Premenstrual Syndrome (PMS)

‘It must be that time of the month’ is the derisive comment offered by some men in response to a woman who is teary or irritable. Perhaps she is just teary or irritable, but the truth is, it could actually be that time of the month when a woman’s hormones are in flux. Nevertheless, he is a thoughtless prat for saying so and deserves that dirty look.

For some women, the premenstrual time sees them change from feeling in control and calm, to being strapped in the front seat of an emotional rollercoaster. Of course this does not mean that women are less able to achieve tasks or make important decisions, it’s just a tad more difficult when you are managing hormonal hijinks as well.

The premenstrual body is a vulnerable body. Your pain threshhold is lower – don’t get your legs waxed. Your immune system is under par – the perfect time to catch a cold. Your vaginal pH changes – thrush is more likely to appear. It is not only the physical body that is more vulnerable; your emotions are also tested at this time.

PMS (premenstrual syndrome) occurs in the second half of the menstrual cycle, during the luteal phase, anywhere from 2 weeks to the day before your period. Symptoms of PMS were first described in the medical literature in 1931 and for many years, the diagnosis was scoffed at by the medical fraternity.

A woman’s menstrual cycle averages 29.5 days – a lunar month. If you are not sure how long your cycle is, keep a track of dates in your diary. Officially, the day your period starts is day 1. Midway through, ovulation occurs, and the last day of the cycle is day 29. This is ‘average’, but it is perfectly normal to have a cycle slightly longer or shorter than this. PMS is the collective name for the 200 symptoms that may occur in any combination, the most common mentioned below. PMS symptoms resolve on the first couple of days of your period.


  • Swollen breasts.
  • Pelvic discomfort, a dragging or cramping pain.
  • Change in bowel habits, often a looser bowel movement.
  • Headaches.
  • Weight gain.
  • Pimples.
  • Swelling of hands, ankles and feet.
  • Back and leg pain.
  • Food cravings, often for chocolate or starches.
  • Fatigue.
  • Insomnia.
  • Anxiety.
  • Mood swings.
  • Depression.
  • Irritability.
  • Lack of concentration.
  • A subgroup of PMS is premenstrual dysphoric disorder, or PMDD. For up to 8 per cent of women, their PMS time is characterised by very severe mood changes including depression, anger and anxiety.
  • The PMS time often sees a worsening of already existing conditions such as IBS, headaches, herpes (cold sores and genital herpes).

Why me?

  • Up to 90 per cent of women experience one or more symptoms of PMS. The actual cause is unknown, but an imbalance between oestrogen and progesterone is a likely hypothesis.

What to do

  • PMS responds very well to natural remedies. It may take a couple of cycles for symptoms to respond, and up to 4 cycles for significant improvements.


  • Women who eat a plant-based diet suffer less from PMS than meat-eating women do. So eat plenty of fruits, vegetables, wholegrains and legumes.
  • Reduce dairy.
  • Increase foods containing soluble fibre including legumes and vegetables and chia seeds. Soluble fibre can stop excess oestrogen from recirculating.
  • Eat fish 4 times a week to provide the omega-3 fatty acid EPA that will help ease the inflammatory symptoms of PMS.
  • Cut out all sugar, salt and white flour products. A study revealed that women with PMS consumed 75 per cent more refined sugar and 62 per cent more white flour products than did women without PMS. It also found that women with PMS consume 79 per cent more sodium.
  • Reduce caffeine (including coffee, cola, chocolate, guarana) all month, and cut it out midway through your cycle. The xanthines in coffee and chocolate have an effect on oestrogen receptors in the breasts, contributing to breast tenderness and enlargement. Caffeine also increases PMS irritability.
  • Drink dandelion root coffee instead. Dandelion root is good for the liver, which helps excrete excess hormones.
  • If your PMS symptoms include cravings for sweet food, mood changes or forgetfulness, eat small meals frequently to steady blood-sugar levels. Each meal should contain a little protein.


