PMS Relief Through Science: Which Natural Supplements Actually Work?

by Kyle Perkovich, BS

Premenstrual syndrome, or PMS can feel like an unavoidable struggle, but the right approach can help make it more manageable. During the luteal phase of the menstrual cycle, hormonal fluctuations trigger the common symptoms of PMS, leading to mood changes and physical discomfort.¹ While various options exist for those seeking to combat these symptoms, natural supplements are increasingly recognized for their ability to provide relief.

Many conventional treatments focus on masking the symptoms, but a growing body of research shows that specific supplements can address the root causes of PMS, such as inflammation, hormonal imbalance, and nutrient deficiencies.² Healthcare providers and women alike are turning toward scientifically proven natural solutions that target these underlying mechanisms and bring about more balanced health during the menstrual cycle.

Natural Solutions versus Drug-Based Options?

Natural remedies for PMS may be favored over conventional treatments due to their potential for fewer side effects and a more balanced approach to symptom management. Conventional treatments like nonsteroidal anti-inflammatory drugs (NSAIDs), while effective for pain relief, can lead to gastrointestinal issues and increased cardiovascular risk when used long-term.³ Similarly, hormonal treatments such as birth control and selective serotonin reuptake inhibitors (SSRIs), though useful in regulating hormones and mood, can result in side effects such as weight gain, mood fluctuations, and digestive issues.^4,5

Natural supplements, on the other hand, focus on restoring balance by addressing nutrient deficiencies or hormonal imbalances without the more severe risks associated with synthetic drugs. While more research is needed in this area, early studies suggest that herbal and natural options provide significant relief for a range of PMS symptoms, including mood swings, cramps, and bloating, without the harsh side effects linked to traditional pharmaceuticals.⁶

Curious about which natural supplements are effective? Discover the science behind clinically researched options below.

Chasteberry
Herbal solution for PMS cramps, mood swings, and hormonal imbalance

What is it?
Chasteberry (Vitex agnus-castus), derived from the fruit of the chaste tree, has a long-standing reputation for supporting female reproductive health. Often recommended as a natural remedy for PMS, chasteberry is especially known for its ability to relieve both physical and psychological symptoms associated with PMS.

How it works
Chasteberry influences the hypothalamus-pituitary axis, which helps restore balance to reproductive hormones like estrogen and progesterone, alleviating common PMS symptoms.⁷ By reducing the production of prolactin, a hormone that can contribute to breast tenderness and mood disturbances, chasteberry restores hormonal equilibrium, mitigating PMS symptoms at their root.⁷

What the science says
Numerous clinical studies back up chasteberry’s effectiveness for PMS relief. In one trial looking at over 1500 women, 93% of participants reported a decrease in symptoms after three menstrual cycles, including improvements in depression, anxiety, and cravings.⁸

Chasteberry’s effectiveness for improving mood swings, headaches, and breast tenderness is backed by statistically significant results versus placebo.⁹ It has even been compared to drug-based treatments, outperforming fluoxetine for physical symptoms like breast tenderness and headaches, though fluoxetine was more effective for psychological symptoms.¹⁰

A 2019 meta-analysis found that women taking chasteberry were 2.57 times more likely to experience remission in their symptoms than those taking placebo,¹¹ making it an appealing, natural alternative for women seeking relief from PMS discomfort.

Black Cohosh
Traditional herbal remedy for improved emotional well-being 

What is it?
Black cohosh (Cimicifuga racemosa) is a plant traditionally used to relieve symptoms associated with women’s reproductive health, particularly PMS and menopause.¹² It has been researched for its role in easing hormonal imbalances and physical discomforts.

How it works
Black cohosh interacts with serotonin receptors to help manage PMS-related mood swings, while its compounds, such as triterpene glycosides, provide anti-inflammatory and hormone-regulating benefits.¹²

What the science says
Several clinical trials show that black cohosh is a safe and effective natural solution, improving key PMS-related psychological symptoms, including nervousness, sleep disturbances, mood swings, and overall mental health for menopausal women.^12,13 Another study revealed that black cohosh can reduce menopausal symptoms, including physical symptoms and depression, which share similarities with PMS symptoms.¹⁴ This makes black cohosh a versatile option for women experiencing hormonal fluctuations, providing relief for both physical and emotional symptoms.

