How many women with PMS does it take to change a light bulb?”

The punch line to that old joke is, “That’s not funny.” And for 80%  of all menstruating women – the number of women in the United States who experience premenstrual syndrome – it is no laughing matter. Though if you do have PMS, you probably get the joke!

More than 150 symptoms have been attributed to PMS! The symptoms are so common that the medical community considered discarding the term “PMS” and accepting the symptoms as normal! This attitude trivializes the daily significance of PMS for the millions of women women who suffer from it.  For at least 5% of all menstruating women, the symptoms of PMS are so severe that they are incapacitated on a monthly basis. For many women, even moderate PMS can interfere with work and can disrupt everything from parenting to social relationships.

What Causes PMS?

PMS is usually due to a combination of factors that lead to hormonal imbalances, imbalances in the stress hormones,  and the neurotransmitters (chemicals that control mood).

Underlying factors:

  • Nutrient deficiencies (especially B6, vitamin E, vitamin A, calcium, and magnesium)
  • Blood sugar dysregulation
  • Environmental factors, especially excess estrogen from plastics and other chemical exposures
  • Stress (relationship, marital/sexual difficulties; workplace stress, money, etc.)

Thyroid problems can also cause PMS, so have your doctor check your thyroid hormones to make sure these are in proper order. And while you’re at it, get your iodine and vitamin D levels checked – when low these can contribute to depression and other related symptoms.

Sometimes improving one factor alone can improve symptoms, but most often a combination approach of improved diet, improved lifestyle habits (for example, adequate rest, increased exercise, and changed beliefs about menstruation), and herbal and nutritional supplements are needed.


Natural Approaches to PMS

Natural approaches to PMS can transform your life! Here are my favorites!

Going with YOUR Flow: Work With Your Natural Energy

This may be the most important advice I can give to you. Recognizing the premenstrual time as one of naturally heightened awareness and emotions can actually help you to relax and get through a lot more easily. Rather than fight how you feel, go with it. Ways to do this include journaling your PMS feelings; setting aside time during the week before your period to pamper yourself with a hot bath, a cup of herbal tea, and a good novel; splurging for a massage; taking a yoga or dance class; or having a night out with your girlfriends. Pay close attention to the insights and feelings that arise during this time and record those in your journal. They may give you insight into some of your deeper feelings and point to things you might want to change in your life. Take the time to nurture yourself each month – eat better, rest more, move your body through exercise, and listen to your heart, mind, and spirit.

Diet and Nutrition

Here’s where a plant-based diet can make a huge difference, so go Mediterranean-style if PMS is getting to you. A daily dose of dark leafy greens such as kale, collards, and broccoli and good quality fats are your ticket to the happier hormone party! The high fiber content of vegetables can help the body to effectively eliminate excessive hormones from the intestine, particularly estrogen, while adequate intake of legumes can support the production of hormones when there is a deficiency. Keep dairy products to a minimum to avoid any excess hormones coming into your system. Include cold-water fish (such as salmon and other low-mercury fish) a couple of times a week or take a high quality fish oil supplement.Dietary fats should come from olive oil, avocados, coconut oil, hemp oil, and other good quality oils.

Women with PMS consume significantly more sugar, dairy products, salt and refined carbohydrates than those who do not experience it. Caffeine intake has also been linked to premenstrual discomforts, especially breast tenderness. Cutting out sugar, all white-flour products and caffeinated items such as coffee, black tea, and sodas may be hard to do but can go a long way to relieve symptoms. Interestingly, dark chocolate (62% or greater) is the exception to the caffeine rule – it can help improve mood and prevent or relieve depression.

Adequate protein and fat at each meal will keep your blood sugar at a nice neutral hum – exactly where you want it to be to avoid the ups and downs of PMS and the roller coaster ride of imbalanced blood sugar – a gnarly combination!

