What is PMS?

“PMS” stands for premenstrual syndrome and can be caused by both genetic and hormonal factors. Around 70% of all women of childbearing age notice changes in the second half of their cycle and 20-50% suffer from PMS symptoms, with just under 5-8% suffering from very severe symptoms.

PMS includes any combination of the following symptoms: irritability, anxiety, mood swings, depression or headaches or sore, swollen breasts.

Because they occur in the second half of the cycle, the symptoms can last for a maximum of 2 weeks, but usually they last for about 1 week.

There are two different forms:

• PMS - Premenstrual Syndrome: This is where psychological and physical changes occur in the second half of the cycle. The symptoms are particularly noticeable in the week before menstruation. When menstruation begins, the symptoms often subside suddenly.
• PMDS – Premenstrual Dysphoric Syndrome: This is the most severe form of PMS, in which psychological symptoms are particularly prominent.

Why do the symptoms occur in the second half of the cycle?

In the second half of the cycle, i.e. after ovulation, the hormone prolactin is released to prepare the female body for a possible pregnancy if an egg is fertilized. This hormone stimulates the mammary glands and causes the breasts to swell and milk to be produced after birth. In PMS, excessive prolactin production is observed, which causes a hormonal imbalance. This in turn causes less progesterone to be released, which can result in additional water retention. The water retention leads to breast tenderness and the feeling of being "bloated".

It is also suspected that changes in sex hormones affect the production and activity of other neurotransmitters. This particularly affects the "happiness hormone" serotonin: its concentration fluctuates with the hormonal changes of the menstrual cycle.

Which micronutrients can be helpful for PMS?

chasteberry

• PMS symptoms can be triggered by a prolactin level that is too high. This hormone is produced in the pituitary gland and is important for milk production during pregnancy, among other things. However, if the level is high without a pregnancy, this can result in menstrual disorders, for example. A prolactin level that is too high is associated with typical PMS symptoms such as cramps in the lower abdomen, headaches and back pain, feelings of tension in the breasts, tiredness and irritability in the middle of the cycle.
• The secondary plant substance group of diterpenes contained in chasteberry apparently acts like dopamine in the body and reduces the release of prolactin levels, thereby restoring the balance between estrogen and progesterone in the second half of the cycle. This can relieve feelings of tension, swelling and heaviness in the breasts, reduce irritability and also reduce symptoms such as headaches or migraines.
• The effectiveness of highly concentrated Vitex-agnus-castus-Extracts were shown in a multicenter, randomized, placebo-controlled, double-blind study with 170 PMS patients. Chasteberry was significantly superior to placebo treatment in terms of the reduction of PMS symptoms within three months [cf.Schellenberg R. BMJ 2001; 322:134].
• Australian researchers at the Royal Melbourne University evaluated numerous studies that had been published to date and were able to clearly demonstrate a positive effect of chasteberry on PMS symptoms [cf. https://pubmed.ncbi.nlm.nih.gov/23136064/].
• Attention: Monk’s pepper only takes effect when taken continuously for at least 3 months!

L-carnitine:

• In a double-blind, randomized, controlled clinical trial, women were randomly assigned to receive L-carnitine or a placebo. There was an improvement in menstrual regularity, ovulation rate, and pregnancy rate compared to the placebo group. (see: https://pubmed.ncbi.nlm.nih.gov/30806102/)
• Functional hypothalamic amenorrhea is a common disorder due to the combination of metabolic, physical or psychological stressors. The addition of L-carnitine reduced the impairment of functional hypothalamic amenorrhea in this study. (cf. https://pubmed.ncbi.nlm.nih.gov/28573875/)

fennel

• Due to its antispasmodic effect, fennel is also considered a medicinal plant for menstrual cramps. Fennel helps against flatulence, stomach pain and a feeling of fullness.
• Fennel and exercise have a positive effect on physical and psychological premenstrual symptoms in physically inactive young women with PMS. This is the result of a study conducted in Shiraz with 40 young women who suffered from PMS symptoms [cf. https://womenshealthbulletin.sums.ac.ir/article_47581_6d1a3428a42ee0935d0a9394b9482eeb.pdf]. Fennel alone had a particularly positive effect on physical complaints, while exercise had a particularly positive effect on psychological symptoms. The combination of spasmolytic (fennel) and circulation-stimulating effects (exercise) had the strongest effect.
• Meanwhile, several studies prove the effectiveness of fennel in dysmenorrhea [cf. https://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0997-9283#R10-1055-a-0997-9283-3]. During the treatment, the intensity of the pain and physical weakness decreased significantly. In addition, general well-being and psychological resilience improved.
• Fennel warms the stomach area, especially in women who tend to shiver easily. If menstruation is weak or irregular, it is recommended to use it in the first half of the cycle, as this is when the phytoestrogens are optimally utilized by the body.

