Women's Health

Herbal Remedies for PMS

Herbal Supplements for PMS

Of the herbal supplements mentioned in connection with PMS symptoms, chasteberry (Vitex agnus-castus) has gained the most traction with scientists for easing PMS-related breast pain. Chasteberry is a shrub that grows in southern Europe and Central Asia.

A few studies have shown that women treated with chasteberry extract reported less breast pain, bolstering the theory that chasteberry suppresses the release of prolactin, a hormone involved in breast milk production that's been linked to breast pain. Another small study showed that chasteberry, combined with St. Johns' wort, lowered levels of depression, anxiety, and cravings.

Evening primrose oil (Oenothera biennis), which contains gamma-linolenic acid (GLA), is often mentioned as an antidote to breast pain, but there's insufficient evidence that it works.

Other herbs purported to help PMS symptoms are:

• Ginkgo biloba for breast tenderness, neuropsychological symptoms
• St. John's wort for depression
• Dandelion leaf for bloating

Joseph Sanfilippo, MD, a professor of obstetrics, gynecology, and reproductive sciences at the University of Pittsburgh School of Medicine, says patients mention chasteberry, and he doesn't have a problem with them using it. But he's not convinced it works.

Sanfilippo says he's also waiting for more evidence that ginkgo biloba and evening primrose oil can ease PMS symptoms.

"The problem is a lack of well-designed studies," he says. "There have been some studies showing that women who take chaste tree berry had some symptomatic improvement, but my problem is, we just don't have robust research we would like."

Are Herbal Supplements Safe?

There are some cautions to consider:

• Chasteberry may interfere with birth control pills, antipsychotic drugs, and estrogen supplements.
• Evening primrose oil may raise the risk of bleeding, especially in people who take blood thinners such as warfarin (Coumadin).
• Dandelion leaf may lead to an allergic reaction in people with a ragweed allergy. It can interfere with the drug lithium and some antibiotics.
• St. John's wort interacts with many other medications, including birth control pills, and can cause rashes with direct exposure to the sun. It is important to check with your doctor before taking St. John's wort and other prescription medications together.

If you're taking, or thinking about taking, these or any other herbal supplements, talk to your doctor about it. They need to have a complete picture of everything you're taking, even if it's "natural" or doesn't require a prescription.

Conventional Treatments for PMS

SSRIs (selective serotonin reuptake inhibitors) include antidepressants like fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and paroxetine (Paxil, Pexeva). They work by adjusting the brain's use of serotonin, a chemical that regulates mood and behavior.

Sanfilippo considers SSRIs to be the most effective therapy for the emotional/psychological symptoms of PMS -- in cases that are more acute.

Supplements like calcium, magnesium, and vitamin B6 are also a consideration, and for severe symptoms, such as in premenstrual dysmorphic disorder, he likes to prescribe a birth control pill.

Before Sanfilippo prescribes anything, however, he first recommends to patients that they avoid eating refined sugar and exercise more. "Treatment is lifestyle," he says.