In addition to a healthy diet, several supplements are beneficial in reducing PMS, particularly for improvement of mood, reduction of bloating, and reduction of breast tenderness. These include:

  • Calcium citrate (up to 1,200 mg per day)
  • Magnesium citrate or glycinate (400 mg per day)
  • Vitamin B6 (50 mg per day as part of a B-complex supplement)
  • Vitamin E ( 400 IU per day)
  • DIM (Diindolylmethane) standardized to 25 mg of 25% diindolylmethane, from Brassicacae vegetables
  • Sulforophane (from Broccoli sprout concentrate) 800 mcg
  • Flax seed, 2 TBS fresh ground daily

Evening primrose oil is commonly recommended by herbalists, in a dosage range of 1,500 to 3,000 mg daily, as part of a treatment protocol for PMS. Unfortunately, most clinical trials have failed to show consistent benefit. Nonetheless, increased fatty acid intake has been associated with improved mood when there is depression, and evening primrose is not harmful, making it a practical addition to a treatment plan until further research proves or disproves its benefits.

Lifestyle Habits

The importance of adequate rest and moderate exercise cannot be overstated for improving PMS symptoms. Fatigue from lack of regular sleep will exacerbate nearly all physical and emotional discomfort. Moderate exercise, even just walking or light cardiovascular exercise for as little as fifteen minutes three to four times per week can drastically improve mood and reduce fatigue. A boogie down dance party with a good sweat is even more fun! When we exercise, we are more likely to feel empowered in our lives and  are more likely to take care of ourselves in ways that reduce PMS and improve overall quality of reproductive health.


Herbs are powerful allies for us in many aspects of our reproductive cycles. PMS is no exception. Herbs can be used to improve mood, support hormonal regulation, and reduce many of the PMS symptoms. Companies such as Gaia Herbs, Herb Pharm, Eclectic Institute, Kan Herbs, and Planetary Formulas will carry products that contain some or all of these in various excellent combinations. Take as directed on the packaging.



Hormonal Regulators

Include herbs that help to regulate the hormones when treating PMS. Vitex (chaste berry) is probably the most commonly used, helping to heal ovarian dysfunction and corpus luteal insufficiency, which cause insufficient progesterone levels. Its prolactin-inhibiting effects may also, in part, explain its beneficial effects in treating PMS. Dosage is 2 to 5 ml of tincture one to two times daily, with one dose typically taken in the morning and the other midday. Black cohosh and peony are also frequently used in formulas for PMS. Black cohosh can be used for treating menstrual headaches, breast tenderness, anxiety, and depression. Its effects may be due in part to its mild enhancement of serotonin reuptake. Peony has been shown to enhance ovarian function, improving levels of both estrogen and progesterone and reducing symptoms of PMS. A standard dose of black cohosh is one to two 40-mg capsules twice daily, or 2 to 4 ml of tincture one to three times daily.

Stress Relieving Nervines

These are herbs that support the nervous system improving mood, reducing headache, stress, and anxiety, and promoting overall relaxation. Passionflower, motherwort, St. John’s wort, milky oats, and kava kava  are some of my all time faves. These herbs may be used alone or in combination and with the exception of kava (which should be used for short durations only) they may be used throughout the month over an extended period of time, or just prior to and through the premenstrual time. Kava should be used only under the supervision of a qualified practitioner as it has been associated with liver disease, and no more than 1 ml twice daily for the week before the menses, and then discontinue. Feverfew, though not a nervine and more of an anti-inflammatory, may be especially appropriate when a woman also experiences premenstrual headache, as it has been shown to reduce migraines, especially when used preventively.


A number of herbs provide general support to the body, improving energy, sugar metabolism, mental functioning, mood, and general health. Among these are the adaptogenic herbs Asian ginseng and American ginseng, eleuthero, schisandra, and ashwaganda. These can be taken alone or in combination, and for best results should be taken for a minimum of two to three months before significant results are seen. Typical dosage ranges are 1 to 2 capsules twice daily or 2 to 4 ml of tincture twice daily.

