Relief from Premenstrual Syndrome

References

Premenstrual syndrome (PMS) is a common name for a wide variety of recurring psychological and physical symptoms experienced by some women during the week or two before menstruation. Symptoms include sudden episodes of tearfulness, irritability or depression; fatigue; water retention; headaches; and joint or muscle pain. Up to half of all women are believed to experience at least one symptom of PMS regularly; approximately 5 percent of these women have symptoms severe enough to interfere with normal activity. PMS can begin with puberty but is most common in women over age 25. The cause is still unknown, but one theory proposes that low progesterone levels in the second half of the menstrual cycle may be responsible.

Conventional medical treatment of PMS sometimes involves prescription of diuretics for water retention and, if symptoms are severe, tranquilizers and antidepressants. Some conventional medical practitioners prescribe progesterone for PMS symptoms. From a complementary and alternative medicine standpoint, certain herbs and nutrients are often used in the treatment of PMS.

Dietary considerations for PMS involve the avoidance of refined sugar, excessive alcohol and caffeine, while consuming a high-fiber, low-fat diet. Women who consume high-sugar foods appear to have an increased risk of PMS.¹ Although an occasional drink is not a problem, alcohol can affect hormone metabolism, and alcoholic women are more likely to suffer PMS than are non-alcoholic women.²

Also, research has shown an increase in the prevalence and severity of PMS in women consuming caffeine-containing beverages.^3,4 Moreover, the more caffeine women consumed, the more likely they weare to suffer from PMS.⁵ In addition, several studies suggest that diets low in fat or high in fiber may help to reduce symptoms of PMS.⁶

Vitamin B6 is one of the most useful of the B-vitamins for reducing PMS symptoms. It particularly reduces fluid retention, breast swelling and tenderness, bloating and edema in general, as well as anxiety, irritability, insomnia, sugar craving and symptoms caused by refined sugar. Furthermore many,^7,8,9,10,11 but not all,¹² studies have shown that taking 50 mg/d to 400 mg/d vitamin B6 for several months can relieve symptoms of PMS. Vitamin B6’s mechanism of action may have to do with its ability to increase the conversion of the fatty acid gamma linolenic acid (GLA) to prostaglandin E1—a chemical that may reduce the effects of PMS.¹³

A nutrient with similar activity is magnesium. Several studies have found women with PMS are often deficient in magnesium,^14,15 and supplementing with magnesium may help reduce symptoms.^16,17 Like vitamin B6, magnesium has the ability to increase the conversion of GLA to prostaglandin E1.¹⁸

Research has shown that the herb Vitex (Vitex angus-castus), also known as chaste tree berry, is able to increase progesterone levels. Studies have shown using Vitex once in the morning over a period of several months helps normalize hormone balance to alleviate the symptoms of PMS.¹⁹ In a double blind study of women with PMS, Vitex was shown to be as effective as 200 mg vitamin B6 in alleviating symptoms.²⁰ In another clinical study, women with PMS were given Vitex or a placebo; by the end of the study, women taking the Vitex had a significantly greater reduction in overall PMS symptoms (including irritability, headache, breast tenderness, etc.) than the placebo group.²¹

Another recent, multi-center trial on the efficacy of a Vitex extract investigated 50 patients with PMS.²² The researchers concluded the extract successfully treated PMS, with the main effect seemingly related to symptomatic relief rather than to the duration of the syndrome. Since Vitex is a slow acting herb, a 120 mg extract should be taken for at least three menstrual cycles to determine whether it shows activity.

Although generally associated with improving short-term memory, Ginkgo biloba extract has also been shown to be beneficial in the treatment of congestive symptoms of PMS (e.g., painful or tender breasts, edema/water retention). In a French study, Ginkgo extract demonstrated statistical significance in reducing breast pain and tenderness.²⁵ There were also improvements in edema, anxiety, depression and headaches but they were not statistically significant. However, in another study of patients with cyclic edema, Ginkgo extract was found to have anti-edema activity.²⁶

June 2005 Health Supplement Retailer
"Relief from Premenstrual Syndrome" References

1. Rossignol AM, Bonnlander H. "Prevalence and severity of the premenstrual syndrome. Effects of foods and beverages that are sweet or high in sugar content." J Reprod Med. 36:131-36, 1991.

