Herbs for PMS

Women have known for thousands of years that physical and emotional symptoms related to their menstrual cycle occur. They recognize that the mood swings, depression, sweet cravings, bloating, headaches, and other cyclic symptoms definitely have something to do with hormonal changes that occur during the cycle.

Until 20 years ago, before many women went through medical school and became doctors, it was mostly men who determined what sets of symptoms could be given a name, an official diagnosis, which was recognized by modern medicine and reimbursed by insurance companies. Because men don’t experience menstrual cycles and are not familiar with unpleasant symptoms that can accompany them, they tended to overlook menstrual difficulties like premenstrual syndrome (PMS) as a medically-defined syndrome. Today, this is changing to the extent that PMS, or premenstrual syndrome, is a medically-accepted ailment. Of course, the menstrual cycle itself is not always problematic for women, even though it is sometimes referred to as ‘the curse.’ At times the process of the lining of the uterus building up with blood and nutrients for the nurturing of new life (and its shedding if conception doesn’t occur) can go very smoothly. Given the complex nature of the hormonal changes that occur during the monthly cycle, it is no wonder that stress, diet, emotional ups and downs, and other factors can cause a disturbance with its inner workings.

PMS or premenstrual syndrome is now a medically-defined syndrome where symptoms come and go in relation to the monthly menstrual cycle. Of course even if a woman doesn’t have PMS in the medical sense, she may well experience some discomfort occasionally. Thus natural remedies such as herbs provide the perfect support for menstrual cycle-associated symptoms.

It is estimated that at least 30–50 percent of women experience Premenstrual Syndrome (PMS) every month. Physical and emotional symptoms generally manifest as early as two weeks before menstruation and may continue for several days after. Although PMS symptoms vary, they generally include vague aches and pains in the muscles, depression, insomnia, tension, bloating, cramping, breast tenderness, water retention, sometimes a strong craving for sweets, and of course the infamous emotional swings and irritability. A holistic treatment program for PMS is comprised of a variety of healthy lifestyle changes, including diet and exercise, as well as herbs. Following is a list of various PMS symptoms and herbal remedies to treat them.

Irritability

Being a man, I can say, perhaps not entirely tongue in cheek, that women often become irritable because they have to deal with men. Since I can see no immediate cure for this situation, we can discuss some very useful herbal remedies for mild irritability associated with hormonal and liver imbalances.

The liver is the organ most associated with irritability and anger. It is also thought to contribute to other symptoms of PMS, because it is the main organ that should break down estrogen and other hormones, especially when levels become excessive. Thus, herbs that ‘smooth the liver Qi’ (vital energy) and cool heat can help reduce irritability. Try the following formula in tea form. There are also a number of good commercial products that contain many of the same herbs, either in liquid or powdered extract form.

• Fringe tree bark (20%) (regulates liver function)
• Dandelion root (25%) (cools and cleanses the liver)
• Artichoke leaf (20%) (promotes bile production, opens liver)
• Centaury herb (15%) (or gentian rt.) (cooling to the liver, activates digestion)
• Orange peel (10%) (‘harmonizes’ digestion, enhances flavor)
• Licorice (10%) (reduces inflammation, enhances flavor)

Blend 1 tsp of the chopped or cut and sifted herbs/1 cup of boiling water, steep for 20–30 minutes, and drink 1 cup 2–3 times daily before meals. The individual tinctures can be added to water (1 tsp/cup, 2-3 x daily).

Other herbs that are useful for easing irritability associated with the menstrual cycle include:

Vitex (Vitex agnus-castus) regulates the endocrine system by targeting the hypothalamus-pituitary axis and regulating the synthesis of hormones. Throughout Europe, it is the number one herb to help relieve the symptoms of female hormonal imbalances such as irritability, depression, mood swings, and other PMS symptoms associated with the menstrual cycle. Vitex specifically acts to reduce the synthesis of FSH (hyperfolliculinism) and estrogen (hyperestrogenism), one of the causes of PMS. There are a number of controlled clinical studies supporting the use of this for premenstrual problems (Dittmar et al, 1992; Feldmann et al, 1995).

