PMS in depth - Healing naturally

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Premenstrual Syndrome(PMS)

JoAnn Guest

Mar 19, 2005 18:33 PST

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Premenstrual Syndrome (PMS) is the most common

disorder experienced by

women during the menstrual years. Up to 90% of women

are affected to

some degree. [1] Many woman have just a few mild

symptoms, while others

suffer severe discomfort which adversely effects their

quality of life.

 

If the mood swings, irritability and depression are

consistently

severe,

the disorder is called PMDD( Premenstrual Dysphoric

Disorder), and is

often treated by conventional physicians with

fluoxetine hydrochloride

(

Prozac® , Serafem®). Although drug therapies may help

mask symptoms, it

does little to address " causative " factors.

 

 

 

Guy Abraham, M.D. was instrumental in classifying the

symptoms of PMS

into 4 main categories, and in establishing the role

of nutrition in

PMS.

 

 

 

PMS-A (anxiety) mood swings, irritability, crying jags

 

 

 

 

PMS-H (hyperhydration) bloating, weight gain, water

retention, breast

tenderness, constipation

 

 

 

PMS-C (cravings) many symptoms of hypo-glycemia(low

blood sugar)-

fatigue,

 

vertigo(dizziness), sweet craving , ‘binging-out’,

heart palpitations,

headache, migraines

 

 

 

PMS-D (depression) crying bouts, insomnia, confusion,

depression

 

 

 

Acne and other skin problems are also common. The bulk

of these

symptoms

occur 7-5 days before the period begins, although some

woman begin to

experience problems shortly after ovulation, and spend

half of each

month in discomfort. Rarely does an individual woman

fit exclusively

into one of the categories, but instead may experience

an overlapping

of

imbalances.

 

 

 

Hormone Imbalance

 

 

In most cases of PMS, there are patterns of hormone

imbalance that can

be uncovered through testing.

 

 

 

Estrogen/Progesterone

 

 

Research has consistently shown that an increased

ratio of estrogen to

progesterone, with a mild to moderate excess of

estrogen and deficiency

of progesterone(estrogen dominance), is a common

factor in most of the

women affected [3] [4] PMS symptoms are usually most

prevalent during

the luteal phase of the menstrual cycle; the 14 days

following

ovulation. Insufficient activity of the corpus luteum

can lead to

decreased progesterone levels. If progesterone levels

are lower than

10-12 ng/ml, tested 3 weeks after the start of the

last menstruation,

corpus luteum insufficiency may well be involved. [5]

 

 

 

Prolactin/ Thyroid/ Adrenals

 

 

Other hormones that are linked to PMS include

prolactin , thyroid and

adrenal hormones.

 

 

 

Prolactin is normally produced by the pituitary gland

and functions in

milk production in lactating women. However, during

periods of stress,

lymphocytes will also produce prolactin. Some woman

with PMS have

elevated prolactin levels, [6] while others appear to

be over sensitive

to normal levels. Symptoms associated with prolactin

include abdominal

tension, edema, weight gain and breast tenderness. [7]

Prolactin levels

can be further elevated due to low levels of Magnesium

and Vitamin B-6.

These nutrients stimulates the production of dopamine,

which, in turn,

limits the release of prolactin. [8] Low Zn levels

also increase

prolactin release. [9]

 

 

 

The thyroid may test within normal limits on blood

tests and still be

functioning at a low level. Woman can monitor their

BBT(basal body

temperature) with a basal thermometer for 1-2 months.

If the BBT is

lower than 97.8 degrees on average, compounded with a

report of several

symptoms associated with low thyroid function, an

underactive thyroid

may be suspect. Symptoms of an underactive thyroid

include cold hands

and feet, thinning hair, dry skin, slightly elevated

cholesterol, mild

anemia and constipation. Low thyroid function, even at

a subclinical

level can be a factor in PMS. [10]

 

 

 

 

 

The adrenal hormones, aldosterone and cortisol, are

often slightly

elevated in PMS, often due to chronic stress. New

research is

uncovering

that not only the level of these hormones, but the

level of response to

them can vary in women with histories of reproductive

endocrine-related

mood disorders. Many women with PMS display abnormal

responses, such as

water retention and depression, to normal levels of

these hormones.

[11]

 

 

 

 

Pharmacies can offer saliva test kits that can be used

by women to

determine hormone levels.

