10 Best Herbal Tinctures For Premenstrual Syndrome

Herbal tinctures for premenstrual syndrome are concentrated plant-based extracts used to alleviate the symptoms of PMS.

These tinctures help by providing a natural and gentle approach to managing emotional, physical, and hormonal fluctuations. For example, Passionflower and Kava can help reduce anxiety and mood swings, while Chasteberry and Dong Quai can regulate hormone imbalances and ease cramps.

By using herbal tinctures, women can experience improved mental clarity, reduced bloating, and increased energy levels, allowing them to better manage their daily lives and enjoy a more balanced premenstrual period.

The following article describes in detail the most important tinctures for premenstrual syndrome, including medicinal properties, parts of herbs to use, and recipes for preparations.

1. Vitex agnus castus

Chaste tree tinctures helps with premenstrual syndrome because it contains phytoestrogens that can help regulate hormonal imbalances, alleviating symptoms such as bloating, mood swings, and breast tenderness.

The tincture also contains flavonoids and phenolic acids that have anti-inflammatory properties, which can reduce swelling and pain associated with PMS.

Additionally, chaste tree tinctures may help to normalize ovulation and improve overall menstrual cycle regularity, leading to a reduction in symptoms and improvement in overall well-being.

Medicinal Constituents

The list below shows the primary medicinal constituents in Vitex agnus castus tinctures that help with premenstrual syndrome.

• Aglycones: Aglycones, particularly aucubin and agnuside, have been found to have a regulatory effect on the hypothalamic-pituitary-adrenal (HPA) axis, which helps to alleviate symptoms of premenstrual syndrome such as anxiety and mood swings.
• Iridoid glycosides: Iridoid glycosides, such as aucubin and acteoside, have been shown to have a sedative effect on the nervous system, which can help to reduce stress and anxiety associated with premenstrual syndrome.
• Phenylethanoid glycosides: Phenylethanoid glycosides, particularly acteoside and verbascoside, have been found to have anti-inflammatory and antioxidant properties, which can help to reduce symptoms of premenstrual syndrome such as breast tenderness and bloating.

Parts Used

The list below shows the primary parts of chaste tree used to make tinctures for premenstrual syndrome.

• Flowers: The flowers are used due to their high content of flavonoids and alkaloids, which are believed to have a regulating effect on hormonal imbalances associated with PMS.
• Seeds: The seeds are used because they contain a higher concentration of ursolic acid, a compound thought to have a balancing effect on the body's hormonal system, particularly for PMS symptoms.
• Leaves: The leaves are used due to their ability to stimulate the pituitary gland, which can help regulate hormonal imbalances that contribute to PMS symptoms.

Quick Recipe

The following recipe gives a procedure to make a basic chaste tree for premenstrual syndrome.

1. Harvest 1 part of dried vitex agnus castus flowers and 1 part of dried roots by cutting them with scissors.
2. Combine the harvested flowers and roots in a 1:1 ratio in a clean glass jar to create a mixture.
3. Cover the mixture with 2 parts of 80-proof vodka or brandy in the jar for a solvent.
4. Steep the mixture for 2 to 6 weeks in a cool dark place with occasional shaking every week.
5. Strain the tincture through cheesecloth into a clean glass bottle and discard the solids after 2 weeks.

2. Melissa officinalis

Lemon balm tinctures helps with premenstrual syndrome because its calming properties can alleviate symptoms of anxiety, irritability, and mood swings often associated with PMS.

The herb's natural relaxant effects help to soothe the nervous system, reducing feelings of tension and stress that can exacerbate PMS symptoms. Additionally, lemon balm's gentle anti-inflammatory properties may also help to ease breast tenderness and swelling common during this time.

By promoting relaxation and reducing discomfort, herbal lemon balm tinctures provide a natural and effective way to manage PMS symptoms.

Medicinal Constituents

The list below shows the primary medicinal constituents in Melissa officinalis tinctures that help with premenstrual syndrome.

• Rosmarinic acid: This phenolic compound acts as an anti-inflammatory agent, helping to reduce symptoms of premenstrual syndrome such as bloating, cramps, and mood swings.
• Luteolin: As a flavonoid with estrogen-modulating properties, luteolin may help alleviate premenstrual symptoms by regulating hormonal imbalances and reducing anxiety and depression.
• Oleanolic acid: This triterpenoid compound exhibits anti-anxiety and sedative effects, potentially helping to alleviate symptoms of premenstrual syndrome such as irritability, mood swings, and insomnia.

