Inexpensive, well tolerated: consider calcium supplements for PMS treatment.(Gynecology)

BIG SKY, MONT. -- Calcium supplementation is the most promising and best-supported alternative therapy to date for premenstrual syndrome. Dr. Eric J. Bieber said at a meeting on ob.gyn., gynecologic oncology, and reproductive endocrinology.

That's not necessarily saying all that much. Most of the scanty research on complementary and alternative medicine (CAM) is seriously flawed. But calcium supplementation in the form of two extra-strength Tums twice a day looks like it may have legs, according to Dr. Bieber, editor of the "Textbook of Complementary and Alternative Medicine" and chairman of the division of ob.gyn. at Geisinger Health System in Danville, Pa., which sponsored the meeting.

"The data on calcium are reasonably compelling, in contrast to some of the other natural products. It's cheap therapy--it's easy, well tolerated. ... So it may be something worth trying," he said.

The rationale for calcium supplementation in women with PMS lies in several studies suggesting that PMS patients have altered calcium homeostasis and increased risk of osteoporosis.

Following a couple of favorable pilot studies, investigators at Columbia University in New York organized a randomized, double-blind, placebo-controlled, 3-month prospective clinical trial in which 497 women with moderate to severe PMS received two Tums E-X tablets b.i.d. or placebo. That's 1,500 mg/day of calcium carbonate, or 1,200 mg/day of elemental calcium.

Patients randomized to Tums showed a 48% reduction from baseline in total symptom scores. All four PMS symptom complexes assessed in the trial--pain, water retention, negative affect, and food cravings--decreased to a significantly greater extent in the Tums-treated patients than in the placebo group.

Patients in the placebo arm improved during the course of ...