British physician Katherine Dalton, M.D., was one of the first to describe PMS and offer some therapeutic help. Guy Abraham, an obstetrician-gynecologist, has further classified PMS problems, a system that Dr. Lark also discusses in her book. The four main types are:
Other groups of symptoms include acne—oily skin and hair and acne—and dysmenorrhea (painful periods)—cramps, low back pain, nausea, and vomiting; recently classified as Type P for pain.
- Type A ("anxiety")—a mixture of emotional symptoms: anxiety, irritability, and mood swings.
- Type C ("carbohydrates" and "cravings")—sugar cravings, fatigue, and headaches.
- Type H ("hyperhydration"), also known as Type W ("water retention")—bloating, weight gain, and breast swelling and tenderness.
- Type D("depression")—depression, confusion, and memory loss.
Dr. Susan Lark’s PMS Self Help Book provides specific treatment plans for the different types of symptoms. The recommendations for the different types, including diet and suggestions, are all very similar. In her programs, all include some form of stress reduction, exercise, supplementation, herbal therapy, acupressure massage, and yoga postures.
For acne problems with PMS, extra vitamin A (20,000–40,000 IUs, mainly as beta-carotene) and zinc (20–40 mg.) are usually helpful. Choline and inositol, nutrients found in lecithin, may help nourish the skin; 500 mg. of each daily are recommended.
Dysmenorrhea and other pain problems respond well to higher amounts of magnesium, about 500 mg. more than calcium, as this has a nerve tranquilizing and muscle relaxing effect. Vitamin E (400–800 IUs) and vitamin B6 (100–300 mg. daily) may also be helpful in reducing pain. Extra B vitamins and a general vitamin and mineral program are usually also necessary.
Anxiety symptoms, such as mood swings and irritability, often respond to extra B vitamins, particularly thiamine (B1), 150–250 mg. per day, and pyridoxine (B6), 200–300 mg. per day, with about 50 mg. each of the rest of the B vitamins. Using inositol and extra magnesium, such as magnesium citrate (which causes fewer bowel symptoms, especially diarrhea, than other magnesium salts), about 400–600 mg. daily, will help. Progesterone therapy may be most helpful for Type A, or anxiety, problems. A doctor must be consulted for this therapy. Also, phenylethanolamine (PEA), a substance found in certain foods, such as bananas, chocolate, and hard cheeses, may increase symptoms of anxiety. These foods should be avoided in this type of PMS.
For depression, added tryptophan (if available), 1,000 mg. before bed, may be helpful. If this does not help, or if it causes side effects, such as headache, Stuart Berger, in his Immune Power Diet, recommends trying another amino-acid, L-phenylalanine, in the same dosage. Zinc, vitamin B6, and calcium/magnesium may also be beneficial in reducing premenstrual depression.
For women with the Type C, or sugar cravings, pattern, often associated with stress, fatigue, and headaches, confusion, or dizziness, a program that should help reduce these symptoms supplements the basic vitamin and mineral plan with additional B vitamins, particularly B6, 200–300 mg. per day, and B1, 150–250 mg. per day; chromium, 200–400 mcg.; vitamin E, 800 IUs; and vitamin C, around 6–8 grams per day. Eating frequent, small meals and avoiding sugar will also be helpful in reducing cravings.