Clinicians PMT Cycle Balance | 30 Vegetable Capsules

Clinicians PMT Cycle Balance 

What is  PMT Cycle Balance?

PMT Cycle Balance is a combination of natural herbal ingredients, vitamins and minerals that supports women health by promoting a healthy and regular menstrual cycle. PMT Cycle Balance restores and maintains hormonal balance to relieve premenstrual discomfort and painful periods; it also supports skin health and helps maintain balanced blood sugar levels.

Why use PMT Cycle Balance?

Hormonal imbalance can be a cause of irregular menstrual cycles, premenstrual discomfort and painful periods. PMT Cycle Balance is a blend of natural herbal ingredients, combined with selected vitamins and minerals that support women through the menstrual cycle by restoring and maintaining hormonal balance and promoting a healthy and regular menstrual cycle. PMT Cycle Balance also supports healthy fluid balance, mood balance and skin health and helps maintain balanced blood sugar levels.

What are the Key Benefits of PMT Cycle Balance?

• Traditional medicinal plant formula 
• Promotes regular menstrual cycles 
• Helps manage premenstrual symptoms
• Suitable for women of all ages who are menstruating
• Supports normal balanced hormone levels
• Promotes normal oestrogen balance
• Suitable whilst taking oral contraceptives
• Suitable for vegetarians
• Does not contain sugar or artificial sweeteners
• Does not contain added colours, flavours, yeast, preservatives, gluten, wheat or dairy

What causes menstrual problems?

The menstrual cycle is regulated by the female hormones oestrogen and progesterone, produced in the ovaries, which are in turn regulated by luteinizing hormone (LH) and follicle-stimulating hormone (FSH) which are produced by the pituitary gland. The menstrual cycle is divided into two phases, the follicular or proliferative phase, during which the uterine lining thickens stimulated by increasing levels of oestrogen. Ovulation then occurs, when a mature egg is released from one of several developing egg follicles. Following ovulation the luteal or secretory phase prepares the uterus for a pregnancy under the influence of increasing progesterone levels. If pregnancy does not occur, the uterine lining is shed during menstruation. The average menstrual cycle is 28 days and blood volume lost is usually around 30mL. Hormonal imbalances can cause variable cycle length (usually in the follicular phase), increased blood loss (Menorrhagia), increased pain with menstruation (dysmenorrhoea), and Premenstrual tension (PMT) which can build up towards the of the cycle.

What is premenstrual tension?

Premenstrual tension (PMT), also known as premenstrual syndrome (PMS), describes a range of physical and mental symptoms that occur during the luteal stage of the menstrual cycle, after ovulation has occurred and before menstrual bleeding begins. These symptoms include breast tenderness or mastalgia, bloating, backache, skin problems like acne, food cravings, irritability, tiredness and mood changes. PMT is related to an imbalance in hormones that regulate the menstrual cycle and may be influenced by many possible factors including stress, alcohol, diet and lack of exercise. Also, it is thought that some women are more sensitive to the effects of progesterone or have low levels of brain serotonin^1. If symptoms are more severe and include depression, this could indicate a condition called premenstrual dysphoric disorder (PMDD) and a health professional should be consulted.

What is dysmenorrhea?

Dysmenorrhea or painful periods are the result of cramping of the uterine muscle wall, which is caused by excess production of prostaglandin PGF2α, by the endometrium (uterine lining), a hormone like chemical that causes contraction of the uterine wall. This is thought to be associated with higher than normal levels of oestrogen.

What are phytoestrogens?

A Phytoestrogen is a plant derived compound that is similar in structure to endogenous (naturally occurring) oestradiol also known as 17-β-oestradiol or E2. Phytoestrogens can bind to the oestrogen receptor on cells that are responsive to oestrogen and can mimic some of the activities of endogenous oestrogen, although their effects are much weaker. These include effects on bone, ovarian, vascular and endometrial tissue^{2, 3.}

What is an anxiolytic?

An anxiolytic is a substance that can relieve anxiety, aid sleep, or have a calming effect.

Oestrogen metabolism

The main forms of the hormone oestrogen in the circulation are estrone and oestradiol, which is the most active form and is responsible for most of the normal activities of oestrogen. Oestradiol works through binding to the intracellular oestrogen receptor (ER), which exists in two subtypes; ERβ receptor and ERα. Oestradiol and estrone are metabolised by hydroxylation, catalysed by the P450 (CYP) enzyme system in the liver and in breast tissue. There are three major metabolites; 2-, 4- and 16-hydroxyestradiol. 2-hydroxyestradiol has reduced affinity for the oestrogen receptor and therefore reduced estrogenic activity. The 4- and particularly the 16-hydroxyestradiol metabolites are thought to be involved in the pathogenesis of breast cancer^4.

What are the Ingredients of PMT Cycle Balance?

Each capsule of PMT cycle balance contains the following ingredients:

• St Mary’s Thistle seed (Silybum marianum) 7000mg (extract equivalent to dry seed) (standardised to 80 mg silymarin
• Gingko leaf (Ginkgo biloba) 6000mg (extract equivalent to dry leaf) (standardised to 29mg gingko flavanoids)
• Withania root (Withania somnifera) 2000mg (extract equivalent to dry root) (standardised to 1.2 mg withanolides)
• Chaste tree fruit (Vitex agnus castus) 200mg (extract equivalent to dry fruit)
• Magnesium citrate complex 250mg (equivalent to magnesium 50mg)
• Zinc amino acid chelate complex 50mg (equivalent to zinc 10 mg)
• Vitamin B6 (Pyridoxine hydrochloride) 63 mg (equivalent to vitamin B6 50mg)

Also contains:

• Magnesium stearate and silicone dioxide

St Mary’s Thistle (Silybum marianum):

St Mary’s Thistle, also known as milk thistle, is member of the Asteraceae/Compositae family that is native to Mediterranean regions but now grows ubiquitously. St Mary’s Thistle has been used for centuries as a natural remedy for diseases of the liver and biliary tract and is used to treat acute and chronic liver diseases. ⁵ Extract of St Mary’s Thistle contains several active hepatoprotective compounds collectively known as silymarin, which is a combination composed of flavonoids and lignin structures^{5, 6, 7.} Animal and in vitro studies have demonstrated that Silymarin in St Mary’s Thistle extract binds selectively to the oestrogen receptor ERβ, indicating that Silymarin may be a selective oestrogen receptor modulator (SERM), which suggests that St Mary’s Thistle has estrogenic effects due to modulation of ERβ by its active component silymarin^{8, 9, 10, 11.} However, these studies do not clarify whether Silymarin is an oestrogen agonist or antagonist^11. Outcomes of a clinical study indicated that a supplement containing St Mary’s Thistle extract protects against metabolism of oestrogen into the potentially harmful 4- and 16-hydroxyestradiol metabolites due to the lignan component of St Mary’s Thistle extract^12.

Gingko leaf (Ginkgo biloba):

Ginkgo Biloba, also known as maidenhair tree, is the oldest living tree and has long been used as a traditional medicine for treating blood disorders and improving memory. Ginkgo leaves contain flavonoids (like kaempferol and quercetin) and terpenoids (like ginkgolides and bilobalide), both of which are antioxidants. Ginkgo Biloba leaf extract has cardioprotective, cerebrovascular protective and antiplatelet properties and is used to treat cardiovascular disease, disorders of the central nervous system and peripheral vascular disease13. Animal and in vitro studies have demonstrated that Ginkgo Biloba leaf extract has vasodilator properties and causes relaxation of blood vessels to improve blood flow through the microcirculation, due to increased nitric oxide production. ^{13, 14} A review of animal and in vitro studies found that Ginkgo Biloba may provide beneficial effects for several clinical conditions due to its various effects on the cardiovascular system^15.