Turmeric + Boswellia
Natural Anti-Inflammatory Blend for Menstrual Pain Relief

What is it?
Turmeric (Curcuma longa) and Boswellia (Boswellia serrata) are two powerful anti-inflammatory herbs widely used for centuries in traditional medicine.¹⁵ Turmeric contains the bioactive compound curcumin, known for its potent anti-inflammatory and antioxidant properties. Boswellia is rich in boswellic acids, which also exhibit strong anti-inflammatory effects. Together, these botanicals have shown potential in reducing pain and inflammation, making them an attractive natural alternative for managing menstrual pain.

How it works
Curcumin, the key compound in turmeric, works by inhibiting multiple inflammatory pathways, including nuclear factor-kappa B (NF-κB) and pro-inflammatory cytokines, which play a central role in the inflammatory response associated with menstrual pain.^16,17 Boswellic acids in Boswellia complement curcumin’s effects by inhibiting the 5-lipoxygenase enzyme, which reduces leukotrienes, inflammatory molecules that contribute to menstrual cramps.^16,17

What the science says
Several studies support the use of turmeric and Boswellia for relieving menstrual pain. A 2024 meta-analysis, with 379 patients included in the study, concluded that curcumin significantly reduces severity of dysmenorrhea, cramps, and overall PMS scores compared to placebo, noting its strong anti-inflammatory and antidepressant activities.¹⁸ Similarly, Boswellia has demonstrated significant pain-relieving effects in inflammatory conditions like osteoarthritis, which could potentially decrease cramp pain and other PMS related discomforts.¹⁹

Combining turmeric and Boswellia enhances their anti-inflammatory action with synergistic effects, offering a natural and effective solution for managing PMS-related pain.¹⁵ A landmark study recently found strong results for a blend of these ingredients’ cramp-relieving ability. In this randomized controlled trial, participants taking a turmeric/Boswellia supplement experienced 12.6x better cramp relief than placebo, with effects beginning in as little as 30 minutes and 73% of participants noting excellent symptom relief.¹⁶ The research on these combined ingredients for premenstrual symptoms is still emerging, but these results point to a potentially powerful, natural option for cramp relief.

Calcium
Key mineral for comprehensive PMS relief

What is it?
Calcium is an essential mineral best known for its role in supporting bone health, but it has also been extensively researched for its ability to alleviate PMS symptoms. Research has demonstrated that calcium can reduce both physical and emotional symptoms, making it one of the most scientifically supported supplements for PMS relief.

How it works
Calcium helps regulate hormone fluctuations during the menstrual cycle. During the menstrual cycle calcium levels can drop, potentially worsening symptoms like mood swings, irritability, and fatigue. Supplementing with calcium helps to stabilize mood and alleviate physical discomforts by maintaining stable calcium levels in the body and aiding in serotonin production.²⁰

What the science says
Clinical research strongly supports the use of calcium for PMS symptom relief, with some reviews and meta-analyses citing it as the most effective mineral solution. In a large randomized controlled trial, women who took 1200 mg of calcium daily saw significant reductions in water retention, food cravings, pain, and overall symptom severity compared to those taking a placebo.²¹ Other studies found benefits for a variety of symptoms including depression, emotional well-being, somatic changes, water retention, fatigue, edema, and appetite.^22,23

A 2020 systematic review, examining 14 separate studies, further validated these findings, showing that calcium supplementation effectively alleviates water retention, food cravings, pain, and psychological symptoms associated with PMS.²⁰ The depth of research on calcium demonstrates its effectiveness as a mineral-based solution for PMS.

Magnesium and Vitamin B6
Key nutrients to alleviate PMS symptoms 

What is it?
Magnesium and vitamin B6 are essential nutrients involved in maintaining overall health. Magnesium supports various bodily functions, including energy production and enzyme reactions, while vitamin B6 contributes to brain health and immune function.²⁴ Both have been studied for their roles in alleviating PMS symptoms due to their impact on mood, muscle health, and hormone regulation.²⁴

How it works
Magnesium aids in muscle relaxation, mood regulation, and reducing inflammation, while vitamin B6 enhances serotonin production, helping stabilize emotions during PMS. Together, they work synergistically to help alleviate emotional and physical PMS symptoms.²⁴

