What is PMS?

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

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

Due to the occurrence in the second half of the cycle, the symptoms can last for a maximum of 2 weeks, i.d.R. the symptoms appear for about 1 week.

There are two different forms:

• PMS – Premenstrual Syndrome: This condition is characterized by psychological and physical changes in the second half of the cycle. Symptoms are particularly noticeable in the week before menstruation. Once menstruation begins, the symptoms often subside dramatically.
• 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, d.hAfter 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, causing the breasts to swell and, after birth, milk production. Excessive prolactin production is observed in PMS, causing a hormonal imbalance. This, in turn, leads to less progesterone being released, which can result in additional water retention. This water retention leads to breast tenderness and a feeling of being "puffy."

It is also suspected that changes in sex hormones influence 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 high levels of prolactin. This hormone is produced in the pituitary gland and is u.a. is relevant for milk production during pregnancy; however, if the level is elevated without pregnancy, it can result in cycle disturbances, for example. An excessively high prolactin level is associated with typical PMS symptoms such as lower abdominal cramps, headaches and back pain, breast tenderness, fatigue, and irritability in the middle of the cycle.
• The diterpenes, a group of secondary plant substances contained in chasteberry, apparently act like dopamine in the body, reducing 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 breast tension, swelling, and heaviness, reduce irritability, and even reduce the frequency of symptoms such as headaches or migraines.
• The effectiveness of highly concentrated Vitex agnus-castusThe efficacy of chasteberry extracts was demonstrated in a multicenter, randomized, placebo-controlled, double-blind study involving 170 PMS patients. Chasteberry was significantly superior to placebo treatment in reducing PMS symptoms within three months [cf. Schellenberg R. BMJ 2001; 322:134].
• Australian researchers at the Royal Melbourne University evaluated numerous studies published so far and were able to clearly demonstrate a positive effect of chasteberry on PMS symptoms [cf. https://pubmed.ncbi.nlm.nih.gov/23136064/].
• Attention: chasteberry only develops its effect after continuous use 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. Improvements in menstrual regularity, ovulation rates, and pregnancy rates were observed compared to the placebo group. (see https://pubmed.ncbi.nlm.nih.gov/30806102/)
• Functional hypothalamic amenorrhea is a common disorder caused by a combination of metabolic, physical, or psychological stressors. The addition of L-carnitine reduced the impairment of functional hypothalamic amenorrhea in this study. (see https://pubmed.ncbi.nlm.nih.gov/28573875/)

fennel

• Due to its antispasmodic properties, fennel is also considered a medicinal plant for menstrual cramps. Fennel helps with flatulence, abdominal pain, and bloating.
• 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 suffering from PMS symptoms [see]. https://womenshealthbulletin.sums.ac.ir/article_47581_6d1a3428a42ee0935d0a9394b9482eeb.pdf]. Fennel alone primarily influenced physical symptoms, while exercise had a particularly positive effect on psychological symptoms. The combination of spasmolytic (fennel) and circulation-promoting effects (exercise) achieved the strongest effect.
• Meanwhile, several studies have proven 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 treatment, the intensity of pain and physical weakness decreased significantly. Furthermore, general well-being and psychological resilience improved.
• Fennel warms the abdominal area, especially in women who tend to feel slightly chilly. For women with light or irregular menstruation, it is recommended to use it especially 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 (reduction of excessively high 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 symptoms.
• Rosemary also has a spasmolytic (antispasmodic) effect on the bile ducts and small intestine, anti-flatulent (carminative) and mood-enhancing effect.

coriander

• According to Hildegard von Bingen, coriander helps women experience their periods pain-free, protects against migraines, and alleviates mood swings. This may be due to both its hormonally active substances and its vascular-regulating properties.
• A low-salt, diuretic diet helps combat water retention during PMS. Herbs like coriander are ideal for this, as they can naturally reduce water retention.

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 function 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 function of the nervous system
• contributes to the normal function of the immune system
• contributes to normal psychological function
• contributes to the regulation of hormonal 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 function 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 function of the nervous system

An ideal addition to o.g. Micronutrients is Evening primrose & 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.
• A 2019 summary of the topic presented two studies, among others. In one, the test subjects received 1500 mg of evening primrose oil daily, and in the other, 180 mg of gamma-linolenic acid. In both studies, PMS symptoms improved significantly, including breast tenderness 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 [link missing]. 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): Chasteberry 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

German pharmacistszeitung.de (2001): “Phytotherapy: chasteberry 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/