CONTROLLING PMS by ZOLTAN P. RONA, M.D., M.Sc. 

Premenstrual syndrome (PMS) is a term used to describe a condition occurring 
in many pre-menopausal women up to two weeks before menstruation (during the 
luteal phase of the menstrual cycle).  There are several different types of 
PMS depending on the predominant symptoms seen in a given individual and each 
is treated somewhat  differently. 

In PMS-A (anxiety), the most common complaints are anxiety, irritability and 
mood swings.  This form of PMS responds best to vitamin B6 (100-300 mgs.) and 
magnesium (300-400 mgs.) along with an improved diet.  By this I mean eating 
more fresh fruits, vegetables, legumes and seafood and less processed, 
sweetened and salted foods including red meats. Red meats and dairy products 
may contain estrogen which aggravates PMS.  From a biochemistry standpoint, 
it is thought that deficiency of vitamin B6 (pyridoxine) together with high 
estrogen levels cause a deficiency of serotonin in the brain.  Since 
serotonin is a soothing, mood-elevating substance, a deficiency leads to 
anxiety and depression.  Women who take the birth control pill which destroys 
vitamin B6 reserves are prone to low serotonin levels and, hence, the 
psychological consequences.  Many doctors and PMS clinics prescribe 
progesterone, a female hormone that antagonizes high estrogen levels. 
Unfortunately, this therapy is  not without its side effects.  

PMS-H (heavy) is characterized by water retention, swelling of the hands and 
feet, abdominal bloating and premenstrual weight gain.  Avoidance of excess 
sugar, salt and fat is important along with stress reduction (meditation, 
visualization, etc.) and regular  exercise.  PMS-H also responds well to 
vitamin B6 and magnesium. 

In PMS-C (craving) the major symptoms are cravings for various foods, 
especially sweets.  There may also be heart palpitations, fatigue, dizziness 
and fainting.  This form of PMS responds to a healthier diet as well as 
vitamin B6, zinc, vitamin C and gamma-linolenic acid (GLA) which comes from 
the oil of evening primrose.  A clever thing to do is to eat five or six 
smaller meals throughout the day instead of three larger ones to  stabilize 
blood sugar levels. 

PMS-P (pain) refers to the type where the primary problem is breast tenderness 
and abdominal discomfort.  Sufferers are benefited by vitamin E 
supplementation (150-600 I.U.).  This is because vitamin E increases the 
body's synthesis of prostaglandin E-1 which antagonizes the hormone, 
prolactin.  An excess of prolactin has been reported in some studies to be 
associated with PMS.  Research indicates that vitamin E is effective in 
controlling breast tenderness and other PMS symptoms including mood swings, 
anxiety, confusion and headaches.  Vitamin E, however, does not handle water 
retention, weight gain and abdominal bloating in PMS.  Caffeine in coffee and 
tea aggravate breast tenderness during PMS and should be replaced by herbal 
teas or  juices. 

Finally, in PMS-D (depression) the major concern is depression which can, at 
times, be so severe that suicide is contemplated. Other symptoms of PMS-D are 
forgetfulness, crying, confusion and insomnia.  In this type, gamma-linolenic 
acid (GLA) supplementation is beneficial as well as calcium and magnesium.  As 
far as diet is concerned, it is important to avoid tyramine-containing foods 
such as cheeses and red wine.  Increased tryptophan intake (from higher protein 
in the diet or supplement) is helpful because tryptophan is converted into 
serotonin in the brain.  As mentioned  earlier, serotonin is a natural mood 
elevator. My experience is that over 80% of the cases of PMS respond well to 
diet, supplements and lifestyle changes.  Individualized homeopathic remedies 
may also be very effective in a large number of cases.  For the best results, 
see a health care practitioner familiar  with the natural approach.