Premenstrual Syndrome (PMS)

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  • Hello,

    Does anyone have a recommendation for a psychiatrist or possibly an Ob/GYN who is experienced with PMDD treatment? In this case, a severe case. Newly returned to the area and desperate for help. Thanks so much! (One who accepts Aetna insurance, ideally)

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  • OBs with PMDD/PMS Experience

    Feb 20, 2024

    Wondering if anyone can recommend an OB at Kaiser Berkeley or Oakland with experience treating a variety of PMDD symptoms including severe mood swings, fatigue and nausea, ideally with holistic considerations. New to Kaiser and experiencing worsening symptoms (freshly) on the other side of 40. Thanks in advance!

    Hi! Just posting as I’m also looking for the same thing, in Sutter Health or non-Keyser insurance. 
    My obgyn just suggested going on the pill for PMDD as it regulates hormones, but to be honest I do not need that. There should be better answers. 
    Would acupuncture help?

    I don't have an OB to recommend, but I had very helpful conversations with my regular doctor about PMDD symptoms (in my case extreme sadness and anger/irritability). She didn't seem to think these issues were out of her scope. For what it's worth, I ended up trying a low dose of an SSRI, and found tremendous relief that way. 

    Hi there, I'm sorry to hear you're dealing with this, and I hope you find a supportive OB. As an acupuncturist I can attest that acupuncture as well as herbal medicine can both make a significant difference with PMDD. Make sure your acupuncturist has treated PMDD before and specializes in women's health. Symptoms typically start to change by the next cycle if you're able to do weekly treatment and herbs. Best of luck!

Archived Q&A and Reviews

Bursts of anger during menstrual onset

Sept 2006

I experience bursts of almost uncontrollable anger that coincide with the onset of my period. I notice that when I have a surge of anger or get too upset about something that would normally not bother me it turns out my period has started. I used to get mad when my husband would say ''oh, is that time of the month.'' But, frankly, I have to admit that for me there is a connection. I recall hearing that people have had success taking evening primrose for this. Has anyone taken evening primrose? Was it helpful? Were there side effects? Any other suggestions? It's that time of the month!

The same thing was happening to me. My doctor suggested vitamin B-12 Bilingual. Make sure it's bilingual, not pill form. You put it under your tongue and hold it for 30 seconds before swallowing. It takes about 1 month but it helped. calmer mom

You sound just like me. I definitely would get angry around my period. While I think the hormones made things worse, I will say going to therapy curbed it a lot. I had anger issues. Now, I have more awareness and have worked through a lot of issues. I still get PMS and get a little agitated but not nearly as bad as before therapy. did it without drugs or herbs

Hello, A few suggestions: Bach Flower Remedies: Available at Whole Foods. Network Chiropractic: A gentle, holistic form of bodywork. Covered by some health insurance. Unwind the tension in your body and everything will be less stressful. Roll up the windows of your car and yell- get it out. Or yell into a pillow and hit your mattress. (Careful not to hurt your voice) In my experience, Anger is about a false sense of powerlessness. What do you want to say, do, or be to feel powerful? Blessings, David

I have several friends with a similar issue. One has had great success with accupuncture, the other with herbs and homopathic treatments. I would also suggest watching your diet when you're your PMSing, cutting back on sugar, caffine, etc anon

PMS in my 30's - worse than ever before

May 2006

I'm 35 with two kids (youngest is 2.5 and we're done nursing) and I've found myself suffering from the worst PMS symptoms ever in my whole life. It feels like I only get one week a month where I'm not either bleeding, bloated, breaking out or weeping into my coffee (which I don't even really like, but seems to be the only way to get energy some days.) The mood swings are the worst part in many ways - I know my life is FINE, sure there are struggles, work/life balance, yadayadayada but some days of the month I wake up just feeling hopeless. Other days my temper is hair-trigger. I'm 14 days past my period now and my pants are tight, my boobs are swollen and all I want to do is climb back into bed and pretend the world doesn't exist.

I never had PMS problems at all in high school or college. Things got worse after I turned 30, but in the last 6 months it's really escalated and I don't know what to do. Is there anything I can take? I have an IUD for birth control which works great, and I didn't react well to the pill last time I tried it (about 8 years ago). Any suggestions would be greatly appreciated - I just want my life back. monthly moody mama

I'm 37 and could have written your post few months ago. you may want to read: ''what your doctor may NOT tell you about prenenopase'' by John R. Lee, M.D. I found this book to be very helpful anon

I'm so sorry to hear that this is happening to you. I'm thirty six and had the same thing happen after I weaned my first child when I was 30. I also had postpartum depression which got better but became premenstrual dysphoric disorder (sounds scary but really can just mean premenstrual depression) I felt much as you describe for about half the month. I have done several things and am now doing great. 1) I got a new amazin OB, Dr. Angelyn Thomas, who specializes in hormones-- she laid out many options for me. 2) You can take many SSRI's (depression meds) for part of the month. -- many folks w/ PMDD do this. 3) I've also found natural projesterone cream to be helpful. I found out about this in the book''What your doctor may not tell you about premenapause'' -- you can find it on amazon. I consider my mood swings to be just part of the changes in hormone levels that happen in later life ending in menapause. I'm still very fertile, and ovulate every month. I just got stuck w/ the emotional issues :-) Hope this helps been there

I suffered terribly from PMS after my kids were born. I finally started to take Prozac, and it helped so much. You can take it just while you are premenstrual, or for the whole month. It's really worth trying-before that I tried acupuncture, therapy, etc. but nothing really touched it till I took the antidepressants anon

Run to the accupuncturist! I had great results with the herbs especially. There are tons of recommendations on the BPN web site less cranky mommy

Dear PMS, It sounds like you're right on target with early symptoms of peri-menopause. Most people don't realize it does start around 35. Nutrition, exercise and psychotherapy can work wonders. Avoid coffee, sugar, complex carbohydrates, and alcohol. Exercise regularly and get LOTS of calcium - drinking milk, eating yogurt, dark leafy greens, tums. If need be, antidepressants, like prosac, are sometimes prescribed to help with the mood swings. And psychotherapy to deal with the stress of everyday life, support for making these necessary changes, and what all these changes mean to you. Of course, only you can decide what's approach works best for you and your life syle and beliefs. Deena

Poor you. It's the worst, isn't it? Fingers crossed, I think I might have found something that works for PMS. I've used it for two months now and have noticed decreased bloatiness, breast tenderness and most importantly, less mooodiness, grumpiness, depression, etc. It's called Estroven and is basically a blend of herbs and B vitamins. I got it at Berkeley Natural Foods and also on-line at Worth a try, anyway! Good luck! fellow PMSer

Hi there, I wonder if this could have anything to do with your IUD. I was experiencing a milder version of what you're describing after I had mine, though there is absolutely no evidence it has anything to do with the IUD. I'm also really sensitive to caffeine so for me that could be a reason too, but of course only if you too respond badly to it.

I really don't like medication, so I turned to more natural treatments, and I feel much better now. Of course I'll never know if it's the herbs I'm eating, my new diet, or if it's just that time went by. At this point I don't care. I couldn't function or feel okay about how I was treating my husband, my two babies and myself before, and now I'm fine, so who cares why. Don't hesitate to contact me if you wish to chat. reutsh

For this newfound PMS, might I suggest the herbal supplement black cohosh? You may have to experiment with dosage to see if it works. Elephant Pharmacy in Berkeley was very helpful to me on this issue. I hope it helps you as it has me Karen

I work with a wonderful accupuncturist, Maureen Raytis. She helps me with a variety of issues, but just recently, she worked with my teenage daughter who has had horrible menstrual irregularity with periods happening once every 2-3 weeks essentially since she first got her period at age 10. She had weekly treatments with Maureen for three months. She has been on a 26-32 day cycle since starting the accupuncture. Not only has that regulated, but her mood has been considerably less like a wild rollercoaster ride. This has been a remarkable success and much better than the putting her on birth control pills forever as the gyn had suggested.

Maureen is gentle and sensitive and a wonderful person to work with. Try it. She is opposite the Grand Lake Theater and her phone number is (510) 501-6960 elizabeth lee

Have you tried Evening Primrose Oil? Your body might be trying to let you know it needs a certain type of nourishment. I read somewhere that good quality and unrefined oils help to normalize hormonal production (for the GLAs and natural occuring Vitamin Es). Could this be what you need? Couldn't hurt. to a speedy recovery

I don't have much advice but boy do I hear ya! I'm guessing it's just my hormones but I've been very similair to what you are saying. I have been drinking this yogi tea called moon cycle. it seems to help. could be psycosamatic but hey if it works;). I'll look forward to any other advice that might pour in

I have had almost miraculous results with acupuncture and herbs. I had to go off HRT suddenly which left me in hormone hell. 24 hours on herbs with acupuncture treatment and I was sleeping again at night and more even during the day. and my hot flashes were knocked back by 2/3.Try Jacques Bernou, offices in Berkeley and Lafayette, (925)962-9228, mention you were referred by me! Julie

You have described perfectly what many women go through at age 35. There is a definite hormone shift that occurs around this time, the main symptom of which is an increase in PMS. Basically what has occured is a shift in the estrogen/ progesterone ratio, leading to estrogen dominance. This can be due to progesterone being low or estrogen being high, but the result is the same.

There are lots of doctors and practitioners in this area who are quite knowledgable about this condition (I've lectured on this topic at Elephant a few times, and am again in August) and there are many things that one can do to correct it with diet, herbs, and nutritional supplements. You may want to check out the book ''What your Doctor May Not Tell you about Pre-Menopause'' (which is not the same as ''peri-menopause''), which discusses progesterone deficiency. Or look at the books or website of Christiane Northrup, MD, who has a lot of good information on the topic. For more personalized recommendations, I would recommend connecting with a naturopathic doctor ( or nutritionally oriented acupuncturist or chiropractor.

You can feel better soon!

After the birth of my third child I found myself with terrible PMS and extremely heavy menstrual cycles. This is partly due to switching from the pill to an IUD, but my doctor gave me a prescription for Progesterone. It seems to have helped me. You might discuss this with your doctor. A friend also informed me of a website where you can get a free sample of Femgest, natural cream that supposedly mimics progesterone.

Dealing with my temper - PMS and kids

July 2004

I have been noticing myself increasingly irritable, inpatient, and stubborn starting from a week before my period, then get worsened for the few days just before my period. I think I am having PMS. I do not have much of physical symptom but fatigue. It seems to me I am more affected emotionally and mentally.

For example, today (a few days before my period) I notice myself arguing with my loving, yet naturally stubborn and active 5 years old son. I tried my best, but I could not help but rose my voice all the time and confronting him more often. Instead of dealing my son's tantrum with simple words and guidance, I found myself fighting him back with anger. This makes me feel very sad because he is in general a great, funny, and kind boy.

Besides what I can take such as natural progesterone cream, vitamins, and herbs, I am interested in learning more about how other moms with PMS are dealing with their emotional change such as depression, rigidness, short tempered and irritable feeling while being a full-time mom of young kids. I saw previous archives but it mainly talked only about what you can take. I am more interested in how to handle or control my own emotion so that I will be able to have more fun time with my kids during my PMS.

Any advices?
PMS mom with two young boys

PMS and breast pain

May 2003

I suffer from severe breast soreness/tenderness for about 10-14 days before my period (almost half of the time!). Aside from diet and exercise advice (I am admittedly not as conscientious as I could be but that's another story), I am looking for recommendations on what to wear to bed--I have to sleep with a bra on and the ones that are supportive enough are very uncomfortable, while the lightweight, comfortable ones do not give me adequate support (I am a D cup). I wear underwires during the day and they are definitely not comfortable to sleep in! Am I the only one who has this problem??? Has anyone found something comfortable and also supportive to sleep in?

Have you tried increasing the amount of calcium in your diet? I found that taking 1200mg of Tums (i.e., 2 Tums, 3x daily) reduced my premenstrual symptoms DRAMATICALLY, and that included breast pain. Just a suggestion. Otherwise, you might try Bravado maternity/nursing bras, which are very comfortable to wear at night. anon

I know you are not asking for this, but Chinese Medicine, especially Acupuncture, has an excellent track record in alleviating and preventing breast pain during PMS. I'd be happy to answer any questions you may have about it if you are interested in following this route. Rhoda Climenhaga, L.Ac.

you might try nursing/pregnancy bras. i remember thinking that the bravado bra (online) was a lifesaver during late pregnancy & early nursing--very supportive yet gentle, and easy to get into w/o lots of twisting & pain! jessica

Over-the-counter medications for PMS?

Feb 2000

Help!! I am hoping that I can get some recommendations for medications over counter, Chinese herbs or anything that could help me. For the past 9 months a week before my menstrual cycle I get really tired, sluggish, light headed and nauseated, my stress level goes up and my temper become uncontrollable. I feel as if I'm expecting. I have spoken to my gynecologist about this and she suggested that I lower the estrogen on the mini pill so I did, this has helped with the terrible cramps and the tender breasts but now I have these other issues. Please help!! before my family divorces me. Thanks

Have you tried taking Tums (or a generic) as a calcium supplement? A study came out (Thys-Jacobs S; Starkey P; Bernstein D; Tian J. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study Group. American Journal of Obstetrics and Gynecology, 1998 Aug, 179(2):444-52) that showed that (some) women who supplemented 1200-1600 mg of calcium daily suffered fewer PMS symptoms. I read that study in Nov. 1998 and haven't missed a day of work due to PMS since. It's quite simple to supplement. You can drink 6 cups of nonfat milk a day, or even easier, take 6 Tums a day (two 200mg Tums three times daily, breakfast, lunch and dinner, preferably). It took two cycles for me to feel relief: May you be counted among those calcium deficient women for whom this simple treatment works!

I read an article in the Chron. this Sunday that said it's not the hormones that cause PMS, but differences in brain responses. They suggested St. John's Wart, exercise, and avoiding caffeine and alcohol. Good luck - I suffer from it too and I find exercise definately helps the most. It also helps to mark your calendar monthly, so then when you feel the anger or depression you can see Oh, ok, it's just PMS. Knowing this, it helps both me and my husband cope with my horrible mood! Stephanie

I also had really bad pms. My friend recommend that I should try wild yam cream. It helps. I believe u can get it at a health food store. saraatje

I swear by 250 mg of vitamin B6 and 800 IU of vitamin E per day starting 10 days (maybe less) before my period's supposed to start. This is the most effective/least invasive remedy I've found to emotional effects and fatigue; it helps a little with cramps too. I haven't tried in at least a decade, but I was never able to take the Pill because of PMS. I try to start my regimen whether I feel symptoms or not and that seems to minimize the whole thing. Laura

Try Evening of Primrose Oil - you can find it in capsule form in most health food stores. One every day greatly relieves PMS problems. Vivienne

You do not say how old you are, which is part of the picture here. For example, after 35, women begin to have problems with estrogen dominance because they no longer ovulate regularly. Taking the mini-pill could be amplifying that effect. Have you considered using another birth control method (barrier) that would not systemically affect your body and being as the pill does? If you do drop the pill and still have the same issues, diet, supplements, and herbs can help. But, from my perspective as a diet counselor, looking at ALL of your health issues would make sense. Nori

To the woman who posted about her PMS symptoms, I have been suffering some of the same symptoms for almost two years and it's very frustrating. In fact, I feel very nauseated this morning as I am writing this...I too feel like I must be nausae feels like morning sickness. I will experience these symptoms 10-14 days before menstration begins. I haven't gotten any satisfactory explanation from the doctor I've seen. I don't want to go on birth control pills at this point in my life (I am in my late thirties.) I would really like to know what is going on in my body. I was wondering whether I might be peri- or pre-menapausal - because apparently this can start in your late 30's. (They did a show on Oprah with Cybil Shepard where they outline the symptoms- hot flashes etc....I don't seem to have the appropriate symptoms.) If anyone has any insight, I would appreciate hearing from them. Although I'm not really into taking medicine (herbal or otherwise) with additonal information I may be open to this idea if it would help. Thank you. Jennifer

Another way to lower your estrogen ratio is through natural progerone cream, such as ProGest. You can buy it at most health food stores, for about $20 a tube. You use it during the second half of your cycle. I've been taking it for several years and most all my PMS symptoms are gone. And there are no side effects as with synthetic hormones! If you want to read up on it, get John Lee's book, What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone (somewhat of a misnomer, since it's really about the many benefits of natural progesterone and covers a lot more than menopause). I have recommended this to other women who have reported success and great relief in how it has helped them.

