Dietary supplements and herbal remedies for premenstrual syndrome (PMS): a systematic research review of the evidence for their efficacy

Many women with PMS use alternative therapies, although there has been little research to demonstrate their efficacy. This systematic review provides a comprehensive discussion of dietary supplements and herbal remedies commonly used for premenstrual syndrome (PMS), including calcium, magnesium, vitamin B6, evening primrose oil, Vitex agnus castus, ginkgo biloba and St John’s Wort. Randomized controlled trials of magnesium and evening primrose oil have produced conflicting results, in contrast to the substantial evidence for the efficacy of calcium and vitamin B6. There are insufficient data to advocate the use of ginkgo biloba, Vitex agnus castus and St John’s Wort, although preliminary data seem supportive. Greater standardization of PMS diagnosis and assessment, with randomized, double-blind, placebo-controlled trials using larger, representative samples, strict, prospectively confirmed diagnostic criteria and assessment of treatment efficacy, would help to clarify the role of these alternative PMS treatments. Although much of the clinical research is preliminary and/or inadequately controlled, this review will be relevant to the practicing clinician looking for greater understanding of the alternative therapies available to their patients with PMS.