Natural vs Conventional PMS & PMDD Treatment
Comparing Approaches
Naturopathic Approach
Naturopathic treatment addresses PMS and PMDD through hormone-balancing botanical medicine like vitex (chasteberry), calcium and magnesium supplementation, vitamin B6, evening primrose oil for breast tenderness, blood sugar stabilization through nutrition, reducing inflammatory foods, adaptogenic herbs for mood support, addressing underlying estrogen dominance through liver support, and stress management techniques. Treatment is individualized based on symptom patterns and severity.
Conventional Approach
Conventional treatment for PMS includes NSAIDs for cramping, diuretics for bloating, and calcium supplementation. For PMDD, SSRIs are first-line treatment (taken continuously or just during luteal phase), hormonal contraceptives to suppress ovulation, or GnRH agonists for severe cases. Treatment aims to suppress the hormonal fluctuations that trigger symptoms or modulate serotonin response to hormonal changes.
Benefits & Considerations
Naturopathic Treatment
Benefits
- +Addresses hormonal root causes including estrogen dominance
- +Supports natural hormone balance
- +Effective for many cases of PMS
- +No medication side effects
- +Can be used long-term safely
Considerations
- −Takes 2-3 menstrual cycles to see full improvement
- −May not be sufficient for severe PMDD
- −Requires consistent daily supplementation
- −Variable individual response to botanical medicines
Conventional Treatment
Benefits
- +SSRIs highly effective for PMDD mood symptoms
- +Hormonal contraceptives eliminate hormonal fluctuations
- +Can be taken just during luteal phase or continuously
- +Strong evidence base for PMDD treatment
- +Rapid symptom relief
Considerations
- −SSRIs can cause sexual dysfunction and other side effects
- −Hormonal contraceptives prevent pregnancy
- −Does not address underlying hormonal imbalance
- −Symptoms return when medication stopped
- −Some women don't respond to SSRIs
When to Consider Naturopathic Treatment
Naturopathic care is appropriate for PMS with physical and emotional symptoms, mild PMDD, women wanting to avoid medications, or as complementary care alongside conventional treatment. It's particularly valuable for addressing underlying estrogen dominance, liver function, and nutritional factors contributing to hormonal sensitivity.
When to Seek Conventional Care
Seek medical care for PMDD with severe mood symptoms significantly impairing relationships or function, suicidal thoughts during luteal phase (call 988 if acute), inability to work or maintain daily activities due to symptoms, severe depression or anxiety that's worse premenstrually, or symptoms not improving with natural approaches after 3 cycles. Severe PMDD often requires SSRIs for adequate symptom control and quality of life.
Frequently Asked Questions
How do I know if I have PMS or PMDD?
PMS involves physical and emotional symptoms in the week before menstruation that improve when period starts. PMDD is more severe with marked mood symptoms (depression, anxiety, irritability, mood swings) that significantly impair daily function. PMDD diagnosis requires at least 5 symptoms with at least one being mood-related, occurring in most cycles. Tracking symptoms through 2-3 cycles helps distinguish PMS from PMDD and confirms the luteal phase pattern. PMDD affects about 5-8% of menstruating women.
Does vitex (chasteberry) really help with PMS?
Research supports vitex effectiveness for PMS symptoms including breast tenderness, mood changes, and irritability. It works by modulating pituitary function to balance progesterone and prolactin. Effects typically emerge after 2-3 cycles of consistent use. However, vitex is not appropriate for everyone (avoid with hormonal contraceptives) and should be prescribed by a knowledgeable practitioner. It's most effective for PMS with luteal phase progesterone deficiency but less effective for severe PMDD.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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