Liver Herbs

Herbs have long been used to support and stimulate the function of the liver, which is the central clearing house for your excess and used up hormones. Dandelion root is a classic. Others include milk thistle, artichoke, and tumeric. Some liver herbs improve digestion,  relieve mild constipation, and help clear up acne.

Chinese Herbs

In Chinese medicine, it is believed that PMS is a result of one or more of several factors, most commonly “liver qi stagnation.” Liver qi stagnation is caused by long-term repressed emotions including anger and frustration, as well as imbalances in lifestyle, particularly a lack of adequate sleep and going to bed too late at night (after 11 p.m.). Excessive consumption of caffeine, alcohol, red meat, nuts, dairy products, and fried, fatty foods can cause or aggravate this condition. Creative activity can help to unblock stagnant liver qi. The premier herbal formula for regulating this problem is a bupleurum  and dong quai  formula known as Rambling Powder (this formula is also used for building the blood). It is available through many herbalists, acupuncturists, and herbal medicine companies.

The Magic of Women’s Cycles

The menstrual cycle has long been a source of magic and mystery. Some cultures consider menstruating women to have strange and magical powers. The Polynesian word “taboo,” which in English has come to mean something that is forbidden, actually means both “sacred” and “menstruating” in its native language. Among many Native American tribes, menstruating women were considered more powerful even than medicine men.

It is thought that how we view our bodies and menstrual cycles may influence how we experience menstruation. If a woman views menstruation negatively, with dread, or shamefully, all of which are deeply entrenched attitudes about menstruation, she may be more likely to experience menstrual difficulties than a woman who has a positive outlook on her body’s natural functions.

Ok, while I’m not saying that having your period is fun, there is no end to how our experience of our lives affects our biology. Many women today are embracing the menstrual cycle as a time of heightened emotional sensitivity, creativity, intuitiveness and personal power. The term “moon time” is sometimes used by women in place of the word “period” as a more poetic affirmation of this. Indeed, the words “menarche,” “menses,” and “menstruation” have their origin in the word “moon,” reflecting the cyclical nature of a woman’s body in harmony with the monthly cycles of the moon. There is even a “Red Tent” Movement going on across this country, where women gather and share stories, ceremony, and helpful ideas and comfort.

While PMS is certainly not just “in your head,” positive reframing may be an important part of helping women to overcome menstrual difficulties.

Wishing you happier, healthier hormonal cycles!

With love always,



  1. I used to experience severe emotional PMS, and I just wanted to share, that since I started doing yoga, as little as once a week, a 1.5 hour class, my symptoms have magically disappeared! other factors might have contributed, but in other aspects of my life i haven’t made any significant changes…so I would really recommend yoga to any ladies suffering out there from the negative effects of PMS…it really helps to bring some balance!

    • ying/yang, warm/cold food properties make a big difference in your cycle. Please pay attention to what you eat and drink because it affects your monthly cycle. It’s amazing how educating yourself with the food you eat and liquids you drink make an impact on your health. After many years of struggling with severe monthly periods, heavy bleeding, anemia, borderline hysterectomy, it was amazing to discover that just by changing my diet I was able to put myself together and basically stop my periods completely.

      • Hello, I just had a blood transfusion have been anemic for quite some time and just two weeks ago had an ablation I have been eating raw but my issues come from a very toxic place of work. I am working on this and hopefully a positive result will come of this. Can I ask how you changed your diet? Was there a book?

