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Cathy Margolin, L.Ac. Dipl. OM

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PMS and Cramps Help: The Alternative Answer

Posted: 05/05/11 09:39 AM ET

When the heating pad is not enough and you're fed up with swallowing the naproxen, aspirin or ibuprofen, and you can't handle their side effects, you just might be ready for natural PMS herbal alternatives. Here is a different approach to menstrual cramps and PMS. Traditional Chinese Medicine hasn't been the accepted answer. We've always been "plugged-into" the Western approach. It's time to get UNPLUGGED!

Herbs have been around longer than mankind. Through the ages every culture has discovered the healing properties nature provides; this has been a universal phenomenon. The Chinese began embracing natural botanicals and documenting their medicinal value circa 300 BC. The Yellow Emperor's Inner Cannon was one of the first ancient Chinese medical texts from this era and the Shen Nong Ben Cao Jing (The Divine Farmer's Materia Medica Classic) was the first to index 365 medicinal plants and compiled circa 100 AD. Some 2,000 years later, these same medicinal plants are still in use and have been extensively studied and dissected by Western science looking for keys to how they work.

When I first began studying Traditional Chinese Medicine (TCM) I was in awe of all the possibilities herbal formulas offered. When I discovered an herb blend or "formula" written in 1113 AD to help menstrual cramps, PMS and irritability, I only wished I had seen it sooner. As both men and women know all too well, it's not only the physical symptoms of a woman's menstrual cycle but the emotional and psychological swings as well. Chinese herbs have been proven to help these mood swings and without the side effects of prescription drugs.

A study by the Cochrane Library -- an international, not-for-profit, independent organization which promotes and disseminates systematic reviews of heath care interventions -- found evidence from 39 clinical trials involving 3,475 women, that Chinese herbal medicine can be used safely and has merit as therapy for women suffering with menstrual cramps also known as primary dysmenorrhea: "Chinese herbal medicine gave significant improvements in pain relief when compared to pharmaceutical drugs. It also reduced overall symptoms. The research revealed that Chinese herbal medicine was also better at alleviating pain than acupuncture or heat compression."(1)

"All available measures of effectiveness confirmed the overall superiority of Chinese herbal medicine to placebo, no treatment, NSAIDs, OCP, (oral contraception pills) acupuncture and heat compression, and, at the same time, there were no indications that Chinese herbs caused any adverse events," said lead author Xiaoshu Zhu, who works at the Center for Complementary Medicine Research at the University of Western Sydney, Australia.(2)

The Japanese adopted TCM into their national medical system decades ago. It was 1976 when the Japanese Department of Pharmaceutical Affairs and Ministry of health and Welfare Service first approved 148 traditional Chinese herbal formulas as part of their National Health Insurance coverage. Today herbal medicine in Japan is prepared as pharmaceuticals which insures dependable potency levels from batch to batch. Some of the same herbs the Cochrane Library studied are part of the menstrual cramp formula commonly used in Japan.

Here's a little background on five of the Chinese herbs from the Cochrane Library study that have been popular with women for ages for menstrual cramp relief, PMS and moodiness associated with a monthly menstrual cycle. 1. Angelicae (dang gui), 2. Red and White peony root, (radix peoniae alba and peoniae rubrae), 3. Licorice root (glycyrrhiza), 4. Nut-Grass rhizome (Cyperus) and 5. Ligusticum (lovage root or chuan xiong). (These herbs and others can be found in PMS Relief Herb Pac)

Angelicae Root (Dang Gui)
Dang qui functions as an anti-inflammatory, pain reliever and is often referred to in Traditional Chinese Medicine as the female ginseng. Mary Hardy, M.D. said "Dang qui may have some efficacy for PMS when used in traditional Chinese multiple-herb formulas."(3) Dang Gui is believed to have an adaptogenic effect on the female hormonal system. It is often included in herbal combinations for abnormal menstruation, suppressed menstrual flow, painful menstruation and uterine bleeding. Dong qui has been traditionally used in balancing the reproductive hormone system, as an anti-inflammatory and anti-spasmodic agent.(4) The chemical constituents in Dang gui include coumarins, ferulic acid and ligustilide, and essential oils, which are compounds that may be useful for blood flow and for relaxing the uterus in premenstrual uterine cramping.(5) Coumarins are known vasodilators and antispasmodics.(6)

White Peony Root (Radix Paeoniae Alba) and Red Peony (Radix Peoniae Rubrae)
Peony root has many important uses, from headaches to abdominal pain and spasms, blood deficiency, menstrual irregularities and even night sweats. White Peony root (the skin removed) has been an important remedy for female reproductive conditions ranging from primary dysmenorrhea (painful menstruation) to irregular menses.