What the science says
Studies show the combination of magnesium and vitamin B6 can significantly reduce PMS-related anxiety, depression, and physical symptoms. In randomized controlled trials, women taking this combination experienced statistically significant improvements in anxiety-related premenstrual symptoms (nervous tension, mood swings, irritability, or anxiety) as well as notable benefits for cravings, water retention, depression, and somatic changes.^24,25

Other studies found that magnesium supplementation alone reduces fluid retention and mood disturbances, with vitamin B6 further enhancing these benefits.^26,27 The supplements appear to have synergistic effects when taken together, with magnesium and vitamin B6 showing greater declines in PMS symptoms than magnesium alone or placebo.²⁸

Omega-3 Fatty Acids
Support for inflammation and emotional balance

What is it?
Omega-3 fatty acids, particularly eicosatetraenoic acid (EPA) and docosahexaenoic acid (DHA), are essential polyunsaturated fatty acids found primarily in fish oil and certain plant oils. They play a vital role in brain health, reducing inflammation, and improving mood, which makes them a popular supplement for managing PMS symptoms.²⁹

How it works
Omega-3 fatty acids help reduce symptoms by regulating inflammation and promoting key neurotransmitters to provide menstrual relief. This is accomplished in-part by releasing emotion-boosting endorphins and producing inflammation-reducing resolvins and peptide mediators to support mental and physical health.²⁹

What the science says
Numerous clinical studies have demonstrated the efficacy of omega-3s for PMS, linking omega-3 supplementation to improvements in mood and reductions in menstrual pain, with some studies even showing greater effectiveness than NSAIDs for cramp relief.^30-32 An in-depth 2022 meta-analysis, with a combined sample size of over 600 women, reported evidence for omega-3 fatty acid supplementation reducing both somatic and psychological PMS symptoms.³³

Furthermore, omega-3 supplementation has been shown to alleviate menstrual pain and decrease the intensity and duration of cramps, as observed in clinical trials and meta-analyses involving women with dysmenorrhea (painful menstrual periods).^34,35 By addressing both inflammation and mood instability, omega-3 fatty acids provide a comprehensive solution for managing a wide range of PMS symptoms.

Probiotics
Microbial allies for gut and hormonal balance

What is it?
Probiotics are live, beneficial bacteria that promote health by supporting a balanced gut microbiome. The gut is closely connected to overall health, including hormone regulation and inflammation, which are central to premenstrual syndrome. By improving gut function and supporting the body’s microbial balance, probiotics have been proposed as a natural aid for managing PMS symptoms, especially bloating, mood swings, and digestive discomfort.

How it works
The gut plays a crucial role in hormone regulation, particularly estrogen. A healthy gut microbiome prevents excess estrogen reabsorption and influences neurotransmitters, such as serotonin, helping regulate mood and manage multiple PMS symptoms.³⁶ Probiotics, particularly Lactobacillus and Bifidobacterium strains, can promote gut health, influence hormonal balance, and reduce inflammation.³⁶

What the science says
Emerging research shows a direct link between gut health and PMS symptom severity. Women with more diverse gut microbiomes tend to experience fewer PMS symptoms, and research suggests that at least 23 types of gut bacteria may be linked to menstrual disorders.^37,38 Probiotic supplementation may help reduce both the physical and emotional symptoms of PMS by promoting better digestion, reducing bloating, and stabilizing mood through its effects on serotonin.³⁹

The use of different Lactobacillus and Bifidobacterium strains of probiotics have also been shown to help with the physical and mental symptoms of PMS, improving pain, irritability, mental health, and quality of life scores.^40,41 Clinical studies suggest that probiotic supplementation may ease common PMS symptoms by restoring gut balance and improving hormonal health.

Best Supplements According to Science: What Should I Take?

When choosing the best supplement for PMSrelief, the most well-researched and proven options are likely Chasteberry and Calcium. Chasteberry is ideal for those experiencing emotional and physical symptoms like mood swings, breast tenderness, and irritability, and is cited by research reviews and expert opinions as the most researched and effective herbal option.^42,43 Calcium, backed by strong clinical evidence, particularly helps with physical discomforts such as fatigue and pain; a systematic review of 62 natural PMS solutions found calcium to have the highest quality evidence.⁶

However, everyone’s body reacts differently. Some may benefit more from anti-inflammatory options like Turmeric and Boswellia, while others may find relief through Magnesium + B6 for mood support. It’s essential to consider each patient’s unique health history and medical needs before recommending a supplement, and consultation with a healthcare provider is critical to ensure safe and personalized symptom relief and treatment options.

