Premenstrual tension (PMT) or Premenstural Syndrome (PMS)

PMS includes recurrent signs and symptoms that develop during the seven to fourteen days prior to menstruation. This condition occurs in most women 3-7 days before the flow starts or in some women it can begin at the time of ovulation and last for 14 days until the flow starts. Usually the symptoms are mild in most of the cases, but in few cases they can be severe when it is known as "Premenstrual dystrophic disorder".

Symptoms and signs:

• Nervousness, irritability, anxiety, mood swings, anger, depression; Abdominal bloating, diarrhoea and/or constipation, Food craving - for sugar, chocolate, starch, carbohydrates and salts; Tender and enlarged breasts; Uterine cramping; Changing in libido, Weight gain due to fluid retention: Headache, backache, acne, fatigue, lethargy..

Causes of PMS/PMT

• Oestrogen excess, Progesterone deficiency, increased prolactin levels, Hypothyroidism Stress, adrenal dysfunction, endogenous opioid deficiency, Depression, Nutritional factors. There is imbalance of hormones, due to excess oestrogen in the second half of the menstrual cycle. When progesterone and LH should be dominant, oestrogen remains high. Imbalance in pituitary FSH&LH can also lead to excess oestrogen & lack of progesterone.

Naturopathic treatment:

The main aim is to detoxify the body

Nutritional supps:

• Vit E
• EPO (evening primrose oil) 2000-4000/day to start, usually works better with Vit B6
• Vit B6
• MagPhos - magnesium (Mg) works together with Vit B6

Herbs:

• Vitex (main herbs) - to correct imbalance between FSH & LH; stimulates progesterone - can use daily or from 14^th day to 28^th day.
• Cramp bark - antispasmodic
• Wild yam - antispasmodic
• Black haw - antispasmodic
• Buchu - diuretic
• Dandelion leaves - diuretic
• Ginger
• Liver herbs - are very important
• Dandelion root
• Blue flag - if congested
• Bupleurum - if inflammation associated

Homeopathic remedies:

Best to treat constitutionally, but the leading remedies are:

Thuja 30 Calc carb, Medorrhinum (for Sychotic type), lachesis 200, Puls 200, Sepia 200, Nat Mur 30, Folliculinum 30 - to balance FSH level for 10 days before periods.

Diet and lifestyle:

There appears to be quite a strong dietary association with PMS. Women whose diets are higher in refined carbohydrates, sugar, dairy and sodium are more likely to experience PMS. Their diets are also comparatively lower in minerals such as iron, manganese, zinc, magnesium and chromium.

• Diet should be high in fresh fruits and vegetables, wholegrain, legumes, nuts and seeds, fish, water, fresh juices and complex/low GI carbohydrate foods
• Increase the consumption of food containing good amounts of magnesium, zinc, tryptophan, iodine, tyrosine and vit B6
• Use flaxseed oil and LSA in the diet.
• Several small meals containing complex carbohydrates may help to alleviate symptoms and maintain blood glucose levels.

The diet should be low in slat, red meat, processed and refined foods, dairy, refined sugar, caffeine, and alcohol. Reducing salt intake and in some cases the use of diuretics may relieve the symptoms related to fluid retention. Smoking should be avoided.

(Christina Scalone 2007, lectures;  Kate Jefferay 2003, Nutrition as Therapy)