Red peony root (bark or skin still on the root) has some similar pharmacological actions and some varying actions. Studies show the major effect of white peony is to calm nerves and alleviate spasms. Both forms of the roots are commonly used in Chinese medicine. White peony has been studied for use in the treatment of depression-like disorders.(7) The roots are full of anti-oxidants and polysaccharides. Research has found the major marker component of white peony is paeoniflorin, but its flavonoids, tannins and polysaccharides all contribute to its medicinal value.(8)

Peony root has been used to treat menstrual irregularities and amenorrhea, which suggests that it may have hormonal effects. Clinical trials with traditional Chinese and Japanese herbal formulas containing peony have suggested various hormonal effects in both pre- and postmenopausal women.(9)

Licorice root (Glycyrrhiza)

Licorice has a long and highly varied record of uses. It remains one of the most important herbs in Traditional Chinese Medicine. It is said this herb goes to all twelve channels of the body, a claim given to only a few Chinese herbs. By entering all body channels this herb is often used for its guiding actions to help other herbs enter into channels they would otherwise not normally effect. In regards to menstrual cramps Licorice root can moderates spasms and alleviate pain, especially in the abdomen and legs. The two major constituents of licorice are glycyrrhizin and flavonoids. Flavonoids are antioxidants known to improve circulation and relieve tissues damage and have a role in reducing inflammation.

Nut Grass (Cyperus)

This herb is commonly combined with Dang Gui for irregular menstruation and dysmenorrhea. This herb has a major role in regulating our liver energy and is known for not only stopping the pain associated with our menstruation but also the ability to help regulate our menstrual cycles. Its actions are intensified when combined with other herbs such as Dang Gui and Bupleurum. The Grand Materia Medica written approximately 200 AD states that Cyperus is the "Commander-in-Chief of Qi disorders, and for gynecology, the Supreme Leader."(10) It is also called an "immortal herb for women" as far back as 1550 AD. Cyperus's known chemical constituents include volatile oils, flavonoids and proteins.

Ligusticum (Chuan Xiong or Lovage)

Ligusticum is a widely used blood tonic and is especially common in women's formulas in Traditional Chinese Medicine. It improves blood circulation and has been studied extensively in for heart circulation because of its profound effects for myocardial circulation.  Ligusticum is related to Dang Gui because it shares some of the same characteristics, but Dang Gui is a stronger blood tonic while Ligusticum is a strong blood mover and analgesic (pain killer).(11) Liguisticum the very special ability of treating all types of headaches along with its well known traits for menstrual symptoms. Because it warms the uterus and decongests blood in the pelvic region, it is especially popular for menstrual cramps.

There are many wonderfully effective herbs to help alleviate the pain and emotional components of a women's monthly menstrual cycle. These herbs are just the tip of the iceberg. Herbs are capable of treating both the symptoms and can even address the root of the disharmony which Traditional Chinese Medicine has historically known to be quite effective. Returning to our roots for answers to these age old problems is a logical solution without the side effects of prescription drugs or over-the-counter pain killers.

According to Mark Blumenthal, Executive Director of The American Botanical Council, "As the public demands more natural forms of healthcare and as healthcare costs continue to spiral out of control, mainstream health practitioners and policy makers might also become more willing to reconsider some of the practices associated with herbalism with both its scientifically confirmed and its less scientific yet hard-to-miss empirical treatments."

To find a qualified practitioner of Chinese herbal medicine who can prescribe the herbs mentioned above please see TCMDirectory.com, Acufinder.com or PacHerbs.com.

References:

1-2 Chinese herbal medicine for premenstrual syndrome , Jing Z, Yang X, Ismail KMK, Chen X, Wu T,   http://www.cochrane.org/reviews/en/ab006414.html 

3 Hardy, ML. Herbs of special interest to women. J Am Pharm Assoc (Wash) 2000 Mar-Apr;40(2):234-42; quiz 327-9.

4 Zhu DP. Dong quai. Am J Chin Med 1987;15(3-4):117-25.

5-6 Tyler V. The Honest Herbal: A Sensible Guide to Herbs and Related Remedies. Philadelphia (PA): George Stickley Company; 1982.

