Wellness

Herbs and Supplements for PMS

Herbs and Supplements for PMS

If you’re an adult woman, chances are you’ve had conversations with other women about period pain. Probably a lot. Probably more than you can count. And likely you dismissed it as a miserable fact of life. Traditionally, we’ve accepted that once the cramps hit, we have a limited toolbox for stopping the pain (and that toolbox is usually stocked with various brands of aspirin).

“We spend so much time trying not to put chemicals in our body, and then the cramps hit and we can’t get to chemicals fast enough,” says Kirsten Karchmer, a board-certified reproductive acupuncturist. “But out of all the different techniques we use in my clinics, I found that our herbal supplements made the biggest difference for women who want to improve their PMS symptoms.”

Karchmer has devoted her career to understanding menstrual cycles and has helped thousands of women learn how to use theirs as a tool to understand overall health. Now, as the founder of Viv Wellness, she’s also giving women access to the same herbal resources you’d get at her clinic. Several goop staffers have found that Viv supplements provide welcome, effective relief both by mitigating PMS symptoms and also by addressing pain when it starts to creep in. We asked her to break down the herbs in her arsenal and explain why—and how—they work.

A Q&A with Kirsten Karchmer

Q
What role can plants, herbs, and/or supplements play in regulating a healthy cycle?
A

For a long time, the goal of Western, or allopathic, medicine has been to stop uncomfortable symptoms as quickly as possible—the patient is in pain and we want that pain to stop. In order to accomplish that goal, we usually use drugs to override the body’s own mechanisms that are causing dysfunction. It works really well, and really fast. But the problem is when you take away the drug, you take away its effect. You’re not fixing the problem; you’re just covering it up.

With holistic medicine, instead of trying to override the body, we work with the body to make changes. It’s slower but usually leads to more-lasting change. A drug isn’t making a correction; the body is, so when treatment ends, you’re healthier than when you started.

In my clinic, I use a huge toolbox of modalities to accomplish this. We use acupuncture, mindfulness, nutrition, and a variety of herbs and supplements. While I think each of these therapies has its place, I find the herbs to be really effective for regulating menstrual cycles. I like to think of our herbal supplements as training wheels: When your cycle starts to get a little wonky, they can help just nudge it back into place.

This is different from regulating a cycle with something like hormonal birth control. When you’re on the pill, your menstrual cycle is regulated by the exogenous hormones in the birth control instead of the hormones that your body normally produces. When you stop taking the pill, your cycle may stop altogether, or it may take months to become regular again. With herbs, we never actually take away your body’s own mechanism for cycle regulation. We just help guide it back into the right rhythm. And just like with training wheels, when you’re ready to ride on your own, we just stop treatment and your momentum keeps you on the right path.


Q
What role can herbs play in soothing PMS?
A

PMS is a big mix and match of symptoms that are different for almost every woman. PMS, while a total bummer, is super useful in helping you identify which body systems aren’t quite working at 100 percent. Do you have a bunch of bowel changes and bloating right before your period? Then you know you need to work on digestion. Feel like you’re going crazy? Time to work on stress and detox.

Because PMS is so unique to each person, there’s not just one herb that’s a silver bullet. What we really need to do is build a blend that targets your specific constellation of symptoms. The best formulas for PMS work in a synergistic way to address all your symptoms. I hate to just pick and choose one or two herbs, but here are a few general categories that can be helpful.

Digestive issues like gas, bloating, nausea, heartburn, diarrhea, or constipation: For your digestive issues, think of culinary herbs. Mint, lemon, honey, ginger, and licorice all help soothe stomach and digestive issues. These are herbs that appear in almost every traditional medicine for common digestive complaints—and you probably have them right in the kitchen. Another herb that I really love is Poria sclerotium1 , which is a superfood fungus that improves digestive function.

Anxiety, irritability, mood swings, or feeling down in the dumps: There are a number of mood-elevating herbs that can be super helpful when you’re riding the PMS mood roller coaster. We use a blend of Chinese peony root, bupleurum root, and cyperus rhizome as the backbone of our popular PMS blend. Valerian is a common choice for tension, irritability, and sleeplessness; it’s easy to find in your local Co-op or drugstore.

Pain, breast tenderness, headaches, and cramps: Anti-inflammatory herbs are helpful here. We dig curcumin, which is the active ingredient in turmeric, as it’s been shown to reduce chronic pain and spasms. Dong quai root2 is also super helpful here and is the most prescribed herb for many women’s health complaints. Chinese skullcap is a fantastic anti-inflammatory that also helps support detoxification and healthy liver function.


Q
Which herbs/plants have you found to be most effective for period pain and cramping?
A

More than 80 percent of women suffer from significant period pain, and the right supplements can make a huge difference. There is a ton of research out there on herbs that are not only safe but as effective as NSAIDs (nonsteroidal anti-inflammatory drugs, like aspirin). These herbs are generally widely available and affordable, and they can be total lifesavers. Here are three of my favorites:

Fennel seed: Fennel3 is actually one of the most studied herbs for dysmenorrhea, or severe period pain. In a study from 2006, researchers found that fennel was as effective at treating dysmenorrhea as mefenamic acid, the preferred prescription for period pain. Fennel was also shown to reduce nausea and fatigue and improve general feelings of well-being in regular users.

