Articles by Dr. Lotte Valentin

Menstruation Disorders and Natural Treatments

Dysmenorrhea, PMS and PCOS



Dysmenorrhea, or painful menstruation, is divided into two categories:

•    Primary dysmenorrhea--no underlying physical problem

•    Secondary dysmenorrhea--pain due to an underlying condition, such as uterine fibroids, endometriosis, pelvic inflammatory disease, adhesions, ovarian cysts, polyps, narrowing of the cervical opening or a birth defect

About half of menstruating women experience some discomfort during their menstrual cycle, and pain is usually worse just before menses start and during the first two days of menstruation. Typical manifestations include: pain in the pelvic and low back area (which may radiate down the thighs), nausea, vomiting, headache, diarrhea, increased urination and fatigue.


Some of the causes of menstrual cramps include diets high in red meat, dairy (cheese, butter, milk, yogurt) and shellfish, which promote the formation of arachiodonic acid, (a fatty acid), eicosanoids, (signaling molecules), and prostaglandins, which contribute to uterine contractions and pain.


Prostaglandin is a hormone-like signaling molecule involved in many body functions and is responsible for inflammation, pain, and contraction and relaxation of smooth muscle, as well as controlling blood pressure and the  dilation and constriction of blood vessels, among other things. Women with menstrual cramps tend to produce 8-13 times more prostaglandins than women without menstrual cramps. 


Excess sugar and refined carbohydrates also increase insulin levels, which activate an enzyme called delta 5 desaturase. This enzyme converts the healthy fats found in evening primrose oil, borage seed or and vegetable oil into arachidonic acid. If sugar and insulin are kept low, this enzyme is not activated.


Other things that contribute to menstrual cramps are: misalignment of the lower spine, stress, emotional factors, poor circulation, overwork, chronic illness, displacement of the uterus, and liver and bowel toxicity, as well as heavy metal burden.


Some remedies for dysmenorrhea include:



•    Vit B3 - decreases pain

•    Vit B6 - improves liver detox and makes good prostaglandins

•    Vit C - decreases menstrual cramps when taken with B3

•    Vit E - decreases inflammation

•    Calcium - decreases cramping

•    Magnesium - decreases cramping

•    Zinc - improves liver detox

•    Curcumin - decreases inflammation

•    Bromelain - decreases pain and inflammation

•    Super EFA fish oil - decreases inflammation

•    HMF Replete probiotics - decreases bowel toxicity and normalizes bowel flora

•    Cramp bark (Viburnum opulus) - reduces menstrual cramps



PMS includes many symptoms, such as mood swings, food cravings, depression and bloating, as well as other symptoms that occur during the luteal phase of the menstrual cycle. The symptoms of PMS usually subside with the onset of menses. An imbalance between estrogen and progesterone, such as progesterone deficiency or increased estrogen, can all trigger PMS. Other factors implicated in PMS are the modern western lifestyle, decreased production of estriol in the liver, too much production of aldosterone, insulin problems, and calcium and magnesium deficiencies. (Aldosterone regulates salt and water levels in the body.)


There are several categories of PMS, though most women experience a combination of symptoms from all categories: 

•    PMS -A: anxiety, nervousness, irritability and sudden mood swings

•    PMS-C: cravings, headache, dizziness, brain fog which is better from eating carbohydrates

•    PMS-D: depression, crying, insomnia, poor memory

•    PMS-H: hyperhydration  - bloating, edema, weight gain

Some of the causes of PMS are: too much estrogen in the luteal phase of the cycle relative to progesterone, low serotonin levels, as well as a drop in TSH, (thyroid hormone) and cortisol, meaning the thyroid and adrenal glands don't function optimally during the luteal phase. There can also be an increase in testosterone and high norepinephrine/cortisol levels.


Dietary recommendations for PMS 

•    Eat fresh fruits and vegetables; avoid refined sugar.

•    Eat whole grain products; avoid white flour products.

•    Drink herbal teas; avoid caffeine and coffee.

•    Eat organic chicken, turkey, beans, nuts and seeds; avoid farm raised fish, pork, beef.

•    Use olive oil, coconut oil, avocado oil, safflower oil; avoid hydrogenated and partially hydrogenated oils.

•    2 TBS of flaxseeds and 2 tsp of turmeric daily to improve estrogen elimination and metabolism. Avoid salt if you have water retention.

•    Drink 60-80 oz of filtered water daily. Avoid alcohol.

•    Flaxseed or fish oil will help decrease overall inflammation.

•    5-HTP and B-complex vitamins can help improve mood and irritability.

Restore balance in your life

•    Keep regular hours, go to bed before 11 PM and sleep in a dark room to increase melatonin production.

•    Spend at least 20 minutes outside every day to increase serotonin and melatonin.

•    Get 40 minutes of aerobic exercise daily to increase endorphins and improve mood.

•    Reduce stress and establish regular rest/relaxation or meditation practice.

•    You can also have your hormones tested with a saliva test to assess hormone imbalance.

 Some treatments for PMS include: 

•    Avoid diets high in meat, saturated and trans fats, simple carbohydrates and salt, as they increase symptoms of PMS.