• Dosage: 40 drops daily of tincture; treatment should continue for an additional 3 to 6 months following the disappearance of symptoms.

Reishi (Ganoderma lucidum) mushroom is a powerful immune strengthener and regulator of blood sugar. It is used to counteract general fatigue or weakness that may be associated with chronic PMS and is an excellent herb for calming and relaxing women who experience irritability, nervousness, emotional excess, and sleeplessness.

• Dosage: 10–25 gm daily in decoction, in divided doses, morning and evening. I have found a dried tea of red reishi fruiting bodies (4:1) to be especially effective. The dose is 3 ’00’ capsules 2 x daily (about 3 gm of the dry extract total/day).

Cramping and Pelvic Pain

Cramps are uncomfortable muscle spasms of the uterus with associated pain in the pelvic area. A crampy feeling often precedes the start of the menstrual cycle. General pelvic pain can be eased with the help of self-massage, herbal antispasmodics (valerian, cramp bark, wild yam, California poppy), anodynes (California poppy, Jamaican dogwood, Chinese corydalis), and blood-moving herbs (ginger, cayenne).

Valerian (Valeriana officinalis) works as an antispasmodic, relieving menstrual cramps by relaxing smooth muscles. It is quite effective for cramps, particularly when taken in fairly large doses, especially when blended with cramp bark (50-50). This time-honored herb is of additional benefit as it is an excellent nervine and helps allay emotional stress and nervousness which sometimes occur before the menstrual cycle.

• Dosage: 1/2 to 1 teaspoon of the tincture; it may be taken in 1/2 teaspoon doses every 2–3 hours until cramping subsides.

Cramp bark (Viburnum opulus) is remarkably effective for relaxing muscle tension and spasms in the uterus, thereby relieving menstrual cramps. A smooth muscle relaxant with similar properties to valerian, it focuses its action on the pelvic area (the ‘valerian of the uterus). Cramp bark is beneficial for ovarian and uterine cramps before and during menstruation.

• Dosage: 2–5 droppersful of the tincture in a little water or juice, or 1 cup tea every 2–3 hour until cramping subsides.

Bloating

Bloating is related to water retention in the abdominal area. According to traditional medicine, water retention happens when the digestive system is weak and cannot ‘move the water,’ and send it on to the kidneys and bladder to be excreted. Herbal ‘aquaretics’ (gentle herbal diuretics) such as dandelion leaf, and digestive warming and stimulating herbs such as ginger, centaury and wormwood can help remedy this problem.
Both Vitamin E and Evening Primrose oil (Oenothera biennis), when taken for two–three months, have been shown to decrease the bloating experienced by women with PMS, as well as helping to alleviate depression and irritability (London, et al. 1983; Puolakka, et al. 1985).

These substances decrease symptoms while working to create balance.

Dosage: Evening primrose, 500 mg 2–4 times daily; Vitamin E, 400–800 iu’s daily.

Dandelion leaf (Taraxacum officinale), an excellent diuretic, helps eliminate excess water from the system, relieving the symptoms of bloating. The leaf contains natural potassium so does not deplete potassium in the system as do synthetic diuretics.

• Dosage: 1 cup 2–3 x daily; tinctures and capsules also available.
  Note: Although dandelion may relieve the symptoms of bloating, it is important to take an herb such as vitex which will simultaneously be working on a deeper level to rebalance the hormones.

Digestive Stimulants

Take a good ‘bitters’ formula that contains some of the following herbs: ginger, gentian, wormwood, centaury, orange peel, artichoke leaf. Use 1/2 to 1 tsp in a little water before meals. This can become a regular healthy habit to increase energy and improve digestion. See my book, Foundations of Health for more information.

Depression

Just before the onset of menstruation, estrogen and serotonin (a neurotransmitter) levels fall drastically, frequently contributing to depression, insomnia, and other mood changes.
St. John’s wort, which might help preserve serotonin levels in the brain, among other actions, is currently the herb of choice for easing mild to moderate depression.

St. John’s wort (Hypericum perforatum), when taken long-term, functions as an antidepressant herb without the adverse side effects often associated with pharmaceutical drugs. Take up to 1 tsp of the liquid tincture 2–3 x daily. Start taking the herb a week before the onset of menstruation, so it has time to begin working.

