PMS and how to beat the monthly monster

PMS or pre-menstrual syndrome can be debilitating for many women, it can start anywhere from 14 to 7 days before the menstrual period is due and the symptoms can range from fatigue, irritability, and depression to bloating, headaches and fluid retention.

In the medical realm PMS is often poorly understood so many go on suffering thinking they have no other option but to deal with it, but rest assured there are many natural options that can offer relief.

There are 4 very distinct types of PMS

PMS-A (A - Anxiety) is the most common symptom and is found to be associated with excessive estrogen and deficient progesterone levels during the pre menstrual phase. Symptoms of PMS-A include anxiety, irritability and emotional instability (1)

PMS-C (C-Carbohydrate Craving) is associated with increased appetite, craving for sugary foods, headache, fatigue, fainting spells and heart palpitations. Women suffering from PMS - C have disordered glucose tolerance.

Currently, there is no clear explanation as to why women suffer with disordered glucose tolerance but some factors that appear to be involved are high salt intake, decreased magnesium levels and irregular prostaglandin synthesis. (1)

PMS-D (D - Depression) is the least common type of PMS. Its main symptom is depression, which is usually associated with low neurotransmitters such as serotonin. It appears that people suffering from PMS-D breakdown neurotransmitters at a faster rate leading to decreased circulating estrogen. (1)

PMS-H (H - Hyper hydration) is characterized by weight gain, abdominal bloating, breast tenderness and occasional swelling of the face, feet and hands. The fluid retention is a result of an increase in a hormone in the kidneys called aldosterone. Causes of high aldosterone during the premenstrual phase may be due to stress, estrogen excess, magnesium deficiency and excess salt intake.  (1)

Some women suffer from a combination of different types of PMS but usually there is one dominant type. Once you know the cause of your PMS it is much easier to treat, so let’s take a look at what you can do to treat your PMS.

Chaste Tree

Chaste Tree (Vitex agnus-castus) is native to the Mediterranean and has long been used to treat female hormonal complaints. Chaste tree is one of the only hormonal herbs that helps to balance hormones from the hypothalamus and the pituitary, the endocrine systems master glands. (2)

Chaste Tree works brilliantly in cases where there is high prolaction, high estrogen or low progesterone so would be suitable for those who suffer from PMS - A and PMS -H. Chaste Tree is also good for those who suffer from breakouts around their period, helping to clear the skin.

For best results, use for a minimum of 3 months or 3 cycles. Chaste Tree is available in tablet, capsule and liquid form and is best taken first thing in the morning.

Vitamin B6

If you have PMS, you’ll want to increase your intake of B6. Vitamin B6 is important because it eases the deficiency of the ‘feel good’ hormone prostaglandin E1. When this hormone is low, irritability and sugar cravings can result. Vitamin B6 is indicated for all forms of PMS so try taking 150 to 200 mg of extra vitamin B6 a day for three to six months and it also helps relieve fluid retention in your hands and fingers.

Please note that intake of B6 in high doses (500mg and higher) per day can be toxic over many months or years so it is best not to exceed 250mg per day.


Magnesium deficiency is strongly implicated as a causative factor in PMS. Red blood cell Magnesium levels in PMS patients have shown to be lower than in normal patients. As magnesium plays a big part in cell function, magnesium deficiency may account for the wide range of PMS symptoms.

Magnesium is critical for a healthy functioning nervous system, making a must have for PMS - A, PMS - H and PMS - D sufferers. Magnesium is also an integral part of glucose tolerance factor and is needed to maintain a healthy blood sugar level so is much indicated for PMS - C.

A specific dosage of magnesium is 6mg to every kilo of body weight. (4) So a 60kg person should be taking 360mg of magnesium per day. For those suffering from PMS it is recommended to double the regular dosage so 12mg of magnesium per kilo of body weight meaning a 60kg person suffering from PMS should take 720mg of magnesium per day.

Note - Do stay away from magnesium oxide as it can stimulate your bowel and at this dose you would most definitely end up with diarrhoea.

Evening Primrose Oil

Evening Primrose Oil contains a fat by the name of gamma-linolenic acid that can be converted into a substance called prostaglandin E1 that is believed to help control the effects of excess prolactin. Excess prolactin is responsible for sore breasts, mood disorders and is partly responsible for oestrogen dominance (high estrogen and low progesterone).

Although it is hard to find positive clinical studies on Evening Primrose Oil for treating PMS symptoms, women have been taking EPO for many years with positive results.Taking about three grams of Evening Primrose Oil each day can quell PMS symptoms such as depression, irritability, breast pain and tenderness and the fluid retention.

Vitamin E

Vitamin E has long been known to help with breast tenderness , but research has shown Vitamin E helps to reduce other PMS symptoms such as; nervous tension, headache, fatigue, depression, and insomnia. (3)

Recommended dosage is 400 IU per day; however, please make sure you get a natural form of Vitamin E such as d-alpha-tocopherol.

Licorice Root

Licorice Root is particularly useful in treating PMS, as it is believed to lower estrogen levels while raising progesterone levels. It raises progesterone levels by inhibiting the enzyme responsible for breaking down progesterone. (2)

Licorice is also beneficial for fluid retention and is a fabulous herb for the adrenal glands, making it beneficial for those experiencing stressful times. Caution should be taken by women who have high blood pressure, as licorice may increase blood pressure.

Dietary Interventions

There are many dietary recommendations for those suffering from PMS. Below is a list of the most commonly prescribed dietary measures for those with PMS -

• Eliminate Caffeine -  caffeine exacerbates both pain and inflammation and also breast tenderness and lumps.

• Reduce your intake of saturated fats - saturated fats increase inflammation and can impede liver function. Your liver breaks down all the hormones on your body so we want it to be functioning well.

• Keep salt intake low - high salt intake can increase fluid retention.

• Follow a high fibre diet - fibre will assist in the removal of excessive hormones via the bowel. Some hormones like estrogen can get reabsorbed into the body from the bowel if they are not excreted in a timely manner.

• Eliminate sugar from your diet - sugar is problematic to so many health conditions and PMS is no exception. This is especially important for those suffering from PMS - C.

Suffering from PMS is nothing to ashamed of, it can be easily managed and in most cases greatly improved by the implementation of some of the above health strategies.

If however after 3 months of treatment your symptoms are unchanged please consult your healthcare professional for further assistance.

Written by Lea McIntyre - Naturopath - ND BHSc
Lea has had many years of professional experience as a naturopath working with her patients and clients both in her clinic and as a senior retail naturopathic adviser. When Lea is not helping people stay well and enjoy a healthy lifestyle, she is busy caring for and nurturing her two young children.


1. Pizzorno J, Murray M Encyclopaedia of natural medicine 2nd edition. Little brown book group London 1998

2. Bone K, Mills S. Principles and practice of phytotherapy2000. Churchill Livingstone

3. Holford, P. The optimum nutrition bible.Little brown book group, London.2004

4. Jefferay, K. Minerals, The macro and micro minerals, trace elements and heavy metals.  2nd edition. 2001

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