Relief for PMS

May 22, 2000 -- As a physician, Mary Hardy, MD, was trained to view herbal medicine with a healthy dose of skepticism. But her patients kept gushing about the remedies they were using for premenstrual syndrome (PMS). "I'd had so many patients come in with dramatic stories," she says. "One woman told me 'these herbs are like magic.' "

So when she herself fell victim to a bad case of PMS, Hardy decided to try the two herbs most commonly used for the problem -- evening primrose oil and chaste tree berry (also known as vitex). To her delight, they eased her symptoms, and when Hardy praised the herbs at a March 2000 conference of the American Pharmaceutical Association, national news reports carried her remarks.

Hardy was more open than many physicians to the idea of herbal remedies; as the medical director of the Cedars-Sinai Integrative Medicine Medical Group in Los Angeles, her clinic melds conventional Western medicine with complementary methods like herbs, osteopathy, and acupuncture. After discovering that herbs relieved her own symptoms, Hardy hit the library to see what researchers had learned.

What she found highlights the dilemma of many women seeking alternative treatments to ease PMS. While self-help books and Internet sites trumpet the power of herbal remedies, there's scant scientific evidence to support the claims.

Fortunately, herbs aren't the only treatment available for PMS sufferers who want to avoid hormones and anti-depressants with their side effects. Researchers have found solid evidence for some vitamins and minerals -- so much that the American College of Obstetricians and Gynecologists (ACOG) in April revised its recommendations on PMS to include them.

The Truth About Herbs

Most of the evidence for botanical PMS remedies is made up of individual anecdotes like Hardy's. And many studies have suggested that the placebo effect -- a patient's belief in the power of a medicine -- may be the reason so many women report relief from these herbs.

For example, PMS sufferers have reported feeling much better in studies using evening primrose oil. But in the August 1990 issue of the Medical Journal of Australia, researchers reported a more careful approach: They divided 38 women in two groups. One took primrose oil and one took a placebo. But groups reported the same improvement.

As for chaste tree berry, most tests haven't compared it to a placebo. And scientists have yet to scrutinize dong quai, another herb said to offer PMS relief.

Vitamins and Minerals to the Rescue

Does this mean women must rely on hormones and antidepressants -- the standard treatments -- for PMS? No, says Susan Johnson, a gynecologist at the University of Iowa who helped develop the new ACOG standards. If you're in the throes of PMS and in search of supplements that work, Johnson says you may benefit from calcium, magnesium, and vitamin E.