Premenstrual Syndrome

Of all the vitamins and minerals used in the treatment of PMS, calcium supplements show overwhelmingly positive results.

© 2007 Elsevier Australia

One of the earliest trials to show that calcium supplementation can alleviate symptoms in PMS was conducted in 1989 (Thys-Jacobs et al 1989). A randomised, double-blind crossover trial involving 33 women with confirmed PMS compared the effects of daily 1000 mg calcium carbonate with placebo over 6 months. Results showed that 73% of women reported improved symptoms while taking calcium supplementation whereas 1 5% preferred placebo. The premenstrual symptoms responding significantly to calcium supplementation were mood changes, water retention and premenstrual pain. Menstrual pain was also significantly alleviated.

In 1993, the American Journal of Obstetrics and Gynecology published a study that compared the effects of calcium (587 mg or 1336 mg) and manganese (1.0 mg or 5.6 mg) on menstrual symptoms. Ten women with normal menstrual cycles were observed over four 39-day periods during the trial (Penland & Johnson 1993). The researchers found that increasing calcium intake reduced mood, concentration and behavioural symptoms generally and reduced water retention during the premenstrual phase. Additionally, menstrual pain was reduced.

A more recent large, double-blind, placebo-controlled, randomised parallel-group study was conducted in the United States and supports the previous findings (Thys-Jacobs et al 1998). Four hundred and sixty-six premenopausal women with confirmed moderate to severe PMS were randomly assigned to receive either 1200 mg elemental calcium (from calcium carbonate) or placebo for three menstrual cycles. Symptoms were documented daily by the subjects based on 17 core symptoms and 4 symptom factors (negative affect, water retention, food cravings and pain). Additionally, adverse effects and compliance were monitored daily. During the luteal phases of both the second and third treatment cycles, a significantly lower mean symptom score was observed in the calcium group. By the third treatment cycle, calcium treatment resulted in a 48% reduction in total symptom score compared with baseline, whereas placebo achieved a 30% reduction. Furthermore, all four symptom factors responded in the calcium treated group.

A 1999 review of multiple trials investigating calcium supplementation as an effective therapy for PMS has found overwhelming positive results (Ward & Holiman 1999).

Some researchers in this area have hypothesised that part of the PMS aetiology lies in calcium dysregulation in the luteal phase and have highlighted the dramatic similarities between symptoms of PMS and hypocalcaemia (Thys-Jacobs 2000). Recent data from the Nurses Health Study II support this theory, with evidence of low calcium and vitamin D levels in PMS populations when compared to controls Calcium 158

(Bertone-Johnson etal 2005).

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