Premenstrual Syndrome (PMS)
20 Case Studies
38 Member Stories
2281 Research

What is PMS?

Premenstrual syndrome (PMS) is one of the significant health issues for childbearing-age girls. Both physical and mental symptoms can impact health and quality of life. Epidemiological studies reveal that 75 percent of fertile women have mild to moderate symptoms of PMS; 3-8% may experience acute symptoms. Hormonal dysfunction may affect mood, sleep, and appetite and result in symptoms like stress, pain, hot flashes, and even memory impairment. How do Functional Medicine practitioners help patients with these issues? There is not a specific hormone included in [PMS], but a balance between many hormones.

What causes PMS?

PMS's actual reason is simply this: Your hormones become unbalanced, your estrogen levels increase, and progesterone levels fall, either relatively or absolutely. Everyone knows that caffeine, sugar, alcohol, anxiety, and lack of exercise contribute to worsening PMS. Additionally, it is a fact that dairy intake can worsen hormonal imbalances due to all of the hormones in milk. Functional medicine uses an approach to deal with based on systems biology. This approach tries to find the hormonal imbalance, address the root causes such as diet and lifestyle, and help the body regain hormonal equilibrium. The body's natural intellect can then begin the healing process.

Imbalances in the gut bacteria and constipation can aggravate the situation, since they contribute to the reabsorption of estrogen in the gut into your bloodstream, even after your liver has attempted to eliminate it. Your body depends on p exercise to help balance hormones. Therefore, if you are not moving enough, it can be a part of the problem also. Fortunately, evidence from science and research proves that there many ways to have hormones back in the balance. 

PMS Symptoms

PMS can cause women to be severely depressed, exhausted, and nervous and endure severe sugar and food cravings, which in turn can lead to overeating and weight gain. Gas and bloating, hair loss, memory problems, heavy bleeding, hot flashes, joint pain, breast tenderness, dry skin, acne, poor sleep, and no sex drive are typical symptoms.

If PMS is an unwelcome monthly guest, you can try to end your suffering using Functional Medicine's systems biology approach.  A simple lifestyle and dietary interventions can help you to do that.  

See: Fibromyalgia, Infection, PMS and Hot Flashes with Bisoma and Tetrasoma Acupuncture

Functional medicine approach for PMS

Traditional medicine usually has one of two choices to offer you if you're searching for relief from PMS or PMDD: take an oral contraceptive, or take an antidepressant for the two weeks before your period each month. Both these choices can have side effects and even make some symptoms worse. And ultimately, they do not address the source of your PMS. If you stop taking the pill or the antidepressant and your PMS will come right back again.

Functional medicine tries to determine the underlying cause of the premenstrual symptoms are can begin with natural approaches to managing the PMS symptoms. Functional medicine comes from a practical perspective is addressing the real underlying hormonal imbalances and causes. High-stress hormones can be one of the top contributors to PMS, lack of sufficient nutrients such as B vitamins and magnesium, and a lack of sleep, which can be critically important in hormonal balancing.

Functional medicine starts with testing to evaluate hormone balance, nutrient deficiencies, gut health, and inflammatory markers to get a comprehensive picture of the many imbalances contributing to a PMS/PMDD. Only then do experts create your treatment plan from there with recommendations made based on your unique laboratory results.

See: Seed Cycling For Hormone Balancing

Functional medicine remedies for PMS

Functional medicine ideas to get rid of PMS

The specific cause of PMS is unclear. We do know that hormonal changes the week or two before your period play a role- particularly associated with progesterone (too small ) and estrogen (too much). There's also research indicating that inflammation plays a role in premenstrual and menstrual symptom severity. Other factors that can contribute to PMS symptoms are poor nutrition and lack of exercise, environmental toxins, stress and anxiety, poor sleeping habits

- Dietary modifications

Ensuring that your body is getting sufficient amounts of nutrients that support hormone balance, which might include cruciferous vegetables to modulate estrogen, resources of Omega-3 fatty acids to help reduce inflammation, higher quality protein to help your body create necessary hormones, and also at least 25 grams of fiber daily to ensure good gut health. Ensuring that you are eating in ways that help to maximize your blood glucose balance is also very important. This means:

Balance your blood sugar by eating protein for breakfast.

Stop eating processed foods.

Cut out caffeine.

Quit drinking alcohol.

Eat equally throughout the day

Do not skip meals.

Do not eat within three hours of bedtime.

Cut out all milk and consider removing other common allergens for a month or two, particularly gluten.

You can increase fiber in your diet from fresh vegetables, fruit, seeds, nuts, beans, and whole grains. Two tablespoons of soil flax seeds per day are particularly beneficial in correcting constipation and balancing hormones. Place them in a shake or sprinkle them on salads or meals.

Boost omega-3 fats by eating more wild fish such as sardines, herring, and wild salmon, in addition to omega-3 walnuts and eggs.

Eat organic food, particularly animal products, to prevent environmental estrogens from pesticides.

