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.¹³
• Sleep deprivation therapy. Though not widely studied, limiting the amount of sleep you get for one night during your premenstrual phase may improve PMS or PMDD depression. After sleeping only 3 to 4 hours at the beginning or end of one night, women with PMDD have shown improved mood, especially after one recovery night of sleep.¹⁴ This is thought to be linked to a change in circadian rhythms, which seem to be abnormal in women with PMDD.¹⁵

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.⁵ A high level of calcium intake [1200 mg ], 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 with PMS have been found to have low magnesium levels, which are linked to abnormal levels of chemicals (prostaglandins) that increase pain and inflammation. Two or more months of daily magnesium has been shown to reduce premenstrual bloating (water retention).¹⁶ Magnesium is also likely to improve premenstrual pain and may improve negative mood.⁹
• 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.^{9, 10} Take no more than 100 mg daily to avoid toxic effects on the nervous system.
• Vitamin E. Taken during the premenstrual phase, this vitamin supplement is a recognized treatment for breast tenderness.¹ It may also reduce mood and physical symptoms.¹⁰ Improvement in weight gain, anxiety, headaches, sweet cravings, depression, insomnia, and low energy are possible.

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.⁹ Studies have shown that vitex reduces irritability, anger, breast tenderness, bloating, cramping, and headaches.² Possible side effects include nausea, gastrointestinal upset, and malaise.⁹
• 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
• Evening primrose (Oenothera biennis). The oil of evening primrose is a rich source of gamma-linolenic acid (GLA), an essential fatty acid, which is thought to affect prostaglandin effects, such as pain, on the body. It may offer mild relief of breast tenderness.¹ However, most studies have not shown that evening primrose relieves PMS symptoms.^{2, 9}

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:	Kathe Gallagher, MSW	Last Updated: July 7, 2006
Medical Review:	Renée M. Crichlow, MD - Family Medicine Kathleen Romito, MD - Family Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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