Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS) is defined as a recurrent, cyclic set of physical and behavioral symptoms that occur 7-14 days before menstruation. It is believed that 80% of women experience symptoms of PMS with 40% of women suffering to a degree that interferes with some aspect of their daily life during that time. The physiological causes of PMS are unknown. It stands to reason that the varying symptoms experienced with PMS speak not only of physiological causes but also cultural and emotional factors. Some 150 symptoms have been ascribed to PMS and women will experience symptoms to varying degrees, but always with very regular onset and regular relief at the beginning of menses. This regularity and cyclical nature is the basis of a diagnosis of PMS.

The most common symptoms of PMS include:

Nervousness

Irritability

Lethargy

Mood swings

Abdominal bloating

Headache

Back pain

Sugar cravings

Low-libido

Clumsiness

Low self-esteem

Insomnia

Anxiety

Fatigue

Depression

Water retention

Tender breasts

Change in appetite

Acne

Diarrhea

Constipation

Dizziness

Social isolation

Joint pain

Dr. Guy Abraham developed a system for categorizing PMS into four distinct groups based upon the most common symptoms experienced together during the premenstrual time. It is important to remember, however, that most women will experience a variety of symptoms from several categories with the majority of their symptoms coming from one category in particular.

PMS-A (anxiety) Believed to be related to high levels of estrogen and deficiency of progesterone. Women experience irritability, anxiety, and emotional changes.

PMS-C (carbohydrate craving) Of unclear etiology, may be due to enhanced intracellular binding of insulin. Women experience increased appetite, sugar and carbohydrate craving, headache, and heart palpitations.

PMS-D (depression) Most likely due to low estrogen levels leading to a breakdown of neurotransmitters. Low estrogen may lead to enhanced adrenal androgen, or progesterone secretion. Women may experience depression.

PMS-H (hyperhydration) Due to increased water retention from elevated levels of aldosterone. Elevated aldosterone in the premenstrual phase of the cycle may be a result of excess estrogen, increased salt intake, stress, or magnesium deficiency. Women may experience weight gain, abdominal bloating, swelling in the hands and feet, and breast fullness and tenderness.

Treatment of PMS should be addressed first through lifestyle and dietary considerations. Women who add regular exercise into their lifestyle experience significant reduction in symptoms during the premenstrual phase. Aerobic exercise appears to be the most beneficial, however, yoga and tai chi are equally effective when performed at least three times per week.  Dietary changes such as reducing refined sugars, caffeine, and sodium will help to lessen the symptoms as well as adequate intake of calcium, magnesium, fiber–rich foods, and vitamin B6.

Considering the many symptoms of PMS, herbs excel in the treatment of this disorder due to their wide range of chemical constituents. Following is a list of several commonly used herbs and a brief profile of each. This list is just a small portion of herbs that are effective and are most commonly compounded together with other herbs rather than being taken alone in order to create effective synergy for a wide variety of symptoms.

(The following information is based upon traditional use of raw plant as well as information from the German Commission E and is not to be used in place of direct guidance from a health care professional)

Vitex agnus-castus (chaste tree) is used for premenstrual syndrome, easing menstrual cramps, soothing symptoms associated with premenstrual herpes and premenstrual acne. It is useful in many of the high estrogen, low progesterone related health problems often accompanying premenstrual symptoms.

Cimicifuga racemosa (black cohosh) is useful for restlessness, nervous excitement, easing temporary mild breast pain, and soothing menstrual headaches.

Ginkgo biloba (ginkgo) supports normal circulation and is useful in women who experience congestive conditions during the premenstrual phase such as fluid retention, weight gain and breast tenderness.

Hypericum perforatum (St John’s wort) promotes a healthy nervous system and emotional balance and has long been used for conditions of mild temporary depression. Hypericum may interfere with certain medications, which makes it advisable to check with your health care practitioner.

Piper methysticum (kava) is approved by the German health authorities for “conditions of nervous anxiety, stress and restlessness.”

Other botanicals traditionally used include Caulophyllum thalictroides (blue cohosh), Chamaelirium luteum (false unicorn), Dioscorea villosa (wild yam), and Viburnum opulus (cramp bark). Traditionally, the herbs mentioned would be used during the premenstrual phase of the cycle (days 15-28) and stopping their use once menstruation begins.

When considering treatment for PMS it is important to remember that lifestyle, cultural views, emotions, and physiology all play a role in the disorder. Treating a symptom without also addressing the psychological and emotional beliefs of the individual may fail to bring about the desired results. It is important to re-educate women on the inherent value and power that is held within the female self and the processes that occur during the menstrual cycle. Addressing treatment from the avenues of lifestyle, exercise, nutrition, and herbs will allow the woman to create comprehensive changes in her physiological and emotional well being.


Kris Vaughan, CH