PMX Provides Effective, Natural Treatment of Menopausal Symptoms and PMS
By Dan Kenner, PhD, LAc.

The recent spotlight on the hazards of hormone replacement therapy has stimulated discussion of natural alternatives to the use of hormones, synthetic or natural. For centuries women in east Asia have used herbal treatments for most female complaints including premenstrual syndrome and menopausal complaints. Even in modern times premenstrual syndrome and complaints of menopause such as hot flashes, irritability, depression and anxiety have been successfully treated in Japan using herbal treatment alone. The fonnulas used for treatment are the same formulas that have been used for centuries. There is one fonnula that has been particularly renowned for treatment of these honnone-related symptoms. This formula has been the subject of scientific studies in Japanese clinics and universities. Research at Japanese medical universities has also uncovered the mechanisms that can explain why this fonnula has been so effective.

Supported by Scientific Studies
PMX is the trade name for a modern variation of this traditional fonnula that dates back to the Sung dynasty (A.D. 1110). The root formula, known as jia-wei-xiao-yao-san in Chinese and kamishoyosan in Japanese, has been the subject of a number of clinical trials in Japanese hospitals and clinics. The Kitazato Research Institute in Tokyo reports several studies using this herbal blend to treat symptoms related to menopause. In one study 10 menopausal patients and 10 patients who had had surgical removal of the ovaries (ovarotomy), which causes menopausal symptoms, were treated for symptoms of depression and anxiety .The treatment caused an apparent improvement in psychological symptoms in all of the subjects as measured by the Cornell Medical Index Masked Depression Scale.

In an earlier study 30 patients, both menopausal and post-ovariotomy patients were given the formula and evaluated for overall symptoms of menopause using the Kuppennan Scale, a system ofrating severity of the symptoms of menopause. Any reduction of greater than 30% on the scale was considered significant in the study. The result was 83.3% improvement on the scale, especially vasomotor symptoms such as hot flashes and heart palpitations and psychological symptoms like depression and anxiety. Another study showed 75.5% improvement in menopausal symptoms according to the Menopause Index, especially hot flashes, sweating, muscle tension headaches and depression.

A study at Osaka University Medical School measured the effects of taking the Chinese herbs for eight weeks on 89 women over 40 years of age who were either menopausal or had had the ovaries removed surgically. Results were measured on the Kupperman Scale to determine the changes in menopausal symptoms. In 8% the response was in the "extremely effective" category , the results were "effective" for 62%, "somewhat effective" in 26% and no effect in 4%. The greatest response once again was for the symptoms of hot flashes, palpitations, headaches, depression and anxiety.

The great majority of Japanese doctors use traditional Chinese fonnulas in their practice and they are available as tablets or capsules in almost all Japanese phannacies. Many Japanese doctors have long considered kamishoyosan to be comparable to estrogen replacement therapy with no dangerous side effects. For example, there are many women who cannot take estrogen if they are at high risk for cancer. Side effects of the Chinese herb formula are minimal. There has been an occasional complaint of diarrhea that is usually temporary .

This formula has been studied for other applications as well. For example, it has been studied for its effects on infertility in reducing the rate of miscarriage in women who are susceptible. It has been studied for muscle tension headaches, back pain, and even depression in
men suffering from chronic back pain.

How PMX Works -Two-fold Action
The mechanism of action appears to be twofold. The pituitary hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone) stimulate the ovaries to produce estrogen and progesterone respectively. The blood levels of estrogen and progesterone control the amount of FSH and LH secreted by the pituitary .During menopause, the secretion of FSH and LH are unchecked and increase to higher levels because of the declining levels of estrogen and progesterone. These pituitary hormones are responsible for some of the symptoms of menopause. Japanese studies have shown that the Chinese herbs can reduce the levels ofFSH and LH.

Some studies showed that the levels of the pituitary hormones did not always decrease, but even when the blood levels stayed the same, there was still relief of the symptoms. This led them to discover that there is also an effect of the herb combination of regulating the autonomic nervous system. The effect on the autonomic nervous system is also responsible for some of the effects of the herbs on regulating body temperature and relieving stress.

This formula has also been traditionally used for premenstrual syndrome. It appears to help premenstrual discomfort by improving the breakdown of estrogen by the liver to lower estrogen levels. Lowering estrogen results in an improvement in mood, as well as bloating and cramps. Estrogen is broken down in the body through sulfur conjugation by the liver. The bound estrogen is transported through the bile ducts and into the intestine where it is broken down by bacteria. If this process bogs down because of sluggish liver function or impaired transport through the bile ducts, estrogen buildup can reach an uncomfortable level. The herb bupleurum, found in PMX accelerates this process and makes estrogen breakdown more efficient.

Resolving Sleep Disturbances, Emotional Distress
According to Yoshiharu Shibata, M.D., an expert on traditional Chinese herbs, the root formula, kamishoyosan, is indicated for a number of complaints that have not yet been researched in hospitals or universities. The main traditional indications for the formula are sleep disturbances, emotional distress especially depression and anxiety, chronic headaches, abnormal bleeding, body aches and pains, especially stiffness or pain in the neck, shoulder or arm. Some of its minor indications include atrophy of the vagina, vaginitis, recurrent urethritis and psychosomatic cardiovascular disease, such as perimenopausal high blood pressure. The formula has not only been used for female complaints, but also traditionally used for liver problems, even cirrhosis of the liver, and thyroid problems such as Basedow's disease.

The herbs in the traditional formula are Chinese angelica root, atractylodes rhizome, bupleurum root, gardenia seeds, dried ginger, white peony, tree peony root bark mint leaf, licorice root and poria, a type of bracket fungi. In PMX Chinese cinnabar sage root and purple nutsedge root are added to increase the potency. Chinese angelica, also known as dong quoi, is a central nervous system sedative, an analgesic, a peripheral vasodilatator (opens up blood vessels throughout the body) and an anticoagulant. White peony is a sedative, an analgesic and increases levels of progesterone and estradiol. Tree peony root bark, also called moutan, is a sedative and analgesic. Angelica, white peony and tree peony are anti-inflammatory and relax uterine muscle. Licorice root stimulates estradiol secretion and inhibits prolactin. Bupleurum is a s.edative, an analgesic, lengthens sleep time and is renowned for its beneficial effects on regenerating the liver and supporting liver function. Gardenia seeds are used to relieve stress and anxiety .Cinnabar sage is used to improve circulation, stimulate immunity and is also used for treating premenstrual syndrome. Cinnabar sage is used in Chinese hospitals in injectable foml for emergency treatment of heart attacks due to coronary thrombosis. Purple nutsedge is used for irregular menses, breast tenderness, uterine spasms, anxiety , irritability and a number of other complaints.

This formula can be a safe answer or an adjunct to treatment for premenstrual syndrome and numerous types of menopausal and perimenopausal complaints. It is nontoxic and is safe to use along with hormone replacement therapy, as it often is in Japan. It seems especially useful
for symptoms of anxiety , depression, mood swings and emotional instability without any effect of sedation or drowsiness.

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