PMS (Premenstrual Syndrome)

General Considerations

Premenstrual Syndrome (PMS) is estimated to affect between thirty and forty percent of menstruating women.

The primary hormonal disturbance in PMS is that estrogen levels are elevated and progesterone levels are reduced.

An increased estrogen-to-progesterone ratio leads to impaired liver function, reduced levels of serotonin (an important mood-elevating neurotransmitter) in the brain, lower endorphin levels, impaired vitamin B6 activity, and alterations in other hormone levels.

The primary nutritional recommendations for PMS are: increase consumption of plant foods (vegetables, fruits, legumes, whole grains, nuts, and seeds); consume small-to-moderate quantities of meat and dairy products; reduce fat and sugar intake; eliminate caffeine intake; and keep salt intake low.

Low thyroid function (hypothyroidism) has been shown to affect a large percentage of women who have PMS.

Vitamin B6 and Magnesium are the two most important nutritional supplements for treating PMS.

The four most useful herbs in the treatment of PMS are angelica or dong quai, licorice root, black cohosh, and chasteberry.

The use of progesterone creams should be reserved as the last choice after other natural measures have failed.

Pre-Disposing Factors:

a. Carbohydrate sensitivity.

b. B vitamin, calcium or magnesium deficiency.

c. Hormonal imbalance.

d. Obesity.

e. Excessive use of alcohol, tobacco or hydrogenated fats and oils.

PMS Classification

In an attempt to bring some order to the clinically and metabolically confusing picture of PMS, several experts have created classification systems that sort PMS sufferers into subgroups. The system with which we have the most experience was developed by Dr. Guy Abraham; it divides PMS into four distinct subgroups. Each subgroup is linked to specific symptoms, hormonal patterns, and metabolic abnormalities. Note that one rarely experiences a particular subgroup in a pure form; usually there is an overlap of one or more of the subgroups.

PMS-A (A = anxiety) is the most common symptom category and is found to be strongly associated with excessive estrogen and deficient progesterone levels during the premenstrual phase. Common symptoms of patients in this category are anxiety, irritability, and emotional instability.

PMS-C (C = carbohydrate craving) is associated with increased appetite, craving for sweets, headache, fatigue, fainting spells, and heart palpitations. Glucose tolerance tests (GTT) performed on PMS-C patients during the five to ten days before their menses show a flattening of the early part of the curve (which usually implies excessive secretion of insulin in response to sugar consumption), whereas during other parts of the menstrual cycle their GTT is normal. Currently, there is no clear explanation for this phenomenon, although an increased cellular capacity to bind insulin has been postulated. This increased binding capacity for insulin appears to be hormonally regulated, but other factors may also be involved, such as a high salt intake or decreased magnesium or prostaglandin levels.

PMS-D (D = depression) is the least common type and is relatively rare in its pure form. Its key symptom is depression, which is usually associated with low levels of neurotransmitters in the central nervous system. In PMS-D patients, this is probably due to increased breakdown of the neurotransmitters as a result of decreased levels of estrogen (in contrast to PMS-A, which shows the opposite results). The decreased ovarian estrogen output has been attributed to a stress-induced increase in adrenal androgen and/or progesterone secretion.

PMS-H (H = hyperhydration) is characterized by weight gain (greater than three pounds), abdominal bloating and discomfort, breast tenderness and congestion, and occasional swelling of the face, hands, and ankles. These symptoms are due to an increased fluid volume, secondary to an excess of the hormone aldosterone which causes increased fluid retention. Aldosterone excess during the premenstrual phase of PMS-H patients may arise due to stress, estrogen excess, magnesium deficiency, or excess salt intake.

General Recommendations

Here are the important steps to take to help you prioritize and implement the various measures detailed above:

1. Evaluate your PMS symptoms by studying the 4 types of PMS as shown above.

2. Rule out hypothyroidism and/or depression. Determine your basal body temperature (discussed in HYPOTHYROIDISM). If your basal body temperature is below 97.8 degrees Fahrenheit, or if you are suffering from other symptoms associated with PMS, consult your physician for complete thyroid-function testing. Determine whether depression may be a factor.

Dietary Recommendations

a. Drink 2 to 3 ounces of water every 30 minutes while awake each day (no well water or water containing fluoride or chlorine).

b. Eliminate all refined carbohydrates – especially sugar, processed foods, alcohol and foods containing caffeine such as coffee, tea, cola and chocolate.

c. Eliminate all hydrogenated fats and oils. Use fish oils, coconut oil and extra virgin olive oil as your only source of dietary oils.

d. Increase raw foods and quality protein especially fish and sea vegetables.

e. If there is obesity, insure total daily carbohydrate intake is limited to not more than 60 grams.

f. Follow a vegetarian or predominantly vegetarian diet

g. Reduce exposure to environmental estrogens in foods

h. Keep processed table salt intake to a minimum, use an unprocessed, deep-mined salt.

Nutritional Supplements

Primary Nutrients:
1. EQUI-FEM – 2 tablets, 3 times daily with meals.

2. BIO-C PLUS 1000 – 1 tablet, 3 times daily after meals.

3. M S M POWDER4. OSTEO-B PLUS – 3 tablets, once daily after a meal.

5. BIOMEGA-3 – 4 – 5 capsules, twice daily after meals for 1 month, then 4 – 5 capsules once daily thereafter M – F of the week.

Specific Nutrients: When symptoms or condition begins to subside, gradually, as needed, wean yourself from the Specific Nutrients & stay on the Primary Nutrients. If any symptoms re-occur resume Specific Nutrients.
6. E-MULSION 200 – 1 capsule, 3 times daily with meals.

7. GAMMANOL FORTE with FRAC – 2 tablets, 3 times daily with meals.

8. MG-ZYME – 1 tablet, 3 times daily with meals.

9. B6 PHOSPHATE – 1 tablet, 3 times daily.

10. ZN-ZYME FORTE – 1 tablet, 3 times daily with meals.

11. B12/FOLATE PLUS ? 2 capsules, 3 times daily with meals.


If, after at least three complete menstrual periods, you are not experiencing a significant improvement or complete resolution of symptoms, further support is probably indicated. Our best recommendation is to consult a physician who is familiar with nutritional therapies for PMS. The physician should help you in identifying possible causative factors and more effective treatment strategies tailored specifically for your case.

Saliva testing for 24 hour Cortisol and 7 other hormones can be performed in your home rather easily and gives significant information to effectively alleviate your symptoms. E-mail me through this web site and we will send you the Saliva Kit. Follow the instructions and send the kit off in the pre-addressed envelope and the rest is done for you.

In those cases where the axillary temperatures are low a prescription for Armour’s Desiccated Thyroid may need to be taken also. SEE: Armour’s Desiccated Thyroid Dosage




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