Lifestyle changes: Making it a high priority for at least 8-hours of sleep each night and finding ways to reduce your stress levels is super important. Anxiety has a huge negative effect on the human body and can cause any hormone imbalance you have worse. Regular exercise, meditation, and links to other people in your life are all ways to decrease stress levels.

- Supplements for PMS.

Vitamin B6 has been demonstrated to work in treating PMS symptoms associated with imbalanced progesterone, while Chaste tree berry helps our body to produce more testosterone that could help rebalance estrogen levels and subsequently reduce PMS symptoms. Oftentimes, vitamin D deficiency has been linked to PMS symptoms, and restoring those amounts is critical to hormone support. A range of supplements has been proven to help alleviate PMS symptoms by enhancing metabolic function and hormone metabolism. You can consider the following:

- Vitamin B6 

- Evening primrose oil 

- Magnesium citrate or glycinate 

- Calcium citrate 

- EPA/DHA (omega 3 fats) 

- Taurine 

- A daily multivitamin with all of the nutrients can be the easiest one to take.

- Herbs for PMS

Herbs and phytonutrients may also be very valuable. Some of the most effective are:

- Chasteberry fruit extract (Vitex Agnus-Castus) can help to balance the hormones. 

- Isoflavones from red clover, kudzu root, or soy enhance estrogen detoxification. They may be consumed in the diet or taken as supplements.

- Wild yam (Dioscorea villosa) can help relieve menstrual cramps and regulate cycles.

- Dandelion root can assist with liver detoxification and functions as a diuretic.

- Flax seeds contain lignans that help prevent the unwanted effects of excessive estrogens and balance hormone metabolism.

- Chinese herbal formulations may also help. Among the most successful is Xiao Yao San, or Rambling Powder. It comprises: Dong Quai Root (Angelica Sinensis), Bai-Zhu Atractylodes Root (Atractylodes macrocephala), Bupleurum Root (Bupleurum chinense), Ginger Rhizome (Zingiber officinale), Chinese Peony Root (Paeonia lactiflora), Chinese Licorice Root (Glycyrrhiza uralensis), Poria Sclerotium (Poria cocos), and Chinese Mint Leaf (Mentha haplocalyx)

- Replacing healthy bacteria in the gut helps normalize hormone and estrogen metabolism. A daily probiotic supplement can help.

- Physical activity & Exercise

Exercise is extremely important for balancing hormones. You need to get in 30 minutes of aerobic exercise, 4 to 5 times per week.

- Reduce stress.

Handling stress is also crucial. Have a hot tub at night,  try yoga, learn deep breathing or meditation, or get a massage. These techniques can help you balance hormones.

- Complementary & alternative therapies.

Therapies, such as Ayurveda, yoga, acupuncture, and homeopathy, can help. One clinical trial demonstrated that individualized treatment is effective in treating PMS. Five homeopathic medications were used: Nux vomica, Pulsatilla, Lachesis, Natrum muriaticum, and Sepia. A strategy like this can have impressive results on premenstrual symptoms.

There are better options available for handling PMS and PMDD than moving right to the pill or an antidepressant. Though in the end, those might be the vital treatments for some women afflicted by acute symptoms-- there are several effective, evidenced-based organic remedies for managing PMS/PMDD.


See: Yoga & meditation for natural stress relief

Science & research for PMS

In a January 2020 research printed in the Journal of Alternative and Complementary Medicine- 72 women with PMS were awarded either 80 mg of Vitamin B6 or a broad-spectrum micronutrient formula (multivitamin) to carry daily for three consecutive menstrual cycles. The results were impressive in that 72 percent of those taking the micronutrient formula and 60 percent of those women taking 80 milligrams of vitamin B6 group identified as being in full remission from PMS symptoms after three cycles and had few to no side effects.

Magnesium is also an integral nutrient that may help alleviate mood swings, headaches, and sugar cravings associated with PMS.

One study found that combining a vitamin D and calcium supplement with cognitive behavioral therapy was helpful for PMS. Another study found that a multivitamin and multimineral supplement relieved many symptoms.

In general, a healthy eating pattern may be protective against PMS. B vitamins dietary consumption is also correlated with decreased PMS risk, although supplementing with the same vitamins did not demonstrate the same impact. Supporting the notion of dietary patterns mattering for PMS symptoms, a traditional Western diet was associated with increased PMS risk, as has the consumption of junk food and dysmenorrhea. Dietary modifications can make a difference. As an example, within a three-month interval, replacing four servings a day of refined grains with whole grains reduced PMS symptoms significantly in a cohort of mature women.

See: Ayurveda for PMS symptoms

Summary

Functional Medicine treatment for someone with PMS can consist of diet, lifestyle factors, stress, and exercise. This approach to PMS looks at the entire patient through the lens of systems biology and examines the root cause of hormonal dysregulation. Addressing lifestyle factors initially, such as diet and nutrition, can often relieve symptoms without the need for additional treatment.

