PMS (Pre-Menstrual Syndrome)

You may be one of the nearly 80% of menstruating women who experience Pre-Menstrual Syndrome or PMS for up to 2 weeks before each period. Fluctuating hormone levels trigger emotional and physical symptoms which can include any of 150 different symptoms.

The exact cause of PMS, headaches and depression are unknown. In fact, it is not known why some women have severe symptoms, some have mild ones, while others have none. It is generally believed that PMS, migraine and depression stem from neuro-chemical changes within the brain. Hormonal factors, such as oestrogen levels, had not been appreciated until recent studies.

The female hormone oestrogen starts to rise after menstruation and peaks around mid-cycle (ovulation). It then rapidly drops only to slowly rise and then fall again in the time before your period starts.

Oestrogen holds fluids and with increasing oestrogen levels comes fluid retention: many women report weight gains of five pounds premenstrually. Oestrogen affects your central nervous system, it can contribute to increased brain activity and even seizures. Oestrogen can also contribute to retention of salt and a drop in blood sugar. PMS patients and migraine sufferers benefit from reducing both salt and sugar in their diet.

These changing hormone levels can bring on a range of symptoms.

Most commonly, women report feeling “out-of-control”, anxious, depressed, having uncontrollable crying spells, headache and fatigue. Symptoms may vary from month to month and there may even be symptom-free months.

You may experience physical symptoms such as headache, migraine, fluid retention, fatigue, constipation, painful joints, backache, abdominal cramping, breast tenderness, heart palpitations and weight gain.

Emotional and behavioural changes may include anxiety, depression, irritability, panic attacks, tension, binge eating, anger, mental confusion, impaired co-ordination, inability to concentrate, and reduced libido. Most women will experience both physical and emotional symptoms.

There are four main “types” of PMS.

Originally described in 1931 by an American neurologist, the grouping of symptoms has remained the same since then:

A- Anxiety: symptoms of anxiety, crying without reason, irritability and mood swings sometimes verbally and/or physically abusive.

C- Cravings: symptoms of food cravings usually for sweets or chocolate, dairy products, alcohol or food in general; headaches; fatigue; dizziness and palpitations. Blood sugar imbalances.

D- Depression: symptoms of depression, fearful, paranoia, withdrawn, crying, forgetfulness, clumsy, confusion, insomnia.

H- Heaviness or Headache: symptoms of fluid retention leading to headache, weight gain, sore breasts, abdominal tenderness and bloating, swollen hands and feet.

Your symptoms may tend to ease off with the start of your period and you may remain symptom-free until the two weeks or so prior to your next period. The most important indication of PMS is the cyclic nature of your symptoms. There is usually a symptom free time period 1 week after your period ends. If you do not have a time free of symptoms then you may not have PMS and should investigate further with your G.P.

There are no laboratory tests that make identification of PMS simple. Correct diagnosis is important, so that you can choose the best way to help deal with the symptoms. The best way to find out if you have PMS is to keep a diary. You can use a symbol to signify the two or three worst symptom, for example:

B=breast tenderness, H=headache, I=irritability & P= the days of your period.

You should keep your symptom diary for at least 3 months. Just as symptoms vary from woman to woman they may also vary with each of your cycles.

Nutritional Supplements that could help. (Refer to the individual supplement for cautions in use.)

You need to make sure you are getting enough vitamin B6, magnesium and zinc. Scientists have now established that the conversion in the body of GLA to prostaglandins depends on adequate B6, magnesium and zinc.

Supplement/Herb What it does Dosage
Omega 6 Fatty Acids (GLA) GLA from evening primrose, starflower or borage oil has been shown to improve many symptoms including pre-menstrual headaches, depression, irritability, and bloating. Use in conjunction with omega 3 fatty acids – see below. 150 – 450mg GLA per day
Omega 3 Fatty acids (fish oil, flax oil) A balance of Omega 3 and Omega 6 fatty acids are needed for correct hormone function and production of progaglandins. 1000 – 3000mg fish oil or equivalent per day
Methionine May help with the removal of excessive oestrogen from the body, approximately 70% of PMS cases are due to high oestrogen levels.Best results may be obtained when methionine is combined with additional B6 and dietary fibre (fibre aids the removal of detoxified oestrogen via the gut). 500 – 1000mg per day (away from food)
Vitamin B6 Vitamin B6 is an important co-enzyme for your body. Your liver requires B6 to break down and deactivate oestrogen. Therefore providing your body with sufficient B6 will help your body naturally balance your oestrogen levels. Your body also uses B6 when releasing the brain’s neurotransmitters, dopamine and serotonin, so it may help with depression and mood swings. Vitamin B6 can reduce food cravings as the metabolism of carbohydrates and proteins also require B6. Women have also found B6 useful for reducing bloating.

