Dong Quai (Angelica sinensis) Benefits

Benefits — scientific infographic poster

Dong Quai is the dried root of Angelica sinensis, one of the most heavily used herbs in the entire Chinese materia medica — and one of the most heavily oversold in Western supplement aisles. These four articles separate what the root is traditionally used for, what its chemistry plausibly does, and what has actually been measured in people. In two of the four areas the honest answer is not the one on the bottle.

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Menstrual Health and Cramps

The Si Wu Tang and Dang Gui Shao Yao San tradition, ligustilide's antispasmodic pharmacology, what the small formula trials in period pain really show, and the heavy-bleeding caution nobody prints on the label.

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Blood Building and Anemia

Why “tonifies blood” in Chinese medicine is not a claim about haemoglobin, why the root contains almost no iron, and why treating anaemia with Dong Quai instead of a workup can hide a serious cause.

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Circulation and Cardiovascular

Ferulic acid and the phthalides as vasodilators and platelet inhibitors, the famous 5:1 Dang Gui Bu Xue Tang ratio, and the bleeding risk that is the flip side of the same chemistry.

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Menopause: Evidence Review

A dedicated look at the best-known trial — Hirata and colleagues, 1997, 71 women, 24 weeks, no effect on hot flushes — and at whether anything published since changes the answer. It does not.

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Table of Contents

  1. What Dong Quai Actually Is
  2. Why “Female Ginseng” Is a Marketing Label
  3. The Honest Summary of the Evidence
  4. The Chemistry That Matters
  5. Safety First: Warfarin, Bleeding, Pregnancy
  6. Buying and Quality: What the Signs Mean
  7. Key Research Papers
  8. External Resources
  9. Connections
  10. Featured Videos

What Dong Quai Actually Is

Dong Quai is the dried root of Angelica sinensis (Oliv.) Diels, a member of the carrot and celery family, Apiaceae. In Chinese pharmacy the drug has a formal name — Radix Angelicae Sinensis — and a common one, 当归 (dāng guī). Vietnamese herbalists call it đương quy. The plant is a tall umbellifer with the hollow, ridged stem and flat-topped flower cluster you would recognise from wild carrot or angelica in a garden.

Almost all commercial supply comes from a small area of north-west China. Gansu province, and Min County in particular, grows the overwhelming majority of the world's Dong Quai. The plants are lifted in autumn in their second year — earlier and the root is thin, later and it bolts to seed and turns woody and worthless as medicine. Harvested roots are traditionally dried slowly in smoke sheds, which is why good Dong Quai has a faint smoky note over the sweet, celery-like aroma.

Traditional pharmacy divides the root into parts and treats them as different medicines:

Not the same as the other Angelicas

Confusion between Angelica species is the single most common error in English-language writing about this herb, and it matters for safety.

PlantCommon nameNote
Angelica sinensisDong Quai, Dang GuiThe subject of these pages. Chinese blood tonic.
Angelica archangelicaEuropean garden angelicaA different plant with a far higher furanocoumarin content. Most photosensitivity warnings originate here. Covered separately on this site.
Angelica dahuricaBai ZhiChinese herb, but used for sinus congestion, headache and discharge — not as a blood tonic.
Angelica pubescensDu HuoUsed for lower-body damp-cold joint pain.
Angelica acutilobaJapanese tōkiThe species generally used in Japanese Kampo where a Chinese formula calls for dang gui.

Why “Female Ginseng” Is a Marketing Label

You will see Dong Quai sold as “female ginseng” on bottles, in blog posts, and in the copy of otherwise reputable retailers. That phrase is a Western marketing invention. It is not a traditional Chinese designation and it misrepresents how the herb is actually used.

In Chinese medicine, Dang Gui is a blood tonic — a category with nothing gendered about it. It appears in formulas for pallor and fatigue after blood loss, for dry constipation in the elderly, for numbness and tingling in the limbs, for chronic non-healing sores, for trauma and bruising, and for the recovery phase after surgery or childbirth. Men receive it as often as women. Two of the four classical formulas it anchors — Dang Gui Bu Xue Tang and Shi Quan Da Bu Tang — are general restoratives, not gynaecological prescriptions.

