Busting PMS myths – do home remedies actually help?

Premenstrual syndrome, or PMS, describes the physical, psychological, and behavioural symptoms which occur during the luteal phase (after ovulation until your period starts) of the menstrual cycle and regress or disappear during the rest of your cycle.¹ The most common symptoms are abdominal bloating, irritability, mastalgia (breast pain), mood swings, and joint pains.

Some people experience severe PMS, otherwise known as premenstrual dysphoric disorder (PMDD). If your symptoms are interfering with your day-to-day life, it is important to seek medical help.

Many theories exist as to why people experience PMS. One of these suggests that some are more sensitive than others to progesterone and progestogens, hormones which increase during the luteal phase of the menstrual cycle. This is because the level of these hormones is the same in people with vulvas, whether or not they experience PMS.²

Another theory is related to the neurotransmitters serotonin and gamma-aminobutyric acid (GABA). Like other neurotransmitters, serotonin and GABA are chemical messengers which communicate across the nerves in the body.

The receptors of these neurotransmitters are responsive to oestrogen and progesterone. One breakdown product of progesterone, called allopregnanolone, influences GABA receptors, and appears to be reduced in people who experience PMS symptoms.^3,4

It is estimated that 40% of people who menstruate experience symptoms of PMS and 5-8% of those people experience severe PMS.⁵ In fact, epidemiological studies show that 75% of people who are fertile experience mild to moderate PMS symptoms.⁶

Given the effect of PMS on society as a whole, and the suggestion that a lot of people are simply tolerating or self-managing their symptoms, in this article we will consider what you can yourself do to alleviate any symptoms you may have. Please note that no strong scientific evidence exists to support these remedies, although some people have said they find them beneficial.

Vitamins and minerals

Vitamin B6, also known as pyridoxine, is thought to be required for the optimum development of the corpus luteum (a structure which develops on the ovary after an egg has been released, and which breaks down after a few days if pregnancy does not occur), which produces progesterone.

Studies have shown mixed results when it comes to its effect on treating PMS symptoms, although some have found it beneficial. The recommended dose from the Department of Health is 10mg.⁷ Most studies used higher doses than this, but side effects such as nerve damage to the hands and feet can occur with high doses.⁸ Instead of a supplement, incorporating foods rich in B6, such as tuna, salmon, chickpeas, and dark leafy greens may be useful.

It is estimated that 40% of people who menstruate experience symptoms of PMS and 5-8% of those people experience severe PMS

Some people have found evening primrose oil useful in calming premenstrual symptoms. In one trial of evening primrose oil it was shown to improve menstrual symptoms when given at both 1g/day dosage and 2g/day dosage when compared with a placebo.⁹

In particular, it may help with breast symptoms. Evening primrose oil contains fatty acids which are thought to help decrease the inflammatory substances associated with breast tenderness. Another trial looked at whether evening primrose oil, flaxseed or Vitamin E helped with breast tenderness, but found that only women taking flaxseed had a significant reduction in breast pain.¹⁰

Other vitamins and minerals such as vitamin D, calcium, magnesium, and isoflavones have been shown in various studies to have some benefits when it comes to relieving symptoms of PMS.¹¹ Calcium and vitamin D were shown to be beneficial in improving overall symptoms in two studies.^12,13

Magnesium, used before menstruation, may also be helpful in reducing symptoms of PMS relating to anxiety.¹⁴ It was also noted to have a positive role in treatment of symptoms when combined with vitamin B6.¹⁵

Lifestyle changes

Basic lifestyle changes may help reduce or relieve your PMS symptoms. With respect to dietary changes, incorporating foods known to have vitamins and minerals shown to improve PMS symptoms may be useful for some people. While no specific dietary modifications have been studied in depth, certain changes have been associated with improved symptoms.

This includes eating little and often to maintain blood sugar levels, incorporating complex carbohydrates and good sources of protein, and cutting back on salt and refined sugars. Maintaining a steady, normal blood sugar level helps maintain hormone levels as it provides regular nutrients and energy needed for hormones to be made and function optimally. Cutting back on alcohol, salt, and caffeine, and drinking plenty of water can help decrease fluid retention, thus easing symptoms of bloating and breast tenderness.

Guidelines recommend that women experiencing severe PMS symptoms could benefit from seeing a dietitian.¹⁶

Maintaining a steady, normal blood sugar level helps maintain hormone levels as it provides regular nutrients and energy needed for hormones to be made and function optimally

Exercise, including aerobic exercise and yoga, have been shown to have mixed benefits in reducing symptoms of PMS. Exercise is known to help with stress reduction by modulating associated hormones, so in theory it should be beneficial for some PMS symptoms too. Seeing a psychologist for a therapy called cognitive behaviour therapy (CBT) has been shown to maintain the effects of treatments if PMS is severe.¹⁷

Herbal remedies

In a systematic review into herbal remedies for PMS, four trials, including almost 600 cisgender women, supported the use of Vitex agnus castus L., also known as chasteberry.¹⁸ However, this study concluded that there was inadequate safety data to support its use.

Another systematic review of 29 randomised controlled trials (RCTs) found the evidence for chasteberry contradictory, and therefore concluded that reliable recommendations could not be given.¹⁹ On top of this, there is no standard dose established for chasteberry.

Other herbal remedies including St. John’s Wort, ginkgo biloba, and curcumin have shown some benefits in studies, but a systematic review found that only calcium had good quality evidence to support its use for PMS symptoms.²⁰ St. John’s Wort can have some adverse effects, and it can interact with other treatments, such as antidepressants.²¹

Alternative therapies

Therapies known to help with relaxation and stress reduction, such as reflexology and acupuncture, have been shown to provide some relief from symptoms. Several studies have suggested a benefit from acupuncture, but these studies are likely to be biased which means that solid conclusions cannot be drawn from their results.²² If seeking alternative therapies like acupuncture, t is important that these are administered by professionally trained practitioners.

It is important to consult with your doctor before trying any alternative therapy to ensure it is safe for you, particularly to ensure it won’t interact with any other medicines you may already be taking.

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Last updated September 2023
Next update due 2026