7 Behav Brain Res. 2010 Jul 11;210(2):171-7. Epub 2010 Feb 20. Long-term treatment with peony glycosides reverses chronic unpredictable mild stress-induced depressive-like behavior via increasing expression of neurotrophins in rat brain.Mao QQ, Xian YF, Ip SP, Tsai SH, Che CT.School of Chinese Medicine, The Chinese University of Hong Kong.

7 Ethnopharmacol. 2008 Sep 26;119(2):272-5. Epub 2008 Jul 18. Antidepressant-like effect of peony glycosides in mice. Mao QQ, Ip SP, Tsai SH, Che CT. School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.

8 Ethnopharmacol. 2010 Jul 20;130(2):407-13. Epub 2010 May 24. Pharmacokinetic properties of paeoniflorin, albiflorin and oxypaeoniflorin after oral gavage of extracts of Radix Paeoniae Rubra and Radix Paeoniae Alba in rats.
Feng C, Liu M, Shi X, Yang W, Kong D, Duan K, Wang Q.
Department of Pharmaceutical Analysis, School of Pharmacy, Hebei Medical University, Shijiazhuang, PR China.

9 Oya A, Oikawa T, Nakai A, Takeshita T, Hanawa T. Published in : J Obstet Gynaecol Res. 2008 Oct;34(5):898-908. Clinical efficacy of Kampo medicine (Japanese traditional herbal medicine) in the treatment of primary dysmenorrhea

10-11  Chinese Medical Herbology & Pharmacology by John K. Chen, Tina T. Chen Art of Medicine Press, 2004

 

Follow Cathy Margolin, L.Ac. Dipl. OM on Twitter: www.twitter.com/PacHerbs

When the heating pad is not enough and you're fed up with swallowing the naproxen, aspirin or ibuprofen, and you can't handle their side effects, you just might be ready for natural PMS herbal alterna...
When the heating pad is not enough and you're fed up with swallowing the naproxen, aspirin or ibuprofen, and you can't handle their side effects, you just might be ready for natural PMS herbal alterna...
 
