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Side effects include nausea, dry mouth, allergic reactions, and fatigue, although, in general, side effects are quite uncommon. In one study, only 1.1% of patients discontinued the agent because of side effects. Some people have reported temporary nerve damage after sun exposure, specifically pain and tingling on sun-exposed areas although a 2001 study found that sun sensitivity reactions were low. There are also some laboratory studies that suggest high doses may impair fertility in men.

St. John's wort may increase the risk for bleeding when used with anti-clotting agents or with other natural or standard medications that thin blood, such as warfarin or high doses of vitamin E. They may interact with oral contraceptives in women.Notably the herbal agent appears to reduce the effectiveness of certain cancer chemotherapy agents and HIV treatments.

Herbs and Supplements

Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Always check with your doctor before using any herbal remedies or dietary supplements.

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The following are special concerns for people taking natural remedies for PMS:

  • Dong quai is a Chinese herb used to treat menstrual symptoms. Dong quai can lengthen the time it takes for blood to clot. People with bleeding disorders should not use dong quai. Dong quai should not be taken with drugs that prevent blood clotting, such as warfarin or aspirin.
  • L-tryptophan diet supplements have caused eosinophilia-myalgia syndrome (EMS) in some people. EMS is a disorder that elevates certain white blood cells and was fatal in a few cases.



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