  2. Thank you, Aviva, for being the brave soul to connect the allopathic with the rest of the world. It is my hope that as more and more people read your articles, which are broad and complete, they will kindly demand other care givers to broaden their knowledge, creating a richer and healthier world. Keep up the good work,
    Mary Kathryn

  3. GREAT article and timely as well . I have had several issues you mention . My family doctor is not concerned with any major health issues and just says I have sensitive ovary problems I am currently taking shatavari every day,passion flower and valarian at bedtime -lemon balm , and skullcap tea often every day or two.I started taking B vitamins and magnesium a couple months ago.
    I have had ovary pain for 5-8 days before ovulation for 19 years !!!! It used to be every other month now it is every month .I feel more pain with a full bladder .I gain 1-2 pounds weight also .After ovulation I lose the weight ,feel normal again until the next month.
    I also get VERY angry 7 days prior to my period starting and can track it on a calender(better this past month after taking B vitamins and magnesium.I have cramps down my legs the first day of my cycle then that gets better .I have been taking butchers broom to help circulation as I have some varicose vein issues as well.
    The article mentions stress and financial and marital issues that compound the problems -yep -I have had all these for many years —hhhmmm 19 0r twenty??

  4. What a wonderful and timely post. I was wondering, though, if any of the abovementioned herbal remedies are safe to use while breastfeeding.

    • be very careful with Vitex!
      I took it for 26 days and it made me bleed for a few months.
      I always had regular menses. After taking vitex my body became so very confused and i got two cycles per calendar month each lasting about ten days. It was very scary. After 8 moths it is getting back to normality. I hope.

      • This is very unusual but with herbs in general, always a good reminder than individuals can have individual responses and that they are “medicines” too! Thanks for sharing.

      • Same reaction here!!!! I had perfectly regular periods lasting 3 to 4 days and Vitex caused spotting before my regular periods and now a year later I still have this issue. It is very powerful so be careful.

  5. Thank you for this important information Aviva! Once again you have written something that I feel compelled to share with every woman I know! I have battled PMS and endometriosis for years. My anxiety levels used to be through the roof the week before my period… my breast tenderness was so severe that I could not exercise or ride my horse and I had terrible digestive issues. My situation is more complicated because of my endometriosis but I have seen great relief in my symptoms by removing dairy, alcohol and wheat from my diet. I have been vegetarian for 17 years but recently became mostly vegan (I eat organic eggs). I exercise 6 days a week and find this is a huge help. I recently had surgical excision of my endometriosis (Stage 4) and I am not wanting to add some herbs to help with healing and to support my liver in the removal of excess estrogen. Can you recommend some safe herbs?
    Thank you!! LOVE this blog and share it on my own professional blog regularly!

    • Hi Hayley! Great work!!! The herbs recommended in the section on bitters are usually used to augment the liver’s ability to detoxify (blog coming soon on natural detox!) while dark leafies in the Brassicacae family and daily doses of flax help eliminate it from the bowel. DIM and sulforophane also help the liver. Stay well! Aviva

      • Thanks for the great article. I have terrible PMS symptoms. I cry everyday starting 1.5 weeks before my period. I also get angry very easily around this time. I am not like this the rest of the month. I was put on antidepressants by my PC, but the side effects are unbearable. I was feeling hopeless until I read your article and the suggestions from the readers. I am going to try your suggestions and try a yoga class. Is there a specific type of yoga that is more helpful than other? (I am sorry, but I have never taken a yoga class). Also, YES !!! please, please, please write an article on how to do a complete liver detox. I found several liver detox formulas online but I am hesitant to try them, as I do not completely trust the source.
        Thanks Aviva

  6. Hi Aviva! Your posts are always so informative and, as my mother would say, sensible. As a previous poster commented, the way you blend of allopathic and alternative approaches seems so reasonable.
    I have been a nail biter my whole life (I am 30)… I have noticed changes in my nail biting over the course of my monthly cycle, with the most intense biting just before my period starts. I consider bleeding nails a symptom of PMS! I had some success at short term cessation of the habit with acupuncture that aimed at treating adrenal issues…

    Surprisingly, the best success I have had is connected with childbirth (or perhaps breastfeeding). I have just given birth to my second son and with both of my children, my nail biting stopped immediately after giving birth… I have no desire to bite my nails at the moment. So, hormones clearly play a part in compulsive habits too!! I am looking forward to trying some of the herbs you suggested for long term use – perhaps they will help to stabilize whatever it was that was contributing to the biting.

