Premenstrual syndrome – or PMS for short – refers to a cyclical and recurring set of symptoms that occur 7 to 10 days before the onset of menstruation. Affecting up to 75% of women, PMS crops up in a predictable pattern, although individual symptoms (and their intensity) can vary from month to month.
Symptoms Of Premenstrual Syndrome
Spanning the physical, emotional, and behavioral, some of the most common PMS symptoms include:
- Abdominal cramps
- Joint pain
- Breast tenderness
- Acne flare-ups
- Fluid retention
- Mood swings
- Changes in appetite
- Poor concentration
- Social withdrawal
- Libido changes
When PMS is especially severe and debilitating, it is called premenstrual dysphoric disorder (PMDD), a much rarer form that affects between 3% to 8% of women.
What Causes PMS?
Although the exact cause of PMS is unknown, several biological factors have been identified that increase PMS symptoms. These include hormone fluctuations, reduced levels of serotonin in the brain, heightened inflammation, lower levels of calcium and magnesium in the body, and an increased sensitivity to prolactin.
While the symptoms of PMS usually subside on their own within the first four days of a woman’s period, experiencing PMS for a stretch of 10 to 14 days each month can have a massive impact on quality of life during one’s child bearing years. On average, a woman will endure 500 periods over the course of her lifetime.
Conventional treatment for premenstrual syndrome include non-steroidal anti-inflammatory drugs to manage pain and anti-depressants to combat mood related symptoms. But these medications, taken over the long-term, carry their own drawbacks and worrisome side effects.
Given these options, many women simply grin and bear it. There are, however, several alternatives that have been shown to be safe and effective for the full spectrum of PMS symptoms…
1. Johns Wort
Long used as a natural anti-depressant, St. John’s wort (Hypericum perforatum) is an herbal remedy that possesses anti-inflammatory properties. It also influences serotonin receptors in the brain that help to regulate mood.
To investigate the effects of St. John’s wort on the symptoms of PMS, researchers recruited 36 women with mild PMS to receive either 900 mg of St. John’s wort supplements or placebo for two menstrual cycles. The 2010 study found that St. John’s wort improved physical and behavioral symptoms of PMS, such as food cravings, bloating, insomnia, headaches, fatigue, and crying spells.
Mood and pain related symptoms, like anxiety, irritability, cramping, and breast tenderness, were not significantly relieved with St. John’s wort. However, some pain related symptoms appeared to improve towards the end of the treatment period, leading researchers to speculate that taking this herb for more than two months may have a beneficial effect on these types of symptoms as well.
Since one of the biological factors of PMS is deficient levels of calcium within the body, supplementing with calcium may help relieve many of the mood-related symptoms of PMS.
Published in Obstetrics & Gynecology Science, a 2017 study involved 66 women who were randomly assigned to receive 500 mg of calcium daily or placebo for two months. Compared with baselines and control groups, those who supplemented with calcium had significant reductions in anxiety and depression; this group was also less emotional, retained less water, and experienced a reduction in somatic symptoms like bloating, breast tenderness, and joint pain.
The recommended daily intake for calcium is 1,000 mg per day for most adults. To ensure you are getting enough calcium in your diet, try to include calcium rich foods like milk, cheese, yogurt, and other dairy products into your meals. Other sources include leafy greens, seafood, tofu, and legumes. You can even eat eggshells for a quick calcium fix.
Native to the Mediterranean and Central Asia, chasteberry (Vitex agnus-castus) refers to the fruit of the chaste tree. First used by monks in the middle ages to decrease sexual desire (hence the name), chasteberry is now taken as a supplement for a range of women’s health conditions like infertility, menstrual problems, and menopause.
In a 2012 systematic review of its impact on a variety of female reproductive issues, researchers analyzed eight clinical trials that involved using chasteberry extracts to treat premenstrual syndrome. Of these, seven studies found that chasteberry was superior to placebo.