 

 

 

 

 

Role of the Liver

 

 

The liver is involved in a great many metabolic

processes in the body,

including breaking down excess estrogens. If the liver

is working well,

it will break down aggressive estrogen into less

harmful varieties,

leading to fewer PMS symptoms. As long ago as the

1940’s it was shown

that the liver cannot efficiently break down excess

estrogen without

the

presence of sufficient B vitamins. [12] The liver can

also be

challenged

by the presence of a wide array of toxins, such as

PBBs (polybrominated

biphenyls), [13] that lead to increased demands on its

ability to

efficiently breakdown excess estrogen. The inability

of the liver to

properly detoxify estrogen leads to the overriding

factor observed in

PMS- Estrogen Dominance.

 

 

 

Estrogen Dominance

 

 

There are many causes of estrogen dominance. In rare

cases it can be

caused by a genetic abnormality. However, it usually

is influenced by

lifestyle choices, which women DO have control over.

One of the main

reasons women have too much estrogen is due to

estrogens that are

coming

into their bodies from inorganic food and

environmental toxins. These

are called xenoestrogens.

 

 

 

Xenoestrogens- a common cause of Estrogen Dominance

 

Xenoestrogens are environmental chemicals with

estrogen-like activity

found throughout the environment, as by-products of

pesticides,

herbicides and the synthetic hormones routinely fed to

animals, which

is

stored in their fat and transferred to people who eat

them. [14] They

also come from petrochemicals found in the coating

inside canned food,

[15]

 

and other plastics; even baby bottles! Once inside the

body,

xenoestrogens can play havoc with the “normal”

mechanisms of the

reproductive cycle, leading to PMS, premature

development of both girls

and boys [16] , and serious illness such as cancer.

[17] Investigations

into the binding interaction for human plasma

sex-hormone binding

globulin (hSHBG) have revealed that xenoestrogens can

displace normal

estrogen from hSHBG binding sites and disrupt hormone

balance. [18]

 

 

 

Natural Management of PMS

PMS is not caused by one single agent, but instead

must be viewed as a

multifactorial imbalance that requires a complete

program to lesson the

input of a number of causative factors. The pharmacist

can act as a

health counselor for PMS, and move beyond the

restrictive role of

dispensing drugs. [19] The outline below suggests an

integration of

therapeutic interventions in order of importance.

 

 

 

Diet

 

 

PMS is one health condition that conventional medicine

suggests has

dietary causes. Some of the well known culprits

include too much

caffeine, sugar, artificial sweeteners, processed

foods and

hydrogenated

fats- in essence the Standard American Diet(SAD).

 

 

 

One well known symptom of PMS is carbohydrate craving.

Research

suggests

that this may be an attempt by the woman to regulate

mood changes that

accompany PMS. In one study, consumption of a

carbohydrate-rich,

protein-poor evening meal during the late luteal phase

of the menstrual

cycle improved depression, tension, anger, confusion,

sadness, fatigue,

alertness, and calmness among patients with

premenstrual syndrome.

Because synthesis of brain serotonin, which is known

to be involved in

mood and appetite, increases after carbohydrate

intake, premenstrual

syndrome subjects may over consume carbohydrates in an

attempt to

improve their dysphoric mood state. [20]

 

 

 

A vegetarian based diet, high in organic dark, green

leafy vegetables,

whole grains and a small amount(if any) of free range

antibiotic and

hormone free animal products can substantially

decrease or eliminate

most symptoms associated with PMS. This dietary

regimen reduces intake

of xenoestrogens. Results of a recent study found “ A

low-fat

vegetarian

diet was associated with increased serum sex-hormone

binding globulin

concentration and reductions in body weight,

dysmenorrhea duration and

intensity, and premenstrual symptom duration. The

symptom effects might

be mediated by dietary influences on estrogen

activity...” [21] Woman

should be encouraged to maintain the diet for a long

period of time,

since a three to four month ‘waiting period’ may be

needed before the

positive effects of dietary change take effect. This

is a long term,

lifetime commitment that will enhance overall health

and well being as

well as provide relief from PMS symptoms.

 

 

 

 

Exercise

 

 

The effect of exercise on PMS symptoms has been the

focus of several

studies, which indicate that exercise is successful in

the diminution

of

all PMS symptoms. Moreover, it appears that these

benefits are can be

at

obtained even with low levels of exercise intensity.

[22] Pharmacists

can make exercise videos available to their clients,

and suggest them

as

part of an overall health and wellness approach to the

alleviation of

PMS.

