Premenstrual Syndrome

Description

Premenstrual syndrome, also called premenstrual tension, is the condition characterized by nervousness and irritability experienced by some women one to two weeks before menstruation begins.

There are two forms of premenstrual syndrome however they differ little or not at all in implications. The first is that which is noticed at menarche and persists throughout the menstrual period. The other form is that which commences several years after menarche.

The effects of premenstrual syndrome can range from minimal discomfort to severe disruption. In any case, the symptoms usually disappear once menstrual flow begins. About 20-30% of all women experience premenstrual syndrome, most cases beginning between the ages of 25 and 40. Within this time, incidence increases with age and is related to parity.

Treatments of premenstrual syndrome are symptomatic. This can involve reduced salt consumption to relieve both the symptoms and the initial edema, adequate rest, a balanced diet, moderated exercise, avoiding stimulants such as caffeine, nicotine and alcoholic beverages, and psychological counseling for cases in which an emotional problem is the underlying cause.

Drug therapies are also available, including the use of diuretics, oral contraceptives, tranquilizers, and lithium therapy; these are not preferred since the underlying cause of premenstrual syndrome is usually unknown.
 

Causes

Primary Factors

The primary cause of premenstrual syndrome is suspected to be due to the fluctuation in the production of female hormones during the course of the menstrual cycle which may be related to:

Prostaglandin levels
Loss of intravascular fluid into body tissues which triggers an increase in antidiuretic and aldosterone hormone secretion, causing the characteristic transient water retention
Estrogen-progesterone mediated changes

Predisposing Factors

Progesterone allergy
Hypoglycemia
Psychogenic factors
 

Signs & Symptoms

Premenstrual syndrome is primarily an increase in the amount of salts and fluid in the body, or generalized edema, during the week or two before menstruation begins.

Behavioral
 

Nervousness	Sleep disturbances
Irritability	Fatigue
Anxiety	Lethargy
Mood shifts	Depression
Agitation	Mild to severe personality change

Neurological
 

Headache	Paresthesia of the arm and legs
Vertigo	Worsened epilepsy
Syncope

Respiratory

Increased incidence of colds
Worsened allergic rhinitis
Worsened asthma

Gastrointestinal
 

Abdominal bloating	Change in appetite
Diarrhea	Worsened irritable bowel syndrome
Constipation

Other symptoms include:
 

Feeling of puffiness	Breast tenderness
Temporary weight gain	Breast enlargement
Backache	Oliguria
Palpitations	Easy formation of bruises
Acne	Eye disorders such as conjunctivitis
Cramps

 

Nutritional Supplements

Structure & Function:
        Women's Health &
        Essential Fatty Acids

---------------------------------
General Supplements
---------------------------------

	Adult
Chromium	50 - 200 mcg
Fish oils*
EPO	1 - 4 g
Magnesium	300 - 600 mg
Proanthocyanidins*
Vitamin B-6	100 - 200 mg
Vitamin E	400 - 800 IU
Indole 3 Carbinol*

* Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

Adherence to a low carbohydrate Mild Sodium Restriction Diet for 10 days prior to menstruation can minimize edema, bloating, weight gain and breast tenderness. Nervousness and irritability can also be alleviated if the individual abstains from use of caffeine, nicotine, and/or alcohol during this period.
 

Homeopathic Remedy

1.* Natrum Muriaticum - 30C
2. Ignatia amara - 15C
3.* Cyclamen europaeum - 15C
4. Nux vomica

To be taken together.

Advanced , by symptoms:

A solo remedy could be Sepia - marked by an indifference to loved ones. .

Fluid retention - Calcarea carbonica

Weepiness - Pulsatilla nigricans.


Cramp - Uterine

1. Cactus grandiflorus - 3C to 15C


Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

----------
Herbs
-----------

Black cohosh
Catnip
Chamomile
Dong quai
Sarsaparilla
Shepherd's purse
Valerian
Vitex (chaste tree)

German Commission E:

Black cohosh
Vitex (chaste tree fruit)
Yarrow

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

Black cohosh has estrogen-balancing, antispasmodic and antiinflammatory properties.

German Chamomile (flowers) are used as an antispasmodic (smooth muscle relaxant). It is also calmative, like Catnip.

Roman Chamomile (flowering heads) are used for their analgesic effect.

Sarsaparilla is reputed to benefit progesterone, thereby balancing female hormones.

Shepherd's purse may help regulate heavy flow.

Valerian is a noted calmative, or relaxant.

Dr. Grabowski also recommends Vitex (chaste tree) for PMS subgroups A, C and D (but not H). Vitex agnus castus targets the hypothalamo-pituitary segments of the endocrine system. (1 capsule daily) It regulates hormones as well as having a stimulating, or tonic, effect. It is the major remedy throughout Europe (Agnolyt). In one study there was an 89% improvement. (Feldmann, 1990/1995)

References:

Amann, W: [Premenstrual water retention. Favorable effect of Agnus castus (Agnolyt) on premenstrual water retention.] ZFA Stuttgart, 1979, 55(1):48-51.

Amann, W: [Amenorrhea. Favorable effect of Agnus castus (Agnolyt) on amenorrhea.] ZFA Stuttgart, 1982, 58(4):228-231.

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Feldmann, H et al. Therapie der gelkorperschwache und des pramenstruellen syndroms. Gyne. 11(1990): 421425-Publikation eingereicht, 1995.

Giss (Long-term study on the efficacy of Agnolyt in treating PMS). 1968.

Grabowski, RJ: Current Nutritional Therapy: A Clinical Reference. Image Press. 1995.

