Supporting PMS with Herbal Medicine

Herbal medicine is a powerful holistic tool for supporting premenstrual syndrome (PMS), a common disorder affecting women during the seven-to-ten-day period prior to menstruation. Symptoms vary widely and are so numerous that diagnosis can frequently be difficult. PMS is diagnosed on the basis of symptoms beyond normal cyclical menstrual body changes that cause disturbance in a woman’s life. This includes hormonal and/or chemical changes that cause debilitating symptoms. It occurs during the proliferative or luteal phase of menses when progesterone and estrogen levels are relatively high.

Several of the etiological factors identified for primary PMS include: excess estrogen, fluid retention, progesterone deficiency, magnesium deficiency, hypoglycemia, decreased production of prostaglandin E1, increased production of other prostaglandins and increased prolactin levels. PMS has over 200 associated symptoms, including any or all of the following: abdominal pain, acne, anxiety, breast swelling and tenderness, cramps, depression, dysphoria, fainting spells, fatigue, food cravings, headaches, insomnia, irritability, joint pain, nervousness, skin eruptions, water retention, personality changes like mood swings, anger outbursts, tension, violence and even thoughts of suicide.

Herbal Actions to Support PMS

Uterine Tonics provide a nourishing, toning and strengthening effects on the function and tissue of the female reproductive system. This herbal action is very beneficial for reducing and preventing PMS symptoms (Hoffman, 2003). Uterine tonics can also help to restore prenatal reproductive essence or vitality lost through menstruation, chronic stress, or illness (Reid, 1995).

Hormonal Normalizers provide an herbal action that directly impacts and naturally stabilizes the levels of hormones in the body. They help with regulating excess estrogen, progesterone deficiency, and other hormonal instability to more balanced levels (Hoffman, 2003).

Antispasmodics assist in preventing or lessening muscular spasms, cramps, and tension. They can even ease psychological tension and instability as well, like the reproductive antispasmodics Viburnum opulus (cramp bark) and V. prunifolium (black haw) (Hoffman, 2003).

Uterine Demulcents aid in soothing and toning inflamed tissue. They aid in reducing the manifestation of inflammatory PMS symptoms like cramps, joint pain, water retention, breast swelling, and tension (Hoffman, 2003).

Hepatics aid the functioning of the liver, along with all cholagogues and bitters. They do this by toning, strengthening and increasing the flow of bile. This herbal action helps with regulating hormonal balance and can also have a marked effect on supporting the muscles of the uterus.

Additionally, the herbal anti-inflammatory, nervine, emmenagogue, uterine demulcent, uterine astringent and yin balancing or tonifying actions can also be very supportive. I often bring in all of the above-mentioned herbal actions into my custom clinical herbal formulas when individually indicated for a person’s unique constitution and healthcare needs.

Specific Herbs to Support Targeted Herbal Actions

Hormonal Normalizers
Vitex agnus-castus, chaste tree berry
Paeonia lactiflora, peony
Salvia officinialis, sage
Dioscorea villosa, wild yam
Glycyrrhiza glabra, licorice
Cnicus benedictus, blessed thistle
Angelica sinensis, dong quai

Uterine Tonics
Cimicifuga racemosa, black cohosh
Mitchella repens, partridgeberry
Rubus idaeus, raspberry leaf
Caulophyllum thalictroides, blue cohosh
Tribulus terrestris, gokshura
Lepedium meyenii, maca
Angelica sinensis, dong quai

Uterine Demulcents
Caulophyllum thalictroides, blue cohosh
Asparagus racemosus, shatavari

Antispasmodic
Viburnum opulus, cramp bark
Viburnum prunifolium, black haw
Dioscorea villosa, wild yam
Valeriana officinalis, valerian
Scutellaria lateriflora, skullcap

Emmenagogues
Achillea millefolium, yarrow
Artemisia vulgaris, mugwort|
Mitchella repens, partridgeberry
Rubus idaeus, raspberry
Vitex agnus-castus, chaste tree berry

Hepatics
Achillea millefolium, yarrow
Agrimonia eupatoria, agrimony
Curcuma longa, turmeric
Mahonia aquifolium, Oregon grape
Zanthoxylum americanum, prickly ash

Yin Balancing/Tonifying
Rehmannia glutinosa
Lycium chinensis, Chinese wolfberry
Dioscorea japonica, East Asian mountain yam
Paeonia suffruticosa, tree peony
Alisma orientalis, Asian water plantain

A Closer Look at Several PMS-Supporting Herbs

Cramp Bark (Viburnum opulus) longstanding reputation as well as modern use for relaxing muscular tension and spasm in voluntary muscles as well as uterine muscles problems; also indicated for painful menstrual cramps, endometriosis, chronic pelvic pain and dysmenorrhea; herbal actions include nervine, anti-inflammatory and emmenagogue

Corydalis tuber (Corydalis yanhusuo) indicated for nociceptive pain, spasmodic dysmenorrhea and endometriosis; herbal actions include antispasmodic, analgesic, mild sedative, hypnotic, anxiolytic; also referenced in the Handbook of Chinese Medicine for traditional use supporting the liver and spleen meridians, and regulating the circulation of chi and blood flow

