Premenstrual Syndrome (PMS) is one of the most common menstrual-related concerns experienced by women. So common in fact that it’s seen as just a part of “being a woman”, a normal monthly experience we all just need to accept & go through. In reality, this couldn’t be more incorrect. Whilst experts are still not entirely sure how or why women experience PMS, partly due to the wide diversity of collective symptoms, current research seems to have an understanding about specific sets of symptoms & their underlying causes. In today’s blog post we delve into what defines PMS, possible underlying causes & most importantly what we can do to reduce it.

What defines Premenstrual Syndrome (PMS)

PMS is defined as a range of physical, emotional & behavioural symptoms which appear in the lead-up to menstruation, typically up to 10 days before your period begins. Yes 10 days! Symptoms can range from very mild to severe, where women can experience such intense PMS symptoms it impairs their ability to go about daily life, this would typically be referred to as PMDD. Most women will experience some or a combination of PMS symptoms in their lifetime.

Here are the most common PMS symptoms experienced by women…

• anxiety
• irritability
• low mood
• depression
• acne & pimples/blemishes
• weepiness
• bloating
• brain fog
• food cravings (usually for sugary or salty foods)
• fluid retention
• breast tenderness
• sinusitis
• headaches
• insomnia
• dull lower back pain
• joint pain
• fatigue & lethargy

What Causes PMS?

There are a number of suspected underlying triggers of PMS & the vast array of symptoms (& symptom clusters) attached to it. Here are a few suspected underlying causes of PMS in many women:

Imbalance Between Oestrogen & Progesterone

Oestrogen & progesterone are both essential sex hormones that contribute to our overall health not just our menstrual health. They both have positive effects on our mood, energy & menstrual cycles but only when they are in balance with one another.  Oestrogen is a stimulatory hormone. It is known to increase energy, enhance stamina & libido as well as support the growth of the endometrial lining. Progesterone acts as an inhibitory hormone & provides a buffer from the fluctuations (& intensity) of oestrogen. Without progesterone we experience the overwhelming nature of oestrogen. Which may result in symptoms such as anxiety, irritability, insomnia, headaches, fluid retention & heavy periods. It’s a “too much of a good thing” type of situation.  For many women supporting progesterone is a key factor for reducing PMS symptoms.

There are many underlying reasons oestrogen & progesterone can be out of balance. It is important to investigate this fully with a qualified practitioner in order to commence an appropriate & individualised course of treatment.

Inflammation 

Inflammation has been linked to an increased risk of experiencing a number of PMS  symptoms including mood changes, abdominal/back pain, breast pain, bloating & weight fluctuations. Research has suggested a disrupted metabolism of prostaglandins (inflammatory mediators) is among one of the triggers of PMS symptoms in some women. Inflammation is also a well known contributing factors to mental health concerns, including those that occur premenstrually, due to its influence on serotonergic function. Evening primrose oil, omega 3 & curcumin are among the most evidence-based anti-inflammatory treatment strategies for PMS.

Chronic Stress

Chronic stress truly is the nemesis to good health, there really is no system in our body that isn’t affected by ongoing chronic stress.  Stress has a direct effect on inflammatory mediators & as mentioned above, inflammation has been shown to negatively impact menstrual cycles in a number of ways.

Stress also impairs our HPA/HPT/HPO axis (aka OAT axis), the communication system between our brain & our endocrine system (adrenals, thyroid & ovaries). One major way stress impacts the functioning of these axes is by preferencing the production of cortisol over progesterone in order to cope with the ongoing stressors. Stress is a survival mechanism, making babies is not.

Nutrient Deficiencies

Common nutrient deficiencies which have can exacerbate PMS include iron, Vitamin D, selenium, iodine, magnesium, B vitamins, zinc, calcium…just to name a few. If you suspect you have a nutrient deficiency please consult a qualified practitioner for diagnosis & appropriate treatment.

How Can I Best Manage PMS?

There are a number of dietary & lifestyle strategies you can implement in order to lessen PMS symptoms & support your natural hormonal fluctuations.

Therapeutics

Chaste tree (Vitex agnes castus)

Chaste tree is one of the most well researched & effective herbal medicines with regards to improving symptoms associated with PMS. There are a number of mechanisms that have been investigated including:

• directly influencing dopamine receptors to support mood, motivation & energy
• support a natural reduction in oestrogen & increase in progesterone levels
• supporting corpus luteum function & development in order to encourage optimal progesterone production.

Magnesium (& Vitamin B6)

Magnesium & Vit B6 is often the first thing I prescribe to all my PMS clients, regardless of what symptoms they are experiencing. It’s been suggested that magnesium deficiency is in fact a common underlying cause & aggravating factor in PMS. Magnesium helps to calm our nervous system & supports our OAT axis by buffering the effects of stress & