Maybe you’ve thought about using complementary therapy to help ease PMS or PMDD symptoms. But what exactly are complementary therapies and is there any evidence that they work?

The NHS considers complementary therapies to be any treatment or practice that isn’t included in conventional healthcare. That might mean anything from using essential oils to going for a relaxing massage.

Sometimes people use the phrase complementary therapy to mean the same thing as alternative medicine. While it’s true that both can include the same practices, complementary therapy means using these practices alongside conventional healthcare, whereas the phrase alternative therapy means replacing conventional medicine with these therapies altogether. 

Complementary therapies are a popular choice for people looking for natural PMS relief. But it’s not always clear whether complementary therapies are backed up by evidence. The good news is that there are lots of different options to explore. If you’re concerned about starting new treatments or would like to discuss the implications of such (for example, if you’re currently taking medication and would like to know if complementary therapies can be used as well), speak with a healthcare professional.

Some people find that general lifestyle modifications can help ease their PMS/PMDD symptoms, such as exercising regularly, eating healthy and balanced meals, getting adequate sleep, and (as much as possible) managing stress.

Exercising - exercising helps boost our endorphin levels and reduce our cortisol and adrenaline levels. The increased endorphin levels help reduce our perception of pain, whilst reduced cortisol and adrenaline help us to feel less stressed and overstimulated.

Diet - a well-balanced diet can help us feel better for a number of reasons: we’re likely to have more energy, topping up our vitamin and mineral levels, and providing our body with all the nutrients it needs to function properly (eg, for skin health, hormone production, nervous system function, brain function, etc). If you’re concerned about getting enough of the right nutrients into your diet, supplements can be a simple and effective way to boost your intake.

The great outdoors - spending time in nature has also been shown to have a calming effect on the mind, so if you’re feeling overwhelmed and in need of a quick relaxant, head outside to a green space for a walk or find a bench to sit and take some time out.  

Stress reduction - many people find that yoga, meditation, mindfulness and breathwork can be particularly helpful in reducing stress, anxiety and feelings of depression. Each of these techniques is thought to work by regulating the body’s stress response and nervous system.

Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a variety of mental health issues, including PMS/PMDD-related symptoms. One of the main benefits of talking therapies compared with pharmacological treatments is that the effects can be longer-lasting and are maintained when therapy comes to an end.

CBT is available in individual, couple-based or group-based formats, and can be offered in-person or online. CBT helps us to think, feel, and act differently in response to PMS/PMDD-related anxiety and other symptoms. The idea is that we identify unhelpful, negative thought patterns and replace them with more positive ones. Studies have shown that CBT can help to reduce PMS/PMDD-related anxiety and depression, as well as improve the ability to cope with other symptoms. However, research indicates that CBT is generally more effective in reducing the severity of psychological symptoms than physical ones. 

Some research has explored the effects of combining CBT with other types of treatments. For example, studies have been conducted on mindfulness-based cognitive therapy (MBCT), which merges traditional CBT with mindfulness strategies. This therapy involves learning different ways of managing anxiety, such as specific relaxation techniques, and promotes non-judgemental awareness and acceptance of current emotions. Although there is a need for further research on MBCT, existing studies have shown it can reduce PMDD anxiety and other PMDD symptoms, and improve quality of life.

Mindfulness is a practice meant to help build awareness of the present moment. It's a technique that encourages us to pay attention to what we think, feel and experience in the present moment.

Mindfulness can be used as part of Cognitive Behavioural Therapy (CBT) - as mentioned above. When used alone, mindfulness is usually considered a conventional healthcare treatment. When used alongside other healthcare treatment options, it’s considered a complementary therapy.

A review of studies looking at mindfulness found that it was likely to increase feelings of wellbeing, improve behavioural regulation, and reduce psychological and mood-based symptoms in people with a range of mental health issues. One of the studies cited in the review found that people who frequently meditate reported higher levels of mindfulness, self-compassion and overall feelings of wellbeing.

In a study of 60 women*, researchers found that mindfulness-based cognitive therapy could help reduce anxiety and depression experienced during PMS. Part of the study involved helping participants become more aware of how these feelings influence the experience of other PMS symptoms.

While this study was small, it's worth noting that NICE guidelines recommend mindfulness-based therapies for mild depression. So, if you suffer from mild depressive symptoms as part of your PMS, this might be worth trying. However, if your symptoms are more severe, it’s best to talk to your GP to make sure you’re getting the full support you need.  

While more research may need to be done on PMS and mindfulness, it’s a well-established technique that’s safe and free to try.

Have you ever smelled something wonderful and felt better? Freshly-ground coffee or cut grass, maybe a bunch of blooming flowers, or baking croissants? The principles behind aromatherapy aren’t so different. Essential oils are usually made from different parts of plants or flowers that are picked and then distilled. Because it takes so much plant or flower to make just a little essential oil, a tiny quantity of oil contains lots of natural compounds. Aromatherapists believe that the smell of essential oils stimulates scent receptors in the nose, which send messages through the nervous system to the part of our brain that controls emotion. Some people use aromatherapy as an alternative or complementary treatment for PMS.

Essential oils can be inhaled or else absorbed through the skin. Note: if you’re putting oils on your skin, make sure you mix them with a neutral carrier oil like coconut or extra virgin olive oil. Essential oils can cause irritation if applied directly to the skin, so make sure to do a patch test with diluted oils before putting any on.

You can also use an oil diffuser to add essential oils into the air, or add a few drops to a warm bath.

While there’s currently no evidence that aromatherapy can cure illness, there is some evidence it could help with symptom relief.

