Problem Periods

During lunch break my coworker, Mary, was obviously feeling unwell. When I asked her what the matter was, she told me she was having problems with her periods; they seemed heavier and more frequent than they had been. The discomfort–and the PMS–were driving her crazy.

Although Mary maintains a healthy diet and exercises regularly to reduce her tension and discomfort, the problems persist.

Dealing With PMS

Mary complained that the increased frequency of her periods was annoying and inconvenient. I told her that the phytoestrogen from soy protein (60g containing 45 mg isoflavones/day) has been shown to delay menstruation and could help regulate her periods.

Mary was also bothered by periodic depression, water retention, and cramps. I suggested that, for these symptoms, she try calcium and magnesium. Elemental calcium (1,000 to1,200 mg/day), when added to a normal dietary intake, seems to reduce these symptoms significantly. Some evidence suggests that calcium citrate and oyster-shell calcium are absorbed better than calcium carbonate, while other research indicates similar bioavailability. Magnesium (200 to 400mg/day) can improve mood and reduce both water retention and premenstrual migraines.

Another suggestion for alleviating mood-related PMS symptoms is vitamin B₆ (pyridoxine). I told Mary that the combination of vitamin B₆, 50 to 100 mg/day (each day or during the last two weeks of the menstrual cycle) plus magnesium (200mg/day) may be effective in relieving nervous tension, mood swings, irritability, and anxiety. I suggested she start with the lowest suggested dose (50 mg daily) of B₆.

Beneficial Botanicals

Mary was concerned about the monthly pain she feels in her breasts (a condition known as mastalgia or mastodynia). There is evidence that taking evening primrose oil (three to four g/day) can relieve cyclic mastalgia and, for some women, evening primrose has been helpful for managing PMS in general. Blackcurrent (Ribes nigrum) and borage seed (Borago officinalis) oils, which contain the essential fatty acid gamma-linolenic acid (GLA) found in evening primrose oil, may also be useful for problem periods.

I suggested that Mary also consider taking the herb chasteberry (Vitex agnus castus), which is officially approved to be sold for the reduction of PMS symptoms in Germany. Chasteberry may decrease many of Mary’s symptoms, especially breast pain or tenderness. Edema (water retention), constipation, irritability, depression, mood swings, and headaches may also be reduced. In fact, taking chasteberry (20 to 40 mg/day) for eight weeks has been shown to be comparable to taking the antidepressant fluoxetine for relieving symptoms of premenstrual dysphoric disorder (unpleasant emotional disturbances before the menstrual cycle). Doses of chasteberry can vary considerably due to different manufacturing processes, so I suggested that Mary follow the directions on the label of the product she buys.

Wild yam root (Dioscorea villosa) was recommended by a friend of Mary’s for her problem periods. Wild yam contains diosgenin, a substance used in the laboratory synthesis of steroid hormones. The use of this herb is based on the rationale that diosgenin will be converted in the body into progesterone which may relieve the symptoms of problem periods. However, the conversion of diosgenin to progesterone has, as yet, only been demonstrated in the laboratory, not in the human body.

When Mary’s periods are really bad, she sometimes suffers from nausea and vomiting. Ginger, standardized to contain gingerols (200 mg every four hours as needed), reduces nausea and vomiting. I suggested that peppermint oil capsules might also be helpful and provide relief from dyspepsia and flatulence.

When Mary and I had lunch together again several months later, she was happy to report back to me that her use of these natural remedies had so effectively reduced the discomfort and inconvenience of her problem periods that they were a problem no longer.