Pms and Menstrual Problems
PMS and menstrual problemsFor many women, monthly periods mean monthly discomfort. As their periods approach, they regularly experience mood swings, headaches, cramping, diarrhea or constipation, acne, and fatigue. Many of these signs point in one direction—to the notorious problem known as premenstrual syndrome (PMS).
If you have PMS, you can almost count on feeling bloated, sore, and headachy every month, plus you’re likely to have predictable cramp- ing. During your period itself, you might have cramping and heavy bleeding. For many of these problems, alternative practitioners recommend some lifestyle changes, along with herbs, minerals, and other supplements.
Defense Tactics
To help defuse PMS symptoms, cut down on or steer clear of coffee, chocolate, soda, and sugar-laden foods, says Barbara Silbert, D.C., N.D., a chiropractor and naturopathic doctor in Newburyport, Massachusetts. Instead, experts recommend that you go for a diet that’s full of fruits, vegetables, and fiber.
Foods that contain soy, such as tofu, miso, and soy milk, can help your body deal with the hormonal shifts during the menstrual cycle, says Samantha Brody, N.D., a naturopathic doctor specializing in women’s health in Portland, Oregon. Regular exercise can also go a long way toward curbing PMS.
If you’re having any kind of menstrual problems, it’s always important to keep your physician informed, says Dr. Silbert. She cautions that supplements can’t take the place of a doctor’s care. If your cramps or blood flow are excessive enough to disrupt your life, be sure that your doctor knows about your symptoms before you start taking supplements.
A Hormonal Balancing Act
One possible cause of cramps and heavy bleeding during periods is an unbalanced ratio of estrogen to progesterone, says Willow Moore, D.C., N.D., a chiropractor and naturopathic doctor in Owings Mills, Maryland. These are the two hormones that play the biggest part in regulating the female reproductive system. Usually, women who experience problems with their periods have too much estrogen and not enough progesterone in the one to two weeks before their periods. This imbalance can set the stage for painful cramping and heavy flow, along with other unwelcome symptoms such as headaches and mood swings.
Supplements that balance estrogen and progesterone can make a big difference in how you feel before and during your period, says Dr. Moore. Along with soy foods, an herb that is believed to have a positive effect on hormone balance is chasteberry. In two surveys of doctors in Germany, chasteberry was rated as "very good" or "good" for treating PMS symptoms, from bloating and cramping to mood swings. Of the 1,500 women included in the studies, one-third reported having no PMS symptoms after being on chasteberry extract for an average of 166 days. Another 57 percent said they had significant improvement.
A Chasteberry Boost
Chasteberry seems to help by stimulating progesterone production. When that happens, your hormone levels start to stabilize and you begin to feel a lot better, says Lauri Aesoph, N.D., a health-care consultant in Sioux Falls, South Dakota.
Chasteberry comes in capsules. A normal dose is 175 to 225 milligrams a day. Be patient, though, advises Dr. Aesoph, since it may take about three months to work. If you are taking birth control pills, she suggests that you try a different remedy, since chasteberry may counteract the effectiveness of oral contraceptives.
More Herbal Help
Licorice works to balance estrogen, says Dr. Aesoph. It can also increase progesterone by inhibiting its breakdown, and it may help prevent bloating. Since high levels of estrogen can cause many menstrual problems, licorice often helps by decreasing the amount of estrogen in your body, says Dr. Moore. Alternative practitioners believe that when your estrogen levels are too high, the weaker form of plant estrogen found in herbs such as licorice takes up receptors that would normally be occupied by your body’s much stronger estrogen. When these sites are occupied by plant estrogen, some of your body’s estrogen has nowhere to go, so it is excreted as waste.
Today, chasteberry extract is popularly used to help relieve symptoms of PMS, along with menopausal discomforts and certain menstrual problems such as the absence of periods.
Chasteberry isn’t for everyone, however. If you experience depression, you may want to avoid chasteberry because it could worsen depression, says James A. Duke, Ph.D., botanical consultant, former ethnobotanist with the U.S. Department of Agriculture who specializes in medicinal plants, and author of The Green Pharmacy.