Withania (Withania somnifera):

Withania also known as Ashwaganda, Indian Ginseng and Winter Cherry is a small shrub belonging to the Solanaceae (Nightshade) family that grows in hot dry climates. Withania root has been used in traditional Ayurvedic medicine for centuries as a tonic, for improving stamina and libido, for treating many ailments including inflammatory conditions like asthma and arthritis and improving sleep. It is still used for treating a variety of clinical conditions including anxiety, degenerative diseases and diseases of the immune system, due to its wide-ranging properties including anti-microbial, antioxidant, anti-inflammatory, anti-tumour, anti-stress, neuroprotective, cardioprotective, and anti-diabetic properties^{16, 17.} Withania has been identified as an adaptogen and reduces the stress response in animal models^{17, 18.} Withania extract contains many pharmacologically active compounds including alkaloids (isopelletierine, anaferine), steroidal lactones (withanolides, withaferins), saponins (sitoindoside), and withanolides (sitoindoside) that contribute to its biological properties including including antioxidant, anti-inflammatory, immunomodulatory, anti-tumour and anti-stress^{17, 18, 19.} The anti-stress action of Withania has been demonstrated in several in vitro and animal studies and supported by a clinical study in subjects with a history of chronic stress. The outcomes of this study demonstrated reduced stress levels in response to taking a root extract of Withania, including reduced blood levels of cortisol^20. Animal and in vitro studies have indicated that Withania extract may have antidepressant and anti-anxiety activity, that is thought to be work through Gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter in the brain^19.

Chaste tree (Vitex agnus castus):

Chaste tree also known as Chasteberry and Monk’s Pepper, is a flowering shrub belonging to the Verbenaceae family that is native to the Mediterranean region. Chaste tree has been used in traditional herbal medicine as a tonic for the reproductive system and was believed to be an aphrodisiac. In contemporary herbal medicine, Chaste tree is widely used to relieve premenstrual symptoms. Clinical studies have demonstrated that premenstrual symptoms like mastalgia (breast tenderness and pain), and premenstrual dysphoria are reduced by Chaste tree extract^21. A review of clinical studies concluded that Chaste tree extract is a safe and effective treatment for premenstrual syndrome and premenstrual dysphoria^22. High levels of the pituitary hormone prolactin, known as latent hyperprolactinaemia, are associated with premenstrual syndrome, which can disrupt hormonal regulation of the menstrual cycle. Clinical studies have shown that Chaste tree extract reduces high prolactin levels, which restores normal levels of oestrogen and progesterone in the menstrual cycle21, 23. Several pharmacologically active compounds have been isolated from Chaste tree extracts including diterpenes, which have dopaminergic activity (dopamine stimulating activity) and bind to receptors for the neurotransmitter dopamine on prolactin producing cells of the pituitary gland in vitro, which inhibits prolactin production^21.

Magnesium citrate complex:

Magnesium is an essential mineral obtained from the diet and has been used in traditional medicine to promote calm and relaxation. Magnesium is important for many physiological processes, including maintaining normal nerve and muscle function, production of energy, control of blood pressure, normal heartbeat, and regulation of the endocrine (hormone) and immune systems. Magnesium deficiency is common and is thought to be related to several health problems including high blood pressure, cardiovascular disease, and mood disorders like anxiety and depression. A review of clinical studies indicates that supplementation with magnesium is associated with reduced stress and anxiety^24, and also depression^25. Magnesium supplementation has also been found to improve sleep quality in a study of elderly people with insomnia and also increased blood levels of melatonin^26. Animal and clinical studies have suggested a role for magnesium in circadian rhythm and sleep regulation and the mechanism is thought to involve stimulation of gamma-aminobutyric acid (GABA), which is the main inhibitory neurotransmitter in the brain. Magnesium also inhibits the activation of the N-methyl-D-aspartate (NMDA) receptor, which regulates a calcium channel in cells involved in the excitatory state, and is its activation is implicated in anxiety and panic disorders. Magnesium is thought to dampen down this excitatory and anxious state to promote relaxation and sleep^{24, 26.} Clinical studies with magnesium in combination with vitamin B6 found some improvement in symptoms associated with PMS including reduced cravings, headache, anxiety and depression, low blood sugar, fluid retention^{27, 28, 29, 30, 31.} Magnesium citrate complex is a combination of magnesium carbonate and citric acid and is one of the most readily absorbed forms of magnesium supplement.

