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Magnesium Supplementation Alleviates Premenstrual Symptoms of Fluid Retention
Abstract
We investigated the effect of a daily supplement of 200 mg of magnesium (as MgO) for two menstrual cycles on the severity of premenstrual symptoms in a randomized, double-blind, placebo-controlled, crossover study. A daily supplement of 200 mg of Mg (as MgO) or placebo was administered for two menstrual cycles to each volunteer, who kept a daily record of her symptoms, using a 4-point scale in a menstrual diary of 22 items. Symptoms were grouped into six categories: PMS-A (anxiety), PMS-C (craving), PMS-D (depression), PMS-H (hydration), PMS-O (other), and PMS-T (total overall symptoms). Urinary Mg output/24 hours was estimated from spot samples using the Mg/creatinine ratio. Analysis of variance for 38 women showed no effect of Mg supplementation compared with placebo in any category in the first month of supplementation. In the second month there was a greater reduction (p = 0.009) of symptoms of PMS-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating) with Mg supplementation compared with placebo. Compliance to supplementation was confirmed by the greater mean estimated 24-hour urinary output of Mg (p = 0.013) during Mg supplementation (100.8 mg) compared with placebo (74.1 mg). A daily supplement of 200 mg of Mg (as MgO) reduced mild premenstrual symptoms of fluid retention in the second cycle of administration.
... 34 In addition, Mg is required for inflammatory balance by synthesis of eicosanoids, nitric oxide, and phenols, which are known to decrease oxidation rate. 35,36 On the other hand, there is evidence about the effect of anthocyanins on the activation of peroxisome proliferator-activated receptor α and on restraining inflammatory cytokines. 37 Peroxisome proliferator-activated receptor α expression inhibits NF-KB, vascular cell adhesion molecule 1 activation, and stimulates catalase and superoxide dismutase enzymes, modulating inflammation, and oxidative stress. ...
Objectives:
Cornus mas fruit has various antioxidants and anti-inflammatory properties, so this study aims at assessing its effect on menopausal symptoms and sex hormones in postmenopausal women.
Methods:
In the current randomized, double-blind clinical trial, 84 individuals (42 per group) were participated. C mas hydroalcoholic extract was prepared, and participants received 300 mg C mas extract or placebo three times a day (900 g in total) for 8 weeks. The demographic, dietary intake, and physical activity information were gathered. Anthropometric indices were measured by standard methods. Furthermore, menopause symptoms were assessed by Greene Climacteric Scale. Also, sex hormones were measured by enzyme-linked immunosorbent assay.
Results:
Based on the results, there was a significant difference in total Greene score reduction between the intervention and placebo groups (-3.19 ± 0.54, -0.76 ± 0.32, and P < 0.001). In addition, vasomotor symptoms had a remarkable decrease in the C mas extract group (P < 0.001). Also, the intervention group demonstrated a decreasing trend in the number and duration of hot flushes. Moreover, follicle-stimulating hormone remarkably decreased and estradiol increased in the intervention group (P = 0.016 and P = 0.018).
Conclusions:
It has been found that the extract of C mas fruit has a favorable effect on vasomotor symptoms, sex hormones, and related complications in women experiencing menopausal symptoms.
... • Magnesium: It has been hypothesized that magnesium affects the regulation of serotonin and other neurotransmitters and may reduce PMS symptoms. Several small, RCT, and double-blind studies have determined the effect of magnesium supplementation on various PMS with promising results (Walker et al. 1998). • Manganese: One small, non-placebo-controlled study has demonstrated increased mood and pain symptoms during the premenstrual phase has been experienced in women who take low dietary manganese (Penland and Johnson 1993). ...
