Exercise and diet are always important first steps in trying to lessen the symptoms of PMS. Routine aerobic exercise improves mood and lowers fluid retention. Exercise is also thought to stimulate endorphin production, which improves feelings of wellbeing.

Whole food diets high in complex carbohydrates help reduce cravings and can also improve mood. Diets high in these carbohydrates increase tryptophan level and therefore serotonin. Reducing salt intake can help reduce fluid retention, bloating, and weight gain. Limiting alcohol and tobacco use is also recommended.
In addition to these, PMS sufferers may benefit from certain nutritional supplements and/or natural antidepressants.

Nutritional supplements worth trying:
Calcium deficiency and PMS share similar symptoms. Clinical trials make a strong case for the benefits of calcium. 1000-2000 mg of elemental calcium daily for a few months significantly improves mood and decreases bloating, food cravings and possibly pain.

Magnesium levels tend to be lower in women with PMS. Taking 360 mg of magnesium supplements per day seems to improve mood and reduce fluid retention. It may also help reduce premenstrual migraine.

Vitamin D is now being studied for prevention of PMS. There is some evidence that increasing total or dietary intake of Vitamin D is associated with a decreased risk of developing PMS. Women with an average Vitamin D intake of 706 IU per day seem to have about a 40 percent lower risk of developing PMS.

Pyridoxine (Vitamin B6) is another vitamin that is often recommended for PMS. There is some evidence from clinical studies that taking 100 mg per day of pyridoxine supplements seems to decrease overall symptoms of PMS, as well as depression. CAUTION: higher doses can cause peripheral neuropathy.

Chasteberry is a very popular “woman’s herb,” evaluated in several studies for PMS. It seems to work best for physical symptoms such as breast tenderness, edema, and constipation, though not bloating. It also seems to improve irritability, mood, anger, and headache. In some women, Chasteberry improves symptoms by as much as 50 percent, though its exact mechanism is not known. It may increase estrogen and progestin activity. Note that though Chasteberry looks promising based on the evidence so far, studies are somewhat limited due to small sample sizes or inadequate study designs.

“Natural” antidepressants that are used in PMS include:

St. John’s Wort. Numerous studies show that it can be beneficial for mild to moderate depression but there is only very preliminary evidence that it can help for PMS symptoms.

St. John’s Wort can decrease the effectiveness of oral contraceptives, which could result in unexpected pregnancy, so use a backup method!

SAMe is another well known natural antidepressant. SAMe increases levels of serotonin, norepinephrine, and dopamine. CAUTION: Has been known to induce mania or bipolar symptoms.
L-Tryptophan or 5-HTP are precursors to serotonin. There’s actually some evidence that L-tryptophan might improve some symptoms of PMS. CAUTION: The safety of these products is controversial.

The bottom line is: exercise, eat a whole foods diet rich in complex carbohydrates, and limit alcohol and tobacco use. In addition, supplement Calcium 1200 mg/day, Vitamin D 800 IU/day, and Vitamin B6 no more than 100 mg/day. Herbs such as Chasteberry (discussed online), St. John’s Wort or SAMe should be used under the supervision of a health care provider.