Vitamin B6 is also necessary for incorporating calcium into bone and may therefore also reduce osteoporosis. Vitamin B6 may also reduce carpal tunnel syndrome. B6 and folate together reduce women’s risk of coronary artery disease.

50 – 100mg per day
Magnesium Magnesium deficiency has been noted in women with PMS. Magnesium is particularly helpful in relieving breast tenderness. Chocolate, especially dark chocolate, is a natural source of magnesium, and that maybe the root of many women’s PMS chocolate cravings. Magnesium is important for hormone production and transformation as well as the proper use of calcium and vitamin D. Providing your body with magnesium gives your body the tools it needs to balance your hormones.

Magnesium supplementation can also help prevent kidney stones, migraine headaches, seizures, dizziness, twitching, tremors, noise aversion, high blood pressure, osteoporosis, heart rhythm disturbances, and muscle weakness. Normal cardiovascular function depends on adequate magnesium intake.

200 – 600mg per day
Dong Quai Dong quai is thought to have a balancing effect on female hormones and it may help with PMS, where oestrogen levels can fluctuate from high to low. Dong quai is thought to improve circulation to the reproductive organs, reduce menstrual cramps, prevent blood clots and regulate the timing of menstruation. Do not taking it during menstruation. 100 – 300mg per day
Agnus Castus Agnus castus contains non-hormone compounds which act on the pituitary gland and are useful for balancing female hormones. It raises progesterone levels and lowers oestrogen levels which are often out of balance. 500mg twice daily
St Johns Wort St Johns Wort contains several compounds including hypericin, hyperforin, flavonoids and volatile oils. Hypericin and hyperforin are thought to be the key active constituent that affect mood making it a very effective natural anti-depressant. It is also anti-viral and anti-bacterial. 500mg to 1500mg per day
Agnus Castus, Wild Yam & Passionflower Useful for Type A – anxiety PMS Use in combination as directed
Siberian Ginseng, Motherwort, Liquorice Useful for Type C – cravings PMS Use in combination as directed
Red Clover, Damiana, Sage Useful for Type D – depression PMS Use in combination as directed
Agnus Castus, Wild Yam, Dandelion Leaf Useful for Type H – heaviness PMS Use in combination as directed

 

Diet and Lifestyle Factors

 

There are three key elements to managing PMS – diet, exercise and supplements. The good news is that the same changes you need to make to reduce your PMS symptoms will improve your overall health. Work on these life changes slowly and steadily, and you will feel better every month.

Diet

Keeping even blood sugar levels throughout the month helps minimise PMS. Headaches and depression can be caused by fluctuating blood sugar levels, so eat little and often, and snack on fruit.

Try eating six small meals at regular three-hour intervals, high in complex carbohydrates and low in simple sugars. Have protein (fish, yoghurt, lean meat, soya) and fibre (vegetables, fruit, wholegrains) at each meal. This helps to maintain a steady blood sugar level and avoid energy highs and lows.

Substantially reduce or if you can, eliminate caffeine, alcohol, salt, fats, and simple sugars to reduce bloating, fatigue, tension and depression. For many women cutting out dairy products is helpful.

Caffeine can increase irritability, mood swings, and anxiety. Caffeine depletes vitamin B which can contribute to hormone imbalance. Caffeine causes your blood sugar to go up, and then when it wears off, your blood sugar drops dramatically. Water instead of a caffeinated drink helps maintain a smoother balance. Water actually reduces bloating and swelling and helps your body eliminate toxins and so remain chemically balanced. Aim to drink 3 to 4 pints of water a day. Drink little and often through the day so that your body has time to assimilate the fluid correctly.

PMS symptoms may include fatigue and insomnia, making it difficult to resist using caffeine as a pick-me-up. Caffeine can create a dependency and if you stop drinking it abruptly, you may suffer from caffeine-withdrawal headaches or flu-like symptoms. Slowly reducing the amount of caffeine you consume on a daily basis will help.

Try to reduce your alcohol consumption. The biochemical changes in the body during PMS may make it harder for your liver to process alcohol, so you may feel hangover effects after fewer drinks. Alcohol can increase hormone imbalance by impairing liver function. It may also increase the physical and psychological depression that can come with PMS.

