Natural Remedies for PMS and Premenstrual Dysphoric DisorderApril 19, 2012 • By Traci Stein, PhD, MPH, Complementary & Alternative Medicine Topic Expert Contributor
Most women have experienced some symptom of premenstrual discomfort at one point or another—whether it be bloating, aches and pains, breast tenderness, fatigue, tension, headaches, or sleep, eating, and/or mood disturbances. By some estimates, up to 80% of women experience at least one symptom with some regularity. For approximately 5% of women, however, symptoms are severe enough to meet criteria for premenstrual dysphoric disorder, or PMDD.
PMDD can lead to impaired functioning and quality of life during the last week of the menstrual cycle and until about 4 days after menstruation has begun. Significant anxiety, depression, and irritability are commonly reported features of PMDD. Women with either premenstrual syndrome (PMS) or PMDD frequently seek relief in one or a combination of over-the-counter medications, a prescription, or natural remedies, but too often relief is elusive.
What Causes PMS and PMDD?
Although at present there is no definitive understanding of why some develop these syndromes and others do not, a woman’s body undergoes a number of hormonal changes throughout her cycle. It is thought that disruptions in these processes may lead to the above symptoms. Specifically, disruptions in the hormone progesterone as well as in neurotransmitters (chemicals in the brain), such as serotonin and gamma-aminobutyric acid (GABA), and the stress hormone cortisol, may be responsible for PMS or PMDD.
There has also been research examining the roles of calcium and magnesium in these conditions because both minerals vary with the menstrual cycle; however, it is not entirely clear whether imbalances in calcium and magnesium directly cause PMS/PMDD. Although there is not enough data to establish a causal relationship, being sedentary, consuming large amounts of caffeine, sugar, and alcohol, and being very stressed are among the factors associated with having PMS.
Mental, Physical, or Both?
Many women with PMDD also meet criteria for major depressive disorder or seasonal affective disorder, and some have panic or other symptoms of anxiety that are quite severe. It is important to note that although PMDD is included in the Diagnostic and Statistical Manual of Mental Disorders, it is a condition that has a physiologic basis, even though it may include psychiatric symptoms or coexist with other psychiatric disorders.
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There are a number of natural remedies that are commonly used for PMS or PMDD symptoms, including chasteberry (also known as Vitex or Monk’s Pepper), evening primrose oil, saffron, St. John’s wort, soy, B6, calcium, and magnesium. Only a few of these remedies have sufficient evidence to support their use at this time, however. These include:
- Calcium – 1,000 to 1,200 mg per day (effective for mood, water retention, food cravings, and pain)
- Vitamin B6 – 100 mg per day (preliminary evidence suggest benefit for relieving mood symptoms)
- Chasteberry – 20 mg per day (preliminary evidence suggests benefits for relieving breast tenderness, headaches, and irritability). Note that in some trials, chasteberry increased the likelihood of becoming pregnant, so make sure to use adequate birth control when taking this herb, and discontinue use if you become pregnant.
Discuss any herbal or vitamin supplements you take with your doctor to make sure these are appropriate for you and that they will not interfere with other supplements or medications you may be taking.
In addition to the above, the following lifestyle changes are recommended:
- Get regular exercise (aim for most days of the week, for at least 30 minutes per day)
- Decrease or eliminate caffeine, alcohol, and sugar
- Engage in active stress management such as meditation, guided imagery, yoga, and involvement in pleasurable activities
- Talk therapy, especially cognitive behavioral therapy, can help you identify triggers of low mood and develop strategies to cope with symptoms when they arise
It goes without saying that if you have premenstrual symptoms that make it hard to do the things you want and need to do, see your gynecologist for an accurate diagnosis. He/she can help rule out other physical or psychological syndromes that may appear similar to PMS or PMDD. If your mood symptoms are severe (e.g., you experience panic or disabling anxiety, feelings of hopelessness, or suicidal thoughts), seek professional help immediately.
For more information, consult the following:
- Pearlstein, T., & Steiner, M. (2008). Premenstrual dysphoric disorder: burden of illness and treatment update. Journal of Psychiatry & Neuroscience, 33(4): 291–301.
- Whelan, A. M., Jurgens, T. M., & Naylor, H. (2009). Herbs, vitamins, and minerals in the treatment of premenstrual syndrome: a systematic review. Canadian Journal of Clinical Pharmacology, 16(3), e430-e431.
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PerryApril 19th, 2012 at 12:16 PM
Although I am encouraged by this news I am still a little skeptical. I have even trued prescription medications and nothing has ever seemed to work for me. It is not that I hate having my epriod so much but the week or so leading up to it, . . what a nightmare! I know that I am being a holy terror but there is nothing that I can do to stop it. I took good notes here though and guess I will head to the ehalth food store because at this point anything is worth a try.