Why does the nickname persist? Because it sells, and because Si Wu Tang, the formula most associated with menstrual complaints, is the one that made it to the West first. The practical consequence is real: shoppers buy Dong Quai as a hormone-like women's tonic and expect it to behave like one. As the menopause evidence review lays out, when that specific expectation was tested in a proper randomised trial, it failed.

The Honest Summary of the Evidence

Here is where the four topic pages land, stated up front so nobody has to read four articles to get the gist.

ClaimBest available evidenceVerdict
Relieves period cramps Mostly multi-herb formula trials of modest quality (see the Cochrane figures below the table); plausible antispasmodic pharmacology from ligustilide Possible as part of a formula. Weak evidence for the single herb.
Builds blood / treats anaemia Animal work on Angelica sinensis polysaccharides; essentially no human haemoglobin data for the single herb, and one 2026 trial of a formula (below the table). The root contains negligible iron. Not established. Using it in place of an anaemia workup can hide a serious cause.
Improves circulation Real vasodilator and antiplatelet pharmacology in laboratory models; no cardiovascular outcome trials Mechanistically plausible, clinically unproven — and the same activity creates bleeding risk.
Relieves hot flushes A 24-week randomised, placebo-controlled trial in 71 postmenopausal women found no difference Negative in this one trial: the single herb was no more helpful than placebo.
Is oestrogenic Inconsistent laboratory results; the same trial found no change in vaginal maturation index or endometrial thickness Unresolved. Caution in hormone-sensitive conditions is precautionary; laboratory and mouse results raise a concern, and human data are limited (see Safety).
Interacts with warfarin A published case report of a more than 2-fold rise in international normalized ratio (INR); Memorial Sloan Kettering says dong quai may increase bleeding risk in people on blood thinners Reported and important. This is the standout safety issue.

Period cramps, in figures. A 2008 Cochrane review pooled 39 randomised trials with 3,475 women. Many were small and of poor quality, and the comparison with placebo was unclear. Against pharmaceutical drugs, Chinese herbal medicine gave better pain relief (14 trials; risk ratio 1.99). These were Chinese herbal medicines in general, not Dong Quai alone.

The classic formula and hot flushes. Dang Gui Buxue Tang (1 part Dong Quai to 5 parts astragalus) was tested for 6 months against placebo in 100 Hong Kong women. The authors found “overall no significant difference” for hot flushes and other vasomotor symptoms; the formula did better than placebo only for mild hot flushes. No serious side effects were put down to treatment.

A 2026 formula trial in anaemia. In 96 patients with anaemia on chemotherapy after colon cancer surgery (86 finished), standard care alone was compared with standard care plus a Danggui Buxue medicinal diet for 21 days. Afterwards, haemoglobin was 115.26 against 106.52 and fatigue scores were 29.14 against 44.02, both in favour of the diet. This is a formula, not the single herb.

The Chemistry That Matters

Three groups of compounds carry most of the pharmacology, and understanding them explains a lot about why product quality varies so wildly.

Z-ligustilide is the dominant compound in the volatile oil and the source of the root's warm, celery-like smell. It is a phthalide — the same chemical family that gives celery its scent — and it is the constituent most often credited with the smooth-muscle-relaxing and vasodilating effects. Crucially, ligustilide is unstable. It oxidises and dimerises on exposure to air, light and heat, so a root that has been sitting in a warehouse or on a shop shelf for two years is genuinely a weaker medicine than a fresh one. If your Dong Quai smells of nothing, it probably does very little. Related phthalides include butylidenephthalide and senkyunolide A.

Ferulic acid is a simple phenolic acid, widely distributed in plants, and the compound that pharmacopoeias use as the analytical quality marker for Dong Quai — the Chinese Pharmacopoeia sets a minimum of roughly 0.05% by high-performance liquid chromatography (HPLC). It is worth being clear about what that means: ferulic acid is a marker, chosen because it is stable and easy to measure, not because it is necessarily the most active constituent. A product can pass on ferulic acid and still have lost most of its volatile oil.

Angelica sinensis polysaccharides (ASP) are large sugar polymers extracted with hot water. They are the fraction studied for effects on blood-cell production and immune signalling. The anaemia results listed on this page are from animals: mice given 100 mg/kg a day by injection into the abdomen after a chemotherapy drug, and, for the Danggui Buxue decoction, rats given it by stomach tube. They are also, notably, the fraction least likely to be present in an alcohol tincture — which matters if the reason you are taking the herb is the polysaccharide research.

