Dong quai (Angelica sinensis)

Traditional Chinese medicine herbal product (food supplement under Spanish RD 1487/2009)

ATC code: G02CX-DONG-QUAI

Brand names – supplements: Solgar Dong Quai, Nature's Way Dong QuaiSupplements are not tested in clinical trials and are not registered as medications.

Updated 21 Jul 2026 · Methodology

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Female rejuvenation and hormonal balance

Not recommended

Marketing and influencers promote dong quai as a product for uterine rejuvenation, restoration of female hormonal balance and libido support. These are traditional Chinese medicine myths: none of the claims is supported by clinical research. The real concern is bleeding risk with warfarin: Heck 2000 described cases of INR elevation and bleeding on dong quai. In patients with uterine fibroids, endometriosis or a history of thromboembolism the supplement remains questionable. If a doctor suggested dong quai for hormonal balance or to continue after uterine procedures, consider seeking a second opinion from a gynecologic endocrinologist.

Sources

Menopausal symptoms

Not recommended

Dong quai is a traditional Chinese medicine product sold for menopausal symptoms. There is no quality evidence for dong quai: the only double-blind RCT (Hirata 1997, 71 patients) showed no advantage over placebo on hot flashes or endometrial thickness. Systematic reviews from NG23 and Memorial Sloan Kettering 2024 classify dong quai as a product without confirmed efficacy. SEGO 2024 does not recommend it. If hot flashes are troubling, discuss evidence-based options with the gynaecologist (MHT, SSRIs, gabapentin, clonidine) – dong quai is not among them.

Sources

ICD-10: N95.1 · ICD-11: GA30

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

The root contains furanocoumarins (psoralen, bergapten), phthalides (ligustilide, butylidenephthalide), ferulic acid and polysaccharides. Traditional Chinese medicine uses it for blood deficiency and female complaints. Modern studies do not confirm estrogenic activity. Furanocoumarins are clinically meaningful photosensitisers, and root-fraction coumarins potentiate warfarin (case reports by Heck 2000). Extracts are not standardised; batch composition varies.

Safety

Contraindications

Hypersensitivity to Angelica sinensis or other Apiaceae
Warfarin, dabigatran, rivaroxaban and other anticoagulants
Antiplatelets (ASA, clopidogrel) combined with other bleeding factors
Pregnancy and lactation
Estrogen-dependent tumours
Active bleeding

Serious adverse effects

Bleeding and INR elevation when combined with warfarin (Heck 2000)
Severe phototoxic burn with UV exposure
Allergic reactions in patients sensitised to Apiaceae

Common adverse effects

Photosensitisation (phototoxic dermatitis after sun exposure)
Gastrointestinal discomfort
Headache
Lowered blood pressure

Pregnancy: can you take Dong quai (Angelica sinensis)?

Contraindicated. Dong quai was historically used as a uterotonic; furanocoumarins are potentially teratogenic. AEMPS classifies it as do not use in pregnancy.

Breastfeeding: can you take Dong quai (Angelica sinensis)?

Not recommended. Active coumarins transfer into milk; safety has not been studied. eLactancia rates this as high risk.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Dong quai (Angelica sinensis) used for?

Dong quai (Angelica sinensis) is evaluated for the following indications with varying evidence strength: Female rejuvenation and hormonal balance (evidence tier F), Menopausal symptoms (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Dong quai (Angelica sinensis)?

Common side effects of Dong quai (Angelica sinensis) (≥ 1 in 100): Photosensitisation (phototoxic dermatitis after sun exposure), Gastrointestinal discomfort, Headache, Lowered blood pressure. See the Safety section for uncommon and serious reactions.

Is Dong quai (Angelica sinensis) safe during pregnancy?

Contraindicated. Dong quai was historically used as a uterotonic; furanocoumarins are potentially teratogenic. AEMPS classifies it as do not use in pregnancy.

Is Dong quai (Angelica sinensis) compatible with breastfeeding?

Not recommended. Active coumarins transfer into milk; safety has not been studied. eLactancia rates this as high risk.

Who should not take Dong quai (Angelica sinensis)?

Dong quai (Angelica sinensis) is contraindicated in: Hypersensitivity to Angelica sinensis or other Apiaceae; Warfarin, dabigatran, rivaroxaban and other anticoagulants; Antiplatelets (ASA, clopidogrel) combined with other bleeding factors; Pregnancy and lactation; Estrogen-dependent tumours. Full list in the Safety section.

Other drugs in this group

Black cohosh (Cimicifuga racemosa), Copper intrauterine device, Etonogestrel + Ethinylestradiol (vaginal ring), Levonorgestrel (intrauterine system)