  • Vitex agnus castus is a natural for PMS as it helps smoothe hormonal regularities. Take a dose every morning throughout the month.
  • Other herbs helpful for normalising hormones include paeonia, dong quai and false unicorn root.
  • If you suffer an angsty time premenstrually, St. John’s wort, passionflower, kava and pulsatilla can prove useful.
  • There are several good ‘women’s formulation’ multivitamin and mineral supplement tablets available specifically for PMS. They have higher amounts of B6, magnesium and zinc. Take a tablet daily until ovulation, then double the dose until your period arrives.
  • Magnesium helps relieve breast tenderness, weight gain, fatigue, anxiety, cramping and nervous tension. Take extra magnesium, twice a day for 2 weeks prior to your period.
  • If you crave chocolate and starches, take a supplement containing chromium, gymnema, zinc and B vitamins.
  • Take vitamin E every day throughout the month. Vitamin E will relieve breast tenderness and normalise hormones.
  • Evening primrose oil (EPO) can be very successful in relieving many of the symptoms of PMS. It contains gamma linolenic acid (GLA) that is converted in the body into hormone-regulating prostaglandins. In order to be effective, GLA needs to be incorporated into every cell, which is why you need to take EPO for several months.
  • If you suffer from premenstrual fluid retention, vitamin B6, dandelion leaf and the tissue salt Natrum Sulphate (nat. sulph.) can be helpful.


  • Women who partake of regular aerobic exercise have less PMS symptoms than women who don’t. However, ease up the intensity a couple of days before and during your period.
  • Massage can help relieve fluid retention and premenstrual pain.
  • There is often no smoke without fire. In the time before the period everything in the body is more vulnerable. Whatever the emotions you feel in the PMS days, whether it be sadness, irritability or murderous rage, they are magnified versions of what is happening the rest of the month, only you are no longer able to keep these feelings under wraps. Rather than ignoring these ‘out of control’ feelings, try to figure out what might happening for you. In the cold light of day (after your period), perhaps you could analyse whether there is any substance to your feelings, instead of brushing them off as PMS dramatics. Counselling can also be helpful.
  • The Bach flower Walnut may be helpful at this time as it protects against outside influences, just the thing if you are feeling vulnerable. Mustard can help if you feel more depressed at this time, and Willow or Holly may fit the bill if you feel resentful and angry.
  • For many women with busy work and family commitments, it is difficult to tune in to your body’s rhythms. However, the premenstrual time can be quite rewarding if you can manage to slow down and listen and feel. As your feelings are heightened, so too is your awareness, and we can be more sensitive to deeper insights, both emotionally and spiritually. It is a time of reflection. Don’t push yourself. Now is not the time for hard physical exercise; stay with stretching and walking.
  • PMS is an opportunity for some ‘gentling’ activities like meditating, soaking in a hot lavender bath with candlelight, or writing in your diary.


The following blend can be used for a full body massage when blended in 20 ml of almond oil. Try an abdominal massage beginning up to a week before the onset of menstruation, or in a bath combined with Epsom salts or a personal perfume in jojoba oil.

  • 3 drops of clary sage oil – excellent uterine tonic, regulator of irregular menstruation, easer of painful cramping in the lower abdominal area, it’s great for easing tension and anxiety while uplifting in cases of depression
  • 3 drops of geranium oil – helps in the balancing of hormones, it can also help in cases of menstruation-related depression and decongestion of the breasts by utilising its diuretic properties along with the ability in relieving inflammation
  • 2 drops of rose otto – warming, comforting and uplifting on the emotions enabling stress relief, it is a stimulating tonic for the uterus with calming and regulating properties
  • 2 drops of neroli oil – wonderfully uplifting to the mood, tonifying on the nervous system and antispasmodic aiding in uterine discomfort

At a glance


  • Avoid red meat and dairy foods (except plain yoghurt) and eat more fruit and vegetables, wholegrains and legumes.
  • Cut out all sugar, salt and white flour products. They add to your premenstrual distress by increasing fluid retention.
  • Reduce caffeine (including coffee, cola, chocolate, guarana) as it has an effect on oestrogen receptors in the breasts, contributing to breast tenderness and enlargement.
  • To reduce premenstrual craving of chocolate and carbohydrates, eat a small meal or snack every 2–3 hours that contains some protein.


  • The best herb for PMS is vitex agnus castus as it helps to regulate hormones.
  • If you find yourself depressed or anxious at this time, take St. John’s wort, passionflower, kava and/or pulsatilla.
  • Take a multivitamin specially formulated for PMS that contains B6, magnesium and zinc.
  • If you experience cramping, headaches and back ache, take extra magnesium.
  • Evening primrose oil (EPO) helps with many of the symptoms of PMS. You need to take it consistently for best results.

Other steps

  • Regular aerobic exercise reduces all symptoms of PMS. Take out a gym membership, jog in the park or join a sports team.
  • If you find yourself more angry, irritable or depressed at this time, it could be worthwhile to book a few sessions with a counsellor to see if there are any underlying issues that bubble up at this time.
  • Your body is more vulnerable too. Treat yourself gently and try having long soaks in the bath or watching soppy DVDs.