Other Therapy

Certain herbs have been evaluated for use in PMS. Many over-the-counter herbal preparations combine various herbs with certain vitamins to create a PMS formula. Although preliminary reports have been promising, more scientific research is needed to evaluate herbal treatment of PMS. Consult your health care provider before using any herbal supplement.

• Black cohosh: Black cohosh has been shown to positively impact the serotonin pathway and thus may have a beneficial impact for some women, especially those with vasomotor symptoms (hot flashes). Black cohosh does not affect estrogen levels or function.  
  
  
• St. John's wort: This herb may help elevate serotonin levels, possibly helping PMS symptoms. Studies do not agree on its effectiveness. St. John's wort should never be used if you take prescription antidepressants.
  
  
• Evening primrose oil: Gamma-linoleic acid (GLA) is the active agent found in evening primrose oil. Much like mefenamic acid, GLA blocks prostaglandin synthesis, resulting in decreased breast tenderness, bloating, and weight gain. The standard dose is 3 grams per day, and it should be started less than 1 week before the onset of your period. This agent is available without a prescription at health food stores and certain pharmacies. A review of the studies on evening primrose oil, however, showed no proven effect on the symptoms of PMS.
  
  
• Ginkgo biloba: Shown to reduce the symptom of breast pain but not other PMS symptoms.
  
  
• Chasteberry (Vitex; agnus castus fruit extract): A study in 2001 evaluated the use of agnus castus fruit extract (20 mg per day) for 3 months. The treated group showed a greater improvement on all scales (irritability, mood alteration, anger, headache, breast fullness) except for bloating. Do not use if you take birth control pills.