If you’ve every had a conversation with a group of friends about PMS you probably found that no two of you experience it exactly the same. Why is that? Well, it’s mostly because no two of us are exactly alike hormonally even though we all experience a menstrual cycle under normal healthy conditions. But we also have different lifestyles, health patterns or issues all of which can influence how we experience our menstrual cycle.
Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, food cravings, fatigue, irritability and depression. It’s estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.
But what is PMS anyway and why do we get it?
While some will tell you we don’t know what causes PMS, most knowledgeable people in the field agree that at it’s very basic level the symptoms you feel are at least in part the result of the fluctuation between estrogen and progesterone. When one or the other rises or declines in a way that makes the other go off kilter you’ll experience some negative effect like cramps or bloating. Now there’s a lot of discussion about other non menstrual related influences that can cause or make PMS worse like estrogen dominance but at its’ core PMS is a hormone imbalance problem. Two in particular: estrogen and progesterone.
These two hormones truly rely on each other to keep the other one in check. As you get older, really past prime childbearing years in your mid 30’s, those symptoms can get worse and intensify. The fatigue that used to last a couple of days now lasts a week and nothing you do seems to make it any better.
As you menstruate estrogen and progesterone naturally shift, but there are many things that exacerbate these hormone imbalances, such as a high-sugar, refined carbohydrate diet, caffeine, stress, dairy, hormones in dairy products and meat, and estrogen-like toxins from pesticides and pollution. Alcohol also contributes to problems because it damages the liver and prevents it from excreting excess estrogen. Low levels of vitamins and minerals, constipation and imbalances in the gut bacteria – these can also worsen the situation, because they lead to the reabsorption of estrogen from the gut back into your blood, even after your liver has tried to get rid of it.
Symptoms of PMS
For most women, symptoms tend to recur in a predictable pattern over time, especially when you’re younger. That’s why when you and your friends talk about it, you may get cramps while your best friend doesn’t, but you can both say exactly when they’ll come each month. The physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense and can very much be influenced by diet, alcohol, sleep and other things. And their intensity can be greater as you age.
The list of potential signs and symptoms for premenstrual syndrome is long and variable, but most women only experience a few of these problems as hormones fluctuate.
Emotional and behavioral symptoms
- Tension or anxiety
- Depressed mood
- Crying spells
- Mood swings and irritability or anger
- Appetite changes and food cravings
- Trouble falling asleep (insomnia)
- Social withdrawal
- Poor concentration
Physical signs and symptoms
- Joint or muscle pain
- Weight gain related to fluid retention
- Abdominal bloating
- Breast tenderness
- Acne flare-ups
- Constipation or diarrhea
Also true about hormone fluctuations although perhaps less clear, are the changes in hormones and the resulting experience of mood swings and even depression. For these symptoms chemical changes in the brain may also be involved. But don’t forget your hormones effect your brain, so while you may not relate those symptoms to hormones directly they certainly are a cause. Stress and emotional problems, such as depression, do not seem to cause PMS, but they may make it worse as your hormones go sideways.
Now the question becomes how do you deal with PMS? Is it something you just have to accept, maybe go to your doctor for a drug? Nope, there’s actually a lot you can do to mitigate or even eliminate PMS altogether. It takes some effort but once you get the hang of it, like anything else it gets easy. And the reward is a body you have control of.
Clean up your diet.
- Stop eating refined flour, sugar, and processed foods.
- Cut out caffeine.
- Stop drinking alcohol.
- Balance your blood sugar by eating protein, such as a protein shake, eggs, and nut butters, for breakfast.
- Eat evenly throughout the day and don’t skip meals.
- Don’t eat within three hours of bedtime.
- Cut out all dairy and consider eliminating other common allergens for a few months, especially gluten.
- Increase fiber in your diet from vegetables, fruit, nuts, seeds, beans, and whole grains. Two tablespoons of ground flax seeds a day are especially helpful in correcting constipation and balancing hormones. Put them in a shake or sprinkle them on salads or food.
- Increase omega-3 fats by eating more wild fish like sardines, herring, and wild salmon, as well as omega-3 eggs and walnuts.
- Eat organic food, especially animal products, to avoid environmental estrogens from pesticides.
A number of supplements have been shown to help ease PMS symptoms by improving metabolic function and hormone metabolism. Here are the superstars:
- Magnesium citrate or glycinate — Take 400 to 600 mg a day.
- Calcium citrate — Take 600 mg a day.
- Vitamin B6 — Take 50 to 100 mg a day along with 800 mcg of folate and 1,000 mcg of vitamin B12.
- Evening primrose oil — Take two 500mg capsules twice a day.
- EPA/DHA (omega 3 fats) — Take 1,000 mg once or twice a day.
- Taurine — Take 500 mg a day to help liver detoxification.
- A good daily multivitamin (all the nutrients work together)
Herbs and phytonutrients can also be very helpful. Here are the best studied and most effective:
- Chasteberry fruit extract (Vitex Agnus-astus) can help balance the hormones released by the pituitary gland that control your overall hormone function. Studies of over 5,000 women have found it effective. Take 100 mg twice a day of a 10:1 extract.
- Wild yam (Dioscorea villosa) and cramp bark (Viburum opulus) can help regulate cycles and relieve menstrual cramps.
- Dandelion root can help with liver detoxification and works as a diuretic.
- Isoflavones from soy, red clover, or kudzu root improve estrogen detoxification by boosting the activity of specific detox enzymes. They can be taken as supplements or consumed in the diet.
- Flax seeds contain lignans that help balance hormone metabolism and block the negative effects of excess estrogens.
- Chinese herbal formulas may also help. One of the most effective is Xiao Yao San, or Rambling Powder. It contains: Bupleurum Root (Bupleurum chinense), Chinese Peony Root (Paeonia lactiflora), Dong Quai Root (Angelica sinensis), Bai-Zhu Atractylodes Root (Atractylodes macrocephala), Poria Sclerotium (Poria cocos), Ginger Rhizome (Zingiber officinale), Chinese Licorice Root (Glycyrrhiza uralensis),and Chinese Mint Leaf (Mentha haplocalyx)
- Replacing healthy bacteria in the gut also helps normalize estrogen and hormone metabolism. Take 5 to 10 billion live organisms in a daily probiotic supplement.
- For intractable cases, I will occasionally use topical, natural bioidentical progesterone in the last two weeks of the menstrual cycle. The usual dose is 1/2 tsp (20 to 40 mg) applied at night to thin skin areas for the last two weeks of the menstrual cycle.
Exercise is very important for balancing hormones. Aim for 30 minutes of aerobic exercise, 4 to 5 times a week.
Dealing with stress is also critical. Take a hot bath at night, get a massage, try yoga, learn deep breathing or meditation. These techniques and others can help balance hormones.
The bottom line is while PMS may be part of having a menstrual cycle, you don’t have to let your whole life be taken over by it. You can make even some of these changes and make a difference.
Daily Wellness Team