    In an unrelated question, I would love to see you discuss the various types of birth control and their impact on our health… We are looking at long term options and are drawing a blank! Vasectomies aren’t exactly a women’s health issue, but I would be interested in your opinion on them too…

  7. Great and a very timely article. Thanks for all the information. My daughter use to have very painful periods. She had nutritional deficiencies and muliple allergies. I started her on vit D, magnesium, fermented cod liver oil, multivitamins and probiotics like water kefir etc. After couple of months she had pain free periods but her cycle changed to 35 days from 30 days. Is this something to worry about.

    • Not necessarily. But could be anovulatory cycles from PCOS or another hormonal imbalance. I’ve used vitex tincture 5ml daily in the morning to help regular periods….

      • Aviva, is vitex an adaptogen herb?? I have low estrogen levels(28) and after taking it for 3 months my estrogen went up to 48, but then stopped taking it because I started 3 months of clomid and my estrogen went dawn again(30). Any advice? Thanks, Diana

  8. Thank you for the information! Which of the herbs you listed are safe while breastfeeding? I am having a hard time finding that out but would love to try treating my PMS with herbs if possible.

      • All of the others you have listed are ok then? I can never get any of my doctors to help me with herbs -I have been pregnant or nursing for 16 years straight! So, I’ve had to guess or figure things out on my own, which makes me nervous sometimes. The few weeks before my last period, i started taking magnesium, calcium and vitamin D, and when my period started I drank one or two cups of raspberry leaf tea. Coincidentally, I had also taken reishi for the first time and some spirullina. Well, for the first two days of my period, I had a headache that wouldn’t go away, but what was more troubling was that I had bad varicose vein pain down my whole right leg, the same side I had my headache on! I usually only have that kind of pain while pregnant, and it was so weird that it was JUST my right leg! So I panicked and stopped taking all of my supplements. I read about so many amazing herbs and the help they can provide but it is hard to figure out how many you can take. Do you know which of these would have caused this to happen? So glad I stumbled upon your site! I read your vaccinations book 7 years ago and have reccomended it to many, including some of my pediatricians. Thanks for your help!

  9. Thank you, as usual a good and thorough read.
    I recently hosted a lovely lady who does a “Womens WIse Cycle” talk. She spoke about the wisdom we gain from our cycle and how the cycle of a womens creativity, sensitivity, needs are really a cycle and differ at different times of the month. And the importance to give ourselves those times and listen and see to our needs. And take that extra time, bath, massage, alone time or whatever as a way of honouring ourselves, in tune with our cycles.
    We tend to harbour on despite our bodies calling out for a change in rhythm … our work goes on day in day out… but our bodies have a rhythm and we need to hear and honour that.
    This was a very enlightening approach to dealing with PMS too.
    love Gauri

    • YES! Women often have creative surges around ovulation, and more introspective times close to their menstrual cycle. LEarning to honor and use this could be very valuable for women! It can make us much more effective in our comnunications and productivity. This is discussed in the new version of the herbal medicine for women distance learning course! 😉

      • Hi Aviva

        I first want to thank you for all the wonderful work you do. I very often refer to your articles/post when in need. I am hoping you could write something on hormone replacement – bio identical hormones and how to wean off them safely whilst supporting hormones in a more natural way.

        Thank you again


  10. This a great post – very helpful as I was just looking for information on dealing with PMS naturally. I’m wondering about treatment for painful cramps? I have moderate-severe cramps, rendering me unable to work or sleep, so for 1-2 days I take the max dose of ibuprofen for the pain. It doesn’t always work but even when it does, it often causes more abdominal pain, diarrhea, and gas. Is there anything I can try to reduce pain during menstruation?

    • Hi Sarah. My fave herbs are cramp bark, wild yam, and motherwort. Cannabis, if you can get a legal source of tincture, is also very effective. Magnesium has been found to be helpful for some women. More to come on a menstrual cramps blog down the road!