Hobbs, C: Naturopathic specific condition review: Premenstrual syndrome. The Protocol J. of Botanical Medicine, Spring, 1996:168-173.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.

Peters-Welte, C & Albrecht, M: Menstrual cycle disorders and PMS. Study on the sue of Vitex agnus castus. TW Gynakol. 1994, 7(1):49-52.

Aromatherapy - Essential Oils

 

Angelica Essence	Chamomile Essence,
Cypress Essence,	Geranium Essence,
Lavender Essence,	Lemon Essence,
Melissa Essence,	Neroli Essence,
Pine Essence,	Rose Essence.

 

Related Health Conditions

Some related health conditions are:
 

Acne	Edema
Allergy	Epilepsy
Anxiety	Eye disorders
Asthma	Fatigue
Backache	Headaches
Bruise	Hypoglycemia
Constipation	Insomnia
Cramp	Irritable bowel syndrome
Depression	Menstruation
Diarrhea	Nervousness

 

Abstracts

References

Abraham, G.E. & M.M. Lubran. Serum and Red Cell Magnesium Levels in Patients with Premenstrual Tension. Am J Of Clin Nutri, 34. 1981.

Backstrom, T. & Hammerback, S.: Premenstrual Syndrome - Psychiatric or Gynecological Disorder. Annals of Medicine, 1991;23:625-633.

Barnhart KT et al., A clinician's guide to the premenstrual syndrome. Med Clin North Am, 1995 Nov, 79:6, 1457-72.

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide. William Morrow and Company Inc., Pub. 594 pp.

Choi PY & Salmon P: How do women cope with menstrual cycle changes? Br J Clin Psychol, 1995 Feb, 34 ( Pt 1):, 139-51.

Dalton, K.: Diet of Women With Severe Premenstrual Syndrome and the Effect of Changing to a Three-Hourly Starch Diet. Stress Medicine, 1992;8:61-65.

DeMonico SO et al., Premenstrual syndrome. Curr Opin Obstet Gynecol, 1994 Dec, 6:6, 499-502.

Facchinetti, F. et al: Oral Magnesium Successfully Relieves Premenstrual Mood Changes. Obstetrics and Gynecology, August 1991;78(2):177-181.

Fink G et al., Estrogen control of central neurotransmission: effect on mood, mental state, and memory. Cell Mol Neurobiol, 1996 Jun, 16:3, 325-44.

Gruber AJ et al., The management of treatment-resistant depression in disorders on the interface of psychiatry and medicine. Fibromyalgia, chronic fatigue syndrome, migraine, irritable bowel syndrome, atypical facial pain, and premenstrual dysphoric disorder. Psychiatr Clin North Am, 1996 Jun, 19:2, 351-69.

Hamilton, H.K. ed. 1982. Professional Guide To Diseases Intermed Communications Inc. Pub, Springfield, Massachusetts. 1323 pp.

Kurzer MS: Women, food, and mood. Nutr Rev, 1997 Jul, 55:7, 268-76.

Moline, M.L. Pharmacologic strategies for managing premenstrual syndrome. Clin. Pharm. 1993, 12:181.

Murray, M.T., & J.E. Pizzorno. 1991. Encyclopedia of Natural Medicine. Rocklin, Ca; Prima Publishing.

Parry BL et al., Neuroendocrine effects of light therapy in late luteal phase dysphoric disorder. Biol Psychiatry, 1994 Sep 15, 36:6, 356-64.

Parry BL et al., Plasma melatonin circadian rhythms during the menstrual cycle and after light therapy in premenstrual dysphoric disorder and normal control subjects. J Biol Rhythms, 1997 Feb, 12:1, 47-64.

Penland, J. G. & Johnson, P. E: The Dietary Calcium and Manganese Effects on Menstrual Cycle Symptoms. American Journal of Obstetrics and Gynecology, May 1993;168(5):1417- 1423.

Penland, J. & Hunt, J.:Diet Related to Menstrual Symptoms,/Nutritional Status and Menstrual-Related Symptomatology. FASEB Journal, 1993;7:A379.

Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York. 2212 pp.

Plesse, J. Nutritional factors in the premenstrual syndrome. Int Clin Nutr Rev 4 (1984): 54-8 1.

Rapkin, A. et al: Tryptophan and Neutral Amino Acids in Premenstrual Syndrome. American Journal of Obstetrics and Gynecology, December 1991;165(Part I):1830-3.

Rossignol, A. et al: Do Women With Premenstrual Symptoms Self-Medicate With Caffeine? Epidemiology, November 1991;2(6):403-408.

Rybak LP: Metabolic disorders of the vestibular system. [see comments] Otolaryngol Head Neck Surg, 1995 Jan, 112:1, 128-32.

Sandyk R: Premenstrual exacerbation of symptoms in multiple sclerosis is attenuated by treatment with weak electromagnetic fields. Int J Neurosci, 1995 Dec, 83:3-4, 187-98.

Seelig, M. S: Interrelationship of Magnesium and Estrogen in Cardiovascular and Bone Disorders, Eclampsia, Migraine and Premenstrual Syndrome. Journal of the American College of Nutrition, 1993;12(4):442-458.

Subak-Sharpe, G.J. 1984. The Physician's Manual For Patients. Times Books Pub, New York. 607 pp.

Thys-Jacobs S: Vitamin D and calcium in menstrual migraine. Headache, 1994 Oct, 34:9, 544-6.

Walji, H. 1992. Vitamin Guide: Essential Nutrients for Healthy Living. Rockport, MA: Element, Inc.