Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) and premenstrual tension (PMT) are terms used to describe a group of physical and emotional symptoms that many women experience in the days leading up to their menstrual period. The symptoms vary, but one common feature is that they disappear once the period starts.


  • Symptoms vary widely, with some women being untroubled by premenstrual syndrome and others being so severely affected that they need to take time off school or work. Symptoms may include:
  • Fatigue
  • Depression, weepiness
  • Irritability, shortness of temper, mood swings and feeling 'out of control'
  • Difficulty concentrating
  • Fluid retention (commonly affecting the breasts, hands, feet and abdomen)
  • Breast pain
  • Back ache, headache, migraine or uterine cramping
  • Altered bowel habits (constipation or Diarrhoea)
  • Reduced pain threshold
  • Altered sex drive
  • Food cravings (e.g. for sugar, chocolate or carbohydrates)
  • Acne


  • The female reproductive cycle involves a complex interplay of fluctuating hormones. Although the exact cause has not been determined, hormonal factors that may be involved include oestrogen and/or prolactin excess and progesterone deficiency
  • There may also be a link between premenstrual syndrome and Thyroid underactivity, Stress (and adrenal hormone production), and Depression
  • Other contributing factors may include deficiency of zinc or magnesium
  • From a naturopathic perspective, liver and gall bladder function are also implicated in premenstrual syndrome. Excess oestrogen inhibits liver and gall bladder function, and conversely, Sluggish Liver activity may also contribute to excess oestrogen levels (by delaying detoxification and clearance of the hormone)

Nutritional & Herbal Support

  • Vitex agnus-castus helps to normalise female hormonal balance and assist in the management of irregular periods. It has traditionally been used to relieve Period Pain, breast tenderness, nervous tension, moodiness, irritability, Fluid Retention, headaches, Acne and any other symptoms that occur during the premenstrual phase of the reproductive cycle.
  • Vitex is sometimes combined with other herbs and nutrients that provide PMT support. Important ingredients to look for include evening primrose oil, vitamins B6, C and E, and the minerals magnesium and chromium
  • Low zinc levels are often observed in women with premenstrual syndrome, and taking a zinc supplement may help to balance hormones. Zinc is especially indicated for premenstrual Acne.
  • Taking vitamin B6 may relieve a number of the symptoms of premenstrual syndrome, including Period PainFluid Retention and Depression
  • Magnesium deficiency may contribute to the development of premenstrual syndrome, and taking a magnesium supplement may help to relieve Period Pain and other symptoms. It also helps relieve tense or contracted muscles and supports the body's ability to cope with Stress. In premenstrual syndrome and Period Pain, it works closely with vitamin B6
  • High doses of vitamin E, taken over several months, may help to relieve premenstrual symptoms of Fatigue, headaches, sugar cravings, Depression, tension and breast tenderness
  • Chromium is essential for the breakdown and utilisation of carbohydrates and sugars, and for maintaining blood sugar balance. It is used to help manage sugar and carbohydrate cravings
  • Evening primrose oil is one of the richest sources of gamma-linoleic acid (GLA) an omega-6 fatty acid that may help relieve Period Pain and other symptoms of premenstrual syndrome
  • Taking calcium supplements providing 1000-1300 mg per day of elemental calcium may help to improve symptoms of premenstrual syndrome, especially mood problems, Fluid Retention and difficulty with concentration
  • Liver-cleansing herbs such as milk thistle, globe artichoke and schisandra support the body's detoxification processes, aid Sluggish Liver and gall bladder function, and support the excretion of toxins (including excess hormones)
  • St John's wort is another herb that is clinically proven to relieve mood disorders such as Anxiety and Depression, and may be useful when these symptoms occur as part of the premenstrual syndrome
  • Grape seed extract can help relieve Fluid Retention and heaviness of the legs when they occur as symptoms of premenstrual syndrome. It may need to be taken for up to four cycles before reaching its full effect

Diet & Lifestyle advice

  • Severe PMS symptoms may be indicative of underlying disease, and require medical investigation
  • Premenstrual syndrome is more likely to affect women whose diet is high in refined carbohydrates and sugars; high levels of saturated fats may also contribute. Stick to a low glycaemic index (GI) diet that includes slow-burning carbohydrates (such as oats and legumes) to help you maintain better blood glucose control. Avoid high GI carbohydrates such as sugars, wheat products (e.g. bread), and potatoes, which are metabolised quickly, leading to blood sugar fluctuations.
  • Following a vegetarian diet may also be beneficial
  • Avoid caffeine throughout your cycle, especially if your symptoms include Depression, AnxietyPeriod Pain or breast tenderness
  • Avoid salt throughout your cycle, especially if your symptoms include Fluid Retention
  • Reduce your exposure to environmental oestrogens by choosing organic food where possible. Pesticide residues may have oestrogenic effects in the body, which may contribute to premenstrual syndrome
  • Premenstrual syndrome is more common in women who are physically inactive, and increasing exercise frequency may help to reduce the severity of symptoms, especially mood changes and Period Pain

If symptoms persist consult your healthcare professional. Information provided is of a general nature and should not replace that of your healthcare professional.

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