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NMU – 200 Vitamins and Minerals in the Management of Premenstrual Syndrome (PMS)

Nutrition / Natural Medicine Update No 200 (April 22, 2021)

with Dr. James Meschino


Topic: Vitamins and Minerals in the Management of Premenstrual Syndrome (PMS)

Source: Cochrane Database Systematic Review (2018)


Premenstrual syndrome or PMS affects about one-third of women ages 25-40 years old and for about 10% of women, the symptoms are very severe. Of course, some of the common symptoms include any combination of intense or debilitating menstrual cramps, abdominal bloating, breast pain, joint swelling, food cravings, mood swings, and even depression. Drugs such as oral contraceptives, anti-depressants, diuretics, and other medications are sometimes prescribed to help treat these symptoms. But these drugs typically treat the symptoms not the cause of the problem. A growing number of published research papers in recent years have shown that the root cause of many PMS cases stems from underlying marginal deficiencies of certain vitamins and minerals and that supplementation to correct these deficiencies often eliminates or minimizes many PMS symptoms. As stated in the 2018 Cochrane Database review on this subject, “deficiencies of certain vitamins and minerals including vitamin B, vitamin D, calcium, and magnesium may play a role in PMS. This hypothesis is based primarily on the high incidence of PMS in populations with low levels of these micronutrients.”

They indicate that magnesium and vitamin B6 status is often low in PMS patients. These nutrients are required for brain synthesis of serotonin – the feel-good brain chemical that is low in cases of depression. Vitamin B6 and magnesium are also required to prevent joint swelling, especially in conjunction with omega-3 fats. Other studies have noted a low intake of vitamin D and calcium in PMS patients compared to women who don’t suffer from PMS. Like vitamin B6 and magnesium, vitamin D also supports brain function and calcium is necessary to prevent the kind of abdominal cramping often seen in PMS. Calcium is also a messenger within cells, which supports the synthesis of ovarian hormones necessary to keep hormones in balance throughout the menstrual cycle. Some clinical trials have shown that supplementation with B-vitamins, magnesium, vitamin E, and-or calcium, as well as certain essential fatty acids (omega-3 fats and GLA-rich -oils like Borage Seed Oil) have helped to improve various physical and brain-associated PMS symptoms, including mood swings and food cravings.

This is the reason I often recommend to PMS patients that they take a high potency multiple vitamin and mineral each day that contains a B-50 complex, 200 mg magnesium, 500 mg calcium, 1000 IU vitamin D and everything else from vitamin A to zinc, along with an essential fatty acid supplement containing a combination of Fish, Flaxseed, and Borage Seed Oil). This combination of nutrients can help to correct any underlying marginal deficiencies and it provides key nutrients to support brain chemistry, suppress inflammation and even muscle cramps in some cases. There are also some other important dietary, lifestyle and botanical considerations that are shown to be effective in the management of PMS, which I will review in the next Lifestyle Medicine Update.

I have included the references for this information in the text below.


Cochrane Database Systematic Review: Vitamin or mineral supplements for premenstrual syndrome (2018),the%20underlying%20pathogenesis%20of%20PMS

Berman MK, et al. Vitamin B6 in premenstrual syndrome. J Am Diet Assoc 1990;90:859-861.

Kliejnen J, et al. Vitamin B6 in the treatment of premenstrual syndrome – A Review. Br J Obstet Gynaecol 1990; 97: 847-852.

London RS, et al. Effect of a nutritional supplement on premenstrual syndrome in women with PMS: a double-blind longitudinal study. J Am Cell Nutr 1991;10:494-499.

Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 1987;32:435-441.

Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndrome. J Reprod Med 1983;28:446-464.

London RS, et al. The effects of Alpha-Tocopherol on premenstrual symptomatology: A double-blind study. II. Endocrine Correlates. J Am Col Nutr 1984;3:351-356.

London RS, et al. Endocrine parameters and alpha-tocopherol therapy of patients with mammary dysplasia. Cancer Res 1981;41:3811-3813.

Thys-Jacobs S, Starkey P, Bernstein D, Tian JCalcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual syndrome Study Group. Am J Obstet Gynecol 1998;179(2):444-52.

Walker AF, De Souza C, Vickers MF, et al. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Women’s Health 1998;7:1157-55.

Facchinetti F, Sances G, Borella P, et al. Magnesium prophylaxis of migraine? Effects on intracellular magnesium. Headache 1991;31:298-301.

Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutr 2000;19:3-12


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Dr. Meschino

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