I would like to respond to the person suggesting Tums and low fat milk for calcium. From all I have read and learned in my nutrition courses: 1) Tums will diminish stomach acid and IMPEDE the absorption of calcium. The combination is not good. 2) To absorb calcium, as with all minerals, one needs some dietary fat. Low fat milk won't do this. If one does milk, get unhomogenized for sure, but get whole milk and drink LESS. The body recognizes the whole food best. Finally, calcium causes contraction, magnesium causes relaxation and they potentiate each other. Taking a combination is ideal (many leafy green vegetables have both nicely packaged together as do some good supplements like Nature's Life Liquid).

I really appreciated the person who referred to the specific article in the newsletter about PMS. It helps me enormously when I see an article citation... I know the source of the information and it helps me decide whether the information is reliable or not, and not from hearsay.

I have had terrible emotioanl swings during PMS and very irregular periods that made it worse. I beleive good diet and exercise helps. I am not into taking pills, either, and I don't want to take hormones because the long term effects may not be known yet. realized that chocolate (Hersheys but I also decided to minimize the hormones that I get through milk and meat. That is, I switched to organic milk and meat. To my surprise, at late 30's I am getting my periods close to regular! and my PMS is much better. good luck. p.s. my PMS sometimes included migraine headaches. I used to take tylenol, now I take Hershey's milk chocolate which has the same effect and prevents or releives my headaches and unlike Tylenol does not damage my liver. I know it is not a part of heathy diet, but it works...

I too have had very difficult cycles in the past six years (I am 41). The cycles were getting shorter, from a 28-31 days to a 21-24 day cycle, with heavy bleeding/clotting, and *extreme* breast tenderness beginning at mid cycle (day 13). I felt like I was pregnant for the week or two leading up to my period. For two weeks a month I couldn't stand to have my breasts touched, wear a bra, etc. I told my ob/gyn who put me on a low dose pill, but I had to go off due to (possibly hormone-induced) migraines. I was in despair after six years of this, but I am happy to report that my periods are back to normal again! I saw an acupuncturist, Brian Barlay, had four treatments at one-week intervals, and now I've had six normal cycles. They are 26-28 days long, and the mid-cycle breast tenderness is *completely* gone. My breasts are slightly tender two days before my period begins, my temper is fairly even, and although I still have some menstrual cramps, the bleeding is shorter and lighter. This qualifies as a minor miracle! I recommend Brian Barlay. L.Ac, 540-0544

To the person who is concerned that Tums is not a wise choice for PMS relief:
Tums is calcium carbonate which is calcium and evidence suggests that it is absorbed as well as traditional calcium supplements. So, the matter of Tums impeding calcium absortion is in fact not accurate. As to combining calcium with fat: I did suggest in my original message (as does research) that taking Tums with food (but not necessarily fatty food) makes for better absorption. Additionally, calcium doesn't cause contraction nor does magnesium cause relaxation and, if this were true, they wouldn't potentiate each other, they would be antagonists, right? Anyhow, for the matter of PMS, the studies suggest a calcium deficiency in sufferers, not a magnesium one. And finally, I recommended taking either 6 glasses of nonfat milk or Tums, because nonfat milk has a higher calcium content than whole milk.

I really felt it necessary to reply only because this is such a potentially helpful, inexpensive and harmless treatment option. This is the conclusion from one reputable source: CONCLUSIONS: Calcium supplementation of 1200-1600 mg/day, unless contraindicated, should be considered a sound treatment option in women who experience premenstrual syndrome. The supplemental dose of calcium can be adjusted downward in the few patients who routinely consume large quantities of calcium in their diet. Ward MW; Holimon TD. Calcium treatment for premenstrual syndrome. Annals of Pharmacotherapy, 1999 Dec, 33(12):1356-8.

Other references: Wilson SA.Calcium therapy for treating PMS.Journal of Family Practice, 1998 Dec. Supplements for PMS [news]. Harvard Womens Health Watch, 1999 Mar, 6(7):7. Thys-Jacobs S; Alvir MJ. Calcium-regulating hormones across the menstrual cycle: evidence of a secondary hyperparathyroidism in women with PMS. Journal of Clinical Endocrinology and Metabolism, 1995 Jul, 80(7):2227-32.

In response to one woman's suggestions for PMS: Suggesting that TUMS is a good calcium supplement is a commonly held misperception for the simple reason that calcium requires an acidic environment in the body in order to be absorbed. Since TUMS reduce stomach acidity, they actually create a barrier to calcium absorbtion! I have no idea why these two things are marketed in one product! Stefan