Premenstrual syndrome: most effective dietary supplements

Premenstrual syndrome (PMS) is a set of physical, psychological and behavioral manifestations that appear in the luteal phase of the menstrual cycle, a few days before menstruation. These symptoms usually disappear at the start of menstruation. PMS affects about 20% of women of reproductive age and its symptoms range from mere nervous tension to actual behavioral disturbances.

Causes

PMS mainly affects women of reproductive age and may become more pronounced with age. Although the exact mechanisms remain poorly understood, a hormonal imbalance between estrogens and progesterone plays a central role. During the luteal phase, the drop in estrogens and fluctuations in progesterone can alter the regulation of neurotransmitters such as serotonin, which partly explains mood disturbances. Additionally, hypersensitivity to prostaglandins and hormonal variations is suspected. Indeed, during the luteal phase, hormonal variations lead to an increase in the production of certain prostaglandins, notably PGE2 and PGF2α, which are pro-inflammatory. These prostaglandins contribute to the contraction of the uterine smooth muscle and the regulation of menstrual flow. Finally, genetic and environmental factors, such as stress and a sedentary lifestyle, can also worsen the symptoms.

Symptoms and Diagnosis

Symptoms of PMS include: • Physical: breast tenderness, bloating, migraines, weight gain due to fluid retention. • Psychological: irritability, sadness, fatigue, difficulty concentrating. • Behavioral: specific food cravings (sugar, chocolate), social withdrawal. Diagnosis is based on careful tracking of symptoms using diaries, such as the Daily Record of Severity of Problems (DRSP). These tools help confirm the cyclical nature of the disorder, ruling out other pathologies such as thyroid dysfunction or psychiatric disorders.

Treatments

Medication options include: • Selective serotonin reuptake inhibitors: first-line for emotional symptoms, although they are associated with frequent side effects. • Combined oral contraceptives: they stabilize hormonal fluctuations and reduce physical symptoms. A combination of drospirenone and ethinyl estradiol is particularly recommended On the nutritional side, supplements rich in calcium, magnesium, vitamin B6 and omega-3 fatty acids (fish oils) have shown significant benefits for symptoms. The chasteberry (Vitex agnus-castus) acts as a dopamine agonist, regulating hormone levels and improving mood disorders. A balanced diet combined with regular physical activity can alleviate symptoms. Stress management is also beneficial.