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are medically unexplained disorders that occur with somatic or psychiatric symptoms presenting during the luteal phase of the menstrual cycle, ending within a few days after the onset of menstruation. Worldwide, the prevalence of PMS is remarkably high, and its causes are still unclear and are multifactorial. This chapter aims to understand better the etiopathogenesis, clinical features, diagnosis, contemporary, and integrative holistic approaches of PMS management. A thorough literature survey from various scientific databases such as Web of Science, ScienceDirect, PubMed, Google Scholar, Scopus, and other databases was retrieved for the evidence connected to premenstrual syndrome, and PMDD was undertaken. The biochemical changes of PMS involve sex steroids, neurotransmitters such as cholecystokinin GABA, serotonin, and regulation of the renin-angiotensin-aldosterone system, genetic vulnerabilities, diet, and lifestyle. The most common symptoms of PMS are affective symptoms (anger outburst, anxiety, depression, confusion, irritability, social withdrawal) or somatic symptoms (headache, breast tenderness, abdominal bloating, and swelling of extremities) that affect the quality of life negatively. Its diagnosis is based on the time of appearance and the type of symptoms in the menstrual cycle. The initial step embraces lifestyle changes and diet regulation, teaching women self-screening, creating awareness about PMS, and methods of coping with stress. Complementary alternative therapies and cognitive behavioral therapy are implemented in the second step. The third step is initiated with pharmacological treatment if the problem continues, and in the fourth step, surgical treatment is applied.
... • Magnesium: It has been hypothesized that magnesium affects the regulation of serotonin and other neurotransmitters and may reduce PMS symptoms. Several small, RCT, and double-blind studies have determined the effect of magnesium supplementation on various PMS with promising results (Walker et al. 1998). • Manganese: One small, non-placebo-controlled study has demonstrated increased mood and pain symptoms during the premenstrual phase has been experienced in women who take low dietary manganese (Penland and Johnson 1993). ...
... Patients with PMS experience symptoms beginning around one week before menstruation, peaking approximately two days before the start of menstruation, and subsiding during menstruation to the point where they are symptom-free before to ovulation. In most cases, the symptoms do not recur during the following menstrual period [12][13][14][15][16][17]. mechanism or role of hormones has been able to explain the full spectrum of symptoms associated with this mental and physical illness, despite several suggestions in the literature to that effect [18]. ...
Physical, emotional, and psychological symptoms are common among women in their reproductive years, particularly during their menstrual cycle's luteal phase and the week before their period. Approximately 5-8 percent of women suffer with premenstrual syndrome, with the majority of those suffering from premenstrual dysphoric disorder (PMDD). Because of the complexity and multifaceted nature of the aetiology, it is yet unknown. Premenstrual syndrome (PMS) is diagnosed entirely on the basis of signs and symptoms, with no particular diagnostic tests available to confirm the diagnosis. Only a small number of therapeutic modalities are backed by clinical data, yet there are many accessible. After providing a brief overview of the disease, the author goes on to discuss the various hypotheses as to why PMS occurs. With an emphasis on tailored treatment based on symptom profile, it examines the wide range of non-pharmacological and pharmaceutical methods that are accessible today.
... Discourse around menstruation varies, both between countries and between people. The way in which PMS is reported and experienced is at least partly culturally mediated, for example through medical discourse and school [17,18]. This discourse has been argued to contribute to the medicalisation of the premenstrual phase, which impacts how the premenstrual phase is experienced [19,20]. ...
The discourse around menstrual cycles is often pathologised, leading to negative perceptions of menstruation. The extent to which premenstrual syndrome (PMS) is inherently negative or the result of medicalised framing has long remained unclear.
We address this gap by investigating whether framing the premenstrual experience as being both negative and positive components would enable individuals to report more diverse and positive experiences than are currently reported.
In an online experiment, 2,638 participants were randomly allocated to one of three question phrasings (control: describe your premenstrual experience; treatment one: describe your positive and negative premenstrual experience; treatment two: describe your negative and positive premenstrual experience).
Sentiment analysis was applied to responses to create polarity scores. A two-part Bayesian model was performed to investigate the effect of phrasing in predicting differences in polarity scores. Across all phrasings, responses were negatively skewed.
However, response polarity scores and diversity of symptoms were higher if the question specified both positive and negative experiences compared to the control group. This corroborates previous literature showing that a negative premenstrual phase is a widespread phenomenon but challenges the idea that the premenstrual experience is solely negative.
The findings have implications for how the premenstrual experience is quantified.
... Consumption of high-calorie diets, sugar, and fat has been identified as crucial risk factor for PMS [14]. On the other hand, enough intake of vitamin D and calcium [15,16], magnesium, vitamin B1, and vitamin B6 [16][17][18][19] might also be beneficial. ...
Background:
Premenstrual disorders involve physical, behavioral, and mood variations that affect women of childbearing age and interfere with family relationships, household responsibilities, professional duties, and social activities.