Cinnamon: Cinnamon4 has been shown to be nearly as effective as ibuprofen at getting rid of pain and cramping. In a 2015 double-blind placebo-controlled trial, cinnamon decreased pain from an average of seven out of ten down to a two. Like fennel, it also helps decrease nausea and vomiting associated with menstruation.

Ginger root: Something else you can find in your kitchen! Ginger5 has been shown to be equivalent to both ibuprofen and mefenamic acid for treating period pain and is considered to be an effective alternative treatment to pharmaceutical interventions. It may also help reduce a number of different PMS symptoms like low back pain, headache, gastrointestinal disturbances, nausea, and joint and muscle pain.


Q
If you’re already experiencing menstrual pain, is it too late? In other words, in that moment, what you probably want to reach for most is aspirin—is there an herbal alternative?
A

It’s definitely not too late—natural products have been demonstrated to be as effective as common over-the-counter painkillers.

NSAIDs, a group of drugs that includes aspirin and ibuprofen, are somewhere around 50 percent effective at reducing period pain. The bummer about NSAIDs is that they come with a host of potential adverse effects: stomach problems, high blood pressure, fluid retention and swelling, kidney and heart issues, and rashes. In fact, recently researchers from the Cochrane group have warned that “women using [NSAIDs] need to be aware of the substantial risk of adverse effects.”

Aspirin also brings up a really great discussion about the difference between herbs and drugs. Aspirin (acetylsalicylic acid) is a totally natural substance that is derived from the leaves of the willow tree. People have been using willow to treat pain and inflammation for thousands of years. A lot of the time we think about drugs as these magical chemical creations that are made in a lab somewhere, but in reality, many drugs are based on traditional medicines.

There’s a really big disconnect for people around this issue. One of the biggest things we hear is that people just don’t believe that herbs are strong enough for their cramps or PMS. In my experience, they are an effective equivalent—with fewer side effects—of what many women are already using. There is a ton of research out there on everything from single herbs to complex formulas for pain.6


Q
What kinds of questions can we ask our doctors to support us in pursuit of a healthy cycle?
A

I hear a lot of stories about women getting the cold shoulder from doctors when they talk to them about period pain or really bad PMS. I don’t think this is because they’re bad doctors or they’re uncaring. The truth is they don’t have a huge toolbox for the treatment of common menstrual complaints.

Doctors usually aren’t trained in nutrition—they’re trained to zero in on disease states and treat them. This is awesome if you have bronchitis but less awesome if your periods are a consistent bummer. In my research and clinical career, I’ve been able to eliminate PMS and period pain for thousands of women through programs that include supplements, diet, exercise, and mindfulness. But that’s because I’ve dedicated my whole life to researching these natural interventions. Most doctors just don’t have the time to dive into wellness research like that.

When you’re talking to your doctor about a healthy cycle, here are a few things to remember: Don’t be afraid to be honest and advocate for yourself. If you’re suffering, you need to let your doctor know that.

Ask lots of questions. If your doctor recommends a pharmaceutical or surgical intervention, ask what the research says about both short- and long-term outcomes. Even if you don’t think you’ll want children later, a certain treatment may impact your future fertility and you deserve to know that. Knowledge is power and gives you with the tools to support your body now and ten years from now.

Do your own research. It’s okay to be an informed patient! The internet is a great tool for keeping up to date about the most common and cutting-edge treatments for conditions like dysmenorrhea, endometriosis, and PMDD. Just make sure that the research you’re reading is from a reputable source, like a peer-reviewed journal. If you want to be sure, look for articles on PubMed, a huge collection of journal articles that are usually good quality.

Find the right fit for you. You’re not necessarily stuck with your doctor if you don’t like them. Ask around and see if your girlfriends have an ob-gyn that they love. You deserve great medical care, so it pays to shop around and find the right fit for you.


Kirsten Karchmer is a women’s health expert, a health-tech pioneer, and the founder of Viv Wellness, a company dedicated to improving women’s periods worldwide. She is also the founder of Conceivable, a technology enabled fertility solution. Karchmer is a board-certified reproductive acupuncturist and her clinical practice has helped more than 10,000 women over the last twenty years.


The views expressed in this article intend to highlight alternative studies. They are the views of the expert and do not necessarily represent the views of goop. This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

1Poria sclerotium is a component of several traditional Japanese herbal remedies, including the herbal Xiaoyao pill developed for period-related indigestion.
2Dong quai, also known as angelica root, contains ligustilide, an anti-inflammatory compound that may help ease the uterine contractions involved in cramps.
3Fennel extract has been shown in a number of studies to be as effective for period-related pain relief as mefenamic acid, and in rat models it has significantly reduced the intensity of uterine contractions.
4There is some preliminary evidence that cinnamon may help reduce menstrual bleeding and related period symptoms, although it may not provide as much pain relief as ibuprofen.
5In controlled trials, ginger root has been found to stand up to both mefenamic acid and ibuprofen for relief from menstrual pain, have no significant side effects, and also help with nausea.
6This is one systematic review that looks at thirty-nine studies on Chinese herbal medicine for period pain.
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