 

 

 

 

 

Stress Reduction

 

 

PMS symptoms are related to the way a woman deals with

stress. Stress

plays a role in regulating adrenal hormones, as well

as

neurotransmitters involved with maintaining mental

wellness. Stress

reduction techniques such as meditation, prayer, yoga

and cognitive

behavior therapy can help to ameliorate anxiety,

depression, negative

thoughts, and physical changes associated with PMS.

[23]

 

 

 

Liver Detoxification

 

 

The first intervention, after addressing the lifestyle

issues of diet,

exercise and stress reduction, is to work on

detoxification of the

liver. Several herbs are particularly useful in

supporting the liver.

These include Dandelion, Milk Thistle and Burdock

Root.

 

 

 

Dandelion(Taraxacum Officinale)

 

 

 

Almost everyone can recognize a dandelion plant, used

as food and

medicine by cultures internationally. The inner

strength of this plant

is reflected by the amount of time, energy and money

spent trying to

eradicate it from suburban lawns! Dandelion is a

storehouse of

nutrients, including the following chemical

constituents: caffeic acid,

 

p-hydroxyphenylacetic acid, chlorogenic acid, linoleic

acid, linolenic

acid, oleic acid, palmitic acid and other acids,

taraxacin(bitter),

terpenoids , flavonoids, vitamin A (14,000 IU/100 g

leaf- one of the

greens highest in Vit A), carotenoids, choline,

mucilage, inulin,

pectin, phytosterols, potassium.

 

 

 

Dandelion supports the liver, and increases its

ability to break down

estrogen.

 

 

 

Dandelion has long been used in herbal medicine for

its choleretic and

diuretic properties. When tested against the

pharmaceutical diuretic,

Lasix, dandelion (2 g/kg) exhibited a comparable

diuretic effect,

without the potentially adverse side effects of Lasix,

such as

potassium

depletion. [24] Although the mechanism of action of

dandelion is not

fully understood, dandelion extract was found to

diminish enzymatically

induced-lipid peroxidation as well as reducing

cytochrome c in a

concentration dependent manner. [25]

 

 

 

Dandelion is considered safe. However, due to the

abundance of

taraxasterol choline, a substance that hastens the

movement of bile, it

should be avoided in high quantities in persons with

bile duct

obstructions. [26]

 

 

 

Dosage: 3 cups of Dandelion Tea/day

 

Tincture/Extract- 20 ml 3X/day

 

500mg caps- 2 caps 2X/day

 

 

 

Interactions: None reported for Taraxacum Officinale.

However, Chinese

dandelion

 

(Taraxacum mongolicum) interferes with absorption of

quinolone

antibiotics.

 

 

 

 

 

 

 

Burdock(Arctium lappa)

 

 

 

Burdock is found throughout the temperate zones around

the world. The

seed stalk produces the characteristic ‘burrs’, which

one

entrepreneurial gentleman used to develop the idea for

‘velcro’!

 

 

 

Burdock is a slow acting nutritional tonic that builds

strength over

time. It is highly nutritious, and contains minerals

such as magnesium,

calcium, potassium, and silica. Other chemical

constituents include:

Sesquiterpene lactones;

trideca-1,11-dien-3,5,7,9-tetrain; caffeic acid

derivatives (including chlorogenic acid,

isochlorogenic acid); 40% to

50% inulin , mucilages; volatile oils

(phenylacetaldehyde,

benzaldehyde,

2-alkyl-3-methoxy-pyrazines); phytosterols, tannins.

 

Burdock is a traditional Alterative or ‘blood

cleanser’ in herbal

medicine. In it is considered a

‘cooling’ herb, useful

for ‘hot’ conditions, such as hot flashes, or swollen

joints. It can

help with frequent urinary tract infections, and has

diuretic

properties. Burdock root is listed as an official

medicine in the

Eclectic Materia Medica and the U.S. Pharmacopoeia..

 

 

 

Burdock extract has a high level of antioxidant

activity, and produces

a

significant inhibitory effect on lipid peroxidation in

the liver. [27]

Burdock also has shown specific hepatoprotective

effects from

acetaminophen induced liver damage. [28]

 

 

 

 

 

According to the German Commission E, there are no

known risks

associated with the use of burdock. It is not

recommended for use

during

pregnancy.

