Premenstrual Syndrome - Other Treatments

Evening Primrose. Some women have reported that taking evening primrose oil helped PMS. However, studies vary as to its effectiveness for PMS symptoms and two rigorous studies reported no benefit. It may be helpful for relieving breast symptoms.

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Agnus Castus Fruit Extract (Chaste Tree Berry). Several studies report that agnus castus fruit, also known as chaste tree berry, may help relieve PMS symptoms including breast pain and tenderness. Some evidence suggests that the compounds in this substance reduce prolactin levels. Prolactin is the important hormone in breast milk production. Women who are breastfeeding should not use this herb.

Flaxseed Oil. Flaxseed oil may help relieve breast pain and tenderness associated with menstruation.

Ginger Tea. Ginger tea is safe and may help in relieving mild nausea and other minor symptoms of PMS.

Krill Oil. In one study, a natural product derived from the krill fish (Neptune Krill Oil) is rich in omega-3 fatty acids and other chemicals has improved PMS symptoms and reduced menstrual cramps compared to omega-3 fatty acids alone.

Melatonin. Women with PMS appear to have lower levels of melatonin, a powerful hormone that regulates sleep. One small study that simulated air travel reported that melatonin was helpful in reducing stress in PMS women, but controlled studies are needed to determine any real benefit.

St. John's Wort. St. John's Wort (Hypericum perforatum) is an herbal remedy that may help some patients with mild to moderate depression. It is not clear, however, how significant the benefits are. Some--but not all--studies report that it is more effective than placebo. Notably, a 2002 study reported no differences between St. John's Wort and placebo for patients with moderate depression. A 2000 study on similar patients, however, reported that it was as effective as a tricyclic.

Even if studies were consistent, this herbal substance is not regulated and there is no guarantee of quality in any brands currently available. In fact, in a 2002 St. John's Word brand comparison only three products out of eight were within 10% of the active ingredient amounts claimed on their labels.

At this time, the following guidelines are recommended:

People with severe depression should not take this remedy without a doctor's guidance. Even those with mild depression should not use St. John's Wort without consulting a doctor. Children and pregnant or nursing women should not take this substance.
People should purchase brands only from well-established manufacturers until regulations have been established for this and other herbal remedies.
Although no dose levels have been established, trials indicate that 300 milligrams taken three times a day may be effective. (Patients should check with a knowledgeable doctor.)
It takes between two and three weeks for the drug to have an effect.
Early studies had suggested that the herbal substance might act in the same way as chemical MAO inhibitors, but the MAO-like activity of St. John's Wort appear to be minimal. Still, some experts suggest avoiding large amounts of foods and substances that have tyramine, such as red wine, meat, and aged cheese.
It should not be combined with other antidepressants.