Customizing Your Approach to PMS Relief

There is no one-size-fits-all solution to managing PMS symptoms. While supplements like chasteberry, magnesium + B6, and probiotics have promising research behind them, certain options may be effective for some more than others.

In addition to the supplements highlighted in detail, there are other options with emerging science that deserve consideration. For example, evening primrose oil was shown  to significantly reduce symptoms like breast pain and tenderness during menstrual cycles, with potential benefits for mood and irritability as well.⁴⁴ Vitamin D, commonly deficient in many populations, may help alleviate PMS-related mood disturbances and irritability.⁴⁵ Ashwagandha, known for its adaptogenic properties, has also been explored as a potential solution for reducing stress and improving emotional well-being during the premenstrual phase.⁴⁶

Some supplements may interact with medications or have specific contraindications, so it’s always wise to check safety guidelines before making any recommendations. Although research is still evolving, the available evidence supports the effectiveness of many natural approaches to PMS relief.

Ultimately, a combination of well-researched supplements and lifestyle adjustments may provide the most effective path to managing PMS symptoms. Encouraging open dialogue between healthcare practitioners and patients ensures that the chosen approach is both safe and personalized.

Citations

1. Yonkers KA et al. Premenstrual syndrome. Lancet. 2008;371(9619):1200-1210.
2. Halbreich U. The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder–clinical procedures and research perspectives. Gynecol Endocrinol. 2004;19(6):320-334.
3. McGettigan P et al. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. PLoS Med. 2011;8(9):e1001098.
4. Wong CL et al. Oral contraceptive pill for primary dysmenorrhoea. Cochrane Database Syst Rev. 2009;2009(4):CD002120.
5. Edinoff AN et al. Selective serotonin reuptake inhibitors and adverse effects: a narrative review. Neurol Int. 2021;13(3):387-401.
6. Whelan AM et al. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can J Clin Pharmacol. 2009;16(3):e407-e429.
7. Jarry H et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol. 1994;102(6):448-454.
8. Loch EG et al. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend Based Med. 2000;9(3):315-320.
9. Schellenberg R et al. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo-controlled study. BMJ. 2001;322(7279):134-137.
10. Atmaca M et al. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol. 2003;18(3):191-195.
11. Csupor D et al. Vitex agnus-castus in premenstrual syndrome: A meta-analysis of double-blind randomised controlled trials. Complement Ther Med. 2019;47:102190.
12. Hedaoo K et al. Exploring the efficacy and safety of black cohosh (Cimicifuga racemosa) in menopausal symptom management. J Midlife Health. 2024;15(1):5-11.
13. Mohapatra S et al. Benefits of black cohosh (Cimicifuga racemosa) for women health: an up-close and in-depth review. Pharmaceuticals (Basel). 2022;15(3):278.
14. Liske E et al. Physiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effect. J Womens Health Gend Based Med. 2002;11(2):163-174.
15. Sethi V et al. Potential complementary and/or synergistic effects of curcumin and boswellic acids for management of osteoarthritis. Ther Adv Musculoskelet Dis. 2022;14:1759720X221124545.
16. Agarwal D et al. Effect of turmeric-boswellia-sesame formulation in menstrual cramp pain associated with primary dysmenorrhea-a double-blind, randomized, placebo-controlled study. J Clin Med. 2023;12(12):3968.
17. Siddiqui MZ. Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci. 2011;73(3):255-261.
18. Sharifipour F et al. Effect of curcumin on dysmenorrhea and symptoms of premenstrual syndrome: a systematic review and meta-analysis. Korean J Fam Med. 2024;45(2):96-104.
19. Sengupta K et al. A double blind, randomized, placebo-controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10(4):R85.
20. Arab A et al. Beneficial role of calcium in premenstrual syndrome: a systematic review of current literature. Int J Prev Med. 2020;11:156.
21. Thys-Jacobs S et al. Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms. Premenstrual syndrome study group. Am J Obstet Gynecol. 1998;179(2):444-452.