Additional categories of herbs which are crucial to the treatment of premenstrual syndrome include liver-regulating herbs, blood tonifying herbs, and vital energy herbs.

Liver-regulating herbs:

Liver-regulating herbs are used to strengthen and support the liver as it clears excess hormone and reduces high estrogen levels.

Fringetree root and bark (Chionanthus virginicus)

• Dosage: 2–5 droppersful of the tincture daily

Burdock root (Arctium lappa)

• Dosage: 1 cup of the tea 2–3 times daily

Dandelion root (Taraxacum officinale)

• Dosage: 1 cup of the tea 2–3 times daily

Blood-tonifying herbs:

Blood-tonifying herbs are useful for supporting women who have anemia, or who have pale cheeks and tongue and are chronically fatigued.

Dang Gui (Angelica sinensis):
This is an important and popular herb from China that does not seem to affect hormone levels so much as it builds the blood and keeps it moving properly to nourish the female organs and reduce pain and cramping that happens during the menstrual cycle. It can be found as a single tincture or herb for tea, and it is in many herbal formulas for PMS.

• Dosage: 1/2 to 1 cup of the herb for 1 each cup of water; simmer for 30–40 minutes. Add other herbs like nettles or yellow dock, depending on its intended use. On other products containing extracts, follow the directions on the label.

Nettles herb (Urtica dioica)

• Dosage: 1 cup of the tea 2–3 times daily

Yellow dock root (Rumex crispus)

• Dosage: 1–2 droppersful of the tincture twice daily

Vital Energy Herbs:

Vital Energy Herbs aid in the assimilation of nutrients and processing of food into energy.

Ginseng rhizome, red Korean of Chinese (Panax ginseng)

• Dosage: 1 cup of the tea twice daily

Ginger root (Zingiber officinalis)

• Dosage: 1 cup of the tea twice daily

Use a combination of ginger and ginseng (50–50) in a tea or tincture form to ‘warm’ the digestion and increase vitality and energy. This is one of my favorite combinations for women who feel cold and fatigued with digestive symptoms of any kind.

Dietary and Exercise Recommendations for PMS

A recommended diet centers around complex carbohydrates, including whole grains, legumes, vegetables, and fruits. Avoid saturated animal fats, polyunsaturated vegetable oils, and foods that are high in sugar and alcohol as they can aggravate PMS symptoms. Decreasing intake of milk and dairy products may also be beneficial. Women suffering from edema should avoid salt to reduce fluid retention. Eliminating caffeinated beverages and chocolate may decrease tension and irritability.
A regular exercise program, such as swimming, aerobics, or walking is recommended to decrease depression, anxiety, and fluid retention. There are several studies documenting the positive effects of exercise in premenstrual women. At least twenty minutes every other day of vigorous, aerobic exercise is effective, and a daily walk of thirty minutes to one hour is highly recommended.

Two general formulas for PMS are given below

PMS TEA:

• 1 Teaspoon Each: Vitex Berry, Wild Yam Root
• 1/2 Teaspoon Each: Burdock Root, Dandelion Root, Feverfew Leaf
• 1 Quart Water
• Combine herbs and water. Bring to a boil, then turn off heat and let steep at least 20 minutes. Strain out herbs. Drink as needed, at least two cups daily.

PRE MENSTRUAL MASSAGE OIL:

• 4 Ounces Vegetable Oil
• 1/4 teaspoon lavender essential oil
• 8 drops Clary Sage essential oil
• Combine ingredients. Use for a relaxing massage.

Bibliography

• Dittmar, F. et al. 1992. Pramenstruelles syndrom. TW Gynekol. 5(1):60–68.
• Feldmann, H. et al. Therapie der gelkÖrperschwäche und des prämenstruellen syndroms. Gyne. 11:421-25.
• London, R.S. et al. 1983. The effect of alpha-tocopherol on premenstrual symptomatology: A double-blind trial. J. Am. Coll. Nutr. 2:115-22.
• Puolakka, J. et al. Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors. J. Reprod. Med. 39(3):149:53.