See: Why Magnesium is important for your diet

References

1. IFM, https://www.ifm.org/news-insights/womhorm-functional-medicine-approach-pms/

2. Dr. Hyman, https://drhyman.com/blog/2010/09/17/how-to-eliminate-pms-in-5-simple-steps/

3. Arab A, Golpour-Hamedani S, Rafie N. The association between vitamin D and the premenstrual syndrome: a systematic review and meta-analysis of current literature. J Am Coll Nutr. Published online May 10, 2019. DOI:1080/07315724.2019.1566036

4. Tartagni M, Cicinelli MV, Tartagni MV, et al. Vitamin D supplementation for premenstrual syndrome-related mood disorders in adolescents with severe hypovitaminosis D. J Pediatr Adolesc Gynecol. 2016;29(4):357-361. DOI:1016/j.jpag.2015.12.006

5. Saeedian KA, Amani R, Cheraghian B. The association between the risk of premenstrual syndrome and vitamin D, calcium, and magnesium status among university students: a case-control study. Health Promot Perspect. 2015;5(3):225-230. DOI:15171/hpp.2015.027

6. Boyle NB, Lawton C, Dye L. The effects of magnesium supplementation on subjective anxiety and stress – a systematic review. Nutrients. 2017;9(5): E429. DOI:3390/nu9050429

7. Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Women's Ment Health. 2017;20(6):713-719. DOI:1007/s00737-017-0791-0

8. Bahrami A, Avan A, Sadeghnia HR, et al. High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescents. Gynecol Endocrinol. 2018;34(8):659-663. doi:1080/09513590.2017.1423466

9. Abdollahi R, Abiri B, Sarbakhsh P, Kashanian M, Vafa M. The effect of vitamin D supplement consumption on premenstrual syndrome in vitamin D-deficient young women: a randomized, double-blind, placebo-controlled clinical trial. Complement Med Res. Published online May 17, 2019. DOI:1159/000500016

10. Dante G, Facchinetti F. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom Obstet Gynaecol. 2011;32(1):42-51. DOI:3109/0167482X.2010.538102

11. Rafieian-Kopaei M, Movahedi M. Systematic review of premenstrual, postmenstrual, and infertility disorders of Vitex agnus castus. Electron Physician. 2017;9(1):3685-3689. DOI:19082/3685

12. van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013;79(7):562-575. DOI:1055/s-0032-1327831

13. Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med. 1987;32(6):435-441.

14. Isgin-Atici K, Kanbur N, Akgül S, Buyuktuncer Z. Diet quality in adolescents with premenstrual syndrome: a cross-sectional study. Nutr Diet. Published online February 6, 2019. DOI:1111/1747-0080.12515

15. Bahrami A, Gonoodi K, Khayyatzadeh SS, et al. The association of trace elements with premenstrual syndrome, dysmenorrhea, and irritable bowel syndrome in adolescents. Eur J Obstet Gynecol Reprod Biol. 2019;233:114-119. DOI:1016/j.ejogrb.2018.12.017

16. Chocano-Bedoya PO, Manson JE, Hankinson SE, et al. Dietary B vitamin intake and incident premenstrual syndrome. Am J Clin Nutr. 2011;93(5):1080-1086. DOI:3945/ajcn.110.009530

17. Verkaik S, Kamperman AM, van Westrhenen R, Schulte PFJ. The treatment of premenstrual syndrome with preparations of Vitex agnus castus: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(2):150-166. DOI:1016/j.ajog.2017.02.028

18. Karimi Z, Dehkordi MA, Alipour A, Mohtashami T. Treatment of premenstrual syndrome: appraising the effectiveness of cognitive-behavioral therapy in addition to a calcium supplement plus vitamin D. Psych J. 2018;7(1):41-50. DOI:1002/pchj.206

19. Abdi F, Ozgoli G, Rahnemaie FS. A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstet Gynecol Sci. 2019;62(2):73-86. DOI:5468/ogs.2019.62.2.73

20. Farasati N, Siassi F, Koohdani F, Qorbani M, Abashzadeh K, Sotoudeh G. Western dietary pattern is related to the premenstrual syndrome: a case-control study. Br J Nutr. 2015;114(12):2016-2021. DOI:1017/S0007114515003943

21. Negi P, Mishra A, Lakhera P. Menstrual abnormalities and their association with lifestyle pattern in adolescent women of Garhwal, India. J Family Med Prim Care. 2018;7(4):804-808. DOI:4103/jfmpc.jfmpc_159_17

22. Esmaeilpour M, Ghasemian S, Alizadeh M. Diets enriched with whole grains reduce premenstrual syndrome scores in nurses: an open-label parallel randomized controlled trial. Br J Nutr. 2019;121(9):992-1001. DOI:1017/S0007114519000333

See: Magnesium supplementation alleviates premenstrual symptoms of fluid retention.

Get a Consultation
(650) 539-4545
Get more information via email