Safety First: Warfarin, Bleeding, Pregnancy

Most herb pages bury the cautions at the bottom. For Dong Quai the safety section is arguably the most useful thing on the page, so it goes here.

  1. Warfarin. A published case report (Page and Lawrence, 1999) describes a 46-year-old woman with atrial fibrillation, stable on warfarin, whose prothrombin time and international normalized ratio more than doubled after 4 weeks of Dong Quai. No other cause was found, and her values returned to acceptable levels 1 month after she stopped. The authors call taking warfarin and Dong Quai together a potential hazard. They write that “the true mechanism remains unknown.” Coumarin-type constituents and the antiplatelet phthalides are the usual explanations; in rats, Z-ligustilide reduced platelet aggregation without changing clotting times. Memorial Sloan Kettering says Dong Quai may increase bleeding risk in people on blood thinners, says the added effect “appears to be limited in a human study,” and lists a brain haemorrhage (subarachnoid) in a 53-year-old woman using a supplement of red clover, Dong Quai and Siberian ginseng. A 2014 review of herb-warfarin interactions does not name Dong Quai among the herbs it rated major severity. The same caution is applied by reasoning to other anticoagulants and antiplatelet drugs, including apixaban, rivaroxaban, clopidogrel and daily aspirin, even though the case-report literature centres on warfarin.
  2. Surgery and dental procedures. Common practice for herbs with antiplatelet activity is described as stopping at least two weeks before a planned procedure and telling the anaesthetist.
  3. Pregnancy and breastfeeding. Memorial Sloan Kettering lists both as reasons to avoid Dong Quai and says it “can raise your risk of miscarriage.” Dong Quai has a traditional reputation as a uterine stimulant and there are no human safety data. Traditional Chinese practice does use it during pregnancy in specific formulas under supervision.
  4. Heavy menstrual bleeding. The same antiplatelet chemistry that is sold as a circulation benefit can make heavy periods heavier. The concern applies to flooding rather than to cramping.
  5. Photosensitivity — the uncertainty. You will read everywhere that Dong Quai causes sun sensitivity. Furanocoumarins do cause phototoxicity, but A. sinensis contains far lower levels of them than A. archangelica, and the warning has largely been extrapolated from related species rather than demonstrated for this one. It is a theoretical caution at high doses, not an established effect.
  6. Hormone-sensitive conditions. Caution is routinely advised in breast, uterine and ovarian cancer, endometriosis and fibroids. The evidence that Dong Quai is meaningfully oestrogenic is weak and inconsistent in both directions, and the caution is precautionary. In the laboratory, a water extract made both oestrogen-receptor-positive and oestrogen-receptor-negative breast cancer cells grow (2005). A 2021 study found that an extract increased oestrogen-receptor-positive tumour growth in mice, reversed by tamoxifen, and its authors do not recommend it in breast cancer. In contrast, a Taiwan insurance study of 34,262 women with breast cancer and 102,786 controls found users slightly less likely to have breast cancer (adjusted odds ratio 0.95). Cause and effect were not tested in people. The oestrogenic question is not settled.

Buying and Quality: What the Signs Mean

Key Research Papers

Botany, chemistry and general pharmacology

  1. Wei WL, Zeng R, Gu CM, Qu Y, Huang LF. Angelica sinensis in China — A review of botanical profile, ethnopharmacology, phytochemistry and chemical analysis. Journal of Ethnopharmacology. 2016;190:116–141. — PubMed PMID: 27211015
  2. Zhang Y, Zhu Z, Li X, et al. Angelica sinensis: Botany, Traditional Uses, Phytochemistry, Pharmacology, Safety, and Applications. The American Journal of Chinese Medicine. 2026;54(4):1213–1251. — PubMed PMID: 42366516
  3. Li T, Zhao X. Research Progress on the Immunomodulatory Effects by Dang Gui (Radix Angelica sinensis) and Its Active Chemical Components. Molecules. 2026;31(7):1153. — PubMed PMID: 41976194
  4. Zhu FQ, Ma JY, Zhang YY, Yu Y. Research progress on mechanisms and pharmacokinetics of ligustilide in treatment of locomotor system diseases. China Journal of Chinese Materia Medica. 2024;49(24):6625–6634. — PubMed PMID: 39805752