Parts Used

The list below shows the primary parts of lemon balm used to make tinctures for premenstrual syndrome.

• Leaves: Known for their calming and anti-anxiety properties, which help alleviate symptoms of premenstrual syndrome such as mood swings and stress.
• Stems: Contain a high concentration of essential oils, including linalool and linalyl acetate, which have a sedative effect and help reduce anxiety and restlessness.
• Flowers: Rich in melissa oil, which has a soothing effect on the nervous system, reducing anxiety, stress, and irritability associated with premenstrual syndrome.

Quick Recipe

The following recipe gives a procedure to make a basic lemon balm for premenstrual syndrome.

1. Gather 250 grams of melissa officinalis dried leaves and flowers for tincture production.
2. Combine the dried melissa officinalis with 750 milliliters of 25% ethanol for 2 weeks.
3. Steep the mixture at room temperature then strain the liquid using cheesecloth for 30 minutes.
4. Store the resulting tincture in a dark glass bottle with a tight-fitting lid at 15 degrees celsius.
5. Label and date the tincture then discard the solids and reserve the liquid for future use.

3. Hypericum perforatum

St John's wort tinctures helps with premenstrual syndrome because it has a natural ability to alleviate symptoms such as mood swings, irritability, and anxiety that often accompany PMS.

The herb contains hyperforin, a compound that has been shown to increase serotonin levels in the brain, helping to regulate emotions and reduce stress. Additionally, St John's wort has anti-inflammatory properties, which can help to ease physical discomforts such as bloating and breast tenderness associated with PMS.

By using a herbal tincture, women can find relief from these uncomfortable symptoms naturally, without relying on pharmaceutical medications.

Medicinal Constituents

The list below shows the primary medicinal constituents in Hypericum perforatum tinctures that help with premenstrual syndrome.

• Hyperforin: Hyperforin, a phloroglucinol derivative, has shown to exert anxiolytic and antidepressant effects, which can help alleviate mood swings, anxiety, and irritability associated with PMS.
• Naphthodianthrones: These compounds have potent antioxidant properties, which can help reduce oxidative stress and inflammation that may contribute to PMS symptoms, such as breast tenderness and mood changes.
• Flavonoids: Flavonoids, a type of phenolic compound, have anti-inflammatory and antioxidant properties, which can help alleviate PMS symptoms like breast pain, mood changes, and fatigue.

Parts Used

The list below shows the primary parts of st john's wort used to make tinctures for premenstrual syndrome.

• Leaves: Contain hyperforin, a compound that helps to regulate mood and reduce stress associated with premenstrual syndrome.
• Flowers: Rich in hyperforin and hypericin, which can help alleviate symptoms of depression and anxiety during the premenstrual phase.
• Roots: Contain a higher concentration of hyperforin and hypericin, making them a popular choice for tinctures aimed at reducing symptoms of premenstrual syndrome.

Quick Recipe

The following recipe gives a procedure to make a basic st john's wort for premenstrual syndrome.

1. Harvest 500g of fresh st john's wort flowers and leaves on a sunny day in mid-summer.
2. Dry the harvested plant material in a single layer for 1-2 weeks in a cool dark place.
3. Chop 250g of dried st john's wort into small pieces and place in a clean glass jar.
4. Add 1l of 60% ethanol to the chopped plant material and seal the jar tightly.
5. Steep the mixture for 2-3 weeks in a cool dark place, shaking the jar daily.

4. Paeonia suffruticosa

Tree peony tinctures helps with premenstrual syndrome because they contain natural compounds that help alleviate symptoms such as bloating, mood swings, and breast tenderness.

The herb's anti-inflammatory properties can reduce water retention and ease cramps, while its adaptogenic qualities promote emotional balance and stability. Additionally, tree peony has been shown to regulate hormones and improve overall menstrual health, making it a natural and effective remedy for women experiencing PMS symptoms.

By using herbal tinctures, women can find relief from the discomforts of PMS without relying on pharmaceuticals.

Medicinal Constituents

The list below shows the primary medicinal constituents in Paeonia suffruticosa tinctures that help with premenstrual syndrome.

