What is PMS?
Whenever the word syndrome is used in a diagnosis we can expect the condition described to comprise a large number of symptoms often affecting different parts of the body.
PMS is defined as a condition characterised by nervousness, irritability, emotional instability, depression and possibly headaches, oedema and mastalgia; it occurs during the 7-10 days before menstruation and disappears a few hours after onset of menstrual flow.
The Merck Manual goes on to list the following as symptoms: vertigo, fainting, palpitations, easy bruising, constipation, nausea, vomiting, and changes in appetite. Also pelvic heaviness, acne, respiratory allergies, and aggravations of visual disturbance and conjunctivitis – to name a few! In other words a lot of symptoms for the classical homeopath to consider.
No one seems quite sure but it seems to be related to hormonal fluctuation (especially oestrogen) though psychogenic causes have also been muted. It is interesting that PMS has by its very nature probably existed for thousands of years, however, in the latter part of this century it has taken on a politicised role for the women’s movement and has been used in arguments both for and against the changing status of women – PMS has even been used as a defence in the Courts of Law.
There are many approaches which is somewhat suggestive of there being no definitive treatment: Hormonal manipulation with progesterone, tranquilliser’s, diuretics for fluid retention, counselling and dietary changes (e.g. increasing protein and decreasing sugars as well as supplementation with Vitamin B complex) have all been tried but none found to be anything nears satisfactory in all cases.
Such a wide variety of symptoms seems to suggest that each case is likely to be different and this is surely the case. As the symptoms are both mental and physical we are dealing with a problem that should draw the attention of any classical homeopath.
As always the best chance of finding the correct remedy is by taking a full history, use the repertory or computer, isolate a short list of remedies and select the one that best fits the patient as a whole.
Nevertheless the syndrome is composed of a labyrinth of symptoms and it is possible to examine these homeopathically.
If the patient says that all the symptoms are markedly relieved as soon as she starts to menstruate, we must look at the rubric, Generals, menses, start of, amel. Synth which gives a small list of remedies.
In my opinion by far the most reliable of these is Lachesis which is the remedy for any condition that improves as soon as menstrual bleeding begins. Kali-carbonicum and Zincum metallicum are also occasionally useful but we would need to find other symptoms of these remedies whereas Lachesis is often useful in PMS if the patient feels remarkably better as soon as the bleeding starts. It is just such a strong keynote of this remedy.
Other useful references to the repertory are:
|MIND||Irritability. menses, before|
|CHEST||Pain, mammae, menses, before|
|CHEST||Swelling, mammae, menses, before|
From these rubrics, I have found the remedies, Calcarea carbonicum, Conium and Sepia often to suit women with PMS. How the actual menstruation is experienced and of course the rest of the homeopathic history needs to be considered.
Sepia: decreased libido and even a strong aversion to sex often makes us think of this remedy. The characteristic ‘bearing down’ feeling in the uterus may be present.
Calc carb: heavy menstruation with swollen tender breasts before it starts is a clue.
Conium: is less frequently indicated in my experience but I think of it when there has been a powerful suppression of sexuality.
I know that it is a homeopathic cliche but it is my experience that any remedy that suits the whole patient well is capable of helping women with this debilitating condition. I have discussed a few remedies whose keynotes quite often occur in PMS but the syndrome varies enormously from woman to woman and therefore I feel sure that a big repertoire of remedies is needed to treat the majority of cases.
In addition to homeopathic treatment I have found the following nutritional supplementation useful in many cases.
1 Evening Primrose oil: 1g three times a day. As the patient improves, this can be reduced to 1g three times a day during the premenstrual period and 1g daily for the rest of the month.
2 Vitamin B6: This is best given in the form of B-complex often marketed as ‘Vit B 100’ by various manufacturers.
3 Calcium, magnesium and zinc supplementation usually available in a single tablet to be twice daily in the premenstrual period and once daily for the rest of the month.
Deep relaxation and counselling also have their place when appropriate. As usual in the holistic approach we look at the whole patient as well as the disease. PMS can certainly be seen as a disease of the complex but extremely elegant female hormonal cycle. In my experience, an holistic approach, in which classical homeopath plays a major role, is a very useful in this condition which decreases the quality of life for a substantial proportion of women today.