Changes to diet and lifestyle are generally the best way to tackle the majority of menstrual problems.

PMSCut down or eliminate dairy products (J Rep Med, 1982; 83: 527-31) and caffeine in the form of soft drinks, coffee or chocolate (Am J Pub Health, 1985; 75: 1335-7). The effect on breast tenderness, especially from cutting out caffeine, should be immediate.

Supplements. High estrogen levels are associated with deficiencies in the B vitamin complex, especially B6 and B12, as well as vitamins C, E and selenium and magnesium. The liver requires these vitamins to break down and inactivate estrogen (Infertility, 1980; 3: 155; J Rep Med, 1983; 28: 446; Am J Clin Nutri, 1982; 34: 2364; Ob Gyn, 1991; 78: 177-81; J Am Col Nutri, 1983; 2: 115-23). Magnesium intake can help mood changes (JAMA, 1991; 266: 3273).

Two hours of bright light treatment in the evening can cure symptoms such as weight gain, depression, carbohydrate craving, social withdrawal, fatigue and irritability (AM J Psychi, 1991; 146: 9).

Increase exercise. 20 minutes of aerobic exercise three times a week and this can be simple brisk walking (Fertil Steril, 1987; 47: 402-9) improves circulation and increases available endorphins which help to deal with depression. Relaxation can also bring relief (Ob Gyn, 1990; 75: 649-89).

Try a vegetarian diet. Vegetarians excrete two to three times more estrogen in the feces than non vegetarians and have as much as 50 per cent less plasma blood levels of unconjugated estrogen (a type of metabolized estrogen) than women who eat meat. As a result they also have a decreased incidence of PMS (N Eng J Med, 1982; 307: 1542-7; Cancer Res, 1981; 41: 3771-3).

Heavy and/ or painful periods

Vitamins. Try 100 mg B6 daily in combination with B complex (and magnesium see above). B6 has been shown to decrease the intensity and duration of menstrual cramps (Headache, 1991; 31: 298-304). Take 50 mg of vitamin E (d-alpha tocopherol) three times daily during your entire cycle (Lancet, 1955; i: 844-47).

Cut down on red meat and milk. Both contain arachidonic acid, which contributes to the production of series 2 prostaglandins. In combination with increased essential fatty acids, such as linseed, borage and blackcurrant seed, it is possible to control heavy bleeding and period pains. Evening primrose oil four to six 500 mg capsules per day in divided doses (Clin Ob Gyn, 1978; 21: 139-45) is also good for breast pain.

Take extra iron, since heavy blood loss can cause anemia, but not in the form of ferrous sulphate an inorganic mineral which is poorly absorbed by the body and causes constipation. You may also be low in other vitamins, such as A, E, C and B complex, magnesium and zinc. Of these, vitamin C, 200 mg three times a day, may also reduce heavy bleeding (Curr Ther Res, 1960; 2: 539-42) and taken with meals will help improve iron absorption from your food.

Try herbs with an astringent action for both regulating blood flow and reducing pain:

Bromelian has been shown to help reduce pain (J Ethnopharmacol, 1988; 22: 191-202; Hawaii Med J, 1977; 36: 39-47). When applied directly to the cervix it appears particularly effective (Am J Ob Gyn, 1960; 79: 1161-8; Lancet, 1958; ii: 827-30).

Feverfew (Tanacetum parthenium) will inhibit the synthesis of prostaglandins at their initial stage (Prostaglandin Leukotri Med, 1982; 8: 653-60). Preparations should have a parthenolide content of 0.4-0.66 per cent.

Black Haw Bark (Ind J Exp Biol, 1977; 15: 231; Nature; 1966; 212: 837; Deutsch Apoth Zeitung, 1965; 105: 1371-2); and Shepherd's Purse (Life Sci, 1969; 8: 151-5; Vet Sci, 1981; 18: 94-8) may also be helpful.

Irregular or scanty periods

Increase phytoestrogens. Vegetables which contain high levels of plant estrogen (phytoestrogens), such as rhubarb, alfalfa, ginseng, fennel and celery, can help to regulate hormone levels with none of the health risks associated with other estrogens (J Alt Comp Med, 1993: 11: 13-6).

Agnus castus is a good hormone regulator which helps to regulate hormones without introducing an external hormone into your system.