What is PMS

It is not exactly known what PMS is or where it comes from. For many women is seems to be genetically linked, or perhaps behaviourally learned from mothers as 70% of all women with PMS have mothers who also have PMS symptoms. Genetic and environmental factors may be related to abnormalities in what scientists term the neuroendocrine axis of the brain and body, where female hormones may act as neurotransmitters in the brain. While some believe it may be specific to progesterone and serotonin, others believe it may be linked to a lower amount of specific prostaglandins being produced.

PMS is definitely stress related; universally women who experience high amounts of stress are most likely to describe their symptoms of PMS as most severe. Some speculate that biological, social and behavioural stress is the most likely predictor of having PMS.

The term premenstrual dysphoric disorder (PMDD) is a similar condition but refers more to mental state than physical symptoms. There is a significant overlap between PMDD and depression.

Also called premenstrual syndrome, PMS, premenstrual mood disorder, premenstrual dysphoric disorder (PMDD).

Symptoms of PMS

Usually includes feelings physical symptoms of fatigue, bloating, water retention, gastric upset, breast tenderness, headache, food cravings backache. It may be combined with changes in mood- anxiety, irritability, sadness and anger.

Symptoms start at mid cycle, near ovulation and last a few days to a week before menses. For most women the symptoms are absent during the menstrual period itself.

Diagnosis and Pharmaceutical Interventions

There are no accurate diagnosis of PMS, however some organization have criteria lists for helping clinicians with a diagnosis For instance the University of California at San Diego gives this list:

  1. At least one of the following affective and somatic symptoms during the five days before menses in each of the three previous cycles:
  2. Affective symptoms: depression, angry outbursts, irritability, anxiety, confusion, social withdrawal
  3. Somatic symptoms: breast tenderness, abdominal bloating, headache, swelling of extremities
  4. Symptoms relieved from days 4 through 13 of the menstrual cycle

PMDD has a different set of diagnostic criteria, for it considered more a mood disorder than physical illness.

Pharmaceutical Medications

The standard medical treatments for PMS consist of oral birth control pills.

The standard medical treatment for PMDD is antidepressants.

Lifestyle and Dietary Modifications

Diet definitely can help ease the symptoms of PMS. A number of foods have been shown to have a negative effect on menstrual cycles: sugar, alcohol, coffee, red meat.

Sugar is one culprit acknowledged by many to have adverse effects. Sugar not only impacts blood sugar, and therefore moods, but it can increase levels of oestrogen. Alcohol, which is a carbohydrate- like molecule can be looked at the same way.

And alcohol causes decreased liver function, a factor for women because hormones are metabolised and detoxified in the liver and eliminated in the body. When there is poor liver function the hormones may not be eliminated properly.

Excess coffee works in a similar fashion to alcohol, and also has been shown to cause fluctuations in blood sugar.

Women who consume large amount of red meat may experience more PMS than vegetarian women. Red meat increases the body’s production of Arachadonic acid, which can cause pain producing chemical to be created in the uterus.

Lifestyle modifications


Women who exercise regularly can have a reduction in PMS physical symptoms, as shown in a study where women that jogged have a reduction in breast tenderness and fluid retention. It has also been shown that exercise significantly improve symptom associated with the emotional aspect of PMS.


Reducing stress and proper self care will not only reduce your PMS symptoms, but it will make you fell better as well! Simple ways of stress reduction include exercise, eating nutritious food and getting enough sleep. Meditation exercises such as yoga or tai chi are also excellent ways to reduce stress and feel the immediate effects. Mediation itself is a valuable therapeutic tool.

Nutritional Factors Shown to be Beneficial

Vitamin B6

Vitamin B6, also called pyridoxine or pyridoxal 5 phosphate, has been studied for the relief of PMS symptoms with good success. Pyridoxine is needed for several enzymatic reactions in the body, including the conversion of serotonin and some pathways to pain relieving prostaglandins. Dose of Vitamin B6 is 50 -100 mg day

There have been reported side effects to Vitamin B6 when used at high doses (>200 mg a day); most common is a neuropathy (tingling sensation, loss of tactile sensation, loss of muscle coordination and degeneration of muscle tissue) in the feet. Any dose over 100 mg a day should be done under the supervision of a health care professional.


Blood levels of Magnesium have been lower in females with PMS. Magnesium works with Vitamin B6 in several enzymatic pathways in the body, so it can be beneficial to take them together.
Dose: 300 mg 1-3 times a day.

Chaste berry (Vitex agnus castus)

This herb has been used for the treatment of PMS; it elevates level so of the pituitary hormone prolactin, which in turn elevates levels of progesterone.
Dose: Vitex is best given in the morning as soon as possible after waking. Usual doses of capsules are 175- 225 mg per day, if taking a liquid extract 2 ml (40 drops). Vitex should be used for at least 3 cycles before results may be seen.

Esssential Fatty Acid’s

Women with PMS tend to have problems with the fatty acid conversion to gamma linoleic acid and subsequent prostaglandins the body produces for pain relief. Fish oils contain high amounts of fatty acids EPA and DHA, FA which increase pain relieving prostanoid chemicals.

Woman who experience breast tenderness may respond better to Evening primrose oil, which has high amounts of GLA
Dose of EFA: 200-500 mg a day.


Women taking 1200 mg of calcium have fewer symptoms of PMS compared to placebo. Calcium not only helps with symptoms of PMS, but a higher calcium diet before menopause is thought to reduce the demineralization in bone brought on by osteoporosis.
Dose: 1200 mg calcium a day.

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