Progesterone therapy is one of the most controversial therapies for PMS, yet it is one of the most widely used. Supporters of British researcher Dr Katharina Dalton, who has researched the treatment for over 30 years, are largely responsible for its widespread use.Despite the enthusiasm, proper studies of progesterone versus a dummy pill have failed to show any benefit with this hormone therapy. But because a few women do seem to benefit many doctors feel if s worth a try if other methods have failed.Dr Dalton and other doctors who follow her teaching believe that natural progesterone should not be taken by mouth because it breaks down before it has a chance to work. So vaginal or rectal ‘suppositories’ – a gel-based ‘pellet inserted into the vagina or rectum – are used instead. Sometimes daily injections are given and work is being done on a tablet form.The dose is 400mg to 800mg taken twice a day, starting on day 12 of the cycle. Treatment usually lasts for a minimum of six months but some women may need to carry on for up to two years or until the menopause if they are over 40.Progestogens are synthetic forms of progesterone which can be taken as tablets by mouth.Dydrogesterone is the type of progestogen most often prescribed. The main drawback of progestogens is that some women find they tend to produce more side-effects than natural progesterone, especially weight gain and irregular periods.Critics of progestogen treatment say its chemical structure is so different from that of progesterone that it does not work and actually makes PMS worse Once again, though, there have been no studies to support or refute this claim.*47\120\4*

The use of psychological therapies to treat PMS, various types of depression and menopausal symptoms such as hot flushes is based on the view that mental processes can play a significant role in the development and maintenance of these conditions and symptoms. Therapists treating women with PMS have used coping-skills therapies to alleviate the condition. These therapies have three main components. First, individuals are taught to examine their ways of responding to stressful situations. The second phase involves rehearsing new coping strategies that are based on a major re-think of the way they respond to stressful life events. In the third phase, women test their coping responses in the stressful situations that previously gave rise to their PMS and depression. Training programs, which sometimes incorporate relaxation skills, generally involve ninety-minute sessions once a week for eight to ten weeks.

In the case of Nina, aged forty, who had had unrelenting PMS for much of her adult life, coping-skills therapy helped her to identify cues associated with her irritability and feelings of tension and fatigue. She became aware that her approaching menstrual period generated feelings of having to ‘get things done’ in anticipation of her ‘bad days’ when even small things required an enormous effort. Instead of allowing these feelings to dominate her activities, causing overloading and a self-fulfilling exhaustion, she trained herself to develop a plan of action. ‘Don’t concern yourself about the bad days, just about what you have to do today,’ she told herself. ‘Keep the focus on the present.’ After several months she considered her PMS to be much less of a problem.

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Nearly all animals make vitamin Ñ in their bodies, except humans, guinea pigs, fruit-eating bats, primates, the red-vented bulbul bird and the teleost fish! We have to get it all from our diet.

Studies have established that vitamin Ñ enhances sperm quality. As a powerful antioxidant, it can protect the sperm and its DNA from damage.

In one study a group of men had their vitamin Ñ intake deliberately reduced from 250mg a day to 5mg a day. Their sperm had double the normal DNA damage. (We do not yet know for sure but it is possible that certain types of DNA damage make it difficult to conceive in the first place or cause an increased risk of miscarriage or a chromosome problem in the developing baby.)

When sperm stick together (agglutinate), this can obviously reduce the chances of conceiving. Yet research has shown that sometimes as little as 500mg of vitamin Ñ per day can help prevent this.

Some placebo-controlled trials (where some of the men were given a ‘dummy’ pill instead of vitamin C) have shown that supplementing with 1000 mg of vitamin Ñ per day increased sperm counts, improved motility and reduced the percentage of abnormal sperm.

If a woman isn’t ovulating she is usually given the drug clomiphene to stimulate ovulation. Sometimes the drug docs not work and there is still no ovulation. But it appears that if vitamin Ñ is taken at the same time as the clomiphene it can help trigger ovulation.

You may have been worried by newspaper scare stories claiming that vitamin Ñ could ‘promote cancer’. These were actually due to the press misinterpreting the findings of a preliminary investigation. In fact, the study to assess the effect of vitamin Ñ on cellular damage drew very conflicting conclusions and attracted criticism from the scientific world which felt that ‘the conclusions were not justified by the data’.

In any event, one piece of research should always be weighed against other existing research. In this case numerous other studies have demonstrated the beneficial effects of supplementing with good levels of vitamin C.

You should take 1000 mg a day.

Your partner should take 1000 mg a day.

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