Although popular culture heralds premenstrual syndrome (PMS) as a rite of passage for women each month, a normal menstrual cycle should be completely free of the symptoms associated with PMS.

Now, before we jump into discussing a number of ways to curb the symptoms associated with PMS, let’s look more closely at what PMS actually is. 

What is PMS?

PMS is characterised by physical and behavioural symptoms that appear in the days preceding menses and interfere with work or lifestyle, followed by a symptom-free interval.

Some of the symptoms of PMS are:

Behavioural Symptoms

• Depression
• Angry outbursts
• Irritability
• Confusion
• Social withdrawal
• Fatigue

Physical Symptoms

• Breast tenderness
• Abdominal bloating
• Headache
• Swollen extremities

How many women deal with PMS?

PMS occurs in 20–30% of women

What does a normal menstrual cycle look like?

The menstrual cycle is divided into three phases: Follicular, Ovulation and Luteal phase. The menstrual cycle is regulated by neuroendocrine influences from the hypothalamus and changes in the patterns of pituitary and ovarian hormone synthesis and secretion. It is during the luteal phase that the onset of symptoms related to the menstrual cycle may occur, resulting in the development of premenstrual syndrome.

What causes PMS?

PMS results when a deviation from normal ovarian function occurs. Current evidence suggests that PMS results from an abnormal or exaggerated effect of cyclic changes in ovarian hormones having an impact on central neurotransmitter mechanisms. Serotonin seems to play an important role. PMS is not simply a matter of hormonal excess or deficiency but rather a multiple of factors that interfere with the Hypothalamic-Pituitary-Ovarian (HPO) axis.

Naturopathic treatments

The Naturopathic approach to treating PMS considers the whole person. Here are some evidence-based approaches that have been found useful in the treatment of PMS:

Dietary

Evidence has suggested that a higher consumption of diary foods, refined sugar (particularly chocolate) and high sodium foods may be associated with increased incidence and increased severity of PMS and that PMS appears worse in women with abnormal glucose tolerance. Consuming small regular meals and lower glycaemic foods is important.

Lifestyle

Increased regular exercise has a positive effect on PMS. Relaxation and meditative techniques have improved PMS.

Herbal medicine

Vitex agnus-castus (Chaste tree):

• Demonstrated effect on treating PMS symptoms
• Reduces prolactin through action on dopamine receptors
• Normalises progesterone levels and lowers prolactin within 3 months
• Exerts activity on the opiate system and has mood regulation and analgesic effects

Hypericum perforatum (St. John’s Wort):

• Reduces the symptoms of PMS and is particularly helpful for irritability, crying or depression in PMS

Crocus sativus (Saffron):

• Useful for symptoms of PMS and depression in PMS

Valeriana officinali (Valerian), Piper methysticum (Kava), Passiflora incarnata (Passionflower), Melissa officinalis (Lemon Balm):

• Traditionally used as nervine herbs in the treatment of PMS, calming effects, anti-anxiety, sedative

Ginkgo biloba (Ginkgo):

• Improvements to psychosocial aspects of PMS and reduced breast pain, tenderness and fluid retention

Nutritional medicines

Calcium: Shown to reduce PMS symptoms

Magnesium: Shown to reduce PMS mood, migraine and fluid retention symptoms

Vitamin E: Useful for breast symptoms, tension, irritability and lack of coordination in PMS

Vitamin B6: Decreases PMS symptoms, PMS related mood changes and PMS related depression

Omega 3: In a pilot trial reduced depression, nervousness, anxiety, lack of concentration, boating, headache and breast tenderness