Dr David Richardson


PMS - Pre-Menstrual Syndrome

Premenstrual syndrome is an extremely common problem for many women of all ages. Premenstrual syndrome often starts soon after puberty.  Girls may find themselves short fused, and grumpy in the week or so before their period.  They may also get bloating and fluid retention.  Some girls develop migraines regularly in the week before their period starts.

This is PMS - premenstrual syndrome.  Many people believe that its primary cause is an imbalance between oestrogen and progesterone, the calming hormone, in the week before the period.  At this time in the cycle, progesterone drops dramatically and this change in the relative amounts of progesterone and oestrogen in some women seems to cause the symptoms known as PMS


PMS can be a real trial.  Girls and women can find their whole personality seems to change during this week.  They become short fused and lose their placidity and tolerance.  They find themselves snapping, angry, unable to concentrate will put things in the normal perspective.

In another group of women, PMS does not start till the mid-30s or even late 30s, when suddenly women find that they are having a dramatic change in personality about 10 days before the period starts.  They again may be uncomfortable with fluid retention but most of all intolerant of their children and family.  Worse still, if they are prone to migraines they may find that they get debilitating migraines regularly during this period, which may lead to days off work or even worse dislocation the family.


The good news is that PMS responds best to natural treatment.  My treatment of PMS is a combination of cognitive behavioural therapy for the woman involved and often their families as well, plus simple level supplements and usually natural progesterone to boost the relative level of progesterone compared with oestrogen in the 7 to 10 days leading up to the period.


Effective supplements for PMS should include: 

vitamin B6.....200 mg per day

evening primrose oil ...3000-6000mg/day

chasteberry  (Vitex Agnus) ....200-500mg/day


In addition to this is natural progesterone, the calming hormone. This comes as a lozenge of up to 200 mg, or 1g of 4% progesterone cream & can make all the difference.  The progesterone is usually given starting 10 to 12 days before the period is due.


In my experience, natural progesterone PMS often has a dramatic effect in both decreasing the physical symptoms of bloating and discomfort, and the mental symptoms all bad temper and intolerance.  It may also bring about a dramatic reduction in period related migraines.