Zinc amino acid chelate complex

Zinc is a trace element and essential mineral needed by the body for many physiological processes but only in small amounts. It is only found in the diet and cannot be stored. Zinc plays an important role in maintaining a healthy immune system, central nervous system, reproductive system, digestive system and for bone development. Zinc supports a healthy skin structure and is particularly important in wound healing^32. Zinc plays a vital role in many aspects of metabolism and is a cofactor in more than 10% of all proteins including enzymes and hormones, including antioxidant enzymes like superoxide dismutase, enzymes like metalloproteinases involved in tissue remodelling and wound healing and the metalloenzyme carbonic anhydrase essential for normal sense of taste and smell. Zinc concentrates in the islet cells of the pancreas and is essential for production of insulin by these cells. Outcomes of a study with diabetic patients indicated that Zinc supplementation has beneficial effects on glycaemic control^33. Changes in sensitivity to insulin and circulating insulin levels are thought to contribute to food cravings that are a common symptom of premenstrual tension (PMT). Studies have indicated a link between low blood glucose levels and PMT^34. The skin contains about 5% of zinc found in the body, where it concentrates in the upper layers (epidermis) and is essential for normal functioning of healthy skin due to its involvement in many aspects of skin physiology^35. Zinc also protects skin against sun damage caused by ultraviolet irradiation due to its antioxidant properties^36. The absorption of zinc is decreased by dietary fibre and phytates (an antioxidant found in whole grains, legumes, nuts and seeds) as they form an insoluble complex and this reduces bioavailability of zinc. Peptides derived from meat protein in the diet can enhance absorption of zinc. Zinc amino acid chelate complex provides improved absorption and bioavailability compared to inorganic zinc salts^37.

Vitamin B6 (Pyridoxine hydrochloride):

The B vitamins are a family of water soluble vitamins that play important roles in many essential physiological processes and act as cofactors for many enzymes involved in various aspects of metabolism^38. Vitamin B6 is a cofactor for many enzymes that perform many metabolic functions throughout the body and is involved in energy production, immune function and formation of red blood cells. It is an essential cofactor in the synthesis of several neurotransmitters, including dopamine that regulates attention, learning, and emotional responses, serotonin that regulates mood, and gamma aminobutyric acid (GABA) the major inhibitory neurotransmitter^38. There is some clinical evidence to suggest a link between vitamin B6 deficiency and physical symptoms of PMS as well as hormone related depression associated with PMS, and that supplementation with vitamin B6 may help relieve symptoms of PMS^{39, 40, 41.}

What are the Contraindications/Interactions of PMT Cycle Balance?

You should always check the ingredients for known allergies and to ensure you do not have any allergies or sensitivities to these ingredients. Stop using if you develop any irritation or allergy while taking PMT cycle balance. Always read the label and use as directed or seek advice from your healthcare professional.

Do not use if you:

• are pregnant or breastfeeding
• are taking anticoagulant like warfarin or antiplatelet medication as Gingko in PMT cycle balance may increase bleeding 
• are taking anticonvulsant medication as Gingko in PMT cycle balance may reduce their effectiveness
• have an oestrogen dependent or sensitive cancer, as St Mary’s Thistle may worsen your condition
• are taking any hormone medication, such as a hormone replacement therapy including oestrogen and/or progesterone, without discussion with your doctor, as Chaste tree can affect hormone levels

Caution:

• If you are taking any prescription medication seek advice from your doctor before you start using PMT cycle balance
• Stop taking PMT cycle balance 5-7 days before surgery as Gingko IN PMT cycle balance may increase risk of bleeding
• Chaste tree in PMT cycle balance may cause a mild rash

What are the Directions for using  for PMT Cycle Balance?