Chasteberry has been approved in Germany for treating menstrual problems, PMS, and breast tenderness. The fresh herb is available, and you can also find it in tinctures and capsules.
If you want to try licorice, follow the directions on the package, says Dr. Aesoph. A typical dose for PMS is 250 to 500 milligrams once a day, beginning 14 days after the first day of your period and continuing until your next period begins—essentially the two weeks prior to the start of your period. Since licorice can have some side effects, check with your doctor before taking it.
Black cohosh is another hormone-regulating herb that’s often used for women’s health problems, says Dr. Aesoph. In one study, researchers analyzed the effects of a standardized black cohosh extract that’s been used in Germany for more than 40 years. They found that it reduced depression, anxiety, and mood swings in women with PMS.
If you take black cohosh, follow the dosage directions on the package you buy, says Dr. Aesoph. A typical dose would be 20 milligrams in the morning and 20 milligrams in the evening.
The Chinese Solution
Dong quai is an herb that’s long been used in Chinese medicine for various women’s ailments. One of its primary benefits is its ability to relieve cramps by helping the uterus relax. Dong quai can also help reduce menstrual blood flow, says Dr. Moore.
If you’d like to try dong quai, it’s available in most health food stores. Just follow the dosage directions on the package you buy. (A typical dose might be one or two 550-milligram capsules twice a day.) Practitioners usually recommend taking it from 14 days after a period begins until the start of your next period. Do not take dong quai while menstruating, as it can increase blood loss.
Clearing Up Cramps
"Cramps are very common among menstruating women," says Samantha Brody, N.D., a naturopathic doctor specializing in women’s health in Portland, Oregon. Fortunately, you may not have to resort to over-the-counter pain relievers to get them under control.
One of the first things you should do is back off on consuming chocolate, coffee, soda, and anything else with caffeine, says Dr. Silbert. These types of foods can lead to cramps.
Menstrual cramps have also been associated with sugar and refined carbohydrates, adds Dr. Brody. After making these dietary changes, consider trying some of the best cramp relievers around—magnesium, calcium, vita min B6, and feverfew.
Calcium works wonderfully to relieve some women’s cramps. According to a study at Metropolitan Hospital in New York City, 73 percent of women who took 1,000 milligrams of calcium a day for at least a month experienced fewer PMS symptoms than they had previously. The research suggests that the calcium helped reduce breast tenderness, headaches, and abdominal cramps. Researchers think that these benefits stem from calcium’s ability to relieve muscle contractions. A good daily dose is 1,000 milligrams, says Dr. Moore.
Like calcium, magnesium helps relieve muscle contractions, says Dr. Moore. Some studies have found lower levels of magnesium in women who have PMS. Other studies suggest that increasing magnesium can ease or eliminate PMS symptoms.
Taking 500 milligrams of magnesium a day may help ease the pain, says Dr. Brody. Too much magnesium, though, can cause diarrhea. If that happens, reduce your intake to a level that your body can tolerate.
Do You Need B6?
Vitamin B6 is a good supplement to take because it helps your body retain the cramp-relieving magnesium, but that’s not the only reason you should consider it. Some research suggests that vitamin B6 supplementation can also decrease cramps if you’re deficient in it, says Dr. Silbert.
Best of all, there’s a little test that you can do to see if you may be lacking this vitamin, says Dr. Moore. Before you get out of bed, try to curl your fingers down to touch your palm where your fingers join. Your fingers should be as curled up as you can get them in this position, she says. If you can’t bend your fingers enough to make them touch your palm, you should probably consider taking B6, she says.
Taking 50 milligrams of B6 twice a day should help, says Dr. Silbert. "I recommend taking a dose with breakfast and another with lunch. Whatever you do, though, don’t take it near bedtime. It seems to cause nightmares in some women."
Many women’s bodies have trouble converting this vitamin into a usable form, says Dr. Silbert. She often recommends P5P, which is short for pyridoxal-5-phosphate, because it is easier to convert. Dr. Silbert suggests taking 50 milligrams of P5P instead of straight B6.