BERTIEApril 19th, 2012 at 4:44 PM
men always just think that all of this is a ploy for us to rant and rave
i had severe symptoms for years and no one ever told me about these things
not so much of a concern now, but boy do i wish that i would have had some of this information 20 years ago
then it was just take some aspirinand things will get better in a few days
carrieApril 19th, 2012 at 11:43 PM
women suffer from body and hormonal changes almost throughout their lives..but it is treated like something that has to happen and thus there is not much thought given to it..
natural remedies are the best for any health issue and it is no different here..thank you for the pointers, am sure to share this with friends.
Traci SteinApril 20th, 2012 at 9:46 AM
Hello all, and thank you for your comments. Please feel free to share. @ Perry (and all), it may take time and some trial and error (which I imagine you already know) to find the right approach for you. Anecdotally, women have told me that some of the old-school remedies, like using a heating pad, having their lower backs massaged, and even doing stretches that help open up the pelvic area and loosen tight quadriceps muscles (such as pigeon lunge in yoga) can help decrease tension and muscle pain, and thus reduce distress. What we know from the chronic pain literature is that anxiety and depression can increase perceived pain severity, as can “catastrophizing” (e.g., “I can’t take it anymore!”). So this is where I think therapy can be particularly helpful in developing good coping skills to practice even well before symptoms begin. Good luck!
MaeApril 20th, 2012 at 1:31 PM
I have never heard of PMDD. How would I know if this is what I am experiencing or just plain old PMS?
polly hApril 21st, 2012 at 11:10 AM
think that i will print out this list of remedies and take it with me to my next ob-gyn appointment and see what she thinks about them
Traci SteinApril 23rd, 2012 at 11:06 AM
@Mae – I think the best way to get an accurate diagnosis and learn about appropriate treatment options for you is to consult with your gynecologist. @Polly – I think that’s a great idea – the stance I take is that it’s important to keep your providers in the loop – even when considering non-medical interventions or treatments.
RileeApril 23rd, 2012 at 3:41 PM
A few years ago I was driving myself and everyone in my house crazy because I was literally a monster when PMS came on. So I started doing some research and I became convinced that my entire lifestyle was contributing to all of my problems. I ate like crap, rarely got any exercise, and good sleep was very low on my priority list. So I made a complete 180 degree change. I wa stired of not feeling like I even knew myself anymore, so I did it. I gave up all meat products, entirely! I started running again, which I did in middle and high school but never really had done any since then. And I devoted at least 7 hours a night to sleep. That was what I did, and I feel better now than I did at 19! iT was hard to make some of those changes, and I will admit that there are still times when I want to stay up a little late and eat the wrong things, but I loook back at how miserable I was when I did all of that and that is enought to change my mind in a hurry. I want to be someone that I like, that my family likes, and making those changes helped me become that again.
LarissaOctober 27th, 2013 at 6:29 PM
A lot of your traditional OBGYN’s won’t listen to what you have to say with regards to alternative medicine and herbs. They just don’t have an open mind about it. Best to meet up with a licensed alternative doctor or naturopath if this is something that interests you.
JoyJuly 18th, 2014 at 9:20 AM
I used the GABA to treat PMDD naturally once and it helped with the anxiety but didn’t cure it. There were several other things I had to do that helped me finally get the PMDD symptoms under control. This article helped lot pmddnaturaltreatment.com/natural-ways-help-treat-pmdd-symptoms/
CindyAugust 21st, 2016 at 5:40 AM
I have suffered for years with pmdd.
First let me just say the first male doctor wanted to commit me for being mental. My husband said no way this is not the real her. You keep feeding her Valium and she is having adverse effects from it. You don’t understand this happens only once a month and it’s right around her cycle,since I ovulated late in my cycle it was hard to tell. My symptoms are like the baby blue’s that are so extreme I was a basket case. So knowing I’m not crazy my husband helped me research it and find the right female doctor this time. She instantly knew what was going on and put me on Prozac to try,that worked a little, then I went on celexa I was on celexa for years just recently 3 months ago I stopped my celexa thinking I’m going to be fine, not so. I started taking evening primrose oil and it helps but not enough right now I’m going through the misery of my cycle and as soon as I can I’m going back to the Dr office and get a script.I didn’t want to be on pharmaceuticals but I have no other choice but to be miserable. This is not in your head it’s not mental it may feel mental but it’s not most male doctors will never fully understand what a women goes thru with a normal cycle much less a Jacked up one. I am 43 and going thru menopause and this seamed to be the trigger for Pmdd for me, never had any symptoms before my late 30’s. Please seek medical care for this you don’t have to suffer.
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