Many women have an increased desire for alcohol during PMS. It can be tempting to deal short-term with the stress and symptoms of PMS with alcohol or drugs. However, this tactic risks compounding the longer term problem, putting your body more out of balance.

Try to include soya products such as tofu and soya milk in your diet. Soya contains substances called phyto-oestrogens which research has shown to positively affect hormonal function. Phyto-oestrogens, mainly two called genistein and daidzein act as weak oestrogens in the body but in a very special, balancing way.

If your natural oestrogen levels are low, they will lock onto oestrogen receptor sites on cells and act as weak oestrogens, thereby raising levels, which could be particularly useful during menopause. Conversely, if your oestrogen levels are high (which can cause premenstrual symptoms), they lock onto the receptors and actually block them from receiving excess oestrogen or toxic chemicals from the environment e.g. pesticides or plastics which have oestrogen-like effects. Eating soya produce regularly has been shown to reduce menopausal symptoms, PMS and hormone-related cancers such as prostate.

Essential Fats or Essential Fatty Acids (EFAs) are polyunsaturated fats that are necessary for a healthy lifestyle. Your body can not produce EFAs from other substances, so food or dietary supplements must supply them. You may already be familiar with the nutritional benefits associated with the omega-3 fatty acids, EPA and DHA, found in fish oils.

Omega-6 fatty acids are also essential to good health, particularly Linoleic Acid and Gamma-Linolenic Acid (GLA). Both omega-3 and omega-6 fatty acids are necessary for optimal health because they are converted to different substances that have different physiological effects in the body.

EFAs are converted in your body to prostaglandins. Prostaglandins are short lived, active, hormone-like compounds that are present in every cell and regulate cellular activity including inflammatory response, energy production, growth and tissue repair, blood pressure regulation and fat metabolism. They are important in reducing inflammation and that is why EFAs are especially effective for some women in reducing breast tenderness and headaches. EFAs also relive menstrual cramps for many women.

You can get EFAs in your diet by eating oily fish such as tuna, sardines, salmon, trout, mackerel, herrings, and nuts and seeds including pumpkin, sunflower, sesame and linseeds. Pumpkin seeds contain EFAs and magnesium, both of which have been shown to help with PMS.

Most people do not get enough EFAs from their diet to support their needs. The reason we don’t get enough of these EFAs is that they are more delicate and perishable than other oils so the food industry doesn’t use them. It is recommended that you supplement using a good quality oil such as Essential Balance or Hemp Oil. You can use EFA oil as a salad dressing, on cooked pasta so it doesn’t stick together, on cooked food or off the spoon. EFA oil must be kept in your fridge and never heated, as you will destroy the structure of the oil.

Food cravings can mean that PMS is a real diet buster. But remember, it’s how you eat the entire month that matters. Give yourself credit for what you do accomplish. As you get your PMS under control and bring your body’s nutrients into balance it will be easier to control your eating on PMS days.

Exercise

Exercise produces endorphins that relieve pain, improve mood and reduces stress and tension. It provides a sense of well-being and improves blood circulation. Some experts believe that women with more PMS problems have lower endorphin levels. This makes exercise a particularly effective treatment to relieve PMS and restore balance.

Try to exercise at least three times weekly for 20-30 minutes. Aerobics, walking, jogging, bicycling, swimming, dancing, yoga, pilates and martial arts are all good ways to exercise. Exercise should be fun, challenging enough to take you out of yourself and give you a good time. Try to vary your scope of exercise activities so that you enjoy what you do.

Exercise to reduce your stress levels! Stress can trigger PMS and exacerbate the worst PMS symptoms. Awareness of PMS reminds you to schedule stressful meetings or tasks for other times. Give yourself extra time to relax and be pampered. PMS creates its own stress as symptoms disrupt your lifes and relationships. Many women are very, very busy taking care of children, spouses, family members, neighbours, bosses and co-workers. Remember to take the time you need for yourself, to both exercise and relax.

Stress

It is worth mentioning that high stress levels will affect your reproductive hormones. Your body makes hormones from basic “building materials”. If you are stressed then your body will use the building materials to manufacture stress hormones such as adrenalin and cortisol. If your body is making a lot of stress hormones, then there will be less building materials available for making reproductive hormones.

It is important for your reproductive and general health to reduce your stress levels and to learn ways in which you can healthfully manage the stress in your life.

Homoeopathic Remedies which may help:

  • Actaea Rac
  • Calcarea carbonica
  • Chamomilla
  • Lachesis
  • Lycopodium
  • Natrum muriaticum
  • Nux vomica
  • Pulsatilla
  • Sepia

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