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by Dr. Daniel J. Heller
Should you take an antidepressant for PMDD only after you ovulate? We explain below why this idea either makes no sense, or means everything we’ve been told for years about how SSRIs and antidepressants work is just plain wrong.
Many of our readers have asked us if they should take an antidepressant only in the two weeks before their period, rather than all month long. Of course, this is a question that should be taken up with your doctor. However, we checked the medical literature on this subject, and the research tends to agree that taking an antidepressant all month long works better than only taking the medication in the two weeks before your period (beginning at ovulation).
While it is an interesting idea that SSRIs like Sarafem® or Prozac® or Zoloft® could be taken solely in the two weeks after ovulation, it doesn’t make sense. Either that, or if it works, the whole psychopharmcology field, including psychiatrists and drug companies and all doctors who prescribe antidepressants need to hit the books, quick. That’s because for years we’ve been told that SSRIs specifically, and antidepressants in general, take weeks or even months to have their effect. And no one in the field of women’s medicine or gynecology has proposed that SSRIs have a different mechanism of action in PMDD compared to in depression or anxiety.
Why, then, would SSRIs work within ten days or so in PMDD, but need much longer in other conditions? It just doesn’t make sense.
Of course, we’re not big believers in drugs, whether they’re antidepressants or birth control hormones, for PMDD or PMS. We understand that they’re lifesavers for some women. But we hear from thousands of women that they didn’t work, or had terrible side effects, or that they just plain don’t trust them. And the deep history of SSRIs is fraught with bad science, drug company influence, and medical doctors who haven’t maintained their ethical standards.
There are alternatives to antidepressants and prescription medications for PMDD and PMS. This whole website, as well as our product offerings, are devoted to telling interested women about these facts. You can find out about a host of natural solutions to premenstrual suffering right here.
Here’s a teaser: St. John’s Wort may be effective for PMDD and PMS, but wouldn’t work only two weeks per month, for the same reasons as we’ve discussed above for SSRIs. You will need to take it all month long.
Vitex Chastetree, on the other hand—including our proprietary, doctor-designed PMS Comfort Herbal—may be effective if taken only in the two weeks before your period. This is because, unlike St. John’s Wort and SSRIs, Vitex is believed to work by helping to balance your hormones. Since the worst part of PMS and PMDD hormone imbalance takes place in the two weeks after you ovulate, it’s possible that this could work for you, especially if your symptoms are mild, or only occur for a couple of days before your period. In practice, however, we usually recommend they be taken all month long, because the hormonal balances associated with PMDD and PMS truly exist throughout the month, not just before your period; and because many of our readers, and most of our customers, are dealing with severe symptoms that have a big impact on their lives and their relationships, and taking the herbs only for two weeks per month probably won’t be enough.
by Dr. Daniel J. Heller
The supplement industry has begun to promote the herb Saffron as a natural PMS remedy, based on a study from Iran from 2007 that found that saffron, an exotic spice that was as valuable as gold in ancient Europe, helps relieve PMS symptoms. This sounds promising, if only because there is actually a little science behind it: the study double-blind and placebo-controlled, and published in a relatively reputable journal.
However, this says more about the tendency of the supplement industry to want to be appear scientific than to actually be scientific. The real reason Saffron is being promoted is because it’s new, and it’s foreign and exotic, and these are the types of products that drive sales in the supplement industry.
The truth is, though, that a single study doesn’t make a product scientific, even when it’s a very good study. The essence of science is “reproducibility”, which means you can repeat a result, just like you can reliably turn on a light by flipping a switch. Turning on the light is a reproducible result. The next study on saffron may have different results, so you need more than one study to make something “scientifically proven.” Unfortunately, in the last 5 years, there have not been any more studies on saffron for PMS – so the only thing anyone can say about saffron and PMS is that it requires more study.
On the other hand, there are many natural products that have been the subject of multiple studies for PMS relief, but the supplement industry doesn’t trumpet them because they’re not new. Vitex, or Chastetree—which is an exotic herb, with origins in the middle east—is the best proven herb or supplement for PMS, and is the number one prescription for PMS in Europe. Yes, in many parts of Europe, doctors prescribe herbs for health conditions.
Calcium supplement is an effective natural PMS remedy and has the studies to prove it. Magnesium supplement works for PMS, as does vitamin B6. None of these are new, exotic, or sexy, so you’re less likely to hear about them or encounter any marketing for them. We here at PMS Comfort discuss and recommend them because they’re scientifically proven to work, with multiple studies proving their results are reproducible.
Evening Primrose Oil is an example of something that showed initial promise, but in multiple scientific studies it was found that it actually doesn’t work for PMS.
There are other things that work for natural PMS relief that you’ll never hear about from the supplement marketers: caffeine avoidance, healthy diet, and other things you can do yourself that don’t cost a penny.
The take-home here is that the marketing of science often has more marketing than science in it.