The third step involves the use of the essential fatty acids in the form of evening of primrose oil. Some women find evening primrose oil particularly helpful for symptoms like breast tenderness, depression, irritability, and bloating. The dosage is increased gradually from one or two capsules twice a day during the first two weeks of the cycle to up to six capsules a day in the last two weeks of the cycle.

The fourth step adds the use of vitamin-E in doses of 200 to 800 IU to the above steps. Vitamin-E is relatively non-toxic, even in large doses. All the above mentioned vitamins and supplements should be taken after meals.

Dr. Fred Mandel, Assistant Professor of Obstetrics and Gynecology at The University of Toronto, suggests adding magnesium 500mg a day plus zinc 10mg a day to this regimen.

Finally, in step five, if none of the above is working, it is wise to consult with a sympathetic doctor.

Other Natural Treatments For PMS

TRYPTOPHAN: Another treatment for PMS which has not been proven, but may well turn out to be useful, is taking the amino acid tryptophan one or two 500mg tablets three times a day between meals with a carbohydrate snack. In the U.S. tryptophan is available by prescription as 5-hydroxy-tryptophan (50mg of 5-hydroxy-tryptophan equals 500mg tryptophan).

Tryptophan is a synthetic version of one of the building blocks of protein and currently available in Canada only by prescription. JoAnn Cutler Friedrich, author of THE PREMENSTRUAL SOLUTION, has pioneered the use of tryptophan for PMS. She has helped over 100,000 women with PMS. She feels that PMS is basically a sleep disorder caused by a deficiency of one of the neurotransmitters called serotonin (neurotransmitters are the substances that transmit messages in the brain). Tryptophan increases the level of serotonin in the brain.

Dr. Susan Steinburg, Assistant Professor of Psychiatry at McGill University in Montreal, is conducting a controlled double blind study comparing 40 women using tryptophan for PMS compared to 40 who are not. The results will ready in October 1993.

DESENSITIZING SHOTS TO PROGESTERONE: Dr. Wayne Konetski, an environmental and allergy specialist from Waukesha, Wisconsin, has found that many women with PMS have developed a hypersensitivity to their own hormones, particularly progesterone. Of the women he has treated, 90 percent also have candida infections, which he treats first. He then treats with desensitizing oral drops of progesterone in the range of 1/100mg to 150mg per month. He has had excellent results when he treats candida first and then prescribes a course of desensitizing drops to the hormone progesterone (similar to allergy shots).

ALLERGIES, CANDIDA AND AMINES: Dr. Robert Wilson specializes in PMS and has authored two books on the subject. He is currently the director of the PMS Clinic at the Marie Stopes's Well Women Institute in London England. Dr. Wilson's book, CONTROLLING PMS summarizes his treatment regime for mild to moderate PMS as well as for more severe PMS. Dr. Wilson also discusses conditions that can have similar symptoms to PMS and are often missed, namely food allergies and chronic candida or yeast infections.

In cases of severe PMS, Dr. Wilson has found it very useful to limit the intake of amine rich foods. These foods include bananas, avocados, old cheeses, mushrooms, soy sauce, oranges, tomatoes, sour cream and anchovies. He believes that some women lack an enzyme that breaks down the amines, the substances that transmit messages in the brain. Rising levels of amines in the body can aggravate or cause PMS symptoms, such as headaches and mood swings.

LOW THYROID FUNCTION: Dr. Nora Brayshaw of the Biopsychiatry Institute in New Jersey found the thyroid gland was mildly underactive in 94 percent of the women with PMS who were tested. Those who took thyroid pills reported complete relief from the symptoms of PMS. Brayshaw said low thyroid may not cause PMS, but two problems could be the result of the same disorder. She believes that virtually everyone with PMS has some kind of thyroid deficiency. See last chapter on The Thyroid Gland And Pregnancy for how to find out if your thyroid gland is mildly underactive.

Other experts say that they doubt that an underactive thyroid contributes to PMS and point out that well designed studies have not yet been done that would prove that thyroid malfunctioning is the cause of PMS.