  11. Thank you so much for writing this! My doctor wanted to give me antidepressants to ease my PMS, but I turned him down. I had been avoiding caffeine, but always allowed my sweet & salty cravings to be satisfied. I really needed to read this today, and feel better just knowing there are other options!

  12. My periods used to be pain free (most of the time). Recently, I accidentally wore a tampon for 12 hours (forgot about it/fell asleep) and I pulled it out right away. (I rarely wear tampons and now I’m going to stop using them completely.) That day (2nd day of my period) after pulling out this tampon in the morning, I felt nauseous on & off. Then I felt nauseous and vomited once. I only vomited my last small meal (blueberries). The next day (today) I feel better and not nauseous – no fever or any other symptom other than a bit dizzy when I get up too fast. I was nervous that I had a mild case of TSS or something.. but I feel better and don’t have a fever. I can’t wait to try your recommendations in this post. But for this recent episode that I had, any advice? Also, I recently cured myself of allergies with your allergies post. I followed your plan and have been off of drugs (zyrtec, etc.) for 2 weeks now… Thank you so much!!!

  13. Thank you for this article very empowering for women. What vitamins you can recommended
    cause i’ve been feeling a bit dizzy. depressed and even palpitation.And with present period my blood clot increases.

  14. Hi, Im trying to find some information but not having a lot of luck. My chiro put me on chaste tree to help balance my hormones. I ended up being very angry all the time. He tried something else, I cant remember what and the same thing. Now he has me on thermo-sea for iodine because im hypothyroid and I find it also makes me super “B” worse than when I normally just had pms. What the heck is the deal? Is it low vit b? I take magnesium. It is driving me nuts that I cant seem to take anything to help me without making everything worse! Any ideas?

  15. Would you think black cohosh would be safe while breastfeeding? I am interested in Gaia women’s balance supplement and this is the main ingredient.

  16. I have come to understand that the more a woman can embrace the energetics of femininity in her life, like following her intuition and being a natural creator, the more the symptoms of PMS can go away… Because symptoms in our female “parts” are calling to us to heal the aspects of our feminine nature.

  17. Aviva,
    I read another blog of yours about this topic on the ultrawellness website. But I guess since you left that practice, I am unable to locate it. Base on this blog I purchased Fem estroplex from metagenics and Magnesium glycinate as well. But I forgot how to use them, as I mentioned, the blog is not there anymore, will you please send me some comments about it. Thanks

    • Yes, LOL! You are correct. The Fem Estroplex can be taken as directed on the bottle; the usual dose of magnesium glycinate is 600-1200 mg/day. Hope that helps! I’ll try to track that blog down and get it published up here! 🙂

  18. I have the same problem my emotional state is not good when I’m PMS I’m pushing away my lover with my emotional week…what do I do?

    • Hi Donna,
      Working on the PMS of course is key; but also, interestingly, we do have cycles in the month, and in our lives where introspection and space really are what we crave – so if can go about that with love and transparency then maybe your lover would understand and then you can reunite when you feel more like it! 🙂

    • Hi Donna,
      Prolactin can be elevated for many reasons from benign (or not) tumors to simply stress. It’s very common to be elevated — work with you doctor to uncover the reason – and repeat testing to see if it’s come down spontaneously. Hang in there! Most of the time it’s not anything serious, though I know it’s scary to have anything abnormal on a lab test. Wishing you the best! Aviva

  19. Good day I appreciate your great work — thank you
    this is a question for a grand niece – 15 yo extreme pain with menses – to the point of being put on the pill — it helped, but she didn’t want this chemical approach. she stopped and pain is back. simple directions for her? cal/mag — what doses, omega 3-6-9 ? will vitex help – and do you take it on days except when bleeding ? you must have many questions — hope you get this —– must be time to take your womens medicine class —- blessings

  20. Great article and very informative! One question though, I have previously purchased a tincture that was pitch black in color and once that ran out I purchased from a different company and it was very pale sand/yellow in color. They claim it’s normal but I’m not sure if it’s been diluted or something. I’m nervous to use it :/ Based on your experience what is the normal color of the vitex tinctures? Should I be concerned with the coloring of this one? Looking forward to your response thanks in advance!

