Getting to the root of PMS

Kate Winslet swears by it, but could the wild Mexican yam really hold a cure for PMS? A new trial aims to find out.

Premenstrual tension causes untold misery to thousands of women every month. Tender breasts, a bloated stomach and migraines are just a few of the symptoms. Other women suffer mood swings, flying off the handle at the slightest thing.

Premenstrual tension causes untold misery to thousands of women every month. Tender breasts, a bloated stomach and migraines are just a few of the symptoms. Other women suffer mood swings, flying off the handle at the slightest thing.

As if the symptoms are not bad enough there is now a baffling array of "miracle" cures ranging from diets and exercise regimes to mainstream drugs and alternative health treatments. The latest product to boast wondrous effects on PMT is natural progesterone, licensed as a cosmetic in the US and is being aggressively marketed on the Internet.

Progesterone first came on the scene in Britain in the Fifties when Dr Katharina Dalton discovered that in the last three months of her pregnancy, when progesterone levels are at their highest, the migraines she had been plagued with all her life just before her periods, disappeared. She came to the conclusion that by boosting progesterone levels in women who suffered from PMT their symptoms would improve. Her research was never repeated, oestrogen came into favour, particularly for HRT, and progesterone was put on a back burner.

Now the first progesterone trial of its kind in this country is about to be launched at Northwick Park Hospital in London. Gynaecologist Dr Adam Carey, who is in charge of the trial, believes that not only could progesterone have a role to play in balancing hormones during the menopause, but it could also help with symptoms of PMT.

The trial will use natural progesterone, which is derived from diosgenin, a plant-based extract found in the Mexican wild yam and which is identical to the human hormone. Many women - including Kate Winslet - already swear by wild yam extract as a remedy for hormone-related problems, though its effects are unproven. Natural progesterone is made in the laboratory from wild yams and is currently available only on prescription.

"Progesterone occurs naturally in the ovaries in the second half of the menstrual cycle," Dr Carey says. "It prepares the womb for the implantation of a fertilised egg. However, women who are particularly prone to PMT often produce little or no progesterone during the last two weeks of their cycles. Giving supplementary progesterone could help [alleviate] their PMT symptoms."

He is also hopeful that the new trial will help shed light on exactly how progesterone balances the hormones in the body. "At the moment we only have anecdotal evidence about the benefits of progesterone," he says. "The menstrual cycle is a delicate balancing act. In the first half of the cycle the body produces oestrogen and in the second half progesterone. Too much oestrogen and too little progesterone may result in sore breasts, fluid retention and headaches - all the classic symptoms of PMT," he says.

In the United States, Dr John Lee has been shouting about the benefits of progesterone for more than 30 years. He believes there is "an epidemic of progesterone deficiency" in the industrialised world due partly to damage to the ovaries while they are developing in the womb and partly to petrochemicals and herbicides used on crops.

He has developed his own brand of natural progesterone cream which is rubbed into the skin twice a day. He recommends it to protect against osteoporosis, for meno- pausal symptoms and even for migraines. "Natural progesterone helps restore normal vascular tone, counteracting the blood vessel dilation which cause the headaches."

Dr Lee also maintains that progesterone can ultimately protect women from breast cancer and other oestrogen-driven diseases. Dr Carey agrees. "Gynaecological disorders such as breast cancer, endometriosis, fibroids and fibrocystic breast disease, which are all driven by oestrogen, are increasing. We know there is an association between oestrogen and breast cancer and we desperately need this research to take a fresh look at the hormones we give women to treat hormonal disorders. We hope this new trial will shed some light on the 'forgotten hormone'."