people.

In summary: for the complaints that drive most searches — cramps, irregular cycles, hot flushes — the evidence is weak, inconsistent or non-existent. There are no robust trials showing that dong quai "regulates" the cycle or improves fertility.

How is dong quai thought to work in the body?

One popular hypothesis is that of phytoestrogens: plant compounds that could bind to oestrogen receptors. However, the 1997 trial tested exactly that hypothesis and found no changes in endometrial thickness or vaginal maturation index in postmenopausal women — that is, in the measures used to detect oestrogenic effect, dong quai alone did not behave like oestrogen ¹.

Pharmacological reviews describe other plausible mechanisms: antioxidant, anti-inflammatory, immunoregulatory properties and effects on circulation ⁴. The 2024 review on cardiovascular and cerebrovascular diseases describes mechanisms such as regulation of protein expression, inhibition of inflammation, anti-apoptosis and antioxidant ⁷. The review on ischaemic stroke mentions anti-inflammatory, antioxidant, antiplatelet and vascular-protective effects for extracts and compounds such as Z-ligustilide and ferulic acid ⁸.

These mechanisms are interesting for research, but they have been studied mainly in the laboratory or in animal models. A plausible mechanism is not the same as a demonstrated benefit in people.

Why are the studies so contradictory?

There are several concrete reasons for the inconsistency:

• Different products: the chemical composition of the root varies with origin and processing, and studies use extracts that are not equivalent ³.
• Formulas vs. isolated: many positive results come from multi-herb formulas ^{5 6}, which makes it impossible to attribute the effect to dong quai.
• Small studies: samples of 50 to 71 participants, as in the trials cited, have little power to detect modest effects ^{1 6}.
• Different populations and contexts: the review even questions whether traditional Chinese use can be transferred to Western women, given differences in context, processing and even individual response ³.

A 2004 systematic review on non-oestrogenic treatments for menopausal vasomotor symptoms already concluded that the evidence for many of these options was limited ¹⁰. The picture has not changed radically since then.

Dong quai and bleeding risk: what is known

A frequent concern is clotting. In a randomised, double-blind, placebo-controlled trial, 25 healthy volunteers per herbal preparation took Angelica sinensis alone, aspirin alone and the combination, in 3-week phases with 2-week intervals, measuring platelet function, PT/APTT and thrombin generation ¹¹. Overall, no clinically relevant impact on platelet and coagulation function was observed ¹¹.

This is reassuring, but it does not remove caution: the study was small, in healthy volunteers, and does not cover every situation (higher doses, other plants, people with clotting disorders or taking anticoagulants). If you take anticoagulants or antiplatelet medicines, or have surgery scheduled, talk to a healthcare professional before using dong quai. We have a dedicated article on this topic: dong quai and drug interactions.

Who should avoid dong quai

There are groups for whom dong quai is not suitable:

• Pregnancy and breastfeeding: it should not be used. TuttiBear product warnings state explicitly that they are not recommended for pregnant or breastfeeding women.
• Hormone-sensitive conditions: as a precaution, anyone with a history of breast, ovarian or uterine cancer should talk to their doctor before considering any supplement with putative hormonal action.
• Anticoagulant or antiplatelet medication: although the trial in healthy volunteers showed no clinically relevant impact ¹¹, the decision should be made with your doctor.
• Active illness or regular medication: always consult a healthcare professional before consuming.
• Children and adolescents: there are no studies in this age group and the hormonal system is still developing — it is not advisable.

If you are under 18, trying to conceive or have any health problem, talk to a doctor first before considering dong quai — it is not a harmless supplement and it has interactions and contraindications.

If your symptoms are intense, persistent or affect your quality of life, dong quai is not a substitute for medical assessment. Very irregular cycles, disabling pain or marked menopausal symptoms have causes that should be investigated.

Doses: what studies used and what the label says

There is no universally recommended daily dose of dong quai. Trials used very different preparations and amounts — from chewable tablets of a combined formula ⁵ to capsules of multi-herb formulas ¹² — and most do not allow the contribution of dong quai to be isolated. Doses used in studies are not instructions for use.

If you choose a supplement, what matters is what the label states. In TuttiBear Female Balance Gummies, each 2-gummy serving provides 100 mg of dong quai extract, among other ingredients (maca, shatavari, saffron, zinc, vitamin B6 and vitamin D3). The directions for use are to chew 2 gummies per day, preferably after a meal, without exceeding the recommended daily dose. The product contains polyols and is not recommended for pregnant or breastfeeding women; in case of illness or medication use, consult a healthcare professional before consuming.

