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PREMENSTRUAL SYNDROME

WHAT IS PMS?

It is estimated that three out of every four women experience premenstrual syndrome. This group of symptoms begins one to two weeks before a woman’s menstrual flow. Symptoms can be both physical and emotional. Most women with PMS experience a few symptoms while others suffer from several. The intensity of symptoms may vary month to monthFollowing are a list of symptoms women may experience:

EMOTIONAL SYMPTOMS:

  • Depression
  • Mood swings (irritability or anger, crying spells)
  • Food cravings and changes in appetite
  • Insomnia
  • Social withdrawal
  • Poor concentration

PHYSICAL SIGNS AND SYMPTOMS:

  • Headache
  • Fatigue
  • Water retention and weight gain
  • Bloating, constipation or diarrhea
  • Breast tenderness
  • Joint or muscle pain
  • Acne
  • Constipation or diarrhea

One type of PMS known as premenstrual dysphoric disorder, or PMDD is so severe that it interferes with a woman’s ability to carry out daily activities and functions.

SIDEBAR: Study on effects of oral contraceptive use

A study published in the American Journal of Obstetrics and Gynecology examined how oral contraceptives affect blood levels of fat-soluble antioxidants, including coenzyme Q10, alpha-tocopherol and gamma-tocopherol (members of the vitamin E family) and the carotenoids beta-carotene, alpha-carotene and lycopene. Non-fasting blood samples were collected randomly at any day of the menstrual cycle from 15 premenopausal women who had used oral contraceptives for at least six months and from 40 women who did not use oral contraceptives. No dietary restrictions were imposed on any of the participants.

Women who consumed coenzyme Q10 supplements and/or multivitamins as well as women who had irregular menstrual cycles were excluded from the study. Researchers found that oral contraceptive users, blood levels of coenzyme Q10 were 37% lower and alpha-tocopherol levels were 23% lower than those in women who did not use contraceptives. Blood levels of the other nutrients were comparable between the two groups. (P.R. Palan, et al., American Journal of Obstetrics and Gynecology, May 2006)

TESTING

Following are tests that help assess possible reasons for PMS:

  • Hormone testing (thyroid, DHEA, cortisol, testosterone, IGF-1, estrogen, progesterone, prolactin) – saliva, blood, or urine
  • Neurotransmitter testing – urine
  • Vitamin and Mineral Analysis (especially magnesium, calcium, B6 B12,) – blood
  • Food and environmental allergies/sensitivities – blood, electrodermal
  • Blood sugar balance – blood

TREATMENT

DIET AND LIFESTYLE CHANGES

It has been our experience that natural therapies are highly effective in even the most severe cases of PMS. Most women will notice a dramatic improvement within one to two cycles.

Many women will notice an improvement in their PMS symptoms after implementing a healthier diet that promotes hormone balance. Since PMS can be related to excess estrogen levels it is important to consume approximately twenty to thirty grams of fiber in the diet. Fiber binds and expels excess estrogen through the digestive tract. Plant foods such as salads, legumes, nuts, and seeds provide fiber. Another good idea is to consume one to two tablespoons of ground flaxseeds in the diet. They promote better estrogen balance. Also, minimize your intake of dairy products and red meat that are not organic. The accumulation of hormones over time from these foods may contribute to hormone imbalance. It is critical to avoid refined carbohydrates in the diet. Studies demonstrate a strong correlation between high sugar consumption and PMS. Too much sodium, caffeine, and alcohol may also worsen symptoms. Regular exercise has been shown to reduce the symptoms of PMS as well.

STUDIES SHOW VITEX IS EFFECTIVE FOR TREATMENT OF PMS

Vitex (Chasteberry)

Several studies have demonstrated that Vitex, also known as Chasteberry, is effective for the treatment of premenstrual syndrome. A two month randomized study published in Human Psychopharmacology involved 41 women with premenstrual dysphoric disorder (PMDD), a more severe form of PMS, compared the effects of Vitex to that of fluoxetine (Prozac). Both treatments were found to be beneficial, with Vitex more helpful for physical complaints and fluoxetine (Prozac) more effective for psychological symptoms. (Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol Clin Exp 2003;18:191–195. ).

Another  randomized, double-blinded, placebo controlled study reported in the British Medical Journal also found Vitex to be effective for PMS. The study included 86 women receiving Vitex and 84 received a placebo.  The average age was 36 years and the study duration was three consecutive cycles.  Women receiving Vitex had much greater improvement compared to placebo and it was well tolerated. (Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo-controlled study. Br Med J 2001;322:134-7.)

Also, a study published in the Archives of Gynecology and Obstetrics found vitex extract to be effective in the symptomatic relief of premenstrual syndrome. (Berger D. Schaffner W, Schrader E, et al. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with premenstrual syndrome (PMS). Arch Gynecol Obstet 2000;264:150-3.)

Also impressive is a multicenter trial published in the Journal of Women’s Health and Gender-Based Medicine. The trial involved 1634 women suffering from PMS. After a treatment period of three menstrual cycles 93% of patients reported a decrease in the number of symptoms or even cessation of PMS complaints. 85% of physicians rated the treatment as good or very good while 81% of patients assessed their status after treatment as very much or much better. Ninety-four percent of patients assessed the tolerance of Vitex treatment as good or very good. (Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med 2000;9:315-20.)