Dong Quai: The Definitive Guide

What is Dong Quai?

Dong quai is Angelica sinensis root, often used inside traditional formulas. The key monotherapy menopause trial was null, while a warfarin case report raises a clinically important interaction concern. NCCIH’s current menopause overview says very little research has examined dong quai for menopausal symptoms and no conclusion can be reached. Monotherapy and multi-herb formulas must remain separate. [1]

Typical Dong Quai Protocols

These rows reproduce sources. Do not average them into one universal regimen.

Which forms and label details matter?

Record Angelica sinensis root, powder or extract, amount each time and every co-herb. Do not substitute Angelica archangelica or assign a multi-herb formula result to dong quai alone.

How should it be stored?

Follow the label, close the container and protect it from heat, light and moisture.

What is it commonly used for?

It is marketed for hot flashes, menstrual symptoms, circulation and “women’s balance.” The principal menopause monotherapy trial did not improve symptoms or estrogen-sensitive tissue measures.

What does human research show?

Hirata randomized 71 postmenopausal women to 4.5 g/day dong quai root or placebo for 24 weeks. Hot flashes, Kupperman scores, vaginal maturation and endometrial thickness did not differ, and no estrogenic effect was established. [2] A current systematic review still identifies this as the central dong-quai monotherapy trial. [3] One 46-year-old woman stable on warfarin experienced more than a twofold rise in prothrombin time and INR after four weeks of dong quai; values returned toward range after discontinuation. A case cannot estimate frequency or prove mechanism, but it is clinically relevant. [4]

How might it act?

Phthalides, coumarin-related compounds and other root constituents are proposed to affect smooth muscle, vascular or hormone-related pathways. Human monotherapy results do not show an estrogenic menopause benefit.

How does it compare with related products?

What are the risks and interactions?

Avoid combining dong quai with warfarin without prescriber oversight. Review anticoagulants, antiplatelets, bleeding disorders, surgery, hormone-sensitive conditions and photosensitivity. Pregnancy and breastfeeding safety is not established; uterine-active traditional use adds concern.

Which medicines require review?

Have the product reviewed with medicines, before surgery, and during pregnancy or breastfeeding. No universal separation interval is established.

Regulatory status: In the United States, supplements generally lack premarket efficacy approval. In Canada, verify the finished product’s NPN or DIN-HM and licensed conditions. [5], [6]

What should be monitored?

Record product, lot, form, amount per administration, frequency, daily total, co-ingredients, meals, symptoms, medicines, chosen outcome and review date.

What happens when it is stopped?

No ingredient-specific withdrawal syndrome is established. Record the stop date, symptoms and chosen outcome; seek care for a persistent serious symptom.

Seek prompt care for a serious allergic reaction, unusual bleeding, persistent palpitations, chest pain or another severe symptom.

What do public communities report?

Public reports can suggest questions to track, but they do not verify the product, dose or causality. This update did not newly quantify a community sample.

Common questions about Dong Quai

Does dong quai reduce hot flashes?

The key monotherapy trial found no advantage over placebo.

Does it act like estrogen?

The 24-week trial did not show estrogenic effects on vaginal or endometrial measures.

Can formula studies prove dong quai works?

No. Multi-herb formulas do not isolate one ingredient.

Can it be used with warfarin?

A published case reported a large PT/INR rise; the prescriber should review any concurrent use.

Is 4.5 g/day a recommended dose?

No. It is the exposure from one null trial, not a universal regimen.

What should I track?

Species, root preparation, each amount, schedule, co-herbs, bleeding/bruising, medicines and review date.

Glossary

Terms for reading the evidence.

Extract identity

Species, plant part, solvent or ratio, and any standardization used to define a preparation.

Amount per administration

Amount taken at one time, distinct from daily total.

IPSS / AUASI

Questionnaires rating lower urinary tract symptom severity; they do not diagnose the cause.

Qmax

Maximum measured urinary flow rate.

PSA

A prostate-related blood marker; it is not a stand-alone cancer test.

Monotherapy

The ingredient was tested without another active intervention.

How this guide was researched

Accessible official sources and human reports were read on October 9, 2026. Titles, authors, journals, DOI, PMID and visible corrections were checked. An unreported frequency was not guessed.

How this guide was made

Research and drafting were AI-assisted. This draft awaits Doserly editorial review and independent clinical review. See the editorial policy.

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