The vast majority of women with PMDD will not require surgical treatment to experience resolution of symptoms. The diagnosis of PMDD must be confirmed
GnRH agonist therapy must be the only medical therapy that has been effective and it must have been effective continuously for a minimum of six months
Tolerance of estrogen replacement therapy has been tested
The woman does not desire further children
The womans age warrants several more years of therapy

Adjunctive and Alternative Treatments
Other proposed treatments include dietary modification, herbal remedies including St Johns Wort and chasteberry, acupuncture, and exercise. Some evidence suggests caffeine, sugar and alcohol intake may increase PMS symptoms. A review article claimed significant improvement of PMS symptoms with herbal treatments and acupuncture but the studies selected for review did not stratify severity of symptoms. Finally, the American College of Obstetricians and Gynecologists recommends regular aerobic exercise to reduce PMS symptoms. History
In the 18th century, there were early accounts of weeping and other symptoms recurring almost every month, and in 1822 Prichard gave this description: "Many women … display a degree of excitement and irritation … at the period of menstruation; these are chiefly females of very irritable habits. In such instances, … an unusual vehemence of feeling and expression is observed … or there is torpor and dejection of mind with a despondent disposition". In 1827 a German mother was acquitted of infanticide on the grounds of menstrual mood disorder. Premenstrual tension was also described in the French literature of the early 19th century.
Supplements
α-GAL derived from the mold Aspergillus niger is an active ingredient in products marketed to reduce stomach gas production after eating foods known to cause gas. It is optimally active at 55°C, after which its half-life is 120 minutes.There are scores of supplements containing the enzyme over the counter in the United States and many more world wide. Products with α-galactosidase include:

Beano
CVS BeanAid
Enzymedicas BeanAssist
Gasfix
Bloateez (in India as Cogentrix)

See also
β-galactosidase
Migalastat, a drug targeting α-galactosidase
Classification of α-galactosidases (according to CAZy)

References
Further reading
External links
alpha-Galactosidase at the US National Library of Medicine Medical Subject Headings (MeSH)
Human GLA genome location and GLA gene details page  in the UCSC Genome Browser.This article incorporates text from the United States National Library of Medicine, which is in the public domain.