In any case, remember that more is not better: with medicinal herbs, high doses can increase the risk of unwanted effects, so you should not exceed the amount stated on the label.

To go deeper into this point, see what the recommended daily dose is and when to take it.

Gummy, tablet or tea: does the format change anything?

There are no studies directly comparing dong quai gummies with tablets or teas, so it is not possible to state that one format is more effective than another. What is known is that the evidence on efficacy concerns the ingredient, not the pharmaceutical form — and that evidence is weak in any format. The format mainly influences convenience and adherence: a gummy is easy to take regularly, but it may contain sweeteners and other ingredients that are worth checking on the label. We compared the formats in detail in dong quai gummies or tablets.

What the evidence does not allow us to say

It is worth being explicit about what is not proven, because that is where many commercial promises fail:

• There is no proof that dong quai "regulates the menstrual cycle" or normalises irregular cycles.
• There is no proof that it improves fertility.
• There is no proof that it relieves premenstrual syndrome.
• There is no proof that it acts as oestrogen in the human body — the trial that tested that hypothesis found no effect ¹.
• There is no proof that it prevents or treats cardiovascular, cerebrovascular or neurodegenerative diseases; the existing reviews describe mechanisms and preclinical studies, not established clinical benefits ^{7 8 9}.

In addition, under Regulation (EU) No 432/2012, there are no authorised health claims for plants and botanical extracts such as dong quai — only for vitamins and minerals with defined conditions of use ¹³. For this reason, no label can legally state that dong quai "balances hormones" or "relieves menopause".

How to decide whether it is worth trying

If, after all this, you still want to consider dong quai, a sensible approach is:

1. Talk to a healthcare professional first, especially if you take medication, have a diagnosed condition or are pregnant or breastfeeding.
2. Set realistic expectations: the evidence does not support strong effects, and the most likely outcome is that you will notice no difference.
3. Choose a product that clearly states the amount of extract per serving and follow the label instructions, without exceeding the dose.
4. Do not use the supplement to delay a medical assessment of persistent symptoms.

If your interest is women's wellbeing in general, you can explore our women's health collection or read how dong quai works according to science. For an overview of the ingredient, see the dong quai page.

In short: dong quai has a long history of use and biologically plausible mechanisms, but the available clinical trials do not confirm the benefits usually attributed to it. The decision to try it should be based on honest information, respect for contraindications and, ideally, the advice of a healthcare professional.

Frequently asked questions

What is dong quai used for?

Traditionally, dong quai is used for menstrual cramps, cycle irregularities and menopausal symptoms. However, clinical trials do not confirm these benefits: in a study with 71 postmenopausal women, dong quai alone was no better than placebo over 24 weeks, and a recent systematic review concluded that trials with dong quai showed no measurable effects.

Does dong quai work for menopausal hot flushes?

The evidence is not favourable. The placebo-controlled trial with 71 postmenopausal women found no differences compared with placebo in the frequency of hot flushes or in the Kupperman index. Some positive results came from multi-herb formulas, which does not allow the effect to be attributed to dong quai.

Does dong quai have hormonal or oestrogenic effects?

The hypothesis exists, but it has not been confirmed in humans. In the trial that specifically tested this question, dong quai alone did not change endometrial thickness or vaginal maturation in postmenopausal women, which are the measures used to detect oestrogenic effect.

Who should not take dong quai?

It should not be used during pregnancy or breastfeeding, or by children and adolescents, since there are no studies in these groups. People with hormone-sensitive conditions or taking anticoagulants should talk to a healthcare professional before considering any supplement with dong quai.

Does dong quai increase the risk of bleeding?

In a randomised, placebo-controlled trial in healthy volunteers, dong quai, alone or in combination with aspirin, had no clinically relevant impact on platelet function or coagulation. Even so, the study was small and does not cover every situation, so anyone taking anticoagulants should seek medical advice.

What is the recommended dose of dong quai?

There is no universally recommended dose. Studies used very varied preparations and amounts, often in combined formulas, and doses from studies are not instructions for use. The most sensible approach is to follow the label of the chosen product and not exceed the recommended daily dose.