Menstrual health

  1. Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database of Systematic Reviews. 2008;(2):CD005288. — PubMed PMID: 18425916

Blood building and haematopoiesis

  1. Wang B, Jiang H, Sun N, et al. Angelica sinensis polysaccharides ameliorate 5-FU-induced stress anemia via promoting extramedullary erythroblastic island central macrophage-mediated erythroid differentiation. International Immunopharmacology. 2024;142(Pt A):113061. — PubMed PMID: 39260313
  2. Sun N, Wang Z, Jiang H, et al. Angelica sinensis polysaccharides promote extramedullary stress erythropoiesis via ameliorating splenic glycolysis and EPO/STAT5 signaling-regulated macrophages. Journal of Molecular Histology. 2024;55(5):661–673. — PubMed PMID: 38969952
  3. Gao Y, Zhang Y, Liu W, et al. Danggui Buxue decoction alleviates cyclophosphamide-induced myelosuppression by regulating β-hydroxybutyric acid metabolism and suppressing oxidative stress. Pharmaceutical Biology. 2023;61(1):710–721. — PubMed PMID: 37096658
  4. Wang L, Yang L, Wang L, et al. Effect of Danggui Buxue Medicinal Diet on cancer-related fatigue in anemic colon cancer patients undergoing chemotherapy: A randomized controlled trial (CONSORT-compliant). Medicine (Baltimore). 2026;105(43):e51072. — PubMed PMID: 42937728

Circulation and platelets

  1. Zhang L, Du JR, Wang J, et al. Z-ligustilide extracted from Radix Angelica sinensis decreased platelet aggregation induced by ADP ex vivo and arterio-venous shunt thrombosis in vivo in rats. Yakugaku Zasshi. 2009;129(7):855–859. — PubMed PMID: 19571521
  2. Gong AG, Li N, Lau KM, et al. Calycosin orchestrates the functions of Danggui Buxue Tang, a Chinese herbal decoction composing of Astragali Radix and Angelicae Sinensis Radix. Journal of Ethnopharmacology. 2015;168:150–157. — PubMed PMID: 25796405

Menopause and safety

  1. Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertility and Sterility. 1997;68(6):981–986. — PubMed PMID: 9418683
  2. Haines CJ, Lam PM, Chung TK, Cheng KF, Leung PC. 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;11(3):244–251. — PubMed PMID: 18568789
  3. Page RL 2nd, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy. 1999;19(7):870–876. — PubMed PMID: 10417036
  4. Ge B, Zhang Z, Zuo Z. Updates on the clinical evidenced herb-warfarin interactions. Evidence-Based Complementary and Alternative Medicine. 2014;2014:957362. — PubMed PMID: 24790635
  5. Lau CB, Ho TC, Chan TW, Kim SC. Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause. 2005;12(6):734–740. — PubMed PMID: 16278617
  6. Zhu H, You J, Wen Y, et al. Tumorigenic risk of Angelica sinensis on ER-positive breast cancer growth through ER-induced stemness in vitro and in vivo. Journal of Ethnopharmacology. 2021;280:114415. — PubMed PMID: 34271113
  7. Chen JY, Wang YH, Hidajah AC, Li CY. A population-based case-control study on the association of Angelica sinensis exposure with risk of breast cancer. Journal of Traditional and Complementary Medicine. 2019;10(5):454–459. — PubMed PMID: 32953561

PubMed Topic Searches

  1. PubMed: Angelica sinensis pharmacology
  2. PubMed: Dong quai clinical trial
  3. PubMed: Ligustilide smooth muscle
  4. PubMed: A. sinensis polysaccharide erythropoiesis
  5. PubMed: Danggui Buxue Tang
  6. PubMed: Angelica sinensis and warfarin
  7. PubMed: Ferulic acid vasodilation
  8. PubMed: Si Wu Tang
  9. PubMed: Angelica sinensis furanocoumarins
  10. PubMed: Angelica sinensis dysmenorrhoea

External Resources

Connections

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