 

 

 

 

 

Dosage: fresh root- 6 inches of root per day

 

Extract-20 drops 3X/day

 

Capsules- 2, 500 caps 3X/day

 

 

 

Interactions: None reported

 

 

 

 

 

Milk Thistle( Silybum marianum)

 

Milk thistle grows in the wild throughout Europe and

North America. It

has large purple flowers surrounded by a sharp array

of thorns, hence

the name ‘thistle’. Milk thistle is an excellent

galactogogue

(increases

lactation). [29] The ripe seeds(actually tiny

fruits-kenguil seeds) are

gathered in late fall to extract the highly medicinal

components. The

fruit contains 1.5%-3% silymarin, the most active

known constituent,

along with flavonolignans, tyramine, histamine,

essential oils, lipids,

alkaloids, saponins, mucilages, flavonoids, and

vitamins C, E, and K.

 

Milk thistle is used first and foremost for its

protective and

regenerative effect on the liver. In one study which

examined the

effect

of silibinin on phase II liver enzymes, oral

administration at doses of

100 and 200 mg/kg/day(in mice) showed a significant

increase in

glutathione, S-transferase and quinone reductase

activities in liver,

lung, stomach, skin and small bowel in a dose- and

time-dependent

manner. [30] Scientific studies have shown that Milk

thistle has at

least two distinct actions on liver cells; membrane

stabilization, [31]

and increasing ribosomal proteins that helps the liver

regenerate new

cells. [32] Milk Thistle is a useful herb to help in

all situations

where liver detoxification is indicated. In relation

to women’s health

issues, it is especially helpful for all imbalances

linked to excessive

estrogen, including PMS, cystic breasts, fibroids,

endometriosis and

infertility. It is also useful for alcohol, drug or

chemically induced

liver damage, including hepatitis, cirrhosis, and

acetominophen

toxicity

[33] Silymarin inhibits 5-lipoxygenase which enhances

its

anti-inflammatory effects. [34] Milk’s thistle

exhibits anti-tumor

activity, which may be due to its inhibition of

promoter-induced edema

,

hyperplasia and a reduction in the proliferation

index. [35]

 

 

 

 

Dosage: Tea: steep one TBS. Finely ground seeds(fruit)

and leaf powder

in one cup

 

hot water.

 

Tincture/Extract- 20 drops 2X/day

 

Capsules- 200 mg 3X/day

 

Milk thistle is often standardized to 75-80%

silymarin.

 

 

 

Interactions: Milk thistle has no known toxic effects.

Numerous studies

have shown that it has protective effects on liver and

kidneys when

used

along with prescription medications including

acetaminophen,

butyrophenones, and ifosfamide

 

cyclosporine. [36] However, due to its marked effect

on the liver,

there

may be a potential for silymarin to influence hepatic

metabolism of

certain coadministered drugs. [37]

 

 

 

 

 

 

 

If the lifestyle modifications and liver cleansing

herbs discussed

above

are instituted, most women will have an amelioration

of most, if not

all, PMS symptoms, both in quantity and intensity.

[38] However, if

further intervention is required, there are several

nutritional

supplements and botanical remedies that can be helpful

for PMS.

 

 

 

 

 

Nutritional Supplementation

 

 

Calcium

 

 

Calcium comprises more of the adult body than any

other

mineral(approximately 2%), and is critical to a myriad

of metabolic

functions, such as the development and maintenance of

bones and teeth,

control of the heartbeat and blood pressure,

transmission of nerve

impulses, muscles contraction and relaxation,

maintaining membrane

integrity, and enzyme activation. Estrogen, which

regulates calcium

metabolism and intestinal calcium absorption,

fluctuates throughout the

menstrual cycle, which may lead to a disregulation of

calcium

homeostasis. In fact, there is a marked similarity in

the overall

symptoms of PMS and low calcium levels (hypocalcemia).

Calcium

supplementation has been tested in randomized, placebo

controlled,

double blind studies, and was found to result in a

major reduction in

overall symptoms associated with PMS. [39]

 

Although calcium supplementation can help PMS, dairy

products often

actually make PMS worse. This may be due to a

sensitivity of some

individuals to dairy products, or because the high

protein content in

milk, along with calcium, vitamin D, and phosphorus,

may decrease

magnesium absorption.

 

Calcium supplements vary in their bioavailability.

