Herbal Treatment for PMS?

Section: Herbal Medicines
Premenstrual syndrome (PMS) is a common disorder that occurs during the latter half of the menstrual cycle. Symptoms include irritability, moodines, anxiety, changes in the sleep and eating habits, bloating, pain,a nd breast tenderness. The causes of PMS are not fully understood, so treating it is difficult. Consequently, clinicians use a range of therapies -- from diet, exercise, vitamins, and calcium, to psychotherapy, antidepressants, diuretics, and contraceptives -- to address its various symptoms. Now, an herbal supplement well known in Europe has been shown to relieve many of PMS's discomforts.

In randomized, double-blind, placebo-controlled trial reported in the British Medical Journal (January 20, 2001), German researchers assigned 170 women diagnosed with PMS to a daily dose of Vitex agnus-castus (chaste tree) extract or to placebo for three menstrual cycles. The women assessed themselves before and after treatment on measures of irritability, mood, anger, headache, bloating, and breast fullness. Clinicians evaluated symptom severity and treatment effects. More than half of the women taking chaste tree fruit extract (popularly known as chasteberry) -- compared to slightly less than one-quarter of those on placebo -- had a 50% or greater improvement in PMS symptoms (with the exception of bloating). Few side effects were reported.

The preparation used in the trial (which was supplied by Zeller AG, its Swiss manufacturer) was made from dried ripe berries of the chaste tree, a large shrub indigenous to southern Europe, the Mediterranean region, and Asia. Chasteberry has been used since ancient Greek times as a treatment for menstrual problems. The German government's Commission E, which evaluates herbal remedies prescribed in conventional medical practice in Germany, has approved it for menstrual irregularities, breast pain, and premenstrual complaints.

The active ingredients in chasteberry have not been completely determined, but according to the PDR for Herbal Medicines, the fruit contains a mixture of iridoid glycosides (agnoside and aucubin), fatty oils, and flavonoids. Chasteberry is thought to have dopamine-like activity and may act on the pituitary gland to influence progesterone levels during the luteal, or late, phase of the menstrual cycle.

The Food and Drug Administration doesn't regulate herbal supplements the way it does drugs, so there are no rigorous studies of chasteberry's long-term effects, drug interactions, or dosage requirements. Observed side effects include itching, rash, headaches, gastrointestinal reactions, and increased menstrual flow. In the absence of more information, women taking hormone therapies of any kind, antidepressants, or dopamine-receptor agonists should consult a clinical before trying this help. It should not be used by women who might be pregnant. Published studies report varying effective doses of chasteberry, but the commonly recommended dose from water-alcohol extracts of chasteberry (in dry or fluid form, standardized to agnuside or aucubin) equals 20-40 milligrams of fresh berries per day.

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