Understanding Pre-Menstrual Syndrome (PMS)
Articles - Health Issues

Fifteen years ago, doctors claimed that PMS did not exist Today, it's one of the most common conditions suffered by women, with symptoms that can be anything from mildly inconvenient to utterly debilitating. PMS is estimated to affect between 70 and 90 per cent of women. Between 30 and 40 per cent of women are believed to have symptoms severe enough to interfere with their daily lives. .

What is PMS?

This is a term used to describe any symptoms that occur after ovulation and disappear almost as soon as the period arrives. The crucial point is not what symptoms are experienced, but when.

What are the Symptoms?

Over 150 symptoms are now believed to form part of the syndrome, and these include:

  • Mood swings
  • Irritability
  • Anxiety and tension
  • Bloating
  • Breast tenderness and swelling
  • Water retention
  • Acne
  • Tiredness
  • Weight gain
  • Headaches/migraines
  • Crying spells
  • Depression
  • Sugar and food cravings
  • Constipation
  • Dizziness

The personality changes associated with this lime of the month can be very severe. Indeed, some women describe a 'Jekyll and Hyde' change, in which they literally become a different person pre-menstrually.

Risk Factors

There are a number of risk factors that can make a woman more likely to suffer from PMS. They include:

  • Being in her thirties or forties
  • Having had two or more children
  • Having a mother who suffered from PMS
  • Having recently experienced a hormonal upheaval, such as having a baby, termination or miscarriage, being sterilised or coming off the pill
  • Experiencing several pregnancies in quick succession

What Causes PMS?

From a conventional viewpoint, there is no answer to this question. There has been an enormous amount of research into PMS and an equally enormous amount of confusion in terms of its cause and treatment.

One of the main reasons for the confusion is that PMS is clearly a hormonal problem. But when scientists examine two groups of women in the second half of their cycles, one with PMS and one without, any difference between the hormone profiles can be found.

It is assumed that PMS has an effect on a woman's general health by giving her any number of 150 different symptoms. But what if the situation is really the other way round? In other words, what if that woman's general health is what's causing PMS to manifest itself?

If a woman has not been eating well, maybe lacking in certain vitamins and minerals, not exercising, suffering from stress and generally feeling run down, it is very possible that her body's ability to produce the right balance of hormones and to utilise those hormones properly each cycle will be seriously compromised.

Diagnosis of PMS

Doctors are taught at medical school to diagnose by symptoms. PMS is a condition that should be diagnosed by timing, not symptoms, and therein lies the problem from the conventional medical point of view.

The best way to know whether a woman has PMS is to keep a menstrual diary. She would write down what symptoms she is experiencing and when they occur. There must be almost a week free of symptoms before they start again.

What Natural Treatments could be Effective?

The aim is not to look at all the different symptoms but to work on the overall lifestyle to ensure optimum health and well-being. This means making sure that the woman is eating well, correcting any vitamin and mineral deficiencies, getting enough sleep, reducing stress levels and using herbs that have been shown to help with PMS.

Dietary changes

Food is the foundation of health and it is the most important aspect of preventing and treating PMS.

Blood sugar

Of all the different dietary changes, this is the most crucial one for eliminating PMS. it has been found that the higher the sugar content of the diet, the more severe the pro-menstrual symptoms. Sugar should be eliminated completely.

Alcohol should also be eliminated, or drastically reduced. The absence of alcohol gives the liver a rest so that it can detoxify and excrete old hormones efficiently; it also helps with blood sugar fluctuations.

Eating little and often is important to keep blood sugar levels even and to stop adrenaline being released. Adrenaline blocks the uptake of progesterone in the second half of the cycle.


When breast tenderness is one of the main premenstrual symptoms, caffeine in any foods or drinks should be avoided. The active ingredients in caffeine are called methylxanthines and they have been proved to increase problems with painful, lumpy and lender breasts.


Supplement are suggested to help get the woman back to optimum health. They ensure that the body has enough of the essential nutrients it needs to balance hormones.

Vitamin B6

Researchers have found that daily doses of vitamin B6 are twice as effective as the placebo treatment Vitamin B6 plays a vital part in synthesising certain neurotransmitters mat control mood and behaviour. It is required as a coenzyme in the production of dopamine, tryptophan and serotonin.


