"Premenstrual Syndrome (PMS) is a common cause of substantial psychological and physical distress for women during their reproductive years.
Forty percent of women have symptoms that are severe enough to disrupt some aspect of their daily lives; 5% are incapacitated by their symptoms.
" So begins a review article by Dr.
Sue Douglas in the Canadian Family Physician journal from November 2002.
 PMS could have been dubbed the forgotten illness until about 20 years ago when gradually it was realized that this collection of symptoms was very common.
 It was first classified in a useful way by Dr.
Guy Abrams in the mid-1980s who outlined 4 types of PMS:

1. PMS-A In this type the symptoms are mainly increased anxiety with too much estrogen relative to progesterone being secreted, that results in a trigger for anxiety.
    This is the most common type found in about 70% of sufferers.
   
2. PMS-C This type is associated with cravings for carbohydrate, increased fatigue, headache and frequently heart palpitations.
    People in this category may have low blood sugar, and represent about 25% of sufferers.
   
3. PMS-D This type is characterized mainly by depression, forgetfulness, and difficulty sleeping.
    These people might also have low thyroid, frequent crying spells, headaches, and usually too much progesterone in relation to estrogen.
    They may have excessive hair growth.
    It is the least frequent of all categories.
   
4. PMS-H This type is characterized by increased fluid retention, abdominal bloating, breast congestion and tenderness.
    It affects about 25% of sufferers.
   

The above categories are not exclusive to each other.
 People can have mixtures of all of these types, and they can vary in severity from mild to highly significant.
 Symptoms usually occur within the last two weeks of the menstrual cycle, but usually during the last 7 to 10 days before the menstrual cycle begins.
 They often end when the menstrual cycle begins.
 While medications may be necessary in some cases, a good deal of relief can be obtained by paying attention to diet, exercise, and relaxation and supplementation -- in other words, healthy lifestyle changes.
Overall, the diet for anyone with PMS should consist of a Mediterranean type diet that consists of meals high in good-quality fruits and vegetables, low in red meats, sugars, and white flour, with moderate amounts of good-quality protein preferably from coldwater fish such as salmon, mackerel, or tuna, but also from chicken and legumes.
 Mild to moderate exercise, such as walking or light running, has been found to help the symptoms of PMS.
 Decreasing the triggers for adrenalin or other stress hormone release through deep relaxation with meditation or self-hypnosis is also important.
Research has shown that a number of supplements can help in all of the types listed:

• B vitamins are very important in PMS-A.
   Take a 50mg B Complex vitamin through the whole cycle.
   You can also add another 100mg of Vitamin B6 (pyridoxine) on its own if the 50mg B Complex is insufficient to relieve symptoms.
  
• Good studies have also found that calcium can be helpful.
   I recommend about 1000 mg per day as the carbonate or about 500 mg a day as the citrate.
  The latter is better absorbed and you need less of it.
  
• Magnesium is also helpful, especially in PMS-C, and can be taken as a Calcium & Magnesium tablet combined if you wish.
   The dose of magnesium required is about half that of the calcium dose.
  
• Oil of Evening Primrose is an essential oil to be taken by mouth in the reduction of PMS symptoms, again particularly in PMS-A and PMS-C.
   The oil reduces the formation of inflammatory hormones called prostaglandins.
   You should take 3 capsules twice daily at breakfast and dinner.
   The anti-oxidant Vitamin E in 400 IU dose daily should be taken to ensure that the Primrose Oil works effectively.
  

All supplements should be taken with meals and are not likely to cause any unpleasant side effects in the dosages recommended here.
 They should always be a part of an overall lifestyle improvement program for greatest effectiveness.
When you are trying any of these lifestyle and supplement treatments, take them for about 3 menstrual cycles before deciding whether to continue or stop.
 There are many other naturopathic and homeopathic treatments that can be helpful, but are beyond the scope of this article.
© Edward Leyton MD 2007 ©Accessing resources for Empowerment 2007 28/04/07 The information and suggestions provided in this and other articles are for educational purposes only and are not necessarily intended as treatment to be used without the further advice of a physician or other health-care practitioner familiar with the diagnosis and treatment of this condition using nutritional approaches.
Please, always see your health care provider to provide a proper diagnosis and for any further details of treatment.