The Consumer Guide to PMS

  Other dietary therapies
  Recent findings
  References
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Premenstrual Syndrome (PMS) has been fodder for countless stand-up comics, but it's no laughing matter for the one in three middle-aged women affected. What causes PMS, and what can women do about it? PMS diagnoses fall into in four main forms (PMS-A, -C, -D, and -H), according to dominant symptoms, and all are linked to female sex hormones. PMS can be alleviated by drugs (e.g., leuprolide) that suppress sex hormones, but these produce adverse side effects. Fortunately, there may be safer, equally effective natural approaches.

Benefits and Uses:

Some research indicates that PMS sufferers consume fewer vitamins and minerals than non-sufferers do, while other studies show no differences. It seems logical to try a vitamin-mineral formula designed to alleviate PMS symptoms. Most contain some combination of the following nutrients, which, based on limited clinical evidence, may offer special benefit. Most multi-vitamin formulas contain some of each of these already. If you are taking one already, you could add just enough of each to reach the total daily dose indicated in parentheses. It is important to note that vitamin B6 has shown the greatest therapeutic benefit, but it cannot be utilized fully without adequate amounts of all the B vitamins. Also, vitamin B6 works closely with magnesium in many enzymatic processes, so both are important to one another's effectiveness:  B Complex vitamins: B6 (50-100 mg); B1, B2, B3 (25 mg each); folic acid (200 mcg); B12 (2 mcg)

Magnesium (400-800 mg)
 Zinc (15 mg)
 Vitamin E (200 IU)

 

Other dietary therapies:

EPO: GLA, an essential metabolic fatty acid found in evening primrose oil (EPO) may be of benefit in some cases of PMS.
How might EPO aid in treating PMS? According to the authors of a 1983 study, "Three double-blind, placebo-controlled studies, one large open study on women who had failed other kinds of therapy for the premenstrual syndrome and one large open study on new patients all demonstrated that evening primrose oil is a highly effective treatment for the depression and irritability, the breast pain and tenderness, and the fluid retention associated with the premenstrual syndrome. Nutrients known to increase the conversion of essential fatty acids to prostaglandin E1 include magnesium, pyridoxine, zinc, niacin and ascorbic acid. The clinical success obtained with some of these nutrients may in part relate to their effects on essential fatty acid metabolism."
 Diet: Vegetarian diets reduce estrogen levels, inflammation, and PMS symptoms. Excess caffeine and refined carbohydrates (starches and sugars) aggravate PMS symptoms.
 Herbs: Vitex has long been the premier "women's' herb," and new clinical evidence indicates it is even more effective than vitamin B6 (pyridoxine) against PMS. Black cohosh may also be of benefit in PMS.
 Acidophilus Supplements may help, as this beneficial bacteria decreases re-absorption of excreted estrogens.

Recent findings:

Many PMS sufferers show above average blood levels of estrogen, and below average progesterone levels. But a recent clinical study indicates that about half experience PMS even when hormone levels are within normal ranges.
The authors of a 1996 review of all prior research found little reliable evidence to support EPO's efficacy in PMS, saying "The two most well-controlled studies failed to show any beneficial effects for EPO, although because the trials were relatively small modest effects cannot be excluded. Nonetheless, on current evidence EPO is of little value in the management of premenstrual syndrome."

References

  • Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndromes. J Reprod Med 1983 Jul;28(7):446-64.
  • Abraham GE. Role of nutrition in managing the premenstrual tension syndromes. J Repro Med 28: 446-464, 1983.
  • Barr W . Pyridoxine supplements in the premenstrual syndrome. Practitioner 1984 Apr;228(1390):425-7.
  • Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of value in the treatment of premenstrual syndrome? Control Clin Trials 1996 Feb;17(1):60-8.
  • Chuong CJ, Dawson EB. Zinc and copper levels in premenstrual syndrome. Fertil Steril 1994 Aug;62(2):313-20.
  • Gorbach SL. Bengt E. Gustafsson memorial lecture. Function of the normal human microflora. Scand J Infect Dis Suppl 1986;49:17-30.
  • Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med 1983 Jul;28(7):465-8.
  • Lauritzen C, et al. Phytomedicine, vol. 4, No. 3, 183-189, 1997.
  • Mira M, Stewart PM, Abraham SF. Vitamin and trace element status in premenstrual syndrome. Am J Clin Nutr 1988 Apr;47(4):636-41
  • Piesse JW. Int Clin Nutr Rev 4:54-81, 1984.
  • Posaci C, Erten O, Uren A, Acar B. Plasma copper, zinc and magnesium levels in patients with premenstrual tension syndrome. Acta Obstet Gynecol Scand 1994 Jul;73(6):452-5.
  • Schmidt PJ, Nieman LK, Danaceau MA, Adams LF, Rubinow . Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. N Engl J Med 1998 Jan 22;338(4):209-16.
  • Wurtman JJ, Brzezinski A, Wurtman RJ, Laferrere B. Effect of nutrient intake on premenstrual depression. Am J Obstet Gynecol 1989 Nov;161(5):1228-34.

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