What is PMS?

Premenstrual syndrome (PMS) consists of a variety of symptoms, mainly consisting of bloating, breast tenderness, fatigue and mood changes occurring the second half of a woman’s menstrual cycle. For some women these symptoms may be quite mild, however for others the symptoms may be quite intense. These symptoms usually begin to resolve after the onset of menses. For some women, these symptoms may be severe enough to interfere with daily activities, and interfere with work and personal relationships. This disabling, extreme form of PMS is referred to as PMDD (premenstrual dysphoric disorder).

Symptoms of PMS include:

  • Mood changes
  • Tension, anxiety, feeling overwhelmed
  • Difficulty concentrating
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Social withdrawal
  • Loss of sexual desire
  • Breast Tenderness
  • Sleep changes
  • Insomnia
  • Cravings
  • Appetite changes and food cravings
  • Blood sugar changes
  • Physical Changes
  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Acne flare-ups
  • Constipation or diarrhea

The cause of PMS is poorly understood, however it is related to hormonal changes and fluctuations in the menstrual cycle. Fluctuations in serotonin, and insufficient levels of serotonin, may also play a role in PMS. Insufficient levels may contribute to depression, fatigue, and sleep problems. Some women with PMS may have undiagnosed depression.

While estrogen and progesterone are the dominant hormones in a woman’s menstrual cycle, other hormones, such as adrenal hormones and insulin, may also be important and play a role in PMS. Poorly managed stress can lead to increased cortisol which can then lead to altered progesterone and insulin production, which can then result in mood swings and food cravings.

Root causes of PMS have been proposed to be:

  • High estrogen to progesterone ratio
  • Abnormal neurotransmitter response in the brain
  • Disrupted sodium metabolism (causing fluid retention and bloating) often caused by stress
  • Stress (causing increased cortisol)
  • Carbohydrate metabolism alternations
  • Nutritional deficiencies

Traditional Treatments

Traditional treatments include: SSRIs (selective serotonin reuptake inhibitors) such as: fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and paroxetine (Paxil). These medications can be taken each day, or just during the two weeks prior to menses. Medications, such as Danazol and Lupron, which affect the ovulatory functions of the ovary may also be used. These may, however, have significant side effects. Antidiuretics, such as spironolactone (Aldactone), may also be recommended to cope with fluid retention and bloating. Birth control pills may also be recommended. Supplements such as calcium, magnesium and vitamin B6 can also be considered. Non steroidal anti inflammatory medications, such as ibuoprofen (Advil, Motrin and others) or naproxen (Alieve, Naprosyn, and others) may also be recommended.

Natural Therapies

Hormone imbalances, and the resulting symptoms, can also be addressed through nutrition, exercise, stress management and natural therapies. There is much in our modern lifestyle that promotes hormone imbalances, such as a high-sugar diets, refined carbohydrate diet, caffeine, stress, dairy, hormones in dairy products and meat, and estrogen-like compounds from pesticides and pollution. Alcohol may also contribute to problem because it affects the function of the liver and prevents proper estrogen metabolism. Alterations in gut bacteria can also lead to PMS issues, as it can also possibly lead to altered estrogen metabolism.

  • Minimize chemical exposures. Get rid of pesticides, plastics, fire retardants, cosmetic additives.
  • et sugar out of yo diet, it triggers the release of inflammatory cytokines.
  • Eat organic food as much as possible, especially animal products, to avoid environmental estrogen like compounds from pesticides (so called, endocrine disrupters).
  • Consider getting rid of gluten grains (these may alter intestinal permeability).
  • Learn how to process stress. Stress releases cortisol, which affects sugar metabolism and the immune system.
  • Sleep.