Many antispasmodic and anti-inflammatory herbs are also used to relieve cramps, says Dr. Silbert. She often recommends feverfew. Some research suggests that this herb helps lessen pain by preventing the formation of prostaglandins, chemicals that are a critical part of the chain that creates the sensation of pain.
Take the amount indicated on the package on the days that you experience cramping, says Dr. Silbert. A typical dosage of feverfew is 125 milligrams three times a day.
Supplements for Heavy Bleeding
Life is busy enough without having to worry about embarrassing accidents. Luckily, there are a lot of supplements that you can try individually or in combination to stem heavy menstrual flow. A few of these are yarrow, shepherd’s purse, iron, vitamin C, and bioflavonoids.
From the time of Hippocrates until World War I, shepherd’s purse was used to close bleeding arteries. It has also been used by midwives around the world from antiquity to the present to slow or stop blood loss from labor and childbirth.
A relative of the mustard plant, shepherd’s purse is safe to take for long periods. With the consent of a doctor, women can take it during labor and delivery, says Wood.
Other uses of shepherd’s purse also relate to bleeding. Some practitioners recommend it for chronic internal bleeding problems, such as blood in urine or stools, and for mild bladder infections, midcycle bleeding, and heavy menstrual bleeding. (If you notice blood in your urine or stools, however, see your doctor.) The French take it orally or put it into their baths to treat varicose veins and hemorrhoids. You can purchase it in tincture form or use the fresh herb for tea.
Yarrow and shepherd’s purse are two herbs that can help stem bleeding. But how do you decide which one to take?
Yarrow works best for women who have bright red blood flow, says Matthew Wood, a professional member of the American Herbalists Guild in Minnetrista, Minnesota, and author of The Book of Herbal Wisdom. It also tends to be more effective in women who have strong, robust constitutions, he says. Shepherd’s purse, on the other hand, is best-suited for women whose flow is more clotted and who have milder temperaments.
Both are astringents that promote rapid blood clotting to slow or stop excess blood loss. Two clinical studies suggest that shepherd’s purse is an effective remedy for heavy menstrual bleeding. Whichever remedy you decide to try, you’ll need to take it every day, says Wood. But he cautions against using shepherd’s purse if you have kidney stones.
"You’ll know within six weeks if it’s working," he says. If you don’t see any results in that time, switch to another remedy or consider seeing a doctor. Since concentrations vary by product, Wood recommends using a tincture and following the dosage instructions on the label.
Iron Things Out
Iron is probably the most important mineral you can take to help control menstrual blood loss, says Dr. Brody. Heavy menstrual flow can deplete your body’s iron stores, and some researchers also believe that chronic iron deficiency may cause heavy bleeding.
In one study, 75 percent of women who supplemented with iron had decreased menstrual blood flow compared with only about 33 percent in a group that took inactive substances (placebos). Thus, iron might just be the answer to your heavy bleeding problems. Do not take more than the Daily Value of iron (18 milligrams) on your own, though, says Dr. Brody. You must be tested for iron deficiency before supplementing with higher doses.
Get a C-Plus
Two other supplements for heavy bleeding are vitamin C and bio flavonoids, says Liz Collins, N.D., a naturopathic doctor and co-owner of the Natural Childbirth and Family Clinic in Portland, Oregon. Vitamin C can significantly increase iron absorption, so it goes in tandem with an iron supplement, but the combination of vitamin C and bioflavonoids is better yet, according to Dr. Collins.
If you’re prone to excessive menstrual bleeding, it might be the result of fragile blood vessels. Vitamin C and bioflavonoids may strengthen those blood vessels and make them less susceptible to damage. In one study, for example, 14 out of 16 women who supplemented with 200 milligrams of vitamin C three times a day along with bioflavonoids found relief from heavy bleeding.
Dr. Collins recommends taking 500 to 1,000 milligrams of vitamin C three times a day and 500 to 1,000 milligrams of bioflavonoids once a day.
Chase PMS with Chasteberry
Shepherd’s Purse Helps with Heavy Flow