•    Focus on wholesome foods and low saturated fats.

•    Limit tea, colas, coffee and chocolate, which contain xanthines that mimic estrogen in the body.

•    Vit B6: helps with metabolism of estrogens in the liver.

•    Magnesium reduces cramping.

•    Calcium supplementation can help with mood, fluid retention, food cravings and cramping.

•    Evening primrose oil: excellent source of GLA, (an essential fatty acid), helps regulate hormone cycles and can help with depression, mood swings, fluid retention and breast tenderness.

•    Vit E: reduces breast tenderness.

•    5-HTP: a precursor to serotonin--low serotonin is associated with depression and anxiety of PMS.

•    Chasteberry (Vitex agnus castus): balances progesterone and prolactin.

•    Milk Thistle - helps with detoxification of estrogen in the liver.

•    Cramp Bark (Viburnum opulus): for acute menstrual cramps.

•    Wild Yam (Dioscorea villosa): antispasmodic, regulates estrogen/progesterone.

•    Dong Quai (Angelic sinensis): relaxes smooth muscle and reduces breast tenderness.

•    Dandelion (Taraxacum officinalis): reduces water retention.

•    Passionflower (Passiflora incarnata): relaxes central nervous system and reduces irritability and insomnia.

•    Melatonin: lowers estrogens and helps with insomnia.

•    Homeopathic remedies may help with symptoms as well.



Poly-Cystic Ovarian Syndrome is characterized by bilateral polycystic ovaries and can be combined with amenorrhea (absence of menses), anovulation (absence of ovulation), infertility, insulin resistance, truncal obesity and hirsutism. 


Some of the symptoms of PCOS include: elevated fasting insulin levels, obesity (especially around the waistline), elevated LH--which makes the ovaries produce more androgens, (androstenedione and testosterone), increase in facial hair, acne, and anovulation or irregular ovulation.


Some of the increased risk factors for PCOS include: early puberty, low birth weight and exposure to testosterone in utero. Hormone imbalances can include the pituitary, hypothalamus, adrenal glands and ovaries, insulin excess, androgen excess and prolactin excess.  Some other diseases that mimic PCOS are Cushings disease and hypo/hyper thyroidism.


New research has found that a protein called zonulin is elevated in women with PCOS. Zonulin has been found to correlate with insulin resistance and increases when you eat foods containing gluten. It has also been found that women with PCOS tend to have higher levels of the chemical BPA, so it is important to avoid drinking water and other beverages from plastic bottles.


Some treatments for PCOS include: 

•    Exercise 30 minutes per day.

•    Practice relaxation and meditation to lower cortisol.

•    Reduce psycho-social stress.

•    Stop smoking.

•    Limit alcohol intake.

•    Limit caffeine.

•    Castor oil packs to the abdomen 3-5 times per week.

•    Low carb diet--lots of vegetables and lean meats.

•    Avoid high glycemic foods--carbohydrates such as white rice, corn, white flower, millet.

•    Avoid red meat and dairy.

•    Avoid all sugars and sweeteners. Stevia is ok.

•    Eat low glycemic soluble fibers with meals to lower insulin, like apples, cabbage, raw carrots, oatmeal, oat bran, sesame seeds, flaxseeds, psyllium seed powder, beans.

•    Drink as much organic green tea every day as you want, as this lowers testosterone and insulin.

•    2 TBS of ground organic flax seeds daily--this will bind testosterone and stimulate ovulation. 

Supplements that can improve symptoms of PCOS include: 

•    Super EFA fish oil: helps cell membrane flexibility, improves glucose metabolism, protects heart, breasts, uterus.

•    Calcium/Magnesium 2:1 ratio: increases bone density and is needed for insulin metabolism.

•    Zinc Picolinate: decreases testosterone.

•    Chromium Picolinate or Brewer's yeast: lowers insulin.

•    Biotin: lowers blood sugar levels and improves insulin resistance.

•    Selenium: enhances thyroid and liver function.

•    Vit C with bioflavonoids: an antioxidant

•    Vit. B-complex: helps metabolize estrogen.

•    B-6: decreases testosterone.

•    Vit E mixed tocopherols: an antioxidant.

•    Alpha Lipoic Acid: regulates blood sugar, antioxidant.

•    N-acetyl Cysteine (NAC): lowers insulin levels.

•    CoQ10: regulates blood sugar, antioxidant.

•    Cinnamon extract: regulates blood sugar.

•    Indole-3-Carbinole (DIM): helps break down hormones and fats.

•    Saw Palmetto: blocks testosterone.

•    Gymnea sylvestre : helps regulate blood sugar.

•    Defatted fenugreek seed powder: reduces cholesterol, triglycerides and fasting blood sugar levels.

 Spices that improve insulin activity:

•    Cinnamon

•    Cloves

•    Nutmeg

•    Bay leaves

•    Turmeric


There are many other treatment options available for each of the symptoms and disorders discussed above. For best results, consult your health care provider to establish a protocol that is best for your individual needs.


The information contained on this site is for educational purposes only.  These statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Please discuss all your medical issues with your doctor.