• Flavonoids: These compounds have anti-anxiety and anti-inflammatory properties, which can help alleviate the emotional and physical symptoms associated with premenstrual syndrome.
• Saponins: Saponins in Paeonia suffruticosa have been shown to have a sedative effect, which can help reduce anxiety and promote relaxation, potentially alleviating some symptoms of premenstrual syndrome.
• Anthraquinones: Anthraquinones in Paeonia suffruticosa have been found to have anti-inflammatory and anti-spasmodic properties, which can help ease menstrual cramps and other physical symptoms associated with premenstrual syndrome.

Parts Used

The list below shows the primary parts of tree peony used to make tinctures for premenstrual syndrome.

• Roots: The roots of Paeonia suffruticosa are primarily used due to their high concentration of paeoniflorin, a glycoside that has been shown to have anti-anxiety and anti-inflammatory effects.
• Flowers: The flowers of Paeonia suffruticosa are used for their analgesic and anti-inflammatory properties, which help alleviate symptoms associated with PMS, such as cramps and mood swings.
• Leaves: The leaves of Paeonia suffruticosa are used for their anti-anxiety and sedative effects, which help reduce stress and anxiety associated with PMS.

Quick Recipe

The following recipe gives a procedure to make a basic tree peony for premenstrual syndrome.

1. Harvest 10-20 grams of fresh paeonia suffruticosa roots and leaves in the morning when the dew is still present.
2. Clean the harvested plant material thoroughly with a soft brush and gently wash with filtered water.
3. Chop the cleaned plant material into small pieces using a sharp knife to increase surface area.
4. Steep the chopped plant material in 250 milliliters of 45-50% ethanol in a clean glass container for 2-3 weeks.
5. Strain the tincture through a cheesecloth or a coffee filter into a clean glass bottle and store in a cool dark place.

5. Angelica sinensis

Dong quai tinctures helps with premenstrual syndrome because it has a regulating effect on hormonal imbalances, alleviating symptoms such as bloating, breast tenderness, and mood swings.

The tincture's antioxidant properties also help to reduce inflammation in the body, which can contribute to physical discomfort and fatigue during the premenstrual phase.

Additionally, dong quai is believed to stimulate blood flow and nourish the reproductive organs, promoting a healthy menstrual cycle and reducing symptoms of PMS.

Medicinal Constituents

The list below shows the primary medicinal constituents in Angelica sinensis tinctures that help with premenstrual syndrome.

• Iridoid glycosides: These compounds help alleviate premenstrual syndrome by exhibiting anti-anxiety and anti-depressant properties, reducing symptoms of mood swings and emotional distress.
• Ligustilide: As a primary component of Angelica sinensis, ligustilide acts to reduce spasms and ease menstrual cramp pain, providing relief from physical discomfort associated with premenstrual syndrome.
• Phenolic acids: These antioxidants help mitigate the oxidative stress associated with premenstrual syndrome, reducing inflammation and promoting a sense of well-being.

Parts Used

The list below shows the primary parts of dong quai used to make tinctures for premenstrual syndrome.

• Roots: They are the primary part used due to their high content of isoflavones, which are believed to have a balancing effect on hormonal fluctuations associated with PMS.
• Barks: The barks are also used, as they contain compounds that may help to relax and calm the body, reducing symptoms of PMS such as anxiety and mood swings.
• Leaves: The leaves are another part used, as they contain flavonoids and terpenoids that may help to regulate menstrual cycles and alleviate symptoms of PMS.

Quick Recipe

The following recipe gives a procedure to make a basic dong quai for premenstrual syndrome.

1. Harvest fresh angelica sinensis roots and clean them thoroughly under cold running water to remove dirt and debris.
2. Dry the angelica sinensis roots in a warm dry place for at least 2 weeks or use a dehydrator at 95°f.
3. Chop the dried angelica sinensis roots into small pieces and mix them with 80% vodka and 20% water in a clean glass jar.
4. Steep the chopped angelica sinensis mixture in the solvent mixture for 2 to 3 weeks in a cool dark place shaking the jar daily.
5. Strain the mixture through a cheesecloth or a coffee filter into another clean glass bottle discarding the solids and store the tincture in a cool dark place.

6. Crataegus monogyna

Hawthorn tinctures helps with premenstrual syndrome because it contains flavonoids, oligomeric proanthocyanidins (OPCs), and other bioactive compounds that have a calming effect on the body.

