ESCAPING THE PMS MAZE
by Geoffrey Redmond, MD
HERBS AND SUPPLEMENTS
A variety of botanical remedies have been reported to help with PMS. Picking the right dose and preparation is important. The biggest problem with herbs is that there are so many, and most of the information available is not reliable. The best source of advice is a trained medical professional with an interest in herbs. Self-described ďherbalistsĒ are often amateurs with incomplete knowledge.
I have listed some useful herbs and some which are popular but questionable. Names can be confusing; I have given the most commonly used ones.
Vitex (chaste tree or chaste berry). Best supported by research. It evens mood and can decrease breast pain. Evening primrose oil. Results of studies have been mixed. Black cohosh Useful when PMS occurs around time of perimenopause.
Dong Quai Used by hundreds of millions of Chinese women as a female tonic, usually as an ingredient in soup. Western studies have not shown clear benefit and safety is uncertain. L-phenylalanine This is converted in the brain to several important neurotransmitters. Not much published but experience suggests it can help. L-tryptophan has been reported to help but safety is problematic due to toxic contaminants in some preparations. The FDA withdrew it. Even if you find it, donít use it.
Eleutherococcus (Siberian ginseng) May be useful for improving energy.
American (Wisconsin) ginseng (Panax ginseng). This form is suitable for women. There are innumerable brands and not all are reliable. Some are adulterated with caffeine. Avoid the very expensive forms sold in Chinese stores unless you are a ginseng expert. Stick with an established brand with a good reputation. Traditionally Asian (as opposed to American) ginseng is considered too yang for women but it is hard to separate fact from folklore.
Hypericum (St Johnís Wort). This is widely used for mood problems. Onset is gradual and there are rumors of liver problems.
Choosing herbs and supplements. Different women vary in their response to these treatments so you should get advice from a knowledgeable practitioner and be willing to try other supplements if the first do not work. Be skeptical of sales pitches in health food stores which urge purchase of many different products. In general, it is reasonable to use at most one or two herbs plus at most three vitamins and minerals. Not all are safe to combine with each other or with medications you may be taking. Also, when you feel better, you may not know which has helped. Itís best to develop a plan with a knowledgeable practitioner.
Safety of Supplements While most vitamins and herbs are safe, not all are. High doses may have different effects than normal ones. Some are nontoxic in themselves but contain dangerous contaminants. It is best to use only supplements for which adequate experience has been accumulated to give confidence in safety.
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