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Question:

What are the Best Remedies for PMS?

Answer:

Let Me Help You Choose What's Best for You

Let’s face it: PMS is the work of the devil. So many women are physically and emotionally miserable for several days of the month because of Premenstrual Syndrome (PMS) and its more severe relative Premenstrual Dysphoric Disorder (PMDD).  But you may not have to suffer nearly so much – or even at all!

First, some definitions and descriptions. The most common symptoms include depression, irritability, anxiety, gastrointestinal symptoms, breast pain, bloating, headache, and increased appetite (1). The symptoms begin sometime in the second half of the menstrual cycle and resolve when the period begins or shortly thereafter (2).

So what can you do to ease the misery? Here are some suggestions:

Medication-Free Remedies

Exercise

In addition to being a terrific way to relieve stress, women with PMS who exercise have a decrease in physical symptoms as well, including decreased headache, nausea, constipation, diarrhea, and increased appetite (3).

Other Stress-Management Strategies

Meditation, yoga, and similar practices are excellent in general for helping people handle acute and chronic stress.

Cognitive awareness is crucial if you have PMS. Here’s what I mean: if you think everyone around you is crazy, if you want to leave your partner, if you want to quit your job – stop and think: “Wait – is my period due in a week?” If it is, then be aware that this is not the time to make big decisions about a relationship, a job, or buying a boat.

 

Herbal Remedy: Chasteberry

Vitex agnus castus (chasteberry) is a popular herbal remedy that appears to be an effective treatment option for women with mild premenstrual symptoms (4). Side effects are generally mild. Keep in mind, though, that supplements are not regulated. This means that you can never be sure about the strength or purity of the medication you’re taking.

 

Medications

Oral Contraceptives (Birth Control Pills)

Combined estrogen-progesterone oral contraceptives (COC’s) can dramatically improve the physical and emotional symptoms of PMS, especially if the pill-free interval is shortened or even eliminated (2). Do know, however, that some people’s PMS symptoms actually worsen when they take COC. Switching to a different hormone may or may not help.

Selective Serotonin Reuptake Inhibitors (SSRI’s)

Of all the treatment options for the mood symptoms associated with PMDD, SSRIs are the most effective (1). Most people notice a beneficial effect in the very first cycle. If, after a couple of cycles, you feel that your response has been suboptimal, the dose can be increased, or you can be switched to a different SSRI. There are many different SSRI’s with different side-effect profiles, along with different regimens for taking them in the treatment of PMDD. Discuss these options with your physician.

Please email me at drj@drjaniceasher.com if you have other questions about PMS and PMDD. I cannot give you specific personal advice, but I’ll try to send you in the right direction.

References

(1)UpToDate. https://www.uptodate.com/contents/treatment-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder?search=pms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

(2) Rapkin AJ, Korotkaya Y, Taylor KC. Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives. Open Access J Contracept. 2019 Sep 20;10:27-39. doi: 10.2147/OAJC.S183193. PMID: 31572029; PMCID: PMC6759213.

(3) Mohebbi Dehnavi Z, Jafarnejad F, Sadeghi Goghary S. The effect of 8 weeks aerobic exercise on severity of physical symptoms of premenstrual syndrome: a clinical trial study. BMC Womens Health. 2018 May 31;18(1):80. doi: 10.1186/s12905-018-0565-5. PMID: 29855308; PMCID: PMC5984430.

(4) Csupor D, Lantos T, Hegyi P, Benkő R, Viola R, Gyöngyi Z, Csécsei P, Tóth B, Vasas A, Márta K, Rostás I, Szentesi A, Matuz M. Vitex agnus-castus in premenstrual syndrome: A meta-analysis of double-blind randomised controlled trials. Complement Ther Med. 2019 Dec;47:102190. doi: 10.1016/j.ctim.2019.08.024. Epub 2019 Aug 30. PMID: 31780016.