  21. Very informative articles! Since going vegan and being active almost daily I have cured my cramps during that time of the month but now I still have slight back pain and I notice that my mood drastically changes the week before the period. My anxiety increases and am far more emotional, sensitive and irritable. Which herb that you have mentioned would work best?! Thanks

  22. Hi Aviva,

    I am a healthy, active 35-year-old woman who has never had children. I don’t have typical symptoms of PCOS (BMI 20) but my sisters have both had infertility issues, one being diagnosed with PCOS. I have long, sometimes irregular cycles (since my teen years) and I’ve started taking Vitex to help with that as I refuse to take oral contraceptives. I’ve read differing opinions on how to take it. Should I take it all month long, even while menstruating, or should I take a break while on my period? Sorry if you’ve already addressed this somewhere and I’ve missed it.


    • Hi Sarah,

      You might want to check out the blog and the Podcast Aviva did on PCOS. Both have a super awesome downloadable chart on how to work with the herbs and supplements (vitex included). Just do a search on her site for PCOS.

      Warm wishes,
      Megan- Aviva Romm’s Executive Assistant & Functional Health Coach

  23. What causes menstrual cycle to be short? For almost a year now my cycle has been short…22 days instead of my usual 28 days. Any diet/herbs/lifestyle tips?

    • Usually excess estrogen which allows the endometrial lining to proliferate more quickly and thus shed earlier….See my book, The Adrenal Thyroid Revolution for how to get back on track with estrogen dominance, and stay tuned for a blog on this.

  24. Hi Aviva,

    Thanks for all of your informative posts. Just participated in your refresh program. I suffer from migraines/tension headaches, but very directly related with my hormones. Usually 24-48 hours before my period, I have a horrible migraine that doesn’t subside for a day or 2. It’s really debilitating. I see above you recommended Feverfew and in another post magnesium. How much/when do you recommend taking these?


    • Hey Ashley, There can be a number of reasons for premenstrual migraines, including histamine issues, low magnesium, and as you recognize, hormonal imbalances or even just big shifts. for the magnesium I usually recommend about 1000 mg/day depending on the individual, and for feverfew and other herbs see my video over on You Tube or under the new hormones section of my website (see under women’s health in the navigation bar). Excuse the bad lighting and bad haircut (there’s a story behind that!). Be well. Aviva

  25. Aviva, ty so much for this excellent article! Wondering if breast tenderness b4 the period normal? Sometimes I get it sometimes not. Should it be consistent each month?

  26. Hi, thank you for this article. I had two miscarriages in the past year and with them my hormones have been off. I finally found a doctor who is helping get underneath my hormones. But with that I also have been experiencing PMS symptoms with anger and fatigue. (I started gluten free and am trying to start more steady excercise) I am already taking Vitex, Fish Oil and a B Complex, what other areas do you suggest, I feel like it’s hard to know where to start with so many options! Magnesium?

    • Hi Becca!
      I am the nurse practitioner in Dr Romm’s practice and I often hop in to answer comments and questions, since Dr Romm doesn’t always have the time to get to them all!
      Sounds like you have made some great hormone-balancing changes so far, and it may take some time to see the results, so hang in there. Dr Romm generally recommends magnesium supplementation for PMS and many other medical issues. She has a great blog on magnesium that can be found here and may be helpful:

  27. Hi, Thanks for the informative article. I am having heavy bleeding during the first 3 days of period in the last 3-4 months. Cycle is regular 28-30 days. However, having PMS mood swings, fatigue, achenes in the lower body starting 7-8 days prior to the periods. I have ordered for Vitex(410mg caps) and Red Raspberry leaf (400mg caps). Please let me know this combination would help me to over come the problem and their right dosage.


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