 
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03:55 PM on 05/09/2011
What about using Shatavari, I have used it for several months now and it seems to help. Shatavari has been used in Ayurvedic medicine for balancing woman's reproductive health such as dryness, PMS, libido. I use it and I buy it from at this place http://www.naturesformulary.com/Products/63-shatavari.aspx
BTW the product is Organic and Made in USA, which I like
09:55 PM on 05/07/2011
There are many way to approach PMS. And thankfully now we are considering alternative and integrative appraoch. As a functional medicine practitioner I get so satisfied when many of my clients completely forget that they even had PMS.
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odyssey58
09:36 PM on 05/07/2011
I found that when I gave up soy, especially tofu, and used more animal fat then vegetable fat my PMS went away. I also switched from a grain based, mostly vegetarian diet to eating grass fed meat and dairy, plus lots of low carb vegetables and a little fruit.
The last time I had significant cramps was a few years ago when I made the mistake of sharing a fried appetizer at a restaurant. I had terrible arthritis pain in my hip and could barely walk, and I had awful cramps that month.
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Cathy Margo
Acupuncturist, Herbalist, Doctor of Oriental Med.
03:53 PM on 05/06/2011
With a history stretching back thousands of years, Traditional Chinese Medicine (TCM) is a deep reservoir of wisdom. Since only knowledge that has stood the test of time is transmitted to later generations, TCM could be considered to have undergone mankind’s largest scale clinical trial.
While Americans are not all that familiar with Chinese herbs as food or medicine, their use as everyday health supplements is extremely popular throughout Asia, Canada, Germany, Australia and Japan. It's likely that over a billion people on the planet use Chinese herbal medicine, everyday.
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Ichor
03:20 PM on 05/06/2011
The answer is in krill oil
03:14 PM on 05/06/2011
I don't get cramps and rarely "PMS" I think most women need to educate themselves on their cycle instead of just assuming it's 'cramps'. There could be further underlying issues too. There is a great book called 'Flow' that covers this issue in depth and I also recommend the book 'Taking Charge of Your Fertility' even for those not trying to conceive as it covers a wide variety of issues regarding this issue too.
05:18 PM on 05/05/2011
I get the worst PMS cramps. Some days I have to take 2-3 ibuprofen every 4 hours just to get through the day. I am always looking for natural ways to alleviate the pain. This article helped a lot. Thanks
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ncyim
11:09 PM on 05/05/2011
When I was in acupuncture school I treated many women with cramps, ovarian cysts and other gyn issues with great success just using acupuncture. Personally, I don't like herbs. On the other hand I ended all my cramps by eating spinach daily. This spinach cure has worked for a few girl friends too.
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FaunaAndFlora
Daughter of Pan
12:44 AM on 05/06/2011
Maybe I shouldn't announce this on a public website, but I always recommend the three M's for PMS... milk, marijuana and masturbation. (For those who can't tolerate lactose, find another source of bio-available calcium.) ;-)
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Jazmo
Cause they're hip to the bull and hip to the lies.
09:37 AM on 05/06/2011
My acupuncturist did both, the herbs and acupuncture. Not only did I used to get PMS, but the menstrual migraine as well. Between the two (herbs & needles) it helped alot. She gave me something in a tea form ... smelled like feet but worked like whoa! I recommend acupuncture all the time to women. I'm pleased it's getting more "mainstream" because I know how much it helped me.
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kbella
11:31 PM on 05/05/2011
Try drinking some pure peppermint tea. I accidentally discovered this method when I forgot to bring some ibuprofen with me and I was out and about. I happened to get some peppermint tea from a coffee shop, and my cramps went away. I have done this for the past 6 months, and it works like a charm. I then found some stuff on the internet that talk about it as well. I hope this helps!
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05:11 PM on 05/05/2011
Has anyone tested these thoroughly so we're sure they don't cause cancer or some other problem? Historical use isn't such a great thing. People used to use lead as a cosmetic and we know how good that is for you.
11:23 AM on 05/09/2011
Really? Two to four thousand years of use in multiple millions of women doesn't satisfy you as "tested thoroughly"? Certainly cancer has been around for ages, but the explosion of the prevalence of cancer is a 20th-21st century phenomenon, particularly in modern societies where these herbs are not used. Yep, Mother Nature is definitely out to get us all.
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08:16 PM on 05/09/2011
No, actually it doesn't.
http://www.ncbi.nlm.nih.gov/pubmed/12110620
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03:11 PM on 05/05/2011
From your cited study: "Authors' conclusions
It is rare in PMS management that efficacy claims are substantiated by clinical trials. One of the identified trials was well designed and reported on the effectiveness of Jingqianping in the treatment of premenstrual syndrome. However, currently there is insufficient evidence to support the use of Chinese herbal medicine for PMS and further, well-controlled trials are needed before any final conclusions can be drawn."

It's not really a ringing endorsement.
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RMankovitz
Researcher, inventor, entrepreneur, author
12:30 PM on 05/05/2011
While Chinese herbs can certainly relieve symptoms of PMS in some women, they do not directly address causation. Could it be that a deficiency of some essential nutrients lies behind PMS? Well, over the last decade or so, a host of studies have been conducted that point to a deficiency in vitamin D, calcium, and magnesium. Use Google Scholar to search: pms vitamin D.

It would seem prudent for those women with PMS symptoms at least to be tested for vitamin D3 blood levels. Of course, supplementing with vitamin D, calcium, and magnesium is a no-brainer for just about everyone eating the SAD diet or its equivalent.

More clues from nature can be found in “The Wellness Project.”

Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization
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11:57 PM on 05/05/2011
so why not recommend something other than the SAD? many of those Chinese herbs can be prepared in the diet... is cholecalciferol synthesized from lanolin, or industrially-sourced mineral supplements better? how does this address causation?
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RMankovitz
Researcher, inventor, entrepreneur, author
01:17 AM on 05/06/2011
So why not look into the listed reference for answers to your questions?
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jacquelinenh
HuffPo Addict
10:52 PM on 05/07/2011
Agree that treating menstrual cramps in isolation isn't getting to the root of the problem -- you have a hormonal imbalance that's triggering the cramps, bloating, moodiness, etc/ Excellent article on natural PMS relief... http://www.womentowomen.com/menstruation/understandingpmsandpmdd.aspx Diet, exercise and some herbs can help!