Adults:

• Take 1 capsule daily with food or as advised by your Healthcare professional.
• Suitable for vegetarians

Product Size

30 Vegetable Capsules

References

The following references provide scientific support for the use of this product:

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2. Sirotkin AV, Harrath AH. Phytoestrogens and their effects. Eur J Pharmacol 2014 Oct 15;741:230-6. 
3. Usui T. Pharmaceutical prospects of phytoestrogens. Endocr J.2006 Feb;53(1):7-20.
4. Samavat HMS, Kurzer MS. Estrogen Metabolism and Breast Cancer Hamed Cancer Lett. 2015 January 28; 356(2 0 0): 231–243.
5. Flora K, Hahn M, Rosen H, Benner K. Milk thistle (Silybum marianum) for the therapy of liver disease. Am J Gastroenterol.1998 Feb;93(2):139-43. 
6. Madrigal-Santillán E, Madrigal-Bujaidar E, Madrigal-BujaidarIsela E, Álvarez-González I, Sumaya-Martínez MT, José Gutiérrez-Salinas J, et al. Review of natural products with hepatoprotective effects. World J Gastroenterol 2014 October 28; 20(40): 14787-14804
7. Dietz BM, Hajirahimkhan A, Dunlap TL, Bolton JL. Botanicals and Their Bioactive Phytochemicals for Women's Health. Pharmacol Rev.2016 Oct;68(4):1026-1073.
8. Seidlová-Wuttke D, Becker T, Christoffel V, Jarry H, Wuttke W. Silymarin is a selective estrogen receptor β (ERβ) agonist and has estrogenic effects in the metaphysis of the femur but no or antiestrogenic effects in the uterus of ovariectomized (ovx) rats. J Steroid Biochem Mol Biol. 2003;86:179–188.
9. Plísková M, Vondrácek J, Kren V, Gazák R, Sedmera P, et al. Effects of silymarin flavonolignans and synthetic silybin derivatives on estrogen and aryl hydrocarbon receptor activation. Toxicology 2005; 215:80–89.
10. El-Shitany NA, Hegazy S, El-desoky K. Evidences for antiosteoporotic and selective estrogen receptor modulator activity of silymarin compared with ethinyl estradiol in ovariectomized rats. Phytomedicine. 2010;17:116–125.
11. Powers CN, Setzer WN. A molecular docking study of phytochemical estrogen mimics from dietary herbal supplements. In Silico Pharmacol.2015 Mar 22;3:4.
12. Laidlaw M, Cockerline CA, Sepkovic DW. Effects of A Breast-Health Herbal Formula Supplement on Estrogen Metabolism in Pre- and Post-Menopausal Women not Taking Hormonal Contraceptives or Supplements: A Randomized Controlled Trial. Breast Cancer: Basic and Clinical Research 2010:4 85–95. 
13. Koltermann A, Hartkorn A, Koch E, Fürst R, Vollmar AM, Zahler S. Ginkgo biloba extract EGb 761 increases endothelial nitric oxide production in vitro and in vivo. Cell Mol Life Sci. 2007 Jul;64(13):1715-22.
14. Zhou W, Chai H, Lin PH, Lumsden AB, Yao Q, Chen C. Clinical use and molecular mechanisms of action of extract of Ginkgo biloba leaves in cardiovascular diseases. Cardiovasc Drug Rev.2004 Winter;22(4):309-19.
15. Tian J, Liu Y, Chen K. Ginkgo biloba Extract in Vascular Protection: Molecular Mechanisms and Clinical Applications. Curr Vasc Pharmacol.2017;15(6):532-548. 
16. Dar NJ, Hamid A, Ahmad M. Pharmacologic overview of Withania somnifera, the Indian Ginseng. Cell Mol Life Sci.2015 Dec;72(23):4445-60. 
17. Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev.2000 Aug;5(4):334-46.
18. Bhattacharya SK, Muruganandam AV. Adaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stress. Pharmacol Biochem Behav.2003 Jun;75(3):547-55.