22. Shobeiri F et al. Effect of calcium on premenstrual syndrome: a double-blind randomized clinical trial. Obstet Gynecol Sci. 2017;60(1):100-105.
23. Ghanbari Z et al. Effects of calcium supplement therapy in women with premenstrual syndrome. Taiwan J Obstet Gynecol. 2009;48(2):124-129.
24. Ebrahimi E et al. Effects of magnesium and vitamin b6 on the severity of premenstrual syndrome symptoms. J Caring Sci. 2012;1(4):183-189.
25. De Souza MC et al. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000;9(2):131-139.
26. Walker AF et al. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Womens Health. 1998;7(9):1157-1165.
27. Facchinetti F et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991;78(2):177-181.
28. Fathizadeh N et al. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010;15(1):401-405.
29. Calder PC. Omega-3 fatty acids and inflammatory processes. Nutrients. 2010;2(3):355-374.
30. Su KP et al. Association of use of omega-3 polyunsaturated fatty acids with changes in severity of anxiety symptoms: a systematic review and meta-analysis. JAMA Netw Open. 2018;1(5):e182327.
31. Rocha Filho EA et al. Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. Reprod Health. 2011;8:2.
32. Zafari M et al. Comparison of the effect of fish oil and ibuprofen on treatment of severe pain in primary dysmenorrhea. Caspian J Intern Med. 2011;2(3):279-282.
33. Mohammadi MM et al. Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2022;48(6):1293-1305.
34. Rahbar N et al. Effect of omega-3 fatty acids on intensity of primary dysmenorrhea. Int J Gynaecol Obstet. 2012;117(1):45-47.
35. Mohammadi MM et al. The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Pharmacol. 2022;78(5):721-731.
36. Millette M. Gut microbiome, probiotics and, premenstrual disorders. International Probiotics Association. 2022. Retrieved from https://internationalprobiotics.org/home/gut-microbiome-probiotics-and-premenstrual-disorders/. Accessed on October 9, 2024.
37. Takeda T et al. Characteristics of the gut microbiota in women with premenstrual symptoms: A cross-sectional study. PLoS One. 2022;17(5):e0268466.
38. Yao Y et al. Association between gut microbiota and menstrual disorders: a two-sample Mendelian randomization study. Front Microbiol. 2024;15:1-10.
39. Merkouris E et al. Probiotics’ effects in the treatment of anxiety and depression: a comprehensive review of 2014-2023 clinical trials. Microorganisms. 2024;12(2):411.
40. Zakaria IA et al. The role of probiotics in improving menstrual health in women with primary dysmenorrhoea: A randomized, double-blind, placebo-controlled trial (the PERIOD study). Womens Health (Lond). 2024;20:17455057241234524.
41. Sato A et al. Lactobacillus paragasseriOLL2809 improves premenstrual psychological symptoms in healthy women: a randomized, double-blind, placebo-controlled Study.  Nutrients. 2023;15(23):4985.
42. Freeman EW. Therapeutic management of premenstrual syndrome. Expert Opin Pharmacother. 2010;11(17):2879-2889.
43. Dante G et al. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom Obstet Gynaecol. 2011 Mar;32(1):42-51.
44. Sarayloo K et al. Effects of the evening primrose oil on women’s mastalgia: a systemic review of randomized controlled trials. MJN. 2017;9(2):28-35.
45. Abdi F et al. A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstet Gynecol Sci. 2019;62(2):73-86.
46. Roni AH et al. Traditional herbal interventions for premenstrual syndrome management: A comprehensive literature review. IJCBS. 2024;25(18):20-40.

Kyle Perkovich is a medical writer with a background in clinical research and leading medical writing teams in the completion of clinical reports to get products approved for global sale. He graduated from the University of California, Santa Barbara with a degree in microbiology and a minor in professional science writing, while writing for the university newspaper and completing a technical writing internship with the Vandenberg Air Force Base. Kyle has helped manage documentation for large-scale clinical studies of medical devices and has been involved in various clinical and scientific research studies. He hopes to educate healthcare practitioners and consumers on the science behind the world of supplements and vitamins to help people better understand the complexities of nutrition and live healthier lives.