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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 cycle. Symptoms can be both physical and emotional. The majority of women with PMS experience a couple of symptoms while others suffer from multiple. The intensity of symptoms may vary month to month

The following are a list of symptoms women might experience:

EMOTIONAL SYMPTOMS:

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

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 intense that it hinders a woman's ability to perform daily tasks and functions.

SIDEBAR: Study on effects of oral contraceptive use

A study released 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 take oral contraceptives. No dietary restrictions were imposed on any of the participants.

Women who took coenzyme Q10 supplements and/or multivitamins in addition to women who had irregular menstrual cycles were omitted from the study. Researchers found that for oral contraceptive users, blood levels of coenzyme Q10 were 37% lower and alpha-tocopherol levels were 23% lower than those in women that 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

The 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 (particularly 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 treatments are extremely effective in even the most severe cases of PMS. Most women will notice a significant improvement within one to two cycles.

Many women will notice an improvement in their PMS symptoms after starting a healthier diet that supports hormone balance. Given that PMS can be related to excess estrogen levels it is important to eat about twenty to thirty grams of fiber in the diet. Fiber binds and expels excess estrogen via the digestive tract. Plant foods like salads, legumes, nuts, and seeds supply fiber. Another good idea is to consume one to two tablespoons of ground flaxseeds in the diet. They support better estrogen balance. Also, limit your consumption of dairy products and red meat that are not organic. The accumulation of hormones gradually from these foods may contribute to hormone imbalance. It is important to avoid refined carbs in the diet. Studies show a strong link between high sugar consumption and PMS. Too much salt, caffeine, and alcohol may also aggravate symptoms. Regular exercise has been shown to reduce the symptoms of PMS also.

STUDIES SHOW VITEX IS EFFECTIVE FOR TREATMENT OF PMS
Vitex (Chasteberry)

Multiple studies have demonstrated that Vitex, also called Chasteberry, is effective for the treatment of premenstrual syndrome. A two month randomized study published in Human Psychopharmacology included 41 women with premenstrual dysphoric disorder (PMDD), a more extreme form of PMS, compared the results of Vitex to that of fluoxetine (Prozac). Both treatments were found to be helpful, with Vitex more effective 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. )

A different randomized, double-blinded, placebo controlled study reported in the British Medical Journal also found Vitex to be helpful for PMS. The study included 86 women receiving Vitex and 84 got a placebo. The average age was 36 years and the study period was three consecutive cycles. Women getting Vitex had much better 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.)

Additionally, a study released 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 released in the Journal of Women's Health and Gender-Based Medicine. The trial included 1634 women suffering from PMS. After a treatment period of three menstrual cycles 93% of individuals reported a decrease in the amount of symptoms or even cessation of PMS symptoms. 85% of doctors rated the treatment as good or very good while 81% of individuals assessed their status after treatment as very much or much better. Ninety-four percent of individuals considered 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.)