PMS – 911
Most women during their reproductive lifespan will probably experience premenstrual syndrome at some point and to some degree. But 20-30% of women of reproductive age experience moderate to severe PMS symptoms, which can often be debilitating.
The hormone fluctuations responsible for PMS are somewhat unique to each individual, but the most common issue seems to be insufficient progesterone in the week or two preceding menstruation. Many of the symptoms that correlate with progesterone deficiency (estrogen dominance) are water retention, breast swelling, headaches, mood swings, irritability, fatigue and poor sleep patterns. However, each woman’s response to her own hormone fluctuations is extremely individual, regardless of the actual “amount” of each hormone in her system and this is part of the reason it has been so difficult to pin down the causes of PMS. The very complex physiologic processes of a woman’s reproductive cycle require both energy and nutrients, and if these nutrients are not present in optimal amounts, then of course these processes may not occur as quickly or easily as intended. Listed below are some supplements that studies have shown can relieve some of the symptoms of PMS, and when taken together can work synergistically for greater effect.
GLA and Omega 3
If a woman’s diet is high in sugar, saturated fats and omega 6 oils from processed foods and baked goods(containing vegetable oils like safflower, corn and soybean oil), this may generate a higher production of the inflammatory prostaglandin PGE2 and a reduced production of PGE1 and PGE3. Excessive and incorrect prostaglandin (PG) synthesis has been implicated as a cause of some PMS symptoms. Borage oil and evening primrose oil are sources of GLA, which converts to PGE1. The strategy of supplementing with GLA for PMS is to support the body’s formation of PGE1. In addition, fish oil is a source of EPA, which converts to PGE3, providing additional balance to offset an overabundance of pro-inflammatory PGE2.
Although conclusions are mixed, there are a number of studies that have found vitamin B6 useful for managing PMS symptoms, especially those involving mood and emotions such as irritability and depression, and also sleep quality and fatigue. Vitamin B6 acts as a cofactor in the production of dopamine and serotonin which are important “feel good” neurotransmitters. Low serotonin level is a common observation during the luteal phase of women with PMS which can negatively affect mood, memory and sleep. “Coincidentally”, vitamin B6 deficiency can cause symptoms such as irritability, forgetfulness, insomnia, anxiety and moodiness –the very same PMS symptoms that taking supplemental vitamin B6 seems to reduce. Vitamin B6 also detoxifies excess estrogen via methylation pathway. Researchers believe that the right dose of vitamin B6 for PMS is above 50 mg and not beyond 100 mg. 
Magnesium is a cofactor in more than 300 enzymatic processes that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. Magnesium is required for energy production, oxidative phosphorylation, and glycolysis. Magnesium also plays a role in the active transport of calcium and potassium ions across cell membranes, a process that is important to nerve impulse conduction, muscle contraction, and normal heart rhythm. Magnesium is very important in helping to reduce muscle tension and relax the vascular system to help reduce fluid retention and also to ease the discomfort and cramping associated with the onset of menstruation. It also helps with mood and sleep. Magnesium supplementation has been shown to be beneficial in decreasing symptoms of PMS and this is not that surprising, considering that the general population in the U.S. is magnesium deficient. 
Vitex or “Chasteberry” Extract:
The presence and severity of PMS seems to be primarily related to the relative balance of all the reproductive hormones and there is one particular botanical that helps with promoting greater balance. Vitex agnus castus, often called just “vitex”, and also known as Chasteberry or Chastetree is well researched and shown to be effective in ameliorating the classic symptoms of PMS. It is believed that some of the plant compounds influence the pituitary gland, which explains its effects in balancing hormone levels. Vitex has been shown to reduce prolactin levels, a hormone made by the pituitary gland. While elevated prolactin is itself responsible for specific PMS symptoms related to breast swelling and pain, it is a hormone that also has an influence on FSH and estrogen. Like most herbal medicines, we have not yet uncovered its exact mechanisms of action but we do know that clinically it is a safe and effective botanical for relieving many of the symptoms of PMS.
In summary, PMS symptoms may be worsened by nutrient deficiencies (which may be the result of inadequate dietary intake or poor absorption) that are necessary to support the physiological processes of the reproductive cycle. Studies have shown that women who did not suffer from PMS ate diets lower in refined sugar and carbohydrates and saturated fats, and had higher intakes of nutrients like iron, zinc and manganese. Consuming a whole food, Mediterranean or Paleo diet, improving the Omega 6 to Omega 3 ratio, supplementing with adequate B vitamins, especially vitamin B6 as well as intake of adequate magnesium are all nutritional strategies to minimize the occurrence of PMS. And, with the added support of Vitex extract, PMS could end up being a thing of the past for many women.
Lisa Murray RDN, LD
Lisa is a Licensed Dietitian/Nutritionist and Medical Educator for Emerson Ecologics. Herbalist, nutrition counselor, writer and educator, Lisa’s passion is teaching others how to integrate botanicals and nutrition supplements into a healthy diet and lifestyle, for optimal health and healing.
 Gaby, Alan R. Chapter 227: Premenstrual Syndrome. Nutritional Medicine. Concord, NH: Fritz Perlberg Publishing;2011 pg 832.
 Fathizadeh N, Ebrahimi E. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec; 15:401-5
 Van Die MD, Burger HG. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013 May;79(7):562-75. doi: 10.1055/s-0032-1327831. Epub 2012 Nov 7.