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Pre-Menstrual Syndrome (PMS)

Pre-Menstrual Syndrome, otherwise known as PMS and currently re-named Pre-Menstrual Dysphoric Dysorder (PMDD), is defined as symptoms beginning on or after ovulation and increasing in severity up until menses. Symptoms resolve with the onset of menses.

There are as many as 150 symptoms documented for PMS, the most common being:

  • breast tenderness
  • headaches
  • bloating
  • mood swings
  • anger
  • irritability
  • sadness
  • fatigue
  • food cravings

As many as 80% of women experience some type of physical or emotional changes with their cycle; however only 5% feel it has a significant negative impact on their lives.

Treatment with SSRI’s

Many women have self-treated with natural therapies to manage their PMS with good result. Early in September 2003, the food and drug administration approved the use of Paxil CR (paroxetine), an anti-depressant, for women suffering from PMS. Earlier in the year, Eli Lilly and company repackaged Prozac (fluoxetine hydrochloride) under the name Sarafem as a treatment for PMS.


The new naming of PMS to PMDD has allowed the drug companies to use selective serotonin re-uptake inhibitors or mood elevating drugs for the treatment of pre-menstrual symptoms. This approach is based on the studies of Anita Rapkin, M.D. who found that women with PMS had lower serotonin levels after ovulation.

Side effects of SSRI’s include: neurological disorders, sexual dysfunction, dizziness, nausea, and anxiety. Although this approach has some merit, from a Naturopathic perspective, it is important to treat the reasons why some women experience decreased serotonin levels after ovulation.

Treatment with Dietary Changes

Traditionally, women suffering from PMS have had dietary habits worse than the average American. Nutritional and dietary patterns must be addressed in treating the cause of the PMS. Refined carbohydrates (white flour), sugar, caffeine, excess dairy products, and alcohol can all contribute to PMS symptoms. Vitamin B6 has had a substantial effect on symptoms and is thought to increase the synthesis of several neurotransmitters in the brain. Although water soluble B6 is associated with toxicity at high levels and should never be taken at more than 50mg in one sitting. A good dose for PMS is 50mg 2-4 times a day.

Essential fatty acids (Flax, fish oils, evening primrose oil) increase prostaglandins in your body and contribute to decreased inflammation, and enhanced neurotransmitter communication at the cellular level. Magnesium can be used to resolve symptoms at 300mg 1-3 times/day. Specific herbal medicines can also be effective in PMS depending on what the main cause is.

Causes of PMS

PMS can come from a multitude of causes the most common being:

  • improper hormone balance
  • vitamin/mineral deficiency
  • essential fatty acid deficiency
  • poor nutritional and lifestyle habits leading to a congested liver
  • other conditions that worsen PMS symptoms

It is important to note that some women have other underlying conditions that will exacerbate PMS symptoms these can include, early menopause symptoms, major depressive or other mood disorders, eating disorders etc.