Myo-Inositol

• Studies show positive, regulating effects on the menstrual cycle and sex hormones (reducing excessive levels of male hormones in women) as well as on insulin and blood sugar levels.
• For further details please refer to our Myo-Inositol mailing a few weeks ago.

rosemary

• Rosemary promotes menstruation by stimulating blood circulation
• At the same time relaxed  rosemary  not only the intestinal muscles, but also the abdominal muscles and thus helps with menstrual problems, premenstrual syndrome and menopausal complaints.
• Rosemary also has a spasmolytic (antispasmodic) effect on the bile ducts and small intestine, is anti-flatulent (carminative) and has a mood-enhancing effect.

coriander

• According to Hildegard von Bingen, coriander helps women to experience their periods without pain, protects against migraines and reduces moodiness. This may be due to the hormonally active substances as well as the vascular regulating properties.
• A diet that is low in salt and dehydrating helps to combat water retention during PMS.Herbs such as coriander are suitable for this purpose, as they can reduce water retention in a natural way.

iron

• contributes to the normal formation of red blood cells and hemoglobin
• contributes to normal oxygen transport in the body
• contributes to normal energy metabolism
• contributes to the reduction of tiredness and fatigue
• contributes to normal cognitive function
• contributes to the normal functioning of the immune system
• has a function in cell division

zinc

• contributes to normal fertility and normal reproduction (reproductive capacity)
• contributes to the maintenance of normal skin, hair and nails
• contributes to the maintenance of normal testosterone levels in the blood
• contributes to normal fatty acid metabolism

vitamin B6

• contributes to normal energy metabolism
• contributes to the normal functioning of the nervous system
• contributes to the normal functioning of the immune system
• contributes to normal psychological function
• contributes to the regulation of hormone activity
• contributes to the reduction of tiredness and fatigue

folic acid

• contributes to the reduction of tiredness and fatigue
• contributes to normal psychological function
• contributes to the normal functioning of the immune system

vitamin B12

• contributes to normal energy metabolism
• contributes to normal psychological function
• contributes to the reduction of tiredness and fatigue
• contributes to the normal functioning of the nervous system

An ideal supplement to the above mentioned micronutrients is evening primrose and borage oil:

• Evening primrose and borage oil are particularly rich in gamma-linolenic acid, which has been shown in various studies to have a soothing effect on PMS.
• In a summary of the topic from 2019, two studies were presented, among others. In one, the test subjects received 1500 mg of evening primrose oil daily, in the other 180 mg of gamma-linolenic acid. In both studies, the PMS symptoms improved significantly, including the tension pain in the breasts and water retention. However, the oil must be taken over a longer period of time, as improvement often only occurs after 4-6 months (see. https://e-jmm.org/DOIx.php?id=10.6118/jmm.18190).

Further sources:

Ellen B. Gold et al. (2016): “The Association of Inflammation with Premenstrual Symptoms” – Journal of Women's  Health https://www.liebertpub.com/doi/abs/10.1089/jwh.2015.5529?journalCode=jwh

gesundheitsinformation.de (2019): Premenstrual Syndrome (PMS) – Institute for Quality and Efficiency in Health Care (IQWiG) https://www.gesundheitsinformation.de/praemenstruelles-syndrom-pms.html

Pharmawiki.de (2022): Monk's pepper https://www.pharmawiki.ch/wiki/index.php?wiki=m%C3%B6nchspfeffer

br.de (2022): BR-Fernshen – how chasteberry helps with women's complaints https://www.br.de/br-fernsehen/sendungen/gesundheit/arzneipflanze-moenchspfeffer-praemenstruelles-syndrom-wechseljahre-dopamin100.html

deutsche-apotheker-zeitung.de (2001): “Phytotherapy: Monk’s pepper extract as a useful therapy for premenstrual syndrome”

https://www.deutsche-apotheker-zeitung.de/daz-az/2001/daz-46-2001/uid-5037

https://pubmed.ncbi.nlm.nih.gov/20522079/#:~:text=All%20the%2017%20symptoms%20showed,of%20negative%20effect%20and%20insomnia.

https://pubmed.ncbi.nlm.nih.gov/22791378/

https://www.bmj.com/content/322/7279/134

https://pubmed.ncbi.nlm.nih.gov/23022391/

https://pubmed.ncbi.nlm.nih.gov/21608442/

https://pubmed.ncbi.nlm.nih.gov/15206484/

https://pubmed.ncbi.nlm.nih.gov/15251831/

https://pubmed.ncbi.nlm.nih.gov/19499845/

https://pubmed.ncbi.nlm.nih.gov/15251831/

https://pubmed.ncbi.nlm.nih.gov/18074942/