The Basics

  • Control sugar fluctuations through elimination of refined carbs and grains.
  • Eat so called “lo-Gylcelmic index” foods.
  • Increase levels of natural fats. These may include polyunsaturated fats such as evening primrose oil. Also increase by consuming more wild fish like sardines, herring, and wild salmon, as well as omega-3 eggs and walnuts.
  • Increase protein in your diet. Should be 70-100 grams per day, or 20 to 25% of calories. Eggs are a good source of protein, Add fish, shellfish, chicken, lamb, beef, turkey, as your diet permits.
  • Increase fiber in your diet from vegetables, fruit, nuts, seeds, beans, and whole grains.
  • Natural Supplementation
  • Add natural anti inflammatories such as curcumin (the active component of turmeric).
  • Add yogurt with live cultures. The natural probiotics are good for your gut.
  • Make sure that you have adequate levels of vitamin A.
  • Two tablespoons of ground flax seeds a day are especially helpful in correcting constipation and balancing hormones. Put them in a shake or sprinkle them on salads or food.
  • Replacing healthy bacteria in the gut also helps normalize estrogen and hormone metabolism. Take 5 to 10 billion live organisms in a daily probiotic supplement.
  • Do Not Deprive Yourself


  •  Do not “diet” and deprive yourself of needed nutrients. Your body needs the appropriate fuel to function properly.
  • Eat small amounts often.
  • Cut out alcohol, processed foods, and caffeine.


  • Salt and salty foods to reduce bloating and fluid retention. o Dairy
  • Foods high in complex carbohydrates, such as fruits, vegetables and whole grains.
  • Choose foods rich in calcium. If you can't tolerate dairy products or aren't getting adequate calcium in your diet, a daily calcium supplement may help.


  • Helps to improve hormones
  • Linked to longer life, less chance of disease and optimizing weight

Relieve Stress

  • Identify and reduce / manage stressors in your life.
  • Meditate.
  • Add techniques such as yoga, aromatherapy, massage, deep breathing, progressive muscle relaxation.


  • Exercise can improve fatigue and help to relieve depressed mood.
  • The proper exercise is important – indeed improper exercise, such as prolonged cardio or extended running may be harmful if employed too rapidly. To gently incorporation into ones daily regimen is important.
  • The T-Tapp method has been reported to be an excellent method to do this – and it is largely available on line. It has been reported to be helpful with hormone balance and other issues.
  • Attempt to increase to 30 minutes of aerobic exercise, 4 to 5 times a week.

Herbal Therapies

Chasteberry Extract

  • may help with breast pain.
  • may also help with swelling, cramps, and food cravings.
  • when combined with St. Johns' wort, may help with depression, anxiety, and cravings.
  • note: may interfere with birth control pills, antipsychotic drugs, and estrogen supplements.

Evening Primrose Oil

  • antidote to breast pain.
  • note: may raise the risk of bleeding, especially in people who take blood thinners such as warfarin (Coumadin).

Ginkgo biloba

  • May help with breast tenderness and psychological symptoms, such as mood changes.

St. John's Wort

  • may help with depression.
  • note; St. John's Wort interacts with many other medications, including birth control pills, and can cause rashes with direct exposure to the sun.

Dandelion Leaf

  • may help with bloating.
  •  note: dandelion leaf may lead to an allergic reaction in people with a ragweed allergy. It can interfere with the drug lithium and some antibiotics.

Black Cohosh

  • may help with irritability and sleep disturbances.

Dong quai



  • may help with fatigue.
  • is thought to be more effective in with black cohosh. may help with depression associated with PMS.

Lemon balm

  • has a calming effect and helps with PMS-related anxiety and insomnia.

Wild yam

  •  may be helpful for women who have high estrogen levels.
  • may improve symptoms associated with hormonal imbalance.


  • may help to combat stress.

If you desire to use herbal remedies, always consult your physician, as they may have significant side effects and interact with medications.


Calcium, Magnesium and Vitamin B6

  • may help with pain, mood, and general PMS symptoms


  • May help stabilize insulin and blood sugar


  • May help with energy levels

Vitamin D



Vitamin E

Bio Identical Hormone Replacement Therapy 

  • Progesterone may be employed in the last two weeks of the menstrual cycle.

Natural Menstrual Options

  • Possibly, may help to reduce cramping in some women as some women do react well to the chemicals in tampons and.pads and these natural options provide a chemical free solution.