Can Flo vitamins help with PMS?

Ask Dr. Gunter

Can you do an article on Flo vitamins?

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Short Take

Flo vitamins claim they are “scientifically-designed” vitamins for PMS. There is no evidence they are effective and the ingredients are largely untested. There is nothing scientific about Flo vitamins.

Go On…

Premenstrual syndrome, also known as PMS, affects 12% of women and consists of physical and emotional symptoms that develop after ovulation (this is known as the luteal phase of the menstrual cycle), but before that month’s menstrual period. PMS symptoms go away shortly after the onset of menstrual bleeding. Common symptoms of include the following:

  • Angry outbursts

  • Abdominal bloating

  • Anxiety

  • Breast tenderness or swelling

  • Depression

  • Food cravings

  • Headache

  • Joint or muscle pain

  • Irritability

  • Moodiness

These symptoms affect approximately 85% of women to a mild degree. PMS is diagnosed when these symptoms negatively impact quality of life or cause significant distress. The diagnosis is premenstrual dysphoric disorder or PMDD when PMS symptoms are severe enough that they are very distressing or they interfere with work, school, social activities, or relationships. PMDD affects approximately 3% to 5% of women.

Flo vitamins are marketed as “scientifically-designed” help for PMS, but something has to have data to be scientific. Meaning, the word “scientifically” is doing a lot of heavy lifting here. Some of the ingredients have been studied individually, but the quality of the studies are poor, and it isn’t possible to determine if individually these ingredients provide any benefit above a placebo response. Meaning, the jury is still out whether they are better than a sugar pill. In addition, the assumption should never be that these products work better or are safe when given together. The opposite could just as easily be true.

Let’s look at the ‘scientifically-designed” ingredients:

Chasteberry or Vitex agnus-castus, a.k.a. vitex: There have been 13 studies worth evaluating, and a recent review found them to be of low quality. While there was a suggestion of benefit, the low quality of the studies made conclusions impossible. The authors of the review said the evidence supporting chasteberry for PMS was “merely exploratory at best.” Meaning, OK, we have a hypothesis; let’s actually test it properly. Verdict: inadequately tested.

Dong quai or Angelica sinensis: It is reported to have estrogenic properties, but appears completely unstudied for PMS. I could not find a single study using dong quai for PMS. I did find a study looking at dong quai for hot flushes in menopause, and it was ineffective. Verdict: untested.

Vitamin B6: Several studies have looking at vitamin B6 for PMS, and they are low quality, making it difficult to draw conclusions. (I know, I sound like a broken record here). There is low-quality evidence that 100 mg of vitamin B6 a day may help women with PMS. Verdict: May help. Likely safe in this dose.

Lemon balm or Melissa officinalis: Despite its widespread recommendation by various herbalists, naturopaths, and functional medicine providers as a therapy for PMS, there is only one low-quality study showing benefit. Lemon balm can be sedating, so this could have impacted the placebo arm (meaning people knew if they were taking lemon balm or not). One animal study showed liver and kidney damage from long-term use, but this is with a very high dose and likely does not reflect a concern for humans (or animals for that matter). Flo vitamins explains they included lemon balm because it is an ancient therapy, stating “Ancient Greek botanist Theophrastus wrote about lemon balm around 300 B.C.” The ancient Greeks also believed the uterus wandered the body like an animal, so perhaps basing therapies on the beliefs of Ancient Greeks isn’t optimal. When you see the word “ancient” attached to ANY medicinal product you should automatically translate that to unstudied. It is a marketing term that companies use when they have no actual medical evidence. Meaning, when all they have is pseudoscience. Verdict: essentially untested.

One More Thing…

For those who wish to try vitamins and botanicals for PMS, the best evidence is a calcium supplement of 1,000-1,200 mg a day. Vitamin B6 at 100 mg a day is something to consider, but the data is lower quality. You can buy a three month’s supply of both calcium and vitamin B6 for $20. A one month’s supply of Flo will set you back $29.99.

To the people at Flo, who I suspect will inevitably read this, study your product you cowards. Do a high-quality placebo-controlled clinical study to show your product can help women. I’d love to have a quality product to recommend. Unless, of course, you don’t believe women deserve to know if what they are taking is safe and effective or perhaps you are worried you can’t outperform placebo?

Verdict: Flo vitamins are pseudoscientifically designed