When recommending

Calcium supplements, be aware that dolomite can have

high lead levels,

calcium carbonate requires a low pH to solubilize, and

often causes

gastrointestinal side effects, [40] and bone sourced

Calcium may cause

consumer concern due to increased awareness of Mad Cow

Disease. Calcium

citrate is absorbed more easily than calcium carbonate

and is

relatively

inexpensive. [41] Food consumption surveys conducted

in the USA have

indicated calcium intake for women are often below the

US recommended

daily allowance (1200 mg/day). “ Evidence to date

indicates that women

with luteal phase symptomatology have an underlying

calcium

dysregulation with a secondary hyperparathyroidism and

vitamin D

deficiency. This strongly suggests that PMS represents

the clinical

manifestation of a calcium deficiency state that is

unmasked following

the rise of ovarian steroid hormone concentrations

during the menstrual

cycle.” [42]

 

 

 

Dosage: 1200-1500 mg/day

 

 

 

Magnesium

Magnesium is an important mineral that helps form

bones, relax muscle

spasms, activate cellular enzymes, and regulate nerve

and muscle

function(including the heart) and acid-alkaline

balance. It is often

referred to as the " anti-stress " mineral. Deficiency

of magnesium is

known to cause many symptoms usually associated with

PMS, such as

irritability, depression, confusion and muscle aches.

However,

determining if a woman is deficient in magnesium can

be a challenge.

Many sources of food that are thought to contain

magnesium according to

old nutrient charts (grains, legumes, vegetables, nuts

and seeds), are

actually low due to low levels in the soil and

depletion due to

processing and cooking. Measuring magnesium levels in

the blood plasma

will often fail to demonstrate low levels, although

RBC magnesium

levels

have been shown to be low in PMS sufferers. [43]

Therefore, woman who

want to have a true picture of their magnesium levels

should be

encouraged to have a RBC magnesium level done.

Estrogen enhances the

utilization of magnesium. However, if estrogen levels

are high, which

is

often the case with PMS, and magnesium intake is less

then optimal,

estrogen-induced shifts of magnesium can be

deleterious, leading to

muscle spasms, migraine, and other PMS disorders. [44]

In one study

serum levels of magnesium were inversely related to

the serum level of

estrogen. [45]

 

Magnesium supplementation can help alleviate many

measurable parameters

of PMS, including cramps, irritability, fatigue,

depression and water

retention. [46] [47] Magnesium citrate, gluconate, and

lactate are

better absorbed than magnesium oxide. Magnesium

glycinate is a well

absorbed form, with minimum laxative effects.

 

 

 

Dosage: 300mg-400mg/day. Natural health care

practitioners often

recommend higher doses until symptoms are alleviated.

Doses should be

spread out throughout the day to avoid laxative

effects.

Supplementation

with Vitamin B-6, along with magnesium, can help to

increase cellular

uptake of magnesium. [48]

 

 

 

Vitamin B-6(Pyridoxine)

 

Vitamin B-6 naturally occurs in three active forms:

pyridoxine (PNP),

pyridoxamine (PMP) and pyridoxal (PLP). Ninety percent

of vitamin B6 is

in the latter form. Vitamin B-6 is a coenzyme

intimately involved with

many vital processes such as the formation of amino

acids, hormones,

and

neurotransmitters including serotonin and dopamine

involved in mood

regulation. Several studies show that supplementing

with this

nutrient(50 mg/day) alleviates PMS symptoms,

especially those related

to

mood. [49] [50] However, other studies contradict this

finding, and

conclude that Vitamin B-6 is not a proven treatment

for women with PMS,

[51] and that studies on B-6 have been poorly done.

[52]

Phosphorylation

of Vitamin B-6 into its active

form(pyridoxal-5-phosphate) takes place

in the liver. Inefficient liver function, often

present in women with

PMS, can lead to conversion difficulties.Vitamin B-6

is found in many

foods, including fish, poultry, eggs, sunflower seeds,

soybeans,

lentils, avocados, kale and bananas.

 

Dosage: The RDI ranges from 1.3-2.0 mg/day, but a

useful therapeutic

dose is 25-50mg/day. Sufficient magnesium is required

for utilization

of

B-6.

