(Published Positive Health Magazine 2006)

Many of the earth’s natural processes are characterised by cyclical change: the seasons, the climate, the waxing and waning of the moon and tidal movements of the seas. A woman’s body reflects this in the cycle of hormones bringing rises and falls of energy, activity and passivity and changing patterns of feelings and desires. Although these changes may be viewed negatively, such cycles are part of a woman’s life. Our hormone balance can affect our general sense of well being, our resilience to stress, efficiency at work, concentration when driving, our ability to care for our children……Tuning in our cyclical nature and living our lives accordingly, not expecting ourselves to behave like machines, may help to take off some of the pressure and allow us to get the best out of our feminine ability to feel, to understand intuitively, to nurture and to care for others. Having said this when our menstrual cycles are disturbed

PMS is one of the most common conditions suffered by women today with symptoms that can range from being mildly annoying to actually incapacitating. It is estimated that 70-90% of menstruating women suffer from PMS and 30-40% of women have symptoms that are so severe they interfere with their normal lives.(1) The uncontrollable emotional changes that frequently occur with PMS have been described as the “Jekyll and Hyde syndrome” and surveys have shown that over half of all sufferers have even experienced suicidal feelings at some time premenstrually. (2)

PMS is a term coined back in 1931 that covers a multitude of symptoms occurring in the second half of the menstrual cycle from ovulation onwards, and relieved spontaneously at the onset of bleeding. Over 150 symptoms have been attributed to PMS including mood swings, irritability, crying, depression, tension and anxiety, fluid retention, weight gain, breast tenderness and swelling, abdominal bloating, acne, constipation, nausea, sugar cravings, binge eating, headaches and migraine, tiredness and lethargy, clumsiness, poor concentration, insomnia and dizziness. On the positive side some women experience greater depth of feeling, creativity, self expression, increased energy, motivation and assertiveness.

So how can PMS be successfully treated? One of the difficulties from a medical point of view is that PMS is not a condition that can be viewed under the microscope, for blood hormone profiles of women suffering PMS symptoms do not differ significantly from those who are symptom free. Numerous theories, both physical and psychological, about the causes of PMS been investigated widely. These include oestrogen excess, progesterone deficiency, vitamin B or vitamin A deficiency, high prolactin levels, decreased serotonin uptake, endorphin deficiency, prostaglandin imbalances, allergies and stress. (3) There is some common agreement however that PMS is more of a lifestyle problem. Because it is related to the menstrual cycle PMS is quite clearly associated with hormone balance and this in turn is influenced by many factors in our daily lives, including diet and nutrition, digestion and absorption of nutrients, liver function, sugar and caffeine intake, stress levels, and exercise. Women suffering from PMS need to ensure that they eat well, balance sugar levels through correct eating, rectify any vitamin and mineral deficiencies, (the most common of which include vitamin B6 and E, zinc, magnesium and essential fatty acids,) find enough time to relax and relieve stress, have plenty of sleep, and regular exercise.

In addition to such therapeutic strategies, there are several very effective herbs which can safely be taken to balance hormones and relieve PMS so that the menstrual cycle can be relatively trouble free. The most important herb for the treatment of PMS is Vitex Agnus Castus. It has been widely studied in relation to PMS and shown to be very helpful in reestablishing normal hormone balance. In a study reported in the British Medical Journal, Vitex was given to women with PMS over three menstrual cycles. (4). Over half of the women had 50% or more improvement in symptoms including mood swings, headaches and breast congestion compared to those in the placebo group. Vitex works primarily on the pituitary gland and has a predominantly progesteronic effect, enhancing the secretion of progesterone from the corpus luteum in the second half of the cycle. In my experience and that of other practising herbalists, Vitex needs to be taken daily over a period of at least three to six months for lasting results, although improvement in PMS symptoms are generally noted within the first cycle after commencing treatment.

Water retention and its associated symptoms such as abdominal bloating, overweight, breast swelling and tenderness, and a feeling of fullness and heaviness is an uncomfortable and all too common part of the PMS picture. It should gradually diminish as the body returns to balance over a few months of treatment. To relieve the discomfort in the meantime there are some excellent diuretic herbs that will eliminate excess fluid by increasing the flow of urine which can be taken during the second half of each cycle. Cleavers and burdock root are good examples of these. Cleavers (Galium aparine) is an excellent diuretic, clearing excess fluid and toxins from the system and promoting lymphatic drainage of wastes so that they can be eliminated via the urinary system. Taken regularly during the premenstrual phase, it is an excellent herb for fluid retention, bloating, skin problems including acne, and congestion of the breasts.

Spots and acne, the curse not only of teenage girls but also women up to their fifties, are also related to the menstrual cycle and can often be significantly worse premenstrually. While other symptoms of PMS may be hard to bear internally, skin problems can be seen by others, bringing embarrassment, self consciousness and lack of self confidence, and causing stress which in turn aggravates hormonal problems and creates a viscious circle. Burdock root (Arctium lappa) is a wonderful blood cleanser and detoxifying herb. It has traditionally been a first choice in herbs for treating stubborn skin conditions such as acne. By stimulating both kidneys and bowels, burdock has diuretic and laxative actions, and hastens the elimination of toxins from the body. It contains bitter substances that stimulate the liver, the great detoxifying organ of the body and one that plays a significant role in the maintenance of hormone balance in the body. It is also an effective antibacterial and antifungal herb and is rich in a compound called inulin which feeds beneficial bacteria in the gut and in this way discourages the proliferation of pathogenic organisms such as candida in the bowel. (5). There are further benefits from burdock in relation to hormone balance. Burdock is rich in magnesium, and research has shown that 50% of women with PMS have low levels of magnesium, a mineral which is vital for normal brain chemical metabolism.(6) Supplements of magnesium can significantly relieve PMS symptoms such as mood swings, tearfulness, depression, tension and anxiety. It is also rich in zinc which is vital for normal hormone balance.

If you are taking such herbs in conjunction with other self help measures, you may expect improvements over a three to six month period but herbs may need to be taken for a longer period for lasting effect. This will depend on factors such as hereditary tendencies, general health and vitality, diet and lifestyle. During this time you can rest assured that such herbs have been used to remedy symptoms described over centuries and there is little to no evidence of any adverse reactions. These herbs are amongst those central to my treatment of PMS and I am sure my practice would be impoverished without them.

(1)Glenville M. PhD. The Natural Health Handbook For Women. Paitkus. London.2001

(2) Stewart M. & Dr. A, Every Woman’s Health Guide. Headline Books, UK, 1997

(3) Lonsdorf N MD, Butler V MD, Brown M PhD. A woman’s Best Medicine. Tarcher/ Putnam, NY, USA 1995

(4)Schellenberg R. Treatment for the premennstrual syndrome with agnus castus fruit extract. BMJ 2001; 322:134-137 (20 January)

(5)Tillotson A.K. PhD. The one Earth Herbal Sourcebook. Kensington Books, New York, 2001
(6) Stewart M. & Dr. A, Every Woman’s Health Guide. Headline Books, IK, 1997