The tannins present in hawthorn help to reduce inflammation and relax uterine muscles, alleviating symptoms such as cramps, bloating, and breast tenderness. Additionally, the adaptogenic properties of hawthorn help to regulate hormonal fluctuations, reducing anxiety, mood swings, and emotional turmoil often associated with PMS.

By addressing these physical and emotional symptoms, hawthorn tinctures provide a natural and holistic approach to managing premenstrual syndrome.

Medicinal Constituents

The list below shows the primary medicinal constituents in Crataegus monogyna tinctures that help with premenstrual syndrome.

• Flavonoids: Flavonoids, such as quercetin and kaempferol, help alleviate premenstrual syndrome by reducing inflammation and oxidative stress in the body.
• Phenolic acids: Phenolic acids, such as chlorogenic and caffeic acids, possess antioxidant properties that help regulate hormonal fluctuations and alleviate symptoms of premenstrual syndrome, such as mood swings and bloating.
• Procyanidins: Procyanidins, a type of flavanoid oligomer, help regulate menstrual cycles by reducing menstrual cramps and promoting relaxation, thereby alleviating symptoms of premenstrual syndrome.

Parts Used

The list below shows the primary parts of hawthorn used to make tinctures for premenstrual syndrome.

• Leaves: The leaves are used for their anti-inflammatory and antioxidant properties to help alleviate symptoms of premenstrual syndrome such as anxiety and mood swings.
• Fruits: The fruits, also known as hawthorn berries, are used for their adaptogenic and antispasmodic properties to help regulate hormonal balance and reduce menstrual cramps.
• Barks: The bark is used for its antioxidant and anti-inflammatory properties to help reduce anxiety and stress associated with premenstrual syndrome.

Quick Recipe

The following recipe gives a procedure to make a basic hawthorn for premenstrual syndrome.

1. Harvest 250g of fresh crataegus monogyna leaves and twigs in the early morning on a dry day.
2. Chop the plant material into small pieces to release the oils and flavor compounds.
3. Combine the chopped plant material with 750ml of 45% ethanol in a clean glass jar.
4. Steep the mixture in a cool dark place for 2-6 weeks, shaking the jar every day.
5. Strain the liquid through a cheesecloth or coffee filter into a clean glass bottle.

7. Sambucus nigra

Elder tinctures helps with premenstrual syndrome because it offers a natural relief from symptoms such as bloating, mood swings, and anxiety.

The bioactive compounds present in elder flowers, like flavonoids and terpenes, have been shown to have a calming effect on the nervous system, reducing feelings of irritability and stress.

Additionally, the antispasmodic properties of elder tincture can help alleviate physical discomforts like cramps and bloating, promoting overall relaxation and well-being during the premenstrual phase.

Medicinal Constituents

The list below shows the primary medicinal constituents in Sambucus nigra tinctures that help with premenstrual syndrome.

• Flavonoids: Flavonoids, particularly quercetin and kaempferol, in Sambucus nigra tinctures have been shown to alleviate premenstrual syndrome symptoms by reducing inflammation and improving mood.
• Phenolic acids: Phenolic acids in Sambucus nigra tinctures have been found to have anti-inflammatory and antioxidant properties, which help to alleviate physical and emotional symptoms associated with premenstrual syndrome.
• Terpenoids: Terpenoids, specifically lignans, in Sambucus nigra tinctures have been demonstrated to have a potential anti-anxiety effect, which can help to reduce anxiety and stress associated with premenstrual syndrome.

Parts Used

The list below shows the primary parts of elder used to make tinctures for premenstrual syndrome.

• Flowers: The flowers are used to make tinctures due to their high content of isoflavones and other phytoestrogens, which help to regulate hormonal imbalances associated with PMS.
• Leaves: The leaves are used to make tinctures because they contain compounds that have anti-inflammatory and antioxidant properties, which help to alleviate symptoms of PMS such as bloating and mood swings.
• Fruits: The fruits are used to make tinctures due to their high content of vitamins, minerals, and antioxidants, which help to support hormonal balance, reduce inflammation, and alleviate symptoms of PMS.

Quick Recipe

The following recipe gives a procedure to make a basic elder for premenstrual syndrome.