 

Cautions: Symptoms of sensory neuropathy have been

noted due to

overdose

of B-6 at levels as low as 200mg/day. [53]

 

Vitamin E

Vitamin E is a fat soluble vitamin that acts as an

antioxidant and free

radical scavenger in cell membranes. It occurs in

plant food sources,

but cooking, processing and freezing destroys a high

percentage of

Vitamin E in foods. Supplementation with 400 IU daily

has been shown to

be advantages for health by favorably influencing

lipid profiles,

antioxidant status, [54] and heart health. [55]

Vitamin E has also been

found to help reduce many symptoms associated with

PMS. [56]

 

Dosage: RDA is 12 IU to 16 IU daily, but studies

suggest 400 IU as a

beneficial therapeutic dose. D-alpha tocopherol, the

natural form, is

often preferred over the synthetic form (dl-alpha

tocopherol). Some

companies offer " mixed tocopherols” with d-beta,

d-gamma, d-delta

tocopherols and various tocotrienols, the way vitamin

E occurs

naturally

in food. Dry Vitamin E (succinate) is water soluble

and is the best

form

for those who have fat absorption problems.

 

Multi-Vitamin Mineral Supplement

 

As we discussed above, individual nutrients have been

found to directly

influence PMS. Several studies have noted a marked

improvement

following

the use of a Multi-Vitamin Mineral Supplement which

contains the

individual nutrients discussed along with a balanced

blend of other

vitamins and minerals. [57] The preferred supplement

must contain

sufficient quantities of Mg (400mg), Vitamin B-6(50mg)

and Vitamin

E(400IU) in the d-alpha form.

 

Omega 3 Oils

 

Research results on the efficacy of the use of

supplemental oils for

PMS

vary in outcome. While fish oil has several positive

outcome studies,

[58] the popular use of Primrose oil for PMS is not

well supported by

study results. [59] Since many women with PMS do not

consume a

sufficient amount of Omega 3 fatty acids, it is

prudent to supplement

with EPH-DHA, fish oils, or flaxseed oil.

 

Dosage: 2000mg /day

 

 

Botanical Remedies

 

We will discuss three herbs that are enjoying

popularity for PMS: Black

Cohosh, Dong quai, and Chaste Berry.

 

 

 

Black Cohosh(Cimicifuga racemosa)

 

 

The Black Cohosh plant is a perennial bush in the

buttercup family that

can grow up to 9 feet high. It is found in woodlands

throughout the

Northeast. The root(rhizome) is used medicinally.

 

The plant has several common names, which reflect the

many uses that

have been attributed to it, including snakeroot,

bugbane, rattleweed

and

squawroot. ‘Cohosh” is a Native American Algonquin

word which refers to

the ‘rough’ surface of the rhizomes. ‘Snakeroot’

reflects its use as a

snakebite remedy. ‘Bugbane’ comes from the ability of

the plant’s odor

to repel insects. In Europe the flowers were stuffed

into pillows for

this purpose. When the dry seeds found on the plants

in late fall are

blown by the wind, they rattle, thus ‘rattleweed’.

Several native

cultures considered ‘rattling’ an important sound used

for sacred

ceremony. Black Cohosh was also called ‘Squawroot’

because it was

commonly used by Native Americans to assist in all

manner of women’s

ailments, including scanty, heavy, painful and

irregular menstrual

flow,

inability to conceive, and menopausal symptoms such as

hot flashes and

vaginal dryness.

 

Black Cohosh root extract was regularly recommended by

the Eclectic

Physicians in the mid 1800’s for all female

complaints, and is among an

ever growing group of herbs where modern scientific

analysis reveals

the

chemical constituents that help to explain the

long-time observations

of

herbalists throughout history. The extract contains

glycosides and

isoflavones, which may impart an estrogenic effect.

One specific

isoflavone, formononetin, was shown to be able to bind

to estrogen

receptor sites in vitro. One study demonstrated that

Black Cohosh

measurably lowered luteinizing hormone (LH) levels in

menopausal women.

[60] Although most current studies focus on the

usefulness of Black

Cohosh for menopausal complaints, Black cohosh has

been approved by the

German Commission E for the treatment of PMS.

 

 

 

Dosage: tea made from dried root- 3-4 cups/day (1 cup

water to 1/2 tsp

dried root)

 

Capsules- 40 mg 2X/ day

 

Extracts- 2-4 ml/day

 

 

 

Black Cohosh may be standardized to 1 mg deoxyactin/20

mg extract, or

 

2.5% triterpene glycosides

 

 

 

 

 

Cautions: discontinue use during pregnancy.

 

Headaches, dizziness, nausea, visual disturbance have

been reported

after

 

taking large amounts ( over 3 grams/day)

 

 

 

Interactions: None reported.

