Supporting Premenstrual Syndrome with Herbal Medicine

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.

Local Immunity-Boosting Echinacea

Have you experienced this herbal medicine gem?

Echinacea spp. is a gorgeous native plant found in diverse abundance and multiple unique species across central and southern North America. I’ve spent many happy hours gardening in breathtakingly beautiful fields of echinacea and planting new seedlings when working for a native gardening company. This is a staple plant in my home garden as well as our Four Seasons Harmony apothecary!

This powerful immune-enhancing herb is indicated for supporting a variety of specific health conditions, like otitis and rhinitis. Echinacea is helpful for ridding the body of microbial infections by both preventing and repairing tissue caused by infection and acts synergistically when combined with other herbs. Longstanding Indigenous applications include pain relief for burns and neck tension, antidotes for poisonous conditions, cough remedies, reducing fevers and migraine treatment. The flower essence holds the ability to provide dynamic support and vitality for the immune system. 

Herbal actions include:

Antimicrobial
Immunomodulator
Lymphatic adaptogenic
Vulnerary

Alterative
Anticancer
Anticatarrhal
Anti-inflammatory

Here is a sample pediatric formula with echinacea that I created to especially support Diabetes I and low immunity:  

Initial Pediatric Dosage: Take 0.5 mL or about 1/2 of a droppers full twice a day, ideally 15 minutes away from meals, other herbs and/or supplements mixed into 4-8 oz. of milk, tea, juice, or water as needed. Add favorite milk and whole sweeteners to taste as needed, such as maple syrup, raw honey, stevia or monk fruit. 

Additional herbs to consider for Type 1 Diabetes from a promising body of growing evidence-based research include artichoke, bilberry, fenugreek, galangal, gymnema, holy basil (tulsi), and mulberry. 

 Here is another original formula with echinacea that I created for a woman with breast cancer:

A few other initial dietary recommendations were to ensure that all salt intake is sourced from unrefined sea salt, such as Celtic or Himalayan brands, increase natural electrolytes and trace minerals, cook with more cinnamon and intake molecularly distilled fish or vegan algae oils rich in Omega-3 fatty acids. 

Safety: very safe for pregnancy and breastfeeding.

Always ensure that only sustainability harvested, pesticide-free herbs are used. Take care to avoid overharvesting echinacea in the wild, as this is an "at risk" herb. Honor sustainable wild harvesting measures and only take from a truly abundant source. If you are a gardener and live in southern or central North America, consider planting this beauty as it can prolifically at your home as a hearty perennial. 

I like to carry a homemade echinacea tincture when traveling to apply as a topical vulnerary in the unforeseen occurrence of a minor scrape, burn, sting or skin rash. This is a wonderful choice to include in your herbal first aid kit for both internal and external application. Please let me know other favorite ways you may enjoy this beauty’s healing gifts!

In health, peace, and gratitude,
Whitney

---

References

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. 
Easley, T., & Horne, S. (2016). The modern herbal dispensatory: A medicine making guide. North Atlantic Books.
Freeman, Camille. (2020). Pregnancy-friendly herbs. Bloom and Grow Nutrition, LLC.
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.
Vickery, N. (2012). Re-engaging our senses: Taste. The Family Herbalist. https://thefamilyherbalist.files.wordpress.com/2012/09/herbal-taste-chart.pdf
Williamson, E. M. (2003). Potter’s herbal cyclopaedia. The C. W. Daniel Company Limited.

Ayurveda for Summer Balance

Tropic like it's hot! As the solar energy builds significantly at the end of the spring season, fire qualities start to accumulate as we transition into the pitta predominant season of summer with more hot, sharp and bright qualities. A major seasonal change can affect our mind, bodies and spirits into either further balance or imbalance depending on how we respond. How are you feeling with the intense solar heat of summer accumulating for those who live in the northern hemisphere? Are you in seventh heaven, struggling immensely or somewhere in between? Wherever you may fall on this spectrum, this tends to be a reflection of each of our unique constitutions and can vary dramatically from person to person.

I acknowledge with humble gratitude how the profundity of holistic tools support staying at each unique person's level best and love to share this knowledge outwardly with others, too. Ayurveda recognizes that our health is significantly influenced by our unique, individual constitution, as well as external factors such as the changing of the seasons throughout the year. Understanding how to best make decisions in balance with the rhythms of nature through the ideas of Ayurveda can greatly improve our ability to heal, quality of life, productivity, and longevity. So, what do we do to take care of ourselves to get through the summer months with grace, health, and fulfillment? 

Pitta is composed of fire and water elements and is responsible for transformation and metabolism in the body. The healing energy of pitta can be balanced with cooling foods, less intense exercise, protection from the heat of the midday sun and softening intense schedules to stay at our level best. 

PITTA BALANCING LIFESTYLE RECOMMENDATIONS FOR SUMMER INCLUDE:

* Self-massage (Abhyanga) before taking a shower or bath with a cooling oil such as coconut or sunflower to calm the nervous system and cool the body
* On hot days, resting, a short nap and/or yoga nidra can be restorative
* Cultivate calm inner awareness
* Dress in light, breathable clothing and cooling colors such as blue, green, white and lavender
* Ideally, exercise by breathing through your nose and to 50-70% of your capacity
* Avoid exercising between 10 am - 2 pm, a high pitta time of day
* Favor the essential oils of Lavender, Jasmine, Vetiver and Rose Geranium
* Wash, dry and massage feet with a plain or herbal oil at bedtime 
* Wear a wide-brimmed hat and sunglasses outdoors to shelter from the sun

Here is a general overview of foods to concentrate on to balance pitta:

Fruits to Favor:
                     Apples
                    Avocados
                     Berries
              Cherries
                     Coconut
                     Cranberries
                     Grapes
                     Limes
                     Mangoes
                     Melons
                     Pears
                     Pineapples
                     Plums
                     Pomegranates
                     Prunes

Vegetables to Favor:
                    Artichokes
                     Asparagus
                   Beet Greens
                     Broccoli
                     Brussel Sprouts
                     Cabbage
                     Cauliflower
                     Celery
                    Chard
                     Collard Greens
                     Cucumbers
                     Green Beans
                     Kale
                     Lettuce
                     Okra
                     Potatoes
                     Watercress
                     Zucchini

Grains to Favor:
                     Barley
                     Rice, Basmati
                     Wheat

Legumes to Favor:
                     Adzuki Beans
                     Black Beans
                     Garbanzo Beans
                     Mung Beans
                     Soy Beans & Products (always fermented)
                     Split Peas

Oils to Favor:
                     Coconut Oil
                     Olive Oil
                     Sunflower Oil

Spices and Garnishes to Favor:
                     Basil
                     Cardamom
                     Cilantro
                     Coriander
                     Dill
                     Fennel
                     Lime
                     Mint
                     Parsley

Animal Products to Favor (If You Eat Them):
                     Fish (freshwater)
                Poultry (white)
                     Shrimp

Sweeteners:
                     Maple Syrup
                     Unrefined Cane Sugar
                     Turbinado

Check out our Summer Seasonal Recipes webpage for recipe ideas! Wishing you and your families vibrant health, happiness, and longevity!

-Whitney Erwin, MSc, MEd, LMT, owner of Four Seasons Harmony