Most women will admit to some decrease in well-being in the 2-14 days prior to menstruation. This is predominantly caused by an increased sensitivity throughout the body because of raised oestrogen and progesterone levels. Deficiencies in vitamins and minerals, an excess of stress chemicals such as adrenaline and physical stress from food allergy may all make matters worse. Premenstrual syndrome is a troublesome and recurrent multi-symptom condition that can be anything from mildly disturbing to profoundly debilitating. The symptoms can be divided into categories.

Psychological symptoms

Anxiety, confusion, depression, memory deficit, irritability, mood swings, tearfulness, exacerbated tension and insomnia occur in 75 per cent of PMS sufferers.

Physical symptoms

Headache, lethargy, dizziness or fainting, fluid retention with associated weight gain, abdominal bloating and breast tenderness will be apparent in about 70 per cent of cases.

Studies have shown that the symptoms are directly related to hormonal imbalances. It is important to understand that on the way to making oestrogen and progesterone the body produces many similar chemicals all of which can have an effect on the system. Some symptoms are created by low levels whilst others by high levels. Other hormones such as androgens, aldosterones, prolactin, follicle-stimulating hormone (FSH) and thyroid levels can be affected.

Deficiencies in vitamin B6 and magnesium can have a profound effect on the production of some of these hormones, as well as affecting brain neurotransmitters such as dopamine, which are responsible for the emotional changes. These two supplements also play a part in the production of a particular hormone known as prostaglandin E,, the function of which is not well understood but is often found to be low in women struggling with PMS. Excessive fat intake or deficiencies in omega 6 and omega 3 fatty acids (which are included in extract of Evening Primrose Oil) can cause low levels of this compound. Mercury and lead poisoning may be associated with PMS, as may deficiencies in vitamins A, C and E and the minerals selenium, zinc and iron, in addition to those mentioned above.

Premenstrual syndrome is not imagined. There is a lot of scientific evidence to support causes that can be treated without using the antidepressants that are the first-line treatment of the orthodox medical world.

Avoid animal fats, fried foods and any hydrogenated oils (that includes many margarines) especially during the time leading up to the period. Reduce sugars and increase vegetable sources of proteins such as soya and legumes. Any compound that affects the liver, such as alcohol and caffeine, will reduce its ability to break down hormones and therefore exacerbate some cases of PMS.

Consider a trial of vitamin B6 or magnesium, or preferably have these levels checked by a competent complementary medical practitioner.

If deficient, for a trial period take vitamin B6 and magnesium both at 50mg per foot of height in divided doses throughout the day starting on day 14 of the cycle and carrying on until the period starts (day 1 is the first day of a period).

Obtain a fish oil or eicosapentaenoic acid (EPA) supplement and take three times the recommended daily allowance (RDA) from day 14 to the first day of the period. Vegetarians may use linseed oil – one teaspoonful per foot of height divided with meals through the day.

Beta-carotene (2mg per foot of height) and vitamin E (5iu per foot of height) in divided doses during the day may be of some benefit. ‘ Gammalinoleic acid (GLA 50mg per foot of height) taken with breakfast may be beneficial. This can be found in Borage, Star Flower or Evening Primrose Oil capsules.

Liquorice taken as a tincture diluted 5:1 with water (1 teaspoonful per foot of height) in divided doses with meals.

Alfalfa contains phyto-oestrogens (plant oestrogens), and should be considered but prescribed by a herbalist.

Hair mineral analysis should be considered if the above are not working.

Bromelain at twice the dose recommended of a good natural product may help.

A study has shown that osteopathy can reduce the physical symptoms of PMS.

Acupressure and acupuncture are beneficial.

Homeopathic remedies that match the symptoms will be beneficial and specific attention should be paid to Calcarea carbonica, Sepia, Causticum, Pulsatilla, Ignatia and Kali carbonicum.

Reflexology with attention paid to the pituitary and adrenal glands will help.

If all this fails, consider seeing a complementary medical practitioner because nearly everyone who practises medicine has some trick up their sleeve! The use of natural progesterone derived from the Mexican yam can be beneficial if the symptoms are created by low progesterone or unopposed oestrogen, but this needs to be prescribed by a practitioner with expertise in this area.

Relaxation and meditation techniques through yoga or Qi Gong can be very beneficial.

Resort to the oral contraceptive pill only if the above measures do not have an effect.