Dong Quai
Summary
Dong quai is sold for menopause and menstrual symptoms, but evidence is thin. Used alone, it did no better than placebo for hot flushes and showed no estrogen-like effects in a 24-week trial (grade C). A dong quai and astragalus formula also showed no overall benefit. It may raise bleeding risk with warfarin and antiplatelet drugs.
Key facts
- The root of Angelica sinensis; it contains ligustilide, ferulic acid and natural coumarin derivatives[2][6]
- Hot flushes: dong quai alone was no better than placebo over 24 weeks in 71 women (C)[3]
- No change in endometrial thickness or vaginal cells, so no estrogen-like response was seen[3]
- May raise bleeding risk with warfarin and antiplatelet drugs; one patient's INR more than doubled on warfarin[2][6]
- LactMed lists photosensitivity reactions as a possible effect[2]
- NCCIH says too little research exists to reach conclusions about dong quai for menopausal symptoms[1]
- 3 graded human outcomes on this page
- October 12, 2026
How it works
ProposedDong quai root contains coumarin derivatives and constituents with antithrombotic and phototoxic activity, which may explain the bleeding and sun-sensitivity concerns. In the one placebo-controlled trial of dong quai alone it produced no estrogen-like effects on the endometrium or vaginal cells.[6][3]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Hot flushes and night sweats | No effect | Grade C | RCT · n = 100 · 2008 Symptomatic menopausal women in Hong Kong Form: Dang Gui Buxue Tang (dong quai with astragalus, 1:5) · Dose: Not stated in the abstract · Duration: 6 months No overall difference from placebo for vasomotor symptoms; only mild hot flushes fell more than with placebo, while night sweats and moderate flushes improved more with placebo. No serious adverse events. | 18568789 (opens PubMed)Source [4] |
| Hot flushes, Kupperman index and estrogen markers | No effect | Grade C | RCT · n = 71 · 1997 Postmenopausal women with hot flashes (mean age 52) Form: Dong quai root · Dose: Not stated in the abstract · Duration: 24 weeks No difference from placebo in hot-flash count, Kupperman index, endometrial thickness or vaginal maturation. | 9418683 (opens PubMed)Source [3] |
| Hot flushes, night sweats and quality of life by dose | Mixed | Grade D | RCT · n = 60 · 2013 Postmenopausal women with severe hot flashes and night sweats Form: Dang Gui Buxue Tang (dong quai with astragalus) · Dose: 1.5, 3.0 or 6.0 g/day · Duration: 12 weeks Symptoms fell from baseline at 3.0 and 6.0 g/day, most at 6.0 g/day; hormones and lipids did not change. There was no placebo group. | 22990757 (opens PubMed)Source [5] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Dong quai root (capsules, powder, tincture) | Varies[3] | No human absorption data in our sources.[2] | Usually well tolerated in general use, but may raise bleeding risk with blood thinners and cause photosensitivity.[2] | Menopausal hot flushes (one placebo-controlled trial, no benefit) |
| Dang Gui Buxue Tang (with astragalus) | Varies[4][5] | No human absorption data in our sources.[4] | No serious adverse events over 3–6 months.[4][5] | Menopausal symptoms (one placebo-controlled trial, no overall benefit) |
Studied doses
Doses studied in human trials ranged from 1.5 to 6.0 g/day of the Dang Gui Buxue Tang formula for 12 weeks; the 24-week trial of dong quai alone did not state its dose in the abstract.[3][5]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Medicines
- WarfarinCase reportA woman stable on warfarin had her prothrombin time and INR more than double after 4 weeks of dong quai; values returned to range a month after stopping. NCCIH also flags this interaction.[6][1]
- Antiplatelet drugsReviewLactMed notes dong quai may increase bleeding risk in people taking antiplatelet drugs.[2]
Who should be careful
- Blood thinners
- People on warfarin or antiplatelet drugs face a possible higher bleeding risk; an INR more than doubled in a reported case.[6][2]
- Sun sensitivity
- Photosensitivity reactions have been reported, so people prone to sun reactions should be cautious.[2]
- Breastfeeding
- LactMed says dong quai is best avoided during breastfeeding.[2]
- Expecting a hormone effect
- Dong quai alone produced no estrogen-like changes and did not ease hot flashes more than placebo.[3]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
Bleeding and sun sensitivity
The main safety concern is bleeding with warfarin or antiplatelet drugs, plus photosensitivity.
How to read the label
- Label dose vs clinical doseThere is no clinically validated dose of dong quai. The 24-week dong quai-alone trial did not state its dose in the abstract and showed no benefit; formula trials used 1.5–6.0 g/day of Dang Gui Buxue Tang, mostly astragalus.[3][4][5]
- Single herb vs formulaDang Gui Buxue Tang is a 1:5 mix of dong quai and astragalus, so its results do not show what dong quai alone does.[4]
- Check your medicines firstWarfarin and antiplatelet drugs are the interactions with published reports.[6][2]
Frequently asked questions
Does dong quai help hot flashes?
In a 24-week placebo-controlled trial of 71 postmenopausal women, dong quai alone was no better than placebo for hot flashes.[3]
Is dong quai a natural estrogen?
The same trial found no estrogen-like changes in the uterine lining or vaginal cells.[3]
Can dong quai be combined with warfarin?
It may increase bleeding risk. In a published case, a woman's INR more than doubled after 4 weeks of dong quai with warfarin.[6][2]
Does dong quai cause sun sensitivity?
LactMed lists photosensitivity reactions as a possible effect of dong quai.[2]
What about Dang Gui Buxue Tang?
This dong quai and astragalus formula showed no overall difference from placebo for menopausal symptoms in a 6-month trial of 100 women.[4]
Sources
- [1]Menopausal Symptoms and Complementary Health Practices: What the Science Says (In Depth). NCCIH, 2017. fact-sheet
- [2]Dong Quai. Drugs and Lactation Database (LactMed).. NICHD, 2026. database
- [3]Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial.. Fertil Steril, 1997. RCT
- [4]A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women.. Climacteric, 2008. RCT
- [5]A randomized, double-blind, multiple-dose escalation study of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) for moderate to severe menopausal symptoms and quality of life in postmenopausal women.. Menopause, 2013. RCT
- [6]Potentiation of warfarin by dong quai.. Pharmacotherapy, 1999. observational
What changed
- First draft (rebuilt after a lost earlier draft). Every PMID checked against NCBI E-utilities esummary (title and year) and the cited abstracts read; no retraction or erratum flagged for any cited PMID. Doses not given in an abstract are marked as not stated. Safety section leads with warfarin/antiplatelet bleeding risk and photosensitivity. No product links.
- Independent adversarial review (PR #201): spot-checked the 24-week trial, both Dang Gui Buxue Tang trials, the warfarin case and LactMed against PubMed records. No changes needed.