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Know Your PMS Constellations

For many women, premenstrual syndrome (PMS) is a term which has become altogether too familiar. One key to alleviating your PMS symptoms is to know to which of four constellations your symptoms belong.

For altogether too long, premenstrual difficulties have been lumped together as one single constellation of symptoms. In fact, professionals involved in the study and treatment of PMS say that this condition has no one single cause.

A better, possibly more useful approach for some women is to divide their PMS symptoms into four groups. Women can then tailor their program according to their particular constellation.

GROUP ONE. The most common constellation of symptoms consists of premenstrual anxiety, irritability and nervous tension, as well as depression, which may be expressed in behavior patterns that are detrimental to self, family, and possibly even society.

It is key to note that medical researchers have observed women with such symptoms generally have elevated blood estrogen and low progesterone. Patients in this subgroup also tend to consume an excess amount of dairy products and refined sugar.

GROUP TWO. The second most common subgroup is associated with symptoms of water and salt retention, abdominal bloating, breast pain, and weight gain. This group may have elevated serum levels of the adrenal hormone aldosterone, which causes fluid retention by preventing the excretion of salt from the body.

GROUP THREE. Women experience an increased appetite, particularly craving refined sugars, consumption of which is followed by heart palpitations, fatigue, fainting spells, headache, nervousness, and sometimes the shakes. These patients have increased carbohydrate tolerance and low red-cell magnesium.

GROUP FOUR. The least common but most dangerous subgroup is the fourth. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. These patients have low blood estrogen levels. Elevated androgens (male hormones) may be high in some patients with facial hair. Complications such as high lead levels may exacerbate this condition; therefore, hair analysis or blood testing to rule out heavy metal intoxication is helpful.

Donna Alderman is a family practice specialist and expert in nutritional health therapies.


Women experiencing PMS problems should be on a foundation supplement program. The Profem II formula supplies key PMS-alleviating nutrients such as folic acid and other B vitamins and estrogen/progesterone-balancing herbs such as dong quai, licorice root, black cohosh, and chaste berry.

Women in groups one, two and four should supplement their diet with 50 to 100 milligrams of vitamin B-6 prior to and during their menstrual periods. I recommend the pyridoxal-5-phosphate form of vitamin B-6, which is the most easily absorbed. If you choose to use pryridoxine hydrochloride, it should be combined with riboflavin and magnesium for enhanced utilization. Occasionally, in cases of poor absorption, particularly where there is liver damage, I may recommend injectable forms of this vitamin.

I also counsel my patients to increase their intake of vitamin B-6-rich foods including bananas, walnuts, salmon, dried beans, dark leafy greens and wheat germ.

Women in group three should supplement with 12 milligrams of supplemental magnesium for every 2.2 pounds of their body weight. A woman of 120 pounds weight would therefore require about 650 milligrams of supplemental magnesium.

Adequate magnesium replacement results in muscle relaxation, activation of B vitamins, and reduction in symptoms including headaches and poor heart function. Magnesium also may help in relieving cramping, backache, and nervousness.

For group four women, phytoestrogen supplements together with vitamins B-5, B-6 and folic acid for fighting depression should be considered. Balanced amino acids, with an emphasis on lysine and tyrosine, can be helpful.

Black cohosh works as a tonic to strengthen the uterus and is particularly useful for group four women. Native American women used it for painful or heavy menses. A clinically proven black cohosh extract provides additional phytoestrogen support.

All women should consider taking three to four tablets daily of a good multimineral formula. Some studies have concluded an imbalance of minerals, including a possible zinc deficient state during the second half of the cycle, may occur and predispose women to PMS symptoms.

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