Objectives:
Considering the side effects of conventional medications, their use is not recommended except in severe cases of premenstrual disorders. Nowadays, there is a tendency to use traditional and complementary medicine that offers various treatments. The purpose of the current study was to investigate the impacts of garlic as a herbal medicine on the severity of premenstrual symptoms.
Methods:
This study was a double-blind, randomized, controlled trial. After identification of participants with moderate-to-severe PMS through the premenstrual symptoms screening tools questionnaire (PSST), they were randomly assigned to placebo (n = 64) or garlic (n = 65) groups. Each participant received one tablet daily for three consecutive cycles and logged the severity of their symptoms in the PSST questionnaire during the intervention period.
Results:
There was no significant difference between the two groups in the baseline level of premenstrual symptoms before the intervention. After treatment with garlic for three consecutive cycles, the total score of the severity of premenstrual symptoms significantly (P < 0.001) reduced from 34.09 ± 7.31 to 11.21 ± 7.17. In the placebo group, this score changed from 33.35 ± 7.96 to 24.28 ± 7.22. The difference between mean changes in the two groups was 13.78, with a 95% Confidence Interval (CI) of 11.23-16.33. No serious side effects were observed in either group.
Conclusion:
Our findings highlight the potential effect of garlic in reducing the severity of premenstrual symptoms; therefore, the use of garlic can be considered as an alternative therapy in the prevention and treatment of premenstrual disorders.
... It is known that the magnesium level of erythrocytes and leukocytes of women with premenstrual syndrome is lower than that in the women without the syndrome [64]. For this reason, magnesium supplementation is widely used to treat premenstrual syndrome [31,65,66]. Women received two cycles of 360 mg of magnesium pyrrolidone carboxylic acid or placebo taken daily from ovulation to the first day of their period. ...
Magnesium deficiency may occur for several reasons, such as inadequate intake or increased gastrointestinal or renal loss. A large body of literature suggests a relationship between magnesium deficiency and mild and moderate tension-type headaches and migraines. A number of double-blind randomized placebo-controlled trials have shown that magnesium is efficacious in relieving headaches and have led to the recommendation of oral magnesium for headache relief in several national and international guidelines. Among several magnesium salts available to treat magnesium deficiency, magnesium pidolate may have high bioavailability and good penetration at the intracellular level. Here, we discuss the cellular and molecular effects of magnesium deficiency in the brain and the clinical evidence supporting the use of magnesium for the treatment of headaches and migraines.
... Mg showed a significant superiority to placebo in the total score of the Menstrual Distress Questionnaire score and especially the cluster "negative effect" as parameter for mood changes. These findings were supported by the data of Mauskop et al. [91], whereas Walker et al. [92] only found an improvement in symptoms related to fluid retention in women taking 200 mg Mg/day or placebo in the second menstrual cycle. Chronic pain lasting more than 3 months concerns among others chronic low back pain, fibromyalgia, and pain of vascular origin. ...
Background:
In non-athletic populations micronutrient consumption is associated with premenstrual syndrome (PMS). PMS can be a debilitating condition for female athletes as it may affect their performance and training. This study investigated potential differences in select micronutrients' intake in female athletes with or without PMS.
Methods:
Participants were thirty NCAA Division I eumenorrheic female athletes ages 18-22 years not using oral contraceptives. Participants were classified with or without PMS using the Premenstrual Symptoms Screen tool. Participants completed dietary logs (two weekdays and one weekend day) one week before their projected menstruation. Logs were analyzed for caloric, macronutrient, food sources, and vitamin D, Mg, and Zn intake. Non-parametric independent T-Tests determined differences in the median and Mann-Whitney U tests determined differences in the distribution between groups.
Results:
23% of the 30 athletes showed PMS. There were no significant (P>0.22) for all comparisons) differences between groups for daily kilocalories (2150 vs. 2142 kcals), carbohydrates (278 vs. 271g), protein (90 vs. 100.2g), fats (77 vs. 77.2g), grains (224.0 vs. 182.6g), dairy (172.4 vs. 161.0g). vegetables (95.3 vs. 263.1g), or fruits (204.1 vs. 156.5g). A statistical trend (P=0.08) indicated differences in vitamin D intake (39.4 vs. 66.0 IU), but not for Mg (205.0 vs. 173.0 mg), or Zn (11.0 vs. 7.0mg) between groups.
