Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) and premenstrual tension (PMT) are terms used to describe a group of physical and emotional symptoms that many women experience in the days leading up to their menstrual period. The symptoms vary, but one common feature is that they disappear once the period starts.


Symptoms vary widely, with some women being untroubled by premenstrual syndrome and others being so severely affected that they need to take time off school or work. Symptoms may include:

  • Fatigue
  • Low moods, weepiness
  • Irritability, shortness of temper, mood swings and feeling 'out of control'
  • Difficulty concentrating
  • Fluid retention (commonly affecting the breasts, hands, feet and abdomen)
  • Breast pain
  • Back ache, headache, migraine or uterine cramping
  • Altered bowel habits (constipation or Diarrhoea)
  • Reduced pain threshold
  • Altered sex drive
  • Food cravings (e.g. for sugar, chocolate or carbohydrates)
  • Acne


  • The female reproductive cycle involves a complex interplay of fluctuating hormones. Although the exact cause has not been determined, hormonal factors that may be involved include oestrogen and/or prolactin excess and progesterone deficiency
  • There may also be a link between premenstrual syndrome and Thyroid underactivity, Stress (and adrenal hormone production), and Low moods
  • Other contributing factors may include deficiency of zinc or magnesium
  • From a naturopathic perspective, liver and gall bladder function are also implicated in premenstrual syndrome. Excess oestrogen inhibits liver and gall bladder function, and conversely, Sluggish Liver activity may also contribute to excess oestrogen levels (by delaying detoxification and clearance of the hormone)

Nutritional & Herbal Support

  • Vitex, or chaste berry, has traditionally been used to balance female hormones and may provide relief of pre-menstrual symptoms such as period pain, breast tenderness and other symptoms.
  • Curcumin is the active component of Tumeric, which has a long history of use in Ayurvedic medicine as an anti-inflammatory and anti-arthirtic which may assist with aches and pains
  • St John's wort is another herb that is clinically proven to relieve mood disorders such as Anxiety and Low moods, and may be useful when these symptoms occur as part of the premenstrual syndrome
  • Ginkgo biloba may increase memory, mental alertness and concentration in healthy people
  • Zinc is especially indicated for premenstrual Acne as low zinc levels are often observed in women with premenstrual syndrome, and taking a zinc supplement may help to balance hormones.
  • Magnesium deficiency may contribute to the development of premenstrual syndrome, and taking a magnesium supplement may help to relieve Period Pain and other symptoms. It also helps relieve tense or contracted muscles and supports the body's ability to cope with Stress.
  • Milk Thistle is a Liver-cleansing herb that increases bile output and supports digestive function. This may be beneficial in cases when indigestion is due to Sluggish Liver or gall bladder function and support the excretion of toxins (including excess hormones)
  • Grape seed extract can help relieve fluid retention and heaviness of the legs when they occur as symptoms of premenstrual syndrome. It may need to be taken for up to four cycles before reaching its full effect

Diet & Lifestyle advice

  • Severe PMS symptoms may be indicative of underlying disease, and require medical investigation
  • Premenstrual syndrome is more likely to affect women whose diet is high in refined carbohydrates and sugars; high levels of saturated fats may also contribute. Stick to a low glycaemic index (GI) diet that includes slow-burning carbohydrates (such as oats and legumes) to help you maintain better blood glucose control. Avoid high GI carbohydrates such as sugars, wheat products (e.g. bread), and potatoes, which are metabolised quickly, leading to blood sugar fluctuations.
  • Following a vegetarian diet may also be beneficial
  • Avoid caffeine throughout your cycle, especially if your symptoms include Low moods, Anxiety, Period Pain or breast tenderness
  • Avoid salt throughout your cycle, especially if your symptoms include Fluid Retention
  • Reduce your exposure to environmental oestrogens by choosing organic food where possible. Pesticide residues may have oestrogenic effects in the body, which may contribute to premenstrual syndrome
  • Premenstrual syndrome is more common in women who are physically inactive, and increasing exercise frequency may help to reduce the severity of symptoms, especially mood changes and Period Pain

If symptoms persist consult your healthcare professional. Information provided is of a general nature and should not replace that of your healthcare professional.

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