Black Cohosh rhizome with rootlet (Actaea racemosa) longstanding Native American application for female reproductive problems, pain during childbirth, dysmenorrhea and uterine colic; traditional Cherokee use as a plant medicine of the North for relaxing the nerves, settling the heart and spirit; eases physical and mental changes associated with perimenopause and menopause as well as hormonal deficits as a result of hysterectomy or ovariectomy; a treatment for hot flashes, insomnia, headache, irritability, depressive moods and spasmodic dysmenorrhea; herbal actions include antispasmodic, anti-inflammatory, alterative, nervine, emmenagogue, hormonal normalizer for the female reproductive system and sedative

Wild Yam rhizome (Dioscorea villosa) extensive traditional Indigenous application globally including Mexico, United States and Nepal; indicated for relieving ovarian and uterine pains, easing dysmenorrhea, pregnancy pains, cramp-like pains, spasmodic dysmenorrhea and congestive dysmenorrhea; plant medicine of the West and traditional American Indian use in herbal formulas for childbirth pain, rheumatism, colic and gallbladder problems; herbal actions include anti-inflammatory, antispasmodic, nervine and autonomic nervous system-relaxant effects

Tincture Preparation

Cramp Bark: tincture dosage 4-8 ml, TID (1:5 in 40%), BHP 5 to 10 ml tincture (1:5 in 45%) TID

Corydalis: tincture dosage 1.5 – 2.5 ml TID recommended by David Winston, 5-20 ml recommended by Dr. Aviva Romm

Black Cohosh: tincture dosage 2 to 4 ml TID (1:5 in 60%), BPC 1.8 to 3.6 ml (1:10 in 60%) (Hoffman, 2003); 2-4 ml TID (1:10)

Wild Yam: tincture dosage is 2 to 4 ml TID (1:5 in 40%), BHP 2 to 10 ml tincture (1:5 in 45%) TID; 2-10 ml TID (1:5)

Safety Considerations & Contraindications

Cramp Bark: no reported side effects or drug interactions

Corydalis: contraindicated in pregnancy unless under the supervision of a healthcare practitioner

Black Cohosh: contraindicated during pregnancy except during birth, unless under the supervision of a qualified healthcare practitioner

Wild Yam: no reported side effects or drug interactions

While PMS is quite debilitating for female reproductive health, this condition can be positively supported through a wide variety of herbal medicinal applications. Targeted herbal actions of high therapeutic relevance include hormonal normalizers, uterine tonics, emmenagogues, uterine demulcents, antispasmodics, uterine astringents, hepatics, yin tonics, nervines and anti-inflammatories. The most caution should be exercised with use and dosage during pregnancy. The aforementioned actions are highly beneficial and clinically indicated to support natural fertility, so with proper clinical guidance they can be safely applied to optimize chances of healthy conception.

Wherever you may be on your journey toward optimal health and well-being, I hope you know that there are a wide variety of incredibly potent and helpful herbs with longstanding clinical use to safely consider integrating into your lifestyle. They can help you to feel at your level best and balance the debilitating effects of PMS. From my heart to yours, I wish you the very best of health, hormonal balance and healing!

In health, peace and gratitude,
Whitney

References

Balch, P. A. (2010). Prescription for nutritional healing. Penguin Group.

Bone, K., & Mills, S. (2013). Principles and practice of phytotherapy. Elsevier Ltd.

Braun, L., & Cohen, M. (2015). Herbs and natural supplements: An evidence-based guide volume 2. Elsevier Australia. 

Cleveland Clinic. (2022, June 4). Amenorrhea. https://my.clevelandclinic.org/health/diseases/3924-amenorrhea

Easley, T., & Horne, S. (2016). The modern herbal dispensatory: A medicine making guide. North Atlantic Books.

Estés, C. P. (1992). Women who run with the wolves: Myths and stories of the wild woman archetype. Ballantine Books.

Frawley, D. (2000). Ayurvedic healing: A comprehensive guide. Lotus Press.

Gardner, Zoe & McGuffin, M. (2013). American Herbal Products Association’s Botanical Safety Handbook. CRC Press.

Garrett, J. T. (2003). The Cherokee herbal: Native plant medicine from the four directions. Bear & Company.

Hobbs, C. (2016). Herbal action categories. https://www.christopherhobbs.com/webdocs/classhandouts/keville-hobbs-2016/Herbal-Actions.pdf

Hoffman, D. (2003). Medical herbalism: The science and practice of herbal medicine. Healing Arts Press.

Johns Hopkins Medicine. (2022, June 4). Dysmenorrhea. https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysmenorrhea

Kapit, W., Macey, R. I., & Meisami, E. The physiology coloring book. HarperCollins College Publishers.

Lad, V. (1999). The complete book of Ayurvedic home remedies: Based on the timeless wisdom of India's 5,000-year-old medical system. Harmony.