Conclusions:
No association was found between Mg, and Zn intake and PMS. However, lower vitamin D intake tended to be associated with presenting PMS in female athletes. Further studies should include vitamin D status to clarify this potential association.
The importance of magnesium in the pathogenesis of migraine headaches is clearly established by a large number of clinical and experimental studies. However, the precise role of various effects of low magnesium levels in the development of migraines remains to be discovered. Magnesium concentration has an effect on serotonin receptors, nitric oxide synthesis and release, NMDA receptors, and a variety of other migraine related receptors and neurotransmitters. The available evidence suggests that up to 50% of patients during an acute migraine attack have lowered levels of ionized magnesium. Infusion of magnesium results in a rapid and sustained relief of an acute migraine in such patients. Two double-blind studies suggest that chronic oral magnesium supplementation may also reduce the frequency of migraine headaches. Because of an excellent safety profile and low cost and despite the lack of definitive studies, we feel that a trial of oral magnesium supplementation can be recommended to a majority of migraine sufferers. Refractory patients can sometimes benefit from intravenous infusions of magnesium sulfate.
Reduced magnesium (Mg) levels have been reported in women affected by premenstrual syndrome (PMS). To evaluate the effects of an oral Mg preparation on premenstrual symptoms, we studied, by a double-blind, randomized design, 32 women (24-39 years old) with PMS confirmed by the Moos Menstrual Distress Questionnaire. After 2 months of baseline recording, the subjects were randomly assigned to placebo or Mg for two cycles. In the next two cycles, both groups received Mg. Magnesium pyrrolidone carboxylic acid (360 mg Mg) or placebo was administered three times a day, from the 15th day of the menstrual cycle to the onset of menstrual flow. Blood samples for Mg measurement were drawn premenstrually, during the baseline period, and in the second and fourth months of treatment. The Menstrual Distress Questionnaire score of the cluster "pain" was significantly reduced during the second month in both groups, whereas Mg treatment significantly affected both the total Menstrual Distress Questionnaire score and the cluster "negative affect." In the second month, the women assigned to treatment showed a significant increase in Mg in lymphocytes and polymorphonuclear cells, whereas no changes were observed in plasma and erythrocytes. These data indicate that Mg supplementation could represent an effective treatment of premenstrual symptoms related to mood changes.
A randomized double-blind crossover trial was conducted to study the effects of pyridoxine (vitamin B6) at a dose of 50 mg per day on symptoms characteristic of the premenstrual syndrome. Sixty three women aged 18-49 years, identified by means of a general practice based survey of menstrual patterns in the community, entered the trial. All of the women had noticed moderate to severe premenstrual symptoms during the previous year. The women kept a daily menstrual diary which graded the severity of nine individual symptoms from zero to three. After completing a diary for an initial month the women were randomized to receive either drug or placebo for three months, after which the treatments were crossed over for a further three months. Thirty two women completed the full seven months of the study. In these women a significant beneficial effect (P less than 0.05) of pyridoxine was observed on emotional type symptoms (depression, irritability and tiredness). No significant effect was observed on premenstrual symptoms of any other type.
In order to assess the nutritional factors in premenstrual tension (PMT) dietary surveys were performed in 14 normal women and 39 PMT patients, using a computer-assisted program. PMT patients consume more refined sugar, refined carbohydrates and dairy products than normal controls. The normal women consume more vitamins in the B series, more iron, zinc and manganese. These findings suggest that nutritional factors may play an important role in the etiology of PMT.
SYNOPSISThe effects of oral Magnesium (Mg) pyrrolidone carboxylic acid were evaluated in 20 patients affected by menstrual migraine, in a double-blind, placebo controlled study. After a two cycles run-in period, the treatment (360 mg/day of Mg or placebo) started on the 15th day of the cycle and continued till the next menses, for two months. Oral Mg was then supplemented in an open design for the next two months. At the 2nd month, the Pain Total Index was decreased by both Placebo and Mg, with patients receiving active drug showing the lowest values (P<0.03). The number of days with headache was reduced only in the patients on active drug. Mg treatment also improved premenstrual complaints, as demonstrated by the significant reduction of Menstrual Distress Questionnaire (MDQ) scores. The reduction of PTI and MDQ scores was observed also at the 4th month of treatment, when Mg was supplemented in all the patients. Intracellular Mg++ levels in patients with menstrual migraine were reduced compared to controls. During oral Mg treatment, the Mg++ content of Lymphocytes (LC) and Polymorphonucleated cells (PMN) significantly increased, while no changes in plasma or Red Blood Cells were found. An inverse correlation between PTI and Mg++ content in PMN was demonstrated. These data point to magnesium supplementation as a further means for menstrual migraine prophylaxis, and support the possibility that a lower migraine threshold could be related to magnesium deficiency.