Overall, chasteberry helped improve both the physical and psychological symptoms of PMS. It reduced headaches, nervousness, restlessness, depression, breast pain, bloating, back pain, menstrual pain, fatigue, irritability, and sleep disturbances with minimal adverse effects.
Chasteberry is available as a dietary supplement that can be purchased here. Since this herbal remedy interacts with hormones and dopamine receptors in the brain, be sure to speak with your doctor before taking chasteberry if you use birth control pills, antipsychotic medications, or hormone therapies.
The red spice with a subtly sweet and earthy aroma, saffron (Crocus sativus) has a long history of use as a seasoning, perfume, dye, and medicinal herb that stretches back three millennia.
Used traditionally as an antidepressant, saffron also appears to be effective for the symptoms of PMS. In a 2007 study, 50 women with PMS were assigned to receive either 30 mg of saffron or placebo each day for two menstrual cycles. Researchers evaluated treatments with a daily symptom report (a checklist of 17 symptoms spanning mood, behavior, pain, and physical ailments) as well as depression rating scales, and found that women in the saffron group reported a significant reduction in symptoms compared to the control group. In total, 76% of women in the saffron group experienced a 50% reduction in severity of daily symptoms.
To ensure a consistent and therapeutic dose, saffron is best taken as a dietary supplement, which can be purchased here.
5. Magnesium & Vitamin B6
Another aggravating factor for PMS is low levels of magnesium in the body. Women who suffer from PMS typically have lower levels of this essential mineral than women without PMS. Though magnesium plays many roles in human biology, it may help prevent menstrual cramping and pain by relaxing the muscles in the uterus.
To investigate the effects of magnesium supplementation on PMS, researchers recruited 150 women diagnosed with premenstrual syndrome in a 2010 study. The women were randomly assigned to receive placebo, 250 mg of magnesium, or 250 mg of magnesium with 40 mg of vitamin B6 each day for two months. Vitamin B6 helps the body make serotonin and norepinephrine, hormones that regulate mood and stress response.
Although the magnesium supplements proved effective for many of the symptoms of PMS, the combination of magnesium and vitamin B6 showed a more dramatic reduction in depression, anxiety, food cravings, water retention, and pain.
While magnesium and vitamin B6 can be found in many foods, you’ll have to eat quite a lot of avocados to reach a therapeutic dose for the management of PMS. We recommend these 250 mg magnesium soft gels by Nature Made and 40 mg vitamin B6 capsules by Vita 1.
6. Krill Oil
Omega-3 fatty acids play a vital role within the membranes that surround each cell in your body. These widely studied polyunsaturated fats help to make hormones, control inflammatory processes, and regulate genetic functions. People who obtain plenty of omega-3 fats in their diet have a greater protection against many types of diseases, from heart disease to cancer to Alzheimer’s. Omega-3 fatty acids are essential and can only be obtained by eating foods like fish, nuts, and flaxseed.
Research has found that women with PMS have an abnormal fatty acid metabolism, with heightened levels of omega-6 fats that trigger pro-inflammatory responses. Normally omega-3s would compete with the omega-6 fats to secrete anti-inflammatory prostaglandins to help reduce pelvic contractions and pain.
While fish oils will provide omega-3 fatty acids, krill oil is an particularly excellent source. Not only is krill rich in omega-3 fats, it is easier for the body to absorb than other fish oils. It is also enriched with astaxanthin, an extremely powerful antioxidant with its own suite of health benefits.
Compared with omega-3 fish oil, krill was found to be more effective for managing the symptoms of PMS. In the 2003 study, 70 patients with PMS were assigned to take 1,000 mg of krill oil or fish oil daily for three months. Assessed at the 45-day and 90-day marks, the women who took krill oil had increasing improvements across all physical and emotional symptoms, including depression, abdominal pain, breast tenderness, irritability, joint pain, and bloating. The omega-3 fish oil group, on the other hand, only experienced improvements in weight gain and abdominal pain. This disparity is possibly due to krill oil having enhanced bioavailability.
When purchasing krill oil, look for sustainably sourced brands like this bottle by Spring Of Life.