“A PMS Dream Come True!” The Secrets of How to Get Hormonal Consistency
Reducing PMS and PMDD Pain and Discomfort with These Top 6 Science-Backed Health Supplements
For all the women out there, and the men who interact with them.
“May You Menstruate In Peace.”
Premenstrual syndrome (PMS) affects 20 to 32 percent of women with moderate-to-severe symptoms, while premenstrual dysphoric disorder (PMDD) is a more rare condition.
As a series of unpleasant mood and physical symptoms, PMS generally begins every month in a usual pattern.
These emotional and physical changes experienced with PMS can range from barely noticeable to intense.
While PMS and PMDD cannot be prevented, lifestyle strategies and supplements have been shown to reduce the severity and duration of PMS and PMDD symptoms.
- Abdominal Pain
- Emotional Outbursts
- Food Cravings (Sugar)
- Hot Flashes
- Light or Sound Sensitivity
- Mood Swings
- Sleep Cycle Changes
- Tender Breasts
Premenstrual Dysphoric Disorder, (PMDD), Severe PMS
Premenstrual dysphoric disorder (PMDD), is the name given to severe PMS, affecting 3 to 8 percent of women.
PMDD is a new condition which we can find in the latest Diagnostic and Statistical Manual of Mental Disorders, (DSM-5).
- Binge Eating
- Crying Spells
- Extreme Anger
- Extreme Anxiety
- Lack of Interest in Daily Activities
- Painful Cramping
- Panic Attacks
- Severe Mood Swings
- Suicidal Thoughts
- Trouble Thinking or Focusing
PMS and PMDD: Possible Causes
- High Estradiol (Estrogen)
- High Luteinizing Hormone (LH)
- High Progesterone
- Iron Deficiency
- Low Calcium, Magnesium, Manganese Levels
- *Other Hormones Testosterone (Mixed Evidence)
(DHEA, DHEA-S, Follicle-Stimulating Hormone (FSH), Prolactin)
13 PMS and PMDD Strategies (How to Ease PMS Symptoms)
- Balancing diet with a variety of fruits and vegetables.
- Consuming a calcium-, iron-, magnesium-, and manganese-rich whole food diet.
- Hydrate with plenty of water and electrolytes, (not Gatorade), to ease bloating.
- Stopping smoking.
- Lowering alcohol intake to one drink daily.
- Lowering salt and simple carb intake prevents swelling. Swap simple carbs for complex carbs.
- Sleeping and optimizing sleep to at least eight hours nightly to combat fatigue.
- Exercising to decrease bloating, stress, and improve mental health. Aerobic exercise is best supported for physical PMS symptoms.
- Using diuretics prevents bloating and water weight. Natural diuretics include dandelion, horsetail, parsley, cilantro, hibiscus, green tea, black tea, coffee, cocoa, and carraway.
- Lowering stress through meditation relaxation techniques, including meditation, cognitive-behavioral relaxation therapy, cognitive-behavioral therapy, and self-hypnosis.
- Practicing yoga is shown in several studies to relieve physical PMS pain symptoms.
- Using acupuncture is seen in multiple studies relieving physical PMS pain symptoms.
- If all else fails, pain medication, such as ibuprofen or NSAIDs such as aspirin, can be considered. Please consider the serious risk of gastrointestinal bleeding with long term NSAID use. Pay special attention to omega-3’s mentioned later in this article.
***Recent evidence suggests contrary to generic PMS advice from the past, lowering caffeine intake is not associated with the improvement of PMS symptoms. As caffeine is a diuretic, we can hypothesize caffeine elimination might be a counterproductive PMS strategy. In support of general health, current evidence shows up to 4 daily servings of caffeine remains optimal for those who are not sensitive to the effects of caffeine. Low caffeine content cocoa or green teas could also be tested.
Estrogen and progesterone levels can cause changes in PMDD symptoms.
Recent research believes serotonin is a more likely first-line PMDD treatment over hormonal treatments.
Interestingly, as in the case for anxiety, antidepressant SSRI drugs have been found to be more effective for PMDD than for depression.
The good news is we have found several safe natural antidepressant supplements which raise serotonin equal to SSRI drugs, without the short- and long term adverse SSRI side effect risks.
Common PMDD Exams
- Complete Blood Count
- Gynecological Exam
- Liver Function Test
- Physical Exam
- Psychiatric Test
Family or personal histories of major depression, substance abuse, trauma, or stress can further complicate PMDD.
Treatment for PMDD varies. Your doctor may recommend:
The only FDA-approved birth control pill to treat PMDD symptoms is drospirenone and ethinyl estradiol tablet (Yaz).
