Ah, yes, premenstrual syndrome, otherwise known as PMS, is that oh-so-special time of the month when your fluctuating hormones can create a smorgasbord of unpleasant side effects leading up to your period: tender breasts, bloating, cramping, headaches, fatigue, anxiety, irritability, and more (because, of course). For those seeking relief, supplements for PMS (to treat both pre- and PMS after period) may just be the answer.

PMS symptoms you can treat

There are many PMS symptoms including symptoms including mood swings, fatigue, bloating, fluid retention, tender breasts, food cravings, and more. “These symptoms recur in a predictable pattern beginning in the luteal phase, which starts with ovulation and ending with the menstrual cycle,” says Dr. Banafsheh Bayati, a board-certified OB/GYN and Medical Co-Founder of Perelel. “These physical and emotional changes are common and can be mild to severe enough to affect their daily lives. Though a majority of women experience some form of PMS with some cycles, Premenstrual Dysphoric Disorder (PMDD) is the term used for a smaller subgroup of women who experience disabling symptoms every month.”

In order to treat PMS/PMDD, it’s important to look at the causes. “We attribute cyclical changes in hormones that occur each month given these symptoms are very much associated with the luteal phase and are relieved by pregnancy and menopause. Chemical changes in the brain with fluctuations of serotonin is believed to play a crucial role as well. And most importantly, underlying mood disorders that may be undiagnosed can be a significant factor,” says Dr. Bayati.

For many women, Dr. Bayati says lifestyle changes can help relieve PMS symptoms. “It’s important to address these issues with your health provider and keep a diary or practice mindfulness in order to understand the triggers or lifestyle activities that are exacerbating these symptoms in order to then be able to manage them all. The success of lifestyle changes which include dietary adjustments, vitamin and herbal supplements, increased cardio exercise, stress reduction and alternative practices such as acupuncture varies with each individual,” she says.

Adds OB/GYN, Jessica Shepherd, MD, “It is important to know how PMS interferes with your daily activities so you can help pinpoint what is needed to help reduce these symptoms. There have been more developments in supplements for PMS, as there have been more efforts to develop non-medicinal treatments for it.”

Can supplements help with PMS symptoms?

There are several foods that can help reduce common PMS symptoms. But another option is to take vitamins, minerals, and herbs for PMS that work to help ease symptoms, too. Some of the best include vitamin B6, vitamin E, Dong Quai, and prebiotics along with probiotics, says Dr. Shepherd. You can also take magnesium for period cramps, as it helps with muscle relaxation.

Calcium, magnesium, and vitamins D, E and B, along with omega supplementation have all been reported to help alleviate symptoms of PMS, says Dr. Bayati. “In my practice, I recommend Perelel prenatal or multivitamins for my patients and add additional calcium and magnesium as needed. The prenatal or multivitamin should include adequate vitamin D and appropriate amounts of DHA/EPA along with methylated folate. I make sure my patients are supplementing with a tolerable iron during their menstrual cycle which includes vitamin C for absorption and methylated B12. Many will need a bloat support and I prefer to start with dietary changes and add gentle herbal remedies such as ginger, lemon balm, licorice root, and/or peppermint. Most importantly, during the luteal phase, I recommend a trial of low dose chasteberry, 5HTP, rhodiola, and Reishi mushrooms to help with energy and mood changes,” she says.

While supplements can help, Dr. Bayati also recommends considering dietary or lifestyle changes such as reducing caffeine and alcohol, avoiding processed snacks/foods, increasing fiber rich whole foods, increasing in water intake, and trying to improve sleep and reduce stress. And movement is essential, too. “Most importantly, I encourage increasing cardio exercise in the luteal phase and increasing time outdoors in sunshine and nature during the menstrual cycle,” she says. “I try to suggest finding a better balance in life between work and play, exercise and rest, time with others and self care.”

What ingredients can help with PMS symptoms?

Our bodies are complex, so no one supplement or ingredient can solve everything. “In general, our lifestyle with increased stressors, melatonin and sleep deprivation, poor dietary choices and deficiencies, lack of regular movement and exercise along with a decrease in natural sources of serotonin through meaningful work, human contact and relationships along with epigenetics and toxic exposures creates havoc in our mind and body. For reproductive aged women this can result in PMS/PMDD symptoms,” says Dr. Bayati. “Most health care providers will try to establish a relationship with the patient and begin addressing these issues with lifestyle adjustments. Supplements are often considered after a good history and physical is performed and labs are drawn to rule out other underlying conditions.”

Supplements and herbal remedies often help in conjunction with each other, says Dr. Bayati. Supplements in general can be powerful tools in our overall health and wellbeing, but they should be supplements to a healthy diet and lifestyle, taken smartly and with care.

Supplements

Vitamin deficiencies are helped by taking a clean and appropriately dosed prenatal or multivitamin to address adequate folate, B12, B6, Vit D, E and omega supplementation.

• Iron: “I prefer iron supplementation during the menses as opposed to daily intake in order to ensure adequate iron uptake without GI symptoms from daily intake, unless there is concurrent iron deficiency,” says Dr. Bayati.
• Vitamin C: Vitamin C helps ensure optimal absorption of iron.
• Methylated folate and B12: These two help address anemia as well as target mood and energy.
• Vitamin B6: B6 has been shown to help with mood changes and is necessary for hormone regulation.
• Vitamin D: Vitamin D needs to be taken with food and allows for optimal calcium absorption from the diet, and also aids with immunity and reducing inflammation.
• Calcium and magnesium: Can be helpful in addressing mood, GI changes, sleep and fatigue.
• Omega supplementation with DHA/EPA: Can help mood stabilization, brain function, and reduce inflammation.
• Vitamin E:  Vitamin E has been shown to reduce breast pain associated with the menstrual cycle.

Herbal remedies

Herbal remedies can be helpful as well in targeting PMS/PMDD symptoms. Here, Dr. Bayati recommends some to consider:

• Chasteberry: Chasteberry is used for its ability to reduce breast pain and help with mood changes. It appears to have a function in hormone regulation by acting as a phytoestrogen and improving progesterone production.
• 5-HTP: 5-HTP is a dietary supplement that helps raise serotonin levels in the brain to help with mood and sleep as well as appetite and pain sensation.
• Rhodiola: Rhodiola is an herbal supplement that has been used to help fatigue, anxiety and mood changes associated with stress.
• Reishi mushrooms: Reishi mushrooms are often used in small doses under supervision to avoid interactions with other medications to aid in immunity and inflammation.

Best Supplements for PMS

FLO PMS Gummy Vitamins — $30.00

Dr. Shepherd likes these supplements because they come in gummy form and contain many ingredients that can help with PMS, including lemon balm, chasteberry, and vitamin B6. She also calls out Dong Quai, a root that has been used in Traditional Chinese Medicine for centuries which has antispasmodic properties and can help with cramps and balancing estrogen.

How to take it: Two gummies or one capsule a day

Happy V Women's Daily Prebiotics and Probiotics — $38.00

“Happy V has the prebiotic and probiotic combo which helps gut health,” says Dr. Shepherd. “PMS symptoms can be reduced when gut heath is in check.”

How to take it: Two pills with or without food

Olly Miss Mellow — $18.00

These capsules contain Dong Quai as well. They’ve also got chasteberry and isoflavones; the former can help with cramps, bloating, and mood swings, while the latter helps keep hormones balanced.

How to take it: One capsule daily with water

HUM Moody Bird — $26.00

Dong Quai and chasteberry make another appearance in this cheekily-named supplement from HUM Nutrition. (It’s also vegan.) Great if your PMS presents as extreme irritability.

How to take it: One capsule 2–3 times daily with food

Rae Wellness Women's Multivitamin — $15.00

This multivitamin contains vitamin E and vitamin B6; Dr. Shepherd says the former can help with breast tenderness because its antioxidant properties help protect breast tissue from inflammation, and the latter helps regulate serotonin, a brain chemical that helps regulate mood.

How to take it: Two capsules daily

MegaFood Relax + Calm Magnesium Powder — $22.00

A magnesium supplement can help regulate some symptoms of PMS because magnesium helps relax muscles and can help with headaches, says Dr. Shepherd. Magnesium is also known for its calming benefits. This powder mixes with water and has 300 milligrams of magnesium per serving, and it doesn’t taste overly sweet like some powders have a tendency to.

How to take it: Mix the powder with 4–6 ounces of water daily

The Nue Co Prebiotic + Probiotic — $55.00

These time delay capsules are contain shelf-stable prebiotics and probiotics, meaning you don’t have to keep them in the fridge in order to protect their potency.

How to take it: Two capsules first thing in the morning on an empty stomach. Wait at least 15 minutes before eating.

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