Here’s What to Do When You Haven’t Got Time for the Pain

Premenstrual syndrome is a collection of physical and emotional maladies that strike some women before their menstrual periods. We ask a medical doctor, an acupuncturist and an herbalist how they treat PMS.

*

The Herbalist: Therese Walsh, Elixir Tonics & Teas, Los Angeles:

“There are two broad categories of PMS,” she said. One is characterized by breast pain, cramping, lower back pain, irritability and excessive hunger. For this, she suggests an herbal mix called Menstrual Ease. It’s a bupleurum and peony combination also called Jia Wei Xiao Yao Wan. “It nourishes the blood and it basically cools the internal environment down.” These symptoms, she said are heat signs.

The other syndrome of PMS includes depression, severe mood swings, pain during menstruation and alternating constipation and diarrhea. For this, she suggests a formula called Harmonizer Tonic. It’s a variation of the ancient Chinese Chai Hu Shu Gan Wan. The formulas are to be taken for the three weeks before the period.

She analyzes customers’ symptoms and takes a pulse and tongue reading. Sometimes, they just need a simple herb--cramp bark--that helps with uterine cramps.

Some need a combination of formulas. Others have poor nutritional habits that aggravate the PMS. Walsh, also an acupuncturist, was trained at the Emperor’s College of Traditional Medicine in Santa Monica.

“There are a lot of herbal things we can do to balance hormones as well,” Walsh said. But she doesn’t think people should just go into a natural foods store and start loading up on treatments. “I definitely recommend that you work with a practitioner who has studied [herbal medicine]. I think you streamline your effectiveness.”

*

The Obstetrician / Gynecologist: Dr. Barry Berman, Mullikin Medical Center, Northridge:

Unfortunately, Berman said, the causes of PMS are not fully known, and the symptoms can be just as confounding. “Women from different ethnic groups have different symptoms, but consistent symptoms.”

Each treatment must be individualized, he said. “Our goal is that the patient feels better in the end.”

As a result, Berman treats the symptoms. He tries a multitude of non-drug approaches before prescribing hormones.

“Somewhere between 30 to 45 minutes of exercise will relieve some of these symptoms,” he said. Exercising on the days of symptoms will release endorphins, or natural opiates, in the body.

He also suggests dietary changes, especially as food cravings increase. “Stay away from alcohol and processed sugar.” There is no medical proof that taking Vitamin B6 helps, but some of his patients swear by it.

If a patient doesn’t want to take traditional medication, Berman suggests holistic medicines. “There are certain formulations designed for PMS. If it works for you, fantastic. If not, come back to my office.”

For patients not relieved by any of these treatments, “We can start looking at other hormonal medications.” They include birth control pills, other ovulation suppressors and long-acting hormones. Some women get good results from a vaginal suppository of progesterone. A few of the drugs are experimental and not covered by insurance companies.

He also tries traditional medications for pain, water retention, anxiety and hypoglycemia.

And sometimes he refers patients with severe mood disorders and depression to a therapist to see if there are non-PMS reasons for symptoms.

*

The Acupuncturist: David Chen, Whittier:

Chen insists his patients first see a gynecologist to make sure it is simple PMS and not a more severe physical problem.

If it is, indeed, PMS, Chen performs a general physical exam, checking the pulse and tongue. In Oriental medicine there are three major causes of disease, Chen said: weakness of the body, energy flow deficiency and stagnation or blockage.

Chen uses acupuncture to remove the blockage and balance the body’s energy. He also recommends herbal medicines and dietary changes. “There are some very, very good herbal medicines quite commonly recommended to increase blood flow and energy and to calm the patient down.”

He also recommends a diet of well-prepared foods without preservatives or salt, a decrease in red meat, and five smaller meals instead of the regular three daily meals.

For patients with cramps, he suggests either heat or ice treatments depending on the patient’s needs.

Patients are also urged to cut down their activity by 30% two days before and during menstruation. With three to six treatments, Chen said, he has a success rate of 90% to 92%. But, he said, “It is not a miracle.”