An Integrative Approach for Improving and Managing Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD): A Case Report

Abstract

Abstract Premenstrual syndrome (PMS) describes symptoms a woman experiences in the luteal phase of menstruation, including physical, emotional, and/or behavioral changes ranging from mild to severe. Premenstrual dysphoric disorder (PMDD) shares defining emotional and behavioral attributes with PMS, though it is the most severe form classified as a depressive disorder. Women are increasingly interested in seeking natural or alternative therapies to address these conditions. The purpose of this case report is to share the experience of one woman who had improvements in premenstrual headaches, menstrual cramping and flow, and intense psychiatric symptoms associated with a diagnosis of PMDD within three months of using Lepidium peruvianum (maca), bio-identical progesterone therapy, and magnesium supplementation. Within four months, normalization of LH levels was achieved. Further, upon reducing or resolving symptoms, she continued to maintain this improvement for three months on Lepidium peruvianum, magnesium, and a B-complex. This case also provides clinical utility for personalized care utilizing a combination of natural therapies alongside bioidentical hormone therapy. Keywords: PMS, PMDD, Lepidium peruvianum, Bio-identical progesterone, Magnesium, B vitamins, Case report Abbreviations: Bid: twice daily; cap: capsule; caps: capsules; CBC: complete blood count; CMP: comprehensive metabolic panel; DC: discontinue; FSH: follicle-stimulating hormone; GABA: gammaaminobutyric acid; H: high; HPA: hypothalamus-pituitary-adrenal; LH: luteinizing hormone; LN: low-normal; mcg/L: micrograms per liter; mIU/mL: milli-international units per milliliter; Mg: milligrams; mg/mL: milligrams per milliliter; mm: millimeter; MRI: magnetic resonance imaging; NA: not applicable; nmol/L: nanomoles per liter; ng/mL: nanograms per milliliter; NSAIDs: nonsteroidal anti-inflammatory drugs; PHQ-9: patient health questionnaire-9; PMDD: premenstrual dysphoric disorder; pg/mL: picograms per milliliter; PMS: premenstrual syndrome; qd: once daily; qhs: bedtime; SR: slow-release; SSRI: selective serotonin reuptake inhibitor; TSH: thyroid stimulating hormone; uIU/mL: micro: international units per milliliter; WNL: within normal limits.