It's no secret that many women suffer through their monthly periods, experiencing cramps, bloating, and lower back pain, to name just a few. But a large number of them-estimated at anywhere from 30 to 90 percent-also endure the symptoms of premenstrual syndrome (PMS). Most women feel some discomfort before their periods. But if you have PMS, you may feel so anxious, depressed, or uncomfortable that you can't cope at home or at work.

What causes PMS?

No one know for sure what causes PMS or why some months are worse than others, but PMS is often linked to the changes in hormone levels that happen during a woman's menstrual cycle. PMS is not caused by stress or psychological problems, though these may make the symptoms worse.

"We probably don't get nearly enough magnesium from out diet," says Dr. Carolyn Dean, who specializes in managing and healing commonly misdiagnosed and chronic conditions such as hormone imbalance, and mood swings. "The Recommended Daily Allowance for magnesium is 350-400 milligrams (mg) per day, but for optimal health you may need twice as much."

Dean, who serves on the medical advisory board of the Healthy Back Institute, suggests taking magnesium supplements to prevent or ease PMS symptoms, including back pain due to water retention. She recommends magnesium citrate and taurate, as well as spraying on magnesium oil that is absorbed through your skin.

Some researchers have found that calcium levels are lower in women with PMS and that calcium supplementation may reduce the severity of symptoms. One study, for instance, reported that 300 mg of calcium carbonate four times a day significantly reduced bloating, depression, pain, and mood swings.

How is PMS diagnosed?

There is no single test to diagnose PMS, but because thyroid disease is common in women of childbearing age, and because some of the symptoms of PMS-such as weight gain-are similar to symptoms of thyroid disease, your doctor may do a thyroid test. This can help rule out a thyroid problem as the cause of your symptoms. Often, a doctor will suggest that you keep a diary to track your symptoms for a few months.

How is PMS usually treated?

Medicines that are commonly prescribed include diuretics to help the body rid itself of extra sodium and fluid, which can ease bloating, weight gain, breast pain, abdominal pain, and back pain. Antidepressants can help with the severe irritability, depression, and anxiety that some women have with PMS. Doctors often prescribe birth control pills to help reduce some PMS symptoms by evening out hormone levels during your cycle.

Experts also suggest making some simple diet and lifestyle changes. These include eating more complex carbohydrates (such as whole grain breads, pasta and cereals), more fiber and protein, and more foods rich in potassium (such as fish, beans, and broccoli). Other things you can do: cut back on sugar and fat; avoid iodine salt (to reduce bloating and fluid retention) try sea salts, eliminate or cut back on caffeine and alcohol, get at least eight hours of sleep each night, and get regular aerobic exercise-even a short walk every day can help. In fact, research has shown that frequency-rather than intensity-of exercise can decrease PMS symptoms.

Are there alternative treatments?

According to a 2004 study in Journal of Alternative and Complementary Medicine, a drugless intervention that may provide relief from PMS is something called "external qigong." First, a little background: Human qi comes from two primary sources: one, your parents; and, two, essential substances in nature such as air, water, and food. Both of these qi sources-inherited and acquired vital energies-are refined and transformed by our organs.

By eating a healthy diet and breathing fresh air, the theory goes, the body extracts their most valuable essences and uses them to help form the vital energy. Following these simple principles are the first steps towards creating a healthy balance in the body.

In external qigong, a trained practitioner directs his or her own qi outward, with the intention of helping patients' clear blockages, remove negative qi, and balance the flow of qi in the body, thus relieving pain and helping the body to rid itself of certain diseases. Scientists in South Korea report that qigong can improve many of the symptoms associated with PMS, and that it may work as well as more traditional methods of relief.

Other techniques-such as breathing exercises, meditation, aromatherapy, and yoga-focus on reducing stress and promoting relaxation. It this regard, it is also advisable (where practical) to schedule events you expect will be stressful-that big family reunion, for example-for the week after your period. And because many women seem to be more sensitive in the weeks before their menstrual period, relaxation experts suggest setting aside personal time to unwind, let out pent-up emotions, and focus on things that will nourish your spirit.

You may also want to try evening primrose oil, a plant oil that contains gamma-linolenic acid, which is an omega-6 essential fatty acid. Gamma-linolenic acid is involved in the metabolism of hormone-like substances called prostaglandins that regulate pain and inflammation in the body. Other natural remedies commonly used for PMS: ginkgo, vitamin E, royal jelly, dandelion, wild yam, oligomeric proanthocyanidins(OPCs), uva ursi, St. John's wort, progesterone cream as well as Proteolytic Systemic Enzymes.