1. Harvest the sambucus nigra flowers and leaves when they are fresh and in full bloom during summer months.
2. Clean and dry the plant material thoroughly to remove any dirt and moisture to prevent spoilage.
3. Combine 250 grams of the dried plant material with 750 milliliters of 95% ethanol in a glass jar.
4. Steep the mixture in a cool dark place for 2 to 3 weeks to allow the tincture to develop.
5. Strain the liquid through a cheesecloth into a clean glass container and discard the solids.

8. Valeriana officinalis

Valerian tinctures helps with premenstrual syndrome because of its ability to alleviate symptoms such as anxiety, insomnia, and restlessness.

The herb's natural sedative properties help regulate the body's hormonal balance, reducing feelings of irritability and mood swings. Additionally, valerian tincture can also help ease cramps and bloating, promoting a sense of calm and relaxation.

By addressing these physical and emotional symptoms, valerian tinctures offer a holistic approach to managing premenstrual syndrome, providing women with a natural and effective way to feel more balanced and in control throughout their menstrual cycle.

Medicinal Constituents

The list below shows the primary medicinal constituents in Valeriana officinalis tinctures that help with premenstrual syndrome.

• Isovaleric acid: Isovaleric acid, a short-chain fatty acid, helps alleviate premenstrual syndrome symptoms by reducing anxiety and promoting relaxation.
• Valerenic acid: Valerenic acid, a sesquiterpene, has a sedative effect on the nervous system, which can help alleviate symptoms of premenstrual syndrome such as insomnia and restlessness.
• Valerenol: Valerenol, a sesquiterpene, acts as a GABA receptor agonist, promoting a calming effect on the nervous system and reducing symptoms of anxiety and stress associated with premenstrual syndrome.

Parts Used

The list below shows the primary parts of valerian used to make tinctures for premenstrual syndrome.

• Roots: Valerian roots are the primary part used to make tinctures for premenstrual syndrome due to their high concentration of valerenic acid, a compound that helps with relaxation and stress relief.
• Roots: Valerian roots are also used for their sedative properties, which can help alleviate symptoms of anxiety and restlessness associated with PMS.
• Roots: The roots of Valeriana officinalis contain valeranone, a compound that has been shown to have a calming effect on the nervous system, making them a popular choice for PMS relief.

Quick Recipe

The following recipe gives a procedure to make a basic valerian for premenstrual syndrome.

1. Harvest valeriana officinalis roots and stems in the fall when the plant is in dormancy.
2. Chop the harvested plant material into small pieces using a sharp knife.
3. Combine the chopped plant material with 80% ethanol in a 1:3 ratio by volume.
4. Steep the mixture in a glass container for 2-6 weeks in a cool dark place.
5. Filter the tincture through a cheesecloth or coffee filter and bottle it in dark glass containers.

9. Gentiana lutea

Yellow gentian tinctures helps with premenstrual syndrome because it has a natural ability to soothe and calm the nervous system, alleviating symptoms such as anxiety, irritability, and mood swings.

Its bitter properties also help to regulate digestion and ease bloating and cramps commonly experienced during PMS. Additionally, yellow gentian's anti-inflammatory properties can help reduce water retention and breast tenderness.

By addressing these physical and emotional symptoms, yellow gentian tinctures provide a natural and holistic approach to managing premenstrual syndrome.

Medicinal Constituents

The list below shows the primary medicinal constituents in Gentiana lutea tinctures that help with premenstrual syndrome.

• Apigenin: This flavonoid acts as a natural anti-inflammatory and antispasmodic agent, which can help alleviate menstrual cramps and other physical symptoms associated with premenstrual syndrome.
• Gentianine: This alkaloid has been shown to exhibit anti-anxiety and sedative properties, which can help reduce emotional symptoms such as mood swings and irritability commonly experienced during premenstrual syndrome.
• Xanthones: These phenolic compounds have demonstrated antioxidant and anti-inflammatory activities, which can help mitigate hormonal fluctuations and reduce oxidative stress that may contribute to premenstrual syndrome symptoms.

Parts Used

The list below shows the primary parts of yellow gentian used to make tinctures for premenstrual syndrome.

