Premenstrual Syndrome; A Natural Approach
Karen is a 39-year-old woman who came to see me because she felt that PMS was running her life for 10 days of the month. Two young children and a part time job were more than she could handle at those times. She experienced breast tenderness, bloating, and emotions that she didn’t understand. A normally loving mother, she found herself impatient and easily angered. She would become overwhelmed with a workload that she normally could handle. Her husband had learned the hard way to stay out of her way during the week or so before her period. What really made her want to seek help was that she was not sleeping and becoming more anxious.
I was delighted that she chose naturopathic treatment because I know that this approach to PMS works very well. I reassured her that if everything went according to plan, she would likely be feeling much better within three months. She would likely have to make some changes but the investment in herself would benefit not only her but her family too.
Many women suffer from premenstrual syndrome not knowing that there are many safe, natural and effective approaches that can help them overcome this problem. PMS affects many women but in varying degrees. Eighty percent of women experience premenstrual emotional or physical changes, whereas only about 20-40% of these women have difficulties as a result. A much smaller number, about 2.5-5%, feel it has a significantly negative impact on their lives, to the point where work, relationships or home life are jeopardized.
The first step in Karen’s naturopathic medical program was to do a thorough evaluation of her health history. She had some early signs of a hormonal imbalance. Not only did she have PMS, but her menstrual cycle had become more irregular. This change indicated that she was likely not producing enough progesterone to balance what may have been an elevated level of estrogen. This situation is quite common and is called estrogen dominance. I immediately put her on a herb called Vitex agnus castus. Vitex or chaste berry is the single most important plant for the treatment of PMS. It causes a net increase in progesterone. It functions by stimulating the pituitary gland to produce more luteinizing hormone (LH), which tells the ovaries to ovulate and produce more progesterone. It works with the body to restore balance. (For this reason, I prefer to use Vitex over progesterone supplementation, but I do sometimes recommend a bioidentical progesterone supplement in certain cases). In one long-term study, 92% of women reported a favorable response to Vitex. A new study used Vitex in a clinical trial of 170 women with PMS. This has been the most well designed trial yet studying the efficacy of Vitex in women’s health. Women were assigned to take either a Vitex or a placebo tablet once daily for three months. Subjective reporting of irritability, mood changes, anger, headache, breast tenderness and bloating were recorded. At the end of the three months, women taking the chaste tree reported an average 52% reduction in PMS symptoms.
The second most effective method of reducing PMS is to cleanse the liver and colon. Estrogen is eliminated via the liver and colon, so any congestion in these essential organs will result in increased levels of estrogen and exacerbate any hormonal imbalance. For instance, pre-menstrual migraine headaches can usually be eliminated quickly by cleansing the liver and using a supplement called indole-3-carbinol to assist the liver in the metabolism of estrogen.
There are other well studied natural approaches to PMS that are often part of a customized program for PMS:
- Balancing seratonin with natural medicine because seratonin (a brain neurotransmitter) can fall after ovulation.
- Enhancing prostaglandin E1 by supplementing with essential fatty acids, vitamins B6, B3, C and Zinc.
- Dietary coaching to reduce sugar, salt and animal fats, which are all linked with PMS.
- Caffeine elimination has been proven to lessen breast tenderness and PMS in many cases. Vitamin E also helps breast tenderness, but not PMS overall.
- Regular physical exercise has been studied and shown to cause PMS to be less intense and reduce the number of symptoms. Regular aerobic exercise worked better in the studies than strength training.
- Vitamin B6 has been shown in 11 scientific studies to reduce PMS. It seems to work by enhancing seratonin and dopamine production in the brain.
- Evening primrose oil has been shown in four double-blind studies to have a significant ability to reduce PMS at levels of three and four grams per day
- Calcium was also studied in 497 women in a double-blind study and was shown to reduce all PMS symptoms by 48% within three months. Magnesium also helps PMS, so a calcium/magnesium/vitamin D capsule is recommended.
Conventional medicine has not been able to offer women a satisfactory solution for PMS. The naturopathic medical approach to PMS is not only highly effective but women also experience many side benefits instead of side effects. I am happy to report that Karen’s PMS symptoms were indeed markedly improved well within the 3 month time frame I had suggested. Her husband even stopped by the clinic to thank me!