 

 

 

 

 

Dong Quai(Angelica sinensis)

Dong quai is the medicinal root of a species of the

Angelica plant

family. The plant has the characteristic umbrella

shaped flower tops of

the Umbelliferae family. The medicinal part is the

root, yellow to

brown

on the outside and white on the inside. Dong quai has

been used

medicinally in China, especially in formulas for

women, for thousand of

years. The name “ Dong quai” translates to “proper

order”; it balances

the entire female system, bringing things back into

‘proper order’.

 

 

 

Scientific research performed on extracts of Dong quai

supports many of

the ancient folkloric uses. Pharmacological effects

include analgesic

activity along with the ability to relax smooth muscle

and tonify the

uterus. [61] Dong quai can help to reduce high blood

pressure, [62] ,

ease asthma and relax the coronary arteries. [63] Dong

quai contains

ferulic acid, which acts as an anticoagulant on blood

cells, and

ligustilide, which may explain its antispasmotic

effect that aids

menstrual cramps, headaches, and acts to tonify the

uterus. Dong quai

contains Vit A and E, folic acid, B-12, various

essential oils and

bioflavonoids. It relieves PMS symptoms such as

bloating, mood swings,

muscle aches and menstrual cramps and increases energy

and vitality.

 

 

 

Dosage:

 

In Chinese medicine it is used as a dried root added

to nutritious

soups.

 

Root: 10 grams added to soup

 

Capsules: up to six 500 to 600 mg per day

 

Tincture/Extract: 1-2 ml 3 times per day

 

Cautions: do not use in pregnancy, May cause heavy

bleeding. May cause

photosensitivity or skin rash.

 

Interactions:

 

Warfarin and other anticoagulants- may potentiate both

therapeutic and

adverse effects

 

Hormone therapies- may compete for estrogen receptor

sites

 

 

 

Chaste Tree Berry( Agnus castus, Vitex)

 

 

 

The Chaste Berry Tree is indigenous to the

Mediterranean area. It is an

attractive bush with finger-like leaves and thin

violet, blue or pink

flowers. The fruit produced by this tree is a dark

brown to black

berry,

about the size of a peppercorn, with a spicy pepper

flavor.

 

The Chaste Berry has a long history of use as an

herbal medicinal. It

was first mentioned in the 4th century BC by

Hippocrates, and was

indicated in The King’s American Dispensary as a

remedy for female

problems. Its common name reflects the belief that

eating the fruit

decreases sex drive, and allows for increased

chastity. . During

ancient

Greek and Roman times, the Priestess of the Temple

would eat the

berries

to lessen the libido. Another name for the plant,

Monk’s Pepper, came

from the use by medieval monks towards a similar goal.

 

 

Chaste Tree Berry is the herb with the best scientific

documentation

for

its role in being specifically useful for PMS. [64]

Chaste Berry

effects

the pituitary gland, by regulating the release of

prolactin. [65]

Problems associated with high prolactin levels, or

hypersensitivity to

normal levels, include PMS, infertility and abnormal

bleeding. Chaste

Berry has been the subject of placebo controlled

double blind studies,

which have uncovered some of the specific mechanisms

of action, such as

binding to opiod receptors. [66] It has proven to be

especially useful

if irregularities are due to a deficiency in the

formation of the

corpus

luteum. Chaste berry increases the production of

lutenizing

hormone(LH),

and decreases follicle-stimulating hormone(FSH). This

enhances the

ratio

of progesterone to estrogen. Chaste Berries may need

to be used for

several months to elicit the desired effect. Please

note that this

herbal remedy is often called Agnus Castus or Vitex-

its all the same

herb.

 

 

 

 

 

Dosage: tea- 1 cup of boiled water poured over 1 tsp

of fresh or dried

berries. Steep

 

for 10 minutes. Drink 1-2 cups per day.

 

Extract- 10-40 drops 2X/day

 

Capsules- 1 cap(40 mg) 1X/ day

 

Cautions: Do not use during pregnancy. If using Chaste

Berry to enhance

fertility, discontinue use once conception has

occurred. Skin rashes,

and increased menstrual flow have been reported in a

small number of

users.

 

Interactions: Do not use along with birth control

pills or other

prescription hormone therapies due to possible

competition for binding

sites. It may weaken the effect of dopamine- receptor

antagonists.

 

 

 

 

 

--

 

 

 

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