Premenstrual Syndrome (PMS)

Other Treatment

Although premenstrual syndrome (PMS) cannot be cured, you do have a number of lifestyle, medication, and other treatment choices that can reduce your symptoms and improve your quality of life. Although most of the therapies listed below are not considered standard treatment for PMS, you may find one or more of them helpful in relieving some of your symptoms. In general, these treatments are safe and well tolerated.

Other Treatment Choices

Complementary or alternative therapies

• Relaxation methods, including relaxation exercises, roll breathing, yoga, and massage therapy.
• Bright light therapy. Small studies of bright light therapy suggest that exposure to cool-white fluorescent light in the mornings and evenings on days when PMS symptoms are present may reduce the severity of your symptoms.¹¹

Vitamin and mineral supplements often recommended for home treatment of PMS and PMDD

These supplements are commonly recommended for PMS home treatment:

• Calcium. This mineral affects the hormone-producing endocrine system. Calcium is strongly linked to PMS symptoms and relief.⁴ A high level of calcium intake, broken up into three doses per day, may improve your negative moods and reduce fluid retention and pain. Calcium has the added advantage of reducing the risk of osteoporosis.
• Magnesium. Some women take magnesium supplements to help with certain symptoms of PMS. But the effectiveness of these supplements is not known.¹⁰
• Vitamin B6 (pyridoxine). This vitamin affects the endocrine system and helps the body use magnesium. Although research and expert opinions are mixed, daily vitamin B6 is likely to improve PMS depression and physical symptoms.⁸ Take no more than 100 mg daily to avoid toxic effects on the nervous system.
• Vitamin E. Some women take vitamin E supplements to help with breast tenderness related to PMS. But the effectiveness of these supplements is not known.¹⁰

Other mineral or herbal therapies sometimes used for PMS

• Zinc. Zinc may help improve PMS-related acne.
• Vitex (agnus-castus, or chasteberry). Although vitex's action on the body isn't well understood, it does seem to change hormone levels that affect ovulation and estrogen production.⁸ Studies have shown that vitex reduces irritability, anger, breast tenderness, bloating, cramping, and headaches.² Possible side effects include nausea, gastrointestinal upset, and malaise.⁸
• Ginkgo biloba. Ginkgo may reduce breast tenderness, bloating, and weight gain.² More study is necessary before ginkgo can be considered a proven PMS treatment.
• Black cohosh. One study has shown that black cohosh relieves PMS symptoms of anxiety, tension, and depression.² Experts do not know for sure if black cohosh causes liver problems. But they have determined that black cohosh products should be labeled with a statement of caution. Stop using black cohosh if you notice that you are weak or more tired than usual, you lose your appetite, or your skin or the whites of your eyes are yellowing. Call your doctor because these symptoms may mean you have liver damage.¹²
• Evening primrose (Oenothera biennis). The oil of evening primrose is a rich source of gamma-linolenic acid (GLA), an essential fatty acid, and may offer mild relief of breast tenderness. But most studies have not shown that evening primrose relieves PMS symptoms.^{2, 8}

What To Think About

You can buy vitamin and mineral supplements and herbal remedies in drugstores, grocery stores, or health food stores.

When trying an alternative therapy for PMS or PMDD, first try those that are most known to be effective. Try a therapy for two to three menstrual cycles: to be helpful, some therapies may require use for more than one cycle.

As with all supplements, it is important to follow the directions on the supplement label. Do not exceed the maximum dose. If you are trying to become pregnant but want some relief from your PMS symptoms, discuss using nutritional supplements and herbal remedies with your health professional. Certain supplements and remedies have side effects that should be avoided if you are trying to become pregnant.

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Author:	Sandy Jocoy, RN	Last Updated: June 19, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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