Premenstrual syndrome (PMS)
PMS affects up to 80-90% of females of reproductive age and is characterised by luteal phase physical, mood and behavioural symptoms. PMS has a large impact on quality of life and daily activities. It is believed magnesium modulates hormonal levels, especially progesterone, to relieve symptoms of depression, irritability, tiredness, and anxiety.1
Dysmenorrhoea
Dysmenorrhoea means painful uterine cramps that precede or accompany menstruation, due to myometrium hypercontractility and arteriolar vasoconstriction. The action of magnesium on dysmenorrhoea is through an inhibitory effect on reducing inflammation resulting in muscular relaxation and vasodilation.1,2,3
Premenstrual migraines
It is estimated 50% of reproductive age women have suffered a menstrual migraine, with the migraine threshold lowered in the premenstrual period. Low magnesium levels are associated with increased platelet aggregation, vasoconstriction, neural excitability, NMDA receptor activity and cortical depression spreading, as well as impairing serotonin receptor function and neurotransmitter production and release. Studies show magnesium supplementation is beneficial in reducing severity and frequency of migraines.1,5-7
Menopause and climacteric symptoms
Mood disorders and hot flushes affect up to 90% of peri– and postmenopausal women. Women are more sensitive to low magnesium levels, with potentially linked to menopausal symptoms. Supplementation has been found beneficial in reducing hot flushes and other symptoms in menopause and in women taking medication for breast cancer.1,5,6
Magnesium supplementation in hot flushes with breast cancer treatment
A phase II trial tested magnesium on hot flush frequency at the dose of 400mg (and escalated to 800mg if needed) per day in breast cancer patients taking tamoxifen, aromatase inhibitors or antidepressants. A 41.4% reduction was seen in hot flush frequency per week and the hot flush score was reduced by 50.4%. Fatigue, sweating and distress were also significantly reduced.
Magnesium and pregnancy related indications
Magnesium deficiency is common in pregnancy with evidence that it can affect pregnancy outcomes and offspring health. Magnesium supplementation has been shown beneficial in pregnancy hypertension, pregnancy outcomes, gestational diabetes and pre-eclamspia/eclampsia.1
Pregnancy hypertension
Pregnancy induced or gestational hypertension (≥140/90) is common, affecting up to 10% of all pregnancies, with mineral deficiencies, such as magnesium, one of the risk factors. Magnesium is involved with BP regulation, with urinary magnesium excretion in early pregnancy positively correlated with a rise in blood pressure in late pregnancy. An increase in diastolic blood pressure by ≥15mmHg is a risk factor for pre-eclampsia.2,3
Preeclampsia/eclampsia
Pregnancy hypertension combined with protein in the urine (0.3gm/day) is defined as pre-eclampsia (PE), and if left untreated can result in convulsions, called eclampsia. These conditions are life threatening. Research showed that 16% of women with PE have significantly lower magnesium levels than those with a normal pregnancy.2,3
Pregnancy-related calf muscular cramps
Calf muscle cramps in pregnancy has been reduced by 80% in one clinical study with the intake of 360mg of magnesium in 73 pregnant women. In another study, 300mg significantly reduced frequency and intensity of calf cramps in pregnancy, compared to placebo.4,5
Premature labour
Preterm infants are at greater risk of adverse health outcomes; therefore, premature labour prevention is critical. Magnesium efficiency can lead to muscle cramps and uterine hyperactivity, which can increase cervical dilatation and premature onset of labour. In women with low magnesium levels, supplementation may prevent preterm labour.6
Offspring outcomes
Magnesium supplementation given before the 25th week of gestation is associated with:
• Less preterm births
• Fewer low birth weight babies
• Less smaller for gestational age newborns
• Fewer days in neonatal intensive care1
Preliminary evidence suggests that foetal hypomagnesaemia is associated with later-life metabolic syndrome.1
Food sources of magnesium
When food is not providing sufficient magnesium, or if your body’s needs are increased (as during pregnancy and while breastfeeding, following illness, or increased exercise), supplementation may be necessary.
Not all magnesium is created equal
When it comes to supplementing with minerals, the form is integral to its function. This means that certain forms of magnesium are more suited to the above conditions than others. One form to be avoided in any mineral supplement is oxide. Preferential forms include citrate and glycinate.
Any supplements should be provided following a comprehensive naturopathic health assessment and prescribed by a qualified health professional. Don’t fall prey to clever marketing as quality is paramount when it comes to everything you put inside your body.
References:
- Casey, L. and Liang, R. Stress and wellbeing in Australia survey, 2014. Australian Psychological Society.
- Dickson, L. and Mazyck, H. Premenstrual syndrome. Am Fam Physician. 2003, 67: 1743-52.
- Kwan, I. and Onwude, J.L. Premenstrual syndrome. BMJ Clin Evid, 2007.
- Wuttke, W., Jarry, H., Christoffel, V., Spengler, B. and Seidlova-Wuttke, D. Chaste tree (Vitex agnus-castus) – Pharmacology and clinical indications. Phytomedicine, 2003. 10 (4): 348-357.
- Mills, S.Y. (1992). Woman Medicine: Vitex agnus-castus, the herb. Amberwood, Christchurch, UK, pp. 10-15.
- Masoumi, S.Z., Ataollahi, M., Oshvandi, K. Effect of combined use of calcium and vitamin B6 on premenstrual syndrome symptoms: a randomized clinical trial. J Caring Sci, 2016. 5 (1): 67-73