Magnesium is classed as 'nature's tranquilliser' and is. therefore, vital in symptoms that relate to anxiety, tension, or other emotional states. Women with PMS have been found to have lower levels of red blood cell magnesium than women who don't suffer symptoms. The supplementation of magnesium has been found to be extremely useful in alleviating many of the PMS symptoms and even more effective when taken with vitamin B6 at the same lime.

A magnesium deficiency can cause blood vessels to go into spasms, so if the woman suffers from menstrual migraines, magnesium can be useful in preventing these spasms.


Zinc is an important mineral because it is a component of more than 200 enzymes. It helps the conversion of linoleic acid to GLA and it also plays a major part in the proper action of many of our hormones, including the sex hormones and insulin Women win PMS have been found to have lower levels of zinc.

Essential Fatty Acids (EFAs)

The Omega 6 series of fatty acids, linoleic acid, is converted to gamma linolenic acid (GLA), which is found in plants such as evening primrose, borage and starflower. Many women with PMS have been found to have a problem making this conversion to GLA. There are a number of factors that can prevent the conversion of linoleic acid into GLA, including stress, a high-sugar diet, and deficiencies of B6, magnesium and zinc.

A number of studies have shown that evening primrose oil (EPO) is effective in reducing the symptoms of PMS whereas other studies have shown that EPO was no more effective than a placebo The interesting point is that the best results with EPO occurred when women were also taking either B6 or a multivitamin at the same time which again confirms that supplements should not be taken in isolation.

Research has also shown that EPO may be most helpful to women whose main pre-menstrual symptom is breast tenderness or fibrocystic breast disease. EPO needs to be taken for about three months to be effective.


The aim with the herbs is to help correct any hormone imbalances. Also included are some herbs for water retention (which may be a particular problem), and herbs for the health of the liver, which helps to detoxify and excrete 'old' hormones.

Agnus castus (Vitex / chaste tree berry)

This is the most important herb in the treatment of PMS. It has been widely studied in relation to PMS and has been shown to be extremely helpful in re-establishing a normal balance of hormones. Agnus castus works on the pituitary gland and has a balancing effect on the hormones. particularly in the second half of the cycle.

Black cohosh (Cicimicifuga racemosa)

This herb was used by the Native North Americans, it is a good normaliser for the female reproductive system and can be useful for PMS. II has a generally calming effect on the nervous system and, as well as having a balancing effect on the hormones, it can be helpful when your main symptoms are anxiety, tension, depression and headaches.

Dong quai (Angelica sinensis)

Dong quai can be helpful for PMS symptoms because it promotes normal hormone balance. Dong quai also has muscle-relaxing qualities SO it is particularly suggested for women who experience pre-menstrual pain and cramp.

Dandelion (Taraxacum officinale)

Dandelion is the herb of choice for water retention because it is a natural diuretic that allows fluid to be released without losing vital nutrients at the same time. It also helps to improve liver function.

Milk thistle (Silybum mariamim)

Milk thistle is an excellent herb for the liver. A number of studies have shown that it can increase the number of new liver cells to replace old damaged ones.


Exercise is important for general health but it is also important to eliminate PMS symptoms. Exercise releases brain chemicals, called 'endorphins', which help us to feel happier, more alert and calmer.


This is an important factor in PMS because of the effects of adrenaline. Unfortunately, adrenaline prevents the body from being able to use progesterone property in the second half of the cycle. Ways of coping with stress need to be investigated. such as relaxation techniques, yoga, meditation, reflexology, aromatherapy, etc.

Dr Marilyn Glenville PhD is the UK's leading nutritional therapist specialising in female hormone problems. She is President Elect of the Forum for Food and Health at the Royal Society of Medicine and a registered nutritionist, Dr Glenville is the author of a number of Internationally bestselling books, including Overcoming PMS the Natural Way, Fat around the Middle, Natural Solutions to Infertility, New Natural Alternatives to HRT and The Nutritional Health Handbook for Women. She works in a gynecology clinic in London.

For more in-depth information visit Marilyn's website www.marilynglenville.com.

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