Researchers have found essential oils may help ease pain around the time of our period. A review of existing research shows that aromatherapy can decrease other PMS symptoms, too, including mood swings, depression, and fatigue.

In one study, students were asked to inhale lavender oil for 5 sessions across each cycle, for three cycles. Those using aromatherapy showed a significant reduction in anxiety, feelings of depression, nervousness, pain, and bloating compared to those who didn’t.

Another study showed that aromatherapy using essential oils including Rosa Damascena (a type of rose) performed for five minutes, twice daily, for five days during the luteal phase was associated with improved psychological, physical, social, and total PMS symptoms after two cycles.

It’s important to be aware that not all essential oils are made the same. Some are synthetically produced, rather than originating from plants. There is regulation over the production and sale of essential oils, so make sure you check the label before buying. Make sure the oil you buy states that the ingredients are 100% pure oil, GMO-free, and extracted using steam distilled or expressed for the highest quality product. If the extraction method isn’t shown, it’s possible that this is because the method used involves chemicals.

It’s also important to never eat or drink essential oils - which can be toxic in even very small amounts. Please also note that essential oils, whether diffused, ingested, or used on skin, can be highly toxic to pets. For these reasons, it’s important to be mindful about how and when you use essential oils, especially if you have sensitive skin, children, or pets. 

When used safely, high-quality essential oils should be low-risk and can provide natural relief for PMS.

Acupuncture involves a practitioner inserting fine needles into specific parts of the body to manage or prevent illness. It’s based on traditional Chinese medicine (TCM) - a complex system of practices and beliefs that have developed over thousands of years, originating in China.

Some people believe that TCM can help reduce PMS symptoms naturally. Because TCM is grounded in ancient history and has a wide range of practices, there’s been controversy over how to best test whether it's effective. Although researching TCM isn’t always straightforward, we’ll look at the evidence for popular practices like acupuncture.

People who practise traditional acupuncture believe that an energy or life force called ‘Qi’ (chee) flows through meridians. In this context, meridians are ‘strings’ connecting different points in the body, and are passageways through which energy flows. When Qi isn’t moving freely, it’s thought to result in sickness. Traditional practitioners believe that acupuncture cures illness by fixing the flow of Qi.

There’s also Western medical acupuncture, which is an adaptation of TCM acupuncture. This practice is similar in that it uses needles, but it focuses on stimulating the nervous system, rather than relating to Qi. Such stimulation of the nervous system is meant to help release natural substances like endorphins - chemical signals that the body produces to help block pain.

Western medical acupuncture is considered a complementary therapy, and is used by the NHS in some pain clinics and hospices. The National Institute for Health and Care Excellence (NICE), which lays out treatment guidelines for the NHS, recommends using acupuncture for issues like chronic pain and headaches.

So is there any evidence that acupuncture could help manage PMS?

A review of various scientific studies found that acupuncture seems to be a promising treatment for relieving PMS symptoms, but further study is still needed. Some studies show that working specific acupuncture points can reduce feelings of anxiety and depression, improving the quality of life for those experiencing severe PMS symptoms.

Acupuncture is usually safe when carried out by a trained practitioner - although some people do experience mild side effects like bruising or dizziness. Acupuncture is also best to avoid if you have a bleeding disorder like haemophilia or are taking blood-thinning medication. 

If you’d like to find out whether acupuncture can help you manage your PMS, the Professional Standard Authority for Health and Social Care provides recommendations to help find an accredited acupuncturist in your area.

Maybe you’ve come across chiropractic treatments when googling how to manage sore muscles. But, it’s not always clear what chiropractors do. Chiropractic is generally used to help treat joint and muscle pain. A chiropractor will use their hands to adjust and manipulate different body parts to manage issues like sports injuries or strains.

Some people state that chiropractic can help with a wide range of medical and psychological issues, including PMS - although explanations about how it works to ease symptoms aren’t very consistent.

A review of scientific literature found that chiropractic may help with muscle and joint pain. As people experience these aches as part of PMS or PMDD, chiropractic could help ease these specific symptoms. However, it’s important to remember that there’s no substantial evidence that chiropractic can help with psychological symptoms.

When done by a trained and registered chiropractor, chiropractic is usually safe. But there are risks, like stiffness and soreness, and more serious side effects can include slipped discs and strokes that occur because of spinal manipulation. This is especially true of adjustments to the neck, where delicate internal structures are less protected and easier to over-rotate.

If you do decide to use a chiropractor, the NHS recommends making sure they’re registered with the General Chiropractic Council - which is a legal requirement for all chiropractors.

Like acupuncture, reflexology is based on the ancient Chinese concept of energy or Qi. Qi is supposed to flow freely through the body but can be blocked by issues like stress, resulting in imbalance and illness.

Reflexology is a massage technique where practitioners apply gentle pressure to specific body parts. Each part of the external body relates to an internal part (you may have seen diagrams and charts showing which parts of the hands and feet correlate with different organs). Massaging or pressing on these pressure points is meant to unblock energy channels and help restore the flow of Qi, helping the body heal itself. It’s intended to promote relaxation and wellbeing, and some people also believe that it’s a natural way to help with PMS.

Other reflexologists believe that a calming massage encourages pain relief.

In a review of the studies done on the effect of reflexology on PMS symptoms, researchers found that these treatments can help to reduce both the physical and psychological symptoms. The review also concluded that longer reflexology sessions (approximately 60 minutes) have the greatest effect on symptom relief (rather than shorter, 30-minute sessions).

But there’s still no agreement on how and why reflexology supposedly works. While reflexology is a low-risk option, more study needs to be done before we understand whether it could be considered a recommended treatment option for PMS.