Understanding PMS
What is PMS?
Premenstrual syndrome, or PMS, is a complex and broad array of symptoms occurring in the second half of a woman’s cycle. Up to 150 symptoms – including psychological, neurological, hormonal, physical and emotional symptoms – may appear during PMS. Common symptoms include: mood swings, anxiety and depression, brain fog, cravings for sweet and/or salty foods, fatigue, joint and muscle pain, lack of interest in sex or social situations, headaches, insomnia, breast tenderness, bloating and weight gain.
Roughly 80% of women experience occasional premenstrual physical or emotional changes, with an estimated 30-40% having recurrent PMS symptoms. Although most women have mild symptoms, approximately 2.5 to 10% report PMS negatively impacts their lives in such a way that their work, relationships or home life suffers. If you are one of the many women who suffer from PMS, whether mildly or severely, it’s important to understand its causes, contributing factors, treatments and holistic interventions to reduce your symptoms and appreciate a healthier menstrual cycle.
Causes and Risk Factors
Although there is no single cause of PMS, there are many theories. Currently, it is believed brain chemistry changes that increase sensitivity to hormones may be the prevailing cause of PMS. This is because your menstrual cycle is controlled by various hormones and the complex interplay between your hypothalamus, pituitary and ovaries. When there is an imbalance of hormones during your cycle, it can lead to other theoretical causes.
Estrogen Dominance. In the second half of your cycle, called the ‘luteal phase,’ progesterone levels should naturally increase and peak just before menses. If you do not produce enough progesterone, or have increased levels of estrogen in the luteal phase, your body is estrogen dominant. This then leads to many other conditions that may contribute to PMS.
Congested Liver and Digestive Tract. Excess estrogen is processed by the liver and then sent to the digestive tract to be eliminated from the body. If you have an overworked or congested liver, estrogen cannot be properly broken down, leading to estrogen dominance. Additionally, if you suffer from constipation estrogen meant to be eliminated from the body will get recirculated into your body, contributing to estrogen dominance.
Thyroid Imbalance. When progesterone levels are low or your body is estrogen dominant, estrogen will block thyroid receptors in the body. This makes thyroid hormone less available to the body. Many PMS symptoms are similar to hypothyroid symptoms so thyroid dysfunction may also contribute to PMS.
Low Serotonin. On the flip side, a dramatic drop in estrogen during the luteal phase can actually decrease serotonin activity. Low serotonin can lead to headaches, irritability, depression and carbohydrate cravings – all symptoms of PMS.
Other risk factors for PMS include:
Deficiencies in vitamin B6, vitamins C and E, magnesium and zinc
Excessive consumption of dairy products, caffeine, sugars and refined flours
Being overweight
Inactivity
Blood sugar dysregulation
Stress
Stress as a Contributing Factor
There are many ways stress affects health, including the health of your menstrual cycle. This is because your adrenal glands are responsible for not only your stress response, but the production of sex hormones. When your body is under stress, the adrenal glands produce cortisol. In times of excessive stress, your adrenals will make less progesterone in favor of cortisol to keep up with your stress levels. As a result, chronic stress depletes progesterone which leads to estrogen dominance and increased risk of PMS symptoms.
Conventional Treatments
There are also several medications your doctor may prescribe if you suffer from PMS:
Oral Contraceptives – These medications suppress ovulation, keep hormones at a relatively constant level and minimize menstrual flow which may reduce PMS symptoms.
Antidepressants – Selective Serotonin Reuptake Inhibitors, SSRIs, may be used on the severe symptom days each month to reduce PMS symptoms.
Anxiolytics and sedatives – Anti-anxiety medications on an as-needed basis may help reduce anxiety and irritability.
Diuretics – These medications may help with bloating.
NSAIDs – When taken at the onset of menstruation, before the pain starts, it can reduce pain and cramping.
Pharmaceuticals could be a viable option if you suffer from severe PMS symptoms. However, keep in mind that all of the medications above also have side effects that create PMS symptoms including: nausea, breast tenderness, headaches, dizziness, drowsiness, mood changes, loss of sex drive, fatigue and weight gain.
Nutrition and Lifestyle Choices
Studies have indicated that women with PMS consume:
275% more refined sugar
79% more dairy products
78% more sodium
77% less magnesium
62% more refined carbohydrates
53% less iron
52% less zinc
If you are suffering from PMS, there are several nutrition and lifestyle changes you can make to reduce your risk factors, balance your hormones and reduce the severity and prevalence of PMS symptoms.
Increase Protein Intake – Women with PMS have been shown to have diets low in protein. Focus on plant proteins and lean, organic animal proteins to balance blood sugar, reduce inflammation and balance hormones.
Choose Carbohydrates Wisely – Eliminate sugars and refined carbohydrates which are associated with higher estrogen levels. Instead, focus on high fiber, complex carbohydrates which promote healthy serotonin production and elimination of excess estrogen.
Consume The Right Fats – Eliminate trans fats, reduce unhealthy omega 6 fatty acids from vegetable oils, and minimize sources of arachidonic acid from poultry, red meats and eggs. Instead, focus on consuming omega 3 fatty acids from fish oil and flax oil as well as healthy omega 6 sources such as evening primrose oil and borage oil to reduce inflammation and modulate estrogen levels.
Reduce Sodium and Stimulants – High consumption of sodium and caffeine aggravates bloating and fluid retention. Additionally, alcohol depletes B vitamins and magnesium, interferes with eliminating excess estrogen and is associated with more menstrual cramps.
Incorporate Exercise – Aerobic exercise as well as specific stretching and strengthening exercises may reduce PMS symptoms.
Supplementation
Additionally, the following supplements may reduce PMS symptoms.
B vitamins are cofactors of estrogen metabolism as well as serotonin production.
Magnesium is critical for adrenal health, estrogen metabolism and relaxing muscles to reduce cramps.
Vitex/Chaste Tree promotes progesterone production which can assist in balancing estrogen.
Calcium has been shown to significantly reduce PMS symptoms.
Vitamin E may minimize breast tenderness and menstrual cramps.
Keep in mind it can take three months to see positive effects from any nutrition or supplement changes. So be diligent with your new nutrition and supplement plan and patient with your results!
RESOURCES:
Women’s Bodies, Women’s Wisdom, Christine Northrup, MD
The Encyclopedia of Natural Medicine, Murray, ND & Pizzorno, ND
Women’s Encyclopedia of Natural Medicine, Tori Hudson, ND
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