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Aug. 10, 2001 -- By many accounts, Americans are in love with complementary and alternative medicines. Surveys suggest about 40% of people use at least one alternative therapy, and the majority do not tell their doctors. It is thought that many people who turn to these largely unproven remedies have chronic conditions, as well as many women experiencing menopause or premenstrual syndrome (PMS).
Common symptoms of PMS include bloating, breast tenderness, weight gain, difficulty sleeping, mood swings, food cravings, irritability, anxiety, and depression. Although many women claim to have PMS, only about 2.5% of all women of actually meet criteria for diagnosis of the condition, according to Clare Stevinson, MSc.
Stevinson, who recently reviewed studies on alternative therapies for PMS, urges caution when considering alternative treatments because she found only a small number of well-conducted studies on alternative therapies for PMS. Of the studies she found, few showed evidence of aiding women with PMS. Stevinson is a researcher at the University of Exeter in England.
In a study in the July issue of the American Journal of Obstetrics & Gynecology, Stevinson examined 27 well-conducted trials of alternative treatments for PMS. The alternative therapies included herbal medicines, homeopathy, dietary supplements, relaxation, massage, reflexology, chiropratic, and biofeedback.
Of the 7 trials involving herbs such as evening primrose oil, chaste tree, and gingko, none provided convincing evidence of lessening PMS symptoms.
"There's really basically no evidence to support whether work or not," says Stevinson. "Most of the ones used in PMS are pretty low-risk generally, although people can have allergic reactions to any type of herb."
Stevinson also found little evidence to support homeopathy or supplements such as vitamin E, calcium, or magnesium. But she says studies in which carbohydrates are increased are worthy of further investigation because carbohydrate cravings are a common symptom of PMS.
Other treatments that appear promising, but don't have enough science behind them include massage and reflexology. These two as well as yoga, exercise, therapeutic touch, and meditation pose less risk of harm than oral supplements, she says.
Regarding massage and reflexology, "We don't know if they are likely to be more effective ... but they generally aren't going to do any harm, and there is some preliminary evidence that they might be worth trying," she tells WebMD.
But women need to be cautious when trying unproven therapies, even if there is little risk of harm.
"If they don't work, then the consumer might be wasting their time," says Richard Nahin, PhD, director of extramural research, training, and review at the National Center for Complementary and Alternative Medicine in Bethesda, Md. "There can be low risk, but if there is low benefit, then what is the advantage to using it?" He points out that in addition to wasting one's time, some therapies may be a waste of money, too.
Still, the public seems interested to know more about possible benefits of these therapies.
Nahin agrees that no particular alternative therapy has been shown to be effective for PMS but adds that conventional treatments usually have little to offer women for PMS relief. "That's why a lot of people have turned to alternative or complementary medicine."