Premenstrual syndrome has recently become the subject of more rigorous scientific scrutiny. As a result, techniques exist for accurate diagnosis, and the pathophysiology of the disorder is less mysterious. At present, the disorder is thought to be the caused by the interaction of cyclic changes in estrogen and progesterone with a variety of systems, particularly neurotransmitters. Serotonin appears to play an especially important role in this regard. Increased understanding of premenstrual syndrome has enabled the development of specific treatment modalities that, unlike previous prescriptions, have demonstrated efficacy in rigorous and reproducible studies.
To assess the effectiveness of a vitamin/mineral supplement in controlling symptoms of premenstrual syndrome (PMS), we conducted a double-blind randomized study on 44 women with PMS. Subjects were carefully screened and excluded if underlying physical or psychopathological conditions were noted. Follicular and luteal testing with a menstrual symptom questionnaire, subdividing PMS into four subgroups, was completed for 1 month prior to treatment and for three menstrual cycles during treatment. Subjects were randomly assigned to receive either placebo or six or 12 tablets of the supplement a day for three menstrual cycles. All subjects had significant differences in severity of symptoms between the follicular and luteal phase of the control cycle. Comparing pre- vs posttreatment luteal phase scores, significant placebo effects were noted for two PMS subgroups. Significant treatment effects were noted in three subgroups for the six-tablet group and in all four subgroups for the 12-tablet group. These results suggest that this nutritional supplement may play a role in the management of women with PMS.
Menstrual health questionnaires were completed by a self-selected sample of the readership of a woman's magazine (n = 5457). Sixty-one per cent of subjects described themselves as suffering from pre-menstrual syndrome (PMS) and this was largely corroborated by ratings of symptoms pre-menstrually, menstrually and post-menstrually for the most recent cycle. Mood symptoms were more strongly implicated than physical ones. Self-report of PMS was found to be modestly associated with aspects of parity and oral contraceptive use, but strongly and positively related to the duration of 'natural' menstrual cycles (i.e. uninterrupted by pregnancy or steroidal contraception) and to psychosocial stress. There were interactions among psychosocial factors and between psychosocial load and duration of natural cycles.
Evidence in vitro and in humans suggest that Mg2+ can alter systemic and renal vascular tone. However, the mechanism of these effects is not known. The role of vasodilator prostaglandin release and Ca2+ flux in Mg2+-induced changes in blood pressure and renal blood flow was studied in 10 normal subjects maintained on a fixed 80-mEq Na+ and K+ diet. Magnesium sulfate infused at 200 mg/hr for 3 hours reduced systolic and diastolic blood pressure within 1 hour (from 119 +/- 2 [SEM] to 109 +/- 4 mm Hg systolic; from 74 +/- 3 to 64 +/- 4 mm Hg diastolic; p less than 0.02). This hypotensive response was seen in all subjects and persisted for 3 hours. The pulse rate did not change, but renal blood flow (p-aminohippurate clearance) increased (from 902 +/- 78 to 1108 +/- 130 ml/min/1.73 m2; p less than 0.05). The Mg2+ infusion produced a significant increase in the excretion of the stable prostaglandin I2 (PGI2) metabolite 6-keto-PGF1 alpha (from 96 +/- 12 to 154 +/- 16 ng/g creatinine; p less than 0.01). In contrast, urinary PGE2 was not altered (328 +/- 75 vs 399 +/- 145 ng/g creatinine; p greater than 0.6). To evaluate the functional role of PGI2 release, the cyclooxygenase inhibitors indomethacin (75 mg) or ibuprofen (600 mg) were given before the Mg2+ infusion. Both cyclooxygenase blockers, given in doses that inhibited immunoreactive 6-keto-PGF1 alpha release, completely prevented the Mg2+-induced decline in blood pressure and increased renal blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)