19. Singh G, Sharma PK, Dudhe R, Singh S. Biological activities of Withania somnifera. Annals of Biological Research, 2010, 1 (3):56-63
20. Chandrasekhar K, Kapoor J, Anishetty S. A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. Indian J Psychol Med. 2012 Jul-Sep; 34(3): 255–262.
21. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlová-Wuttke D. Chaste tree (Vitex agnus-castus) pharmacology and clinical indications. Phytomedicine.2003 May;10(4):348-57.
22. Cerqueira RO, Frey BN, Leclerc E, Brietzke E. Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Arch Womens Ment Health.2017 Dec;20(6):713-719. 
23. van Die D, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus Extracts for Female Reproductive Disorders: A Systematic Review of Clinical Trials. Planta Med 2013; 79: 562–575
24. Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review Nutrients2017 May; 9(5): 429.
25. Derom ML, Sayón-Orea C, Martínez-Ortega JM, Martínez-González MA Magnesium and depression: a systematic review. Nutr Neurosci.2013 Sep;16(5):191-206. 
26. Abbasi B, Masud Kimiagar M, Khosro Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci2012. Dec; 17(12): 1161–1169 
27. Parazzini F, Di Martino M, Pellegrino P. Magnesium in the gynecological practice: a literature review. Magnesium Research 2017; 30 (1): 1-7
28. De Souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med.2000 Mar;9(2):131-9.
29. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res.2010 Dec;15(Suppl 1):401-5.
30. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. Magnesium Supplementation Alleviates Premenstrual Symptoms of Fluid Retention. J Womens Health; 7, 9, 1998
31. Quaranta S, Buscaglia MA, Meroni MG, Colombo E, Cella S. Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome. Clin Drug Investig. 2007; 27 (1): 51–58
32. Roohani N, Hurrell R, Kelishadi R, Schulin R. Zinc and its importance for human health: An integrative review. J Res Med Sci.2013 Feb;18(2):144-57.
33. Jayawardena R, Ranasinghe P, Galappatthy P, Malkanthi RLDK, Constantine GR, Katulanda P. Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr2012; 4: 13.
34. Trout KK, Basel-Brown L, Rickels MR, Chutta MH, Petrova M, et al. Insulin Sensitivity, Food Intake, and Cravings with Premenstrual Syndrome: A Pilot Study. J Womens Health (Larchmt). 2008 Ma ; 17(4): 657–665
35. Ogawa Y, Kinoshita M, Shimada S, Kawamura T. Zinc and Skin Disorders. Nutrients 2018, 10, 199;
36. Udechukwu MC, Collins SA, Udenigwe CC. Prospects of enhancing dietary zinc bioavailability with food-derived zinc-chelating peptides. Food Funct.2016 Oct 12;7(10):4137-4144.
37. Rostan, E.F.; DeBuys, H.V.; Madey, D.L.; Pinnell, S.R. Evidence supporting zinc as an important antioxidant for skin. Int. J. Dermatol. 2002, 41, 606–611.
38. Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review. Nutrients 2016, 8, 68;
39. Williams AL, Cotter A, Sabina A, Girard C, Goodman J, Katz DL. The role for vitamin B-6 as treatment for depression: a systematic review. Fam Pract.2005 Oct;22(5):532-7.
40. Wyatt KM, Dimmock PW, Jones PW, O’Brien PMS. Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ 1999 May 22; 318(7195): 1375–1381.
41. Canning S, Waterman M, Dye L. Dietary supplements and herbal remedies for premenstrual syndrome (PMS): a systematic research review of the evidence for their efficacy. J Reproduct Infant Psychol, 24, no. 4, 2006, 363–378.