• Roots: They are used to make tinctures for premenstrual syndrome due to their adaptogenic properties, which help in balancing hormonal fluctuations.
• Roots: They also contain bioactive compounds, such as gentiopicroside, that exhibit anti-inflammatory and antioxidant effects, providing relief from PMS symptoms.
• Roots: The roots of Gentiana lutea are traditionally used to ease menstrual cramps, mood swings, and other PMS symptoms due to their sedative and analgesic properties.

Quick Recipe

The following recipe gives a procedure to make a basic yellow gentian for premenstrual syndrome.

1. Gather 100 grams of dried root material and clean glass containers with tight-fitting lids for storage.
2. Combine the dried root material with 70% vodka and 30% glycerin in a 1:3 ratio by weight.
3. Store the mixture in a cool dark place for 2-6 weeks to allow for extraction.
4. Strain the liquid mixture through a cheesecloth or a coffee filter into the glass containers.
5. Label and store the finished tincture in a cool dark place for up to 2 years.

10. Ziziphus jujuba

Chinese date tinctures helps with premenstrual syndrome because of its unique combination of herbs that work together to alleviate symptoms such as bloating, breast tenderness, and mood swings.

The tincture's blend of Dong quai, Angelica sinensis, and Chinese dates helps to regulate hormonal imbalances and reduce water retention, resulting in a significant reduction in premenstrual discomfort.

Additionally, the herbs have been shown to possess anti-inflammatory properties, which can help to soothe cramps and alleviate overall PMS symptoms.

Medicinal Constituents

The list below shows the primary medicinal constituents in Ziziphus jujuba tinctures that help with premenstrual syndrome.

• Flavonoids: These plant compounds help alleviate premenstrual syndrome by reducing inflammation and modulating hormonal imbalances, thus providing relief from symptoms such as bloating and mood swings.
• Phenolic acids: Phenolic acids in Ziziphus jujuba have antioxidant and anti-inflammatory properties, which help reduce oxidative stress and inflammation associated with premenstrual syndrome, thus providing relief from symptoms such as breast tenderness and anxiety.
• Saponins: Saponins in Ziziphus jujuba have a sedative effect, which helps alleviate symptoms of premenstrual syndrome such as insomnia and anxiety by promoting relaxation and reducing stress.

Parts Used

The list below shows the primary parts of chinese date used to make tinctures for premenstrual syndrome.

• Fruits: The fruits are commonly used due to their high concentration of flavonoids and saponins, which have been shown to have a positive effect on hormonal balance and mood regulation.
• Barks: The barks are often used due to their high antioxidant content and ability to reduce inflammation, which can help alleviate symptoms of PMS such as anxiety and mood swings.
• Seeds: The seeds are commonly used due to their high content of isoflavones, which have been shown to have a positive effect on hormonal balance and may help reduce symptoms of PMS such as bloating and mood swings.

Quick Recipe

The following recipe gives a procedure to make a basic chinese date for premenstrual syndrome.

1. Harvest ziziphus jujuba fruits in late summer or early fall when they are fully ripe.
2. Clean and dry the harvested fruits to prevent contamination and preserve their potency.
3. Combine 1 part dried ziziphus jujuba fruits with 2 parts high-proof vodka in a clean glass jar.
4. Store the mixture in a cool dark place for 2 to 6 weeks to allow for extraction.
5. Strain the liquid through a cheesecloth or a coffee filter into a clean glass bottle.

What is the best combination of herbal tinctures to use for premenstrual syndrome?

The best combination of herbal tinctures that help with premenstrual syndrome is often a blend of Vitex (Chasteberry) and Dong Quai.

Vitex helps regulate hormonal imbalances and alleviate mood swings, while Dong Quai supports uterine health and eases menstrual cramps. Adding a small amount of Blue Cohosh can also help with cramp relief and promote a more balanced cycle.

This combination may also include a calming tincture like Passionflower or Lavender to further soothe symptoms and promote relaxation.

What ailments similar to premenstrual syndrome are treated with herbal tinctures?

Ailments similar to premenstrual syndrome that are treated with herbal tinctures are menopausal symptoms, perimenopause symptoms, and hormonal imbalances.

Herbs like Black cohosh, Dong quai, and Wild yam are used to alleviate hot flashes, night sweats, mood swings, and anxiety associated with menopause.

Other herbs such as Chasteberry and Red clover have been traditionally used to help regulate menstrual cycles and reduce symptoms of PMS-like conditions in women experiencing perimenopause or hormonal imbalances.