There was an article this week in Maclean’s, the Canadian news weekly, that was making the point that alternative treatments and holistic medicine are unscientific. One of the conditions mentioned was in the article was PMS, and the article said herbs for the treatment of PMS haven’t been proven. Having been involved in natural medicine for decades, I find that the same old weary arguments are trotted out over and over by people with little knowledge of their subject, and with an enormous bias.
I too have a bias, but in my case it favors natural medicine. But there is absolute evidence that dietary supplements do help PMS. In fact, it’s more than evidence, it’s proof. The Maclean’s article mentioned only herbs for PMS, but some of the best evidence for natural treatment of PMS is for nutritional supplements, not herbs: calcium, magnesium, and vitamin B6 supplements have all been found effective. As to claims about herbs, Vitex agnus castus (Chaste Tree Berry) and Hypericum perforatum (St. John’s Wort) have both been extensively studied and are somewhere between solidly proven and extremely promising for PMS symptoms. In Germany, medical doctors have made Vitex the leading prescription medication for PMS.
A holistic approach to any condition, including PMS and PMDD, involves multiple healing modalities. This brings us to a major methodological problem with science as it is conventionally understood, and natural medicine. The gold standard of clinical trials is the double-blind, placebo-controlled, crossover study, which means that neither the patient nor the provider knows who is getting the real treatment. If this were the only way to glean useful information, though, we’d have no useful trials on food and diet, exercise, physical therapy, surgery, or any other intervention where one party knows who is getting the real treatment.
That brings us to another problem. The standard for concluding that a treatment works requires that the researchers be 95% certain that the result is not the result of random chance. That is a very high and difficult standard, one that only high-powered trials are likely to be able to meet: meaning, very expensive studies with hundreds or thousands of participants. This usually means that only large, well-funded (often by drug or medical device companies) studies can reach “statistical significance.”
The other problem with this approach is that it holds meaningful results hostage to an arbitrary statistical definition. If a treatment is studied in just 35 people, and results in a 50% improvement—their symptoms are half as severe as they were before the intervention—but the degree of certainty is only 75% rather than 95%, most researchers and medical commentators will say the treatment did nothing! Nothing! That, obviously, is throwing the baby out with the bathwater. Most of us would be happy to use a condition if we were 75% sure it would work to reduce our symptoms by half.
Finally, herbal and dietary supplements have a very low risk of side effects, and so shouldn’t be directly compared to drugs and devices that have a very steep risk of major problems. Most natural approaches, when used correctly, have side benefits instead of side effects.