2. Halliday A et al. "Alcohol abuse in women seeking gynecologic care." Obstet Gynecol. 68:322-6, 1986. www.greenjournal.org

3. Rossignol AM et al. "Tea and premenstrual syndrome in the People's Republic of China." Am J Public Health. 79:67-76, 1989.

4. Rossignol AM. "Caffeine-containing beverages and premenstrual syndrome in young women." Am J Public Health 75, 11:1335-37, 1985.

5. Rossignol AM, Bonnlander H. "Caffeine-containing beverages, total fluid consumption, and premenstrual syndrome." Am J Public Health 80:1106-10, 1990.

6. Werbach MR, Nutritional Influences on Illness, 2nd ed., pp. 540-1. Third Line Press, Tarzana, Calif., 1993.

7. Barr W. "Pyridoxine supplements in the premenstrual syndrome." Practitioner. 228:425-27, 1984.

8. Gunn AD. "Vitamin B6 and the premenstrual syndrome (PMS)." Int J Vitam Nutr Res. 27:S213-24, 1985.

9. Kleijnen J, Ter Riet G, Knipschild P. "Vitamin B6 in the treatment of the premenstrual syndrome--a review." BJOG. 97:847-52, 1990. www.womenshealth-elsevier.com/doc/journals/bjog1.html

10. Williams MJ, Harris RI, Dean BC. "Controlled trial of pyridoxine in the premenstrual syndrome." J Int Med Res. 13:174-9, 1985.

11. Brush MG, Perry M. "Pyridoxine and the premenstrual syndrome." Lancet. 1:1399, 1985. www.thelancet.com

12. Hagen I, Nesheim B-I, Tuntland T. "No effect of vitamin B-6 against premenstrual tension. A controlled clinical study." Acta Obstet Gynecol Scand. 64:667-70, 1985.

13. Horrobin DF. "Evening primrose oil and premenstrual syndrome." Med J Aust. 153, 10:630-1, 1990. www.mja.com.au

14. Abraham GE, Lubran MM. "Serum and red cell magnesium levels in patients with premenstrual tension." Am J Clin Nutr. 34:2364-6, 1981. www.ajcn.org

15. Sherwood RA et al. "Magnesium and the premenstrual syndrome." Ann Clin Biochem. 23:667-70, 1986.

16. Nicholas A. "Traitement du syndrome pre-menstruel et de la dysmenorrhee par'lion magnesium." First International Symposium on Magnesium Deficit in Human Pathology, 1973.

17. Facchinetti F et al. "Oral magnesium successfully relieves premenstrual mood changes." Obstet Gynecol. 78:177-81, 1991. www.greenjournal.org

18. Horrobin DF, op cit.

19. Blumenthal M et al, eds. The ABC Clinical Guide to Herbs. American Botanical Council, Austin, Texas, 2003.

20. Dittmar FW et al. Therapiwoche Gynekol. 5:60-8, 1992.

21. Lauritzen C et al. Phytomedicine. 4:183-89, 1997. www.urbanfischer.de/journals/frame_template.htm?/journals/phytomed/phytmed.htm

22. Schellenberg R. "Treatment of the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo controlled study." BMJ. 332:134-7, 2001. http://bmj.com

23. Qi-bing M, Jing-yi T, Bo C. Chin Med J. 104:776-81, 1991.

24. Blumenthal M et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines, pp. 90. American Botanical Council and Boston: Integrative Medicine Communications, Austin, Texas, 1998.

25. Tamborini A, Taurelle R. "[Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndrome]." Rev Fr Gynecol Obstet. 88:447, 1993.

26. Lagrue G et al. "[Idiopathic cyclic edema. The role of capillary hyperpermeability and its correction by Ginkgo biloba extract]." Presse Med. 15:1550-3, 1986.

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