As with PMS, cognitive-behavioral therapy (CBT), has shown to be helpful for PMDD, along with the other strategies outlined in the PMS and PMDD strategies section.
The Top 6 PMS and PMDD Supplements
#1 Chasteberry (Vitex Agnus Castus Extract)
Chasteberry or vitex agnus castus extract consistently performs in studies with notable PMS symptom improvements.
With well over 10 research studies, chasteberry offers the best evidence of PMS symptom improvement, as we find clear agreement on this conclusion across all of them.
Chasteberry improves an array of PMS symptoms including anger, breast pain and tenderness, constipation, depressed mood, irritability, migraines, and swelling.
By decreasing prolactin, chasteberry restores healthy estrogen levels.
Through lowering progesterone levels, chasteberry improves estrogen to progesterone ratios.
And these two notable adjustments of hormonal levels is what likely promotes significant PMS symptoms.
Chasteberry also shows mild improvement for anxiety, cramps, depression, insomnia, and irritability.
Study doses are seen as 8, 20, and 30mg, and while both the higher doses outperform the 8mg dose, we find no differences between the 20 mg and 30 mg doses. Full PMS symptom improvement occurs after 6 cycles.
Myo-inositol supplementation appears to be effective in reducing dysphoric and depressive symptoms during PMS.
Inositol performs as perhaps the single best PMS mood related option, reducing PMS symptoms and improving mood.
Inositol is also proven as a top choice for Polycystic Ovary Syndrome, (PCOS) for both mood and physical symptoms.
While it does have general support for depression, inositol performs much better as a top anti-anxiety supplement for women, most notably with PMS, PMDD, or PCOS, as it is even effective for panic attacks.
While inositol is a sugar, it has been shown to modestly reduce blood sugar levels and improve insulin sensitivity.
Finally, we see strong support for inositol for acne, entirely eliminating acne in 3 to 6 months, however, this may likely only apply to women with PCOS.
Inositol takes up to 6 cycles for best PMS effects to occur. We generally need higher dosages in the 12 to 18 gram range for mood-related symptoms, as lower doses in the 3 to 6 gram range can help physical PMS symptoms. Look for either myo-inositol or inositol on the label. It can mix easily in coffee or a favorite beverage.
#3 Saffron (Most Especially for PMDD)
Saffron, also highly effective for depression and appetite suppression, performs equally well for PMS symptoms over the course of two menstrual cycles.
This is not surprising, as one of the oldest saffron uses is for PMS treatment.
Even the smell of saffron in just 20 minutes, significantly lowers PMS symptoms, while improving period irregularity.
In addition to serotonin, we believe saffron serves to lower cortisol, the stress hormone.
15 mg standardized extract taken twice daily. Benefits improve over the course of two cycles.
The most recent research shows curcumin significantly reduces overall PMS symptoms, four times as much as placebo, because of its believed anti-inflammatory and mood boosting mechanisms of actions.
We have strong evidence in support of curcumin for depression in other studies.
Curcumin prevents a drop in brain-derived neurotrophic factor, BDNF levels, which means the plant can fight inflammation, in effect lowering the severity of psychological and physical PMS symptoms.
As curcumin is an adaptogenic plant, it is often found to take up to two months in some cases to realize any initial benefits. Use a bioavailable type of curcumin taken with a meal with fat and black pepper in divided doses. Studies use a total of 200 mg of curcuminoids per day in divided doses for 7 days before and 3 days after the onset of menstrual bleeding, with full benefits achieved after 3 menstrual cycles.
Ginger performs equal to nausea medication in a variety of studies for a variety of conditions.
It should be no surprise, ginger performs well for PMS symptoms, in which we see behavioral, mood, and physical improvement.
500 mg 7 days prior to menstrual bleeding and up to 3 days after as benefits increase over three cycles.
#6 Melissa (Lemon Balm)
Mainly psychological, with some evidence of physical benefits, studies show PMS symptom improvement with lemon balm.
In anxiety and sleep studies, we do have better support for the use of lemon balm, so this is perhaps where it could be most effective with respect to PMS benefits.
Typically 1200 mg. One study shows 500 mg twice daily. Best results seen in mood.
Micronutrients: (Essential PMS Vitamins and Minerals)
Some improvement in severity of pain and duration of menstrual cramps occurs with boron supplementation. Dosage is 88.5 mg of sodium tetraborate or 10 mg of elemental boron for 2 menstrual cycles.
Shown to relieve anxiety, depression, pain, and swelling due to PMS, studies seem to agree high dose calcium can reduce mood- and pain-based PMS symptoms.
500 to 1000 mg calcium daily is often best taken with B6. For optimizing overall health magnesium should always be balanced with calcium intake. We feel high dose calcium should be a final, not first option due to cardiovascular concerns.
Omega-3’s (Krill and Vegan Algae Oil Might be Superior to Fish Oil)
Krill oil and fish oil reduce mood- and physical-related PMS symptoms in studies, with benefits increasing in time. Omega-3’s might be more effective for cramps than ibuprofen. A couple studies show krill oil to be more effective on day 45 and even more on day 90 head to head versus fish oil. See comments below on lecithin, for an explanation on the better performance. 1 gram of krill oil, twice daily 8 days prior to the menstrual cycle for 90 days is what we see as performing best in studies. Fish oil dosage is two times that of fish oil, because of lower absorption rates.
Magnesium, a calming mineral for smooth tissue relaxation and essential for efficient absorption of oral vitamin D, shows a moderate PMS symptom reduction. Magnesium is also used as a key cofactor in many core body and central nervous system functions. It is apparent magnesium effects are best with vitamin B6. We see magnesium dosages of 250 mg with 50 to 100 mg vitamin B6 used in studies.
B1, B-6, and Folic Acid/ Folate (B-Complex)
Studies show both folic acid B9 and 50 to 100 mg of B6 are effective in lowering physical and psychological PMS symptoms. Effectiveness seems to increase with calcium and magnesium, as we believe they promote cycle regularity and healthy hormones. B-vitamins support the liver in detoxification, as the liver eliminates excess estrogen. High estrogen levels, or “estrogen dominance”, can be a significant cause of PMS symptoms such as irritability.
As b-vitamins “work best as a team,” we suggest a methylated b-complex, which are now included in high-quality multi-vitamins. Taking a two-a-day can allow for better absorption. We see 50 to 100 mg of B6 in studies. 100 mg of vitamin B1 is the study dosage. 500 to 1,000 mg of calcium might best improve results along with 250 mg of magnesium. A high-quality multi-vitamin can also deliver much needed iron and manganese.
Vitamin D and Vitamin E
Vitamin E performs as more effective for mood related PMS symptoms, with Vitamin D appearing more effective for physical PMS symptoms. We see a variance in vitamin D results, however for general health, new studies appear to show we generally need higher vitamin D intake. Studies use 2,000 to 7,000 IU and the vitamin D dosage, with vitamin E doses between 200 to 400 IU. We suggest a D3/ K2 combo, as K2 keeps D3 in the bones and out of the arteries.
As zinc plays a role as a NMDA-antagonist, which means it blocks excessive, neurotoxic, and mood disturbing glutamate in the brain, it is not a surprise to see notable psychological benefits, and maybe even physical improvements in those with zinc deficiency. We see improvement increase over time with studies using 30 to 220 mg of zinc, with no observable difference with the higher dosage range.
As a classic health supplement containing phosphatidylserine (PS), phosphatidylcholine (PC), and phosphatidylinositol (PI), lecithin is expected to be confirmed as effective for treating PMS and PMDD symptoms, most notably regularity. Studies appear to be using 1,200 mg of soy lecithin. We recommend sunflower-derived Non-GMO lecithin instead. Lecithin also appears to be effective for liver detoxification, cholesterol, and digestive health, along with menopause- and PMS-related fatigue. We will watch for further conclusions to see if lecithin is effective because of its phosphatidylserine (PS) content, or it is more effective than isolated PS, because of its other two compounds.
Notable Other PMS and PMDD Supplements
Brewer’s yeast, Saint John’s wort, Ginkgo biloba, Royal Jelly, Tryptophan, Fennel, Phosphatidylserine (PS), Valerian, Evening Primrose Oil.
Conclusions on PMS
The effects of micronutrients on PMS and PMDD symptoms most reflect correcting common modern day nutrient insufficiencies and deficiencies.
The modern western diet reminds us once again of micronutrient insufficiency and deficiency, especially b-vitamins, vitamin D, magnesium, and omega-3’s are increasingly common and widespread.
We can find even greater nutrient deficiency such as iron, iodine, folate, vitamin A, and zinc, in the developing world.
Caffeine intake might be helpful contrary to previous cookie cutter advice.
We have some science-backed supplements which can provide further support based on specific needs.
Chasteberry has by far the clearest and best evidence for use as a PMS and PMDD supplement.
Be patient, as most PMS supplements seem to take 1 to 3 cycles, and some even six months prior to getting full benefits.
If further support is needed for PMDD in the form of serotonin, we suggest consideration and discussion of a safer science-backed serotonin-boosting supplement first, such as saffron, prior to moving onto an SSRI.
Getting back to focusing on the basics, seems most appropriate in reclaiming our health.
With PMS and PMDD, once again there is no exception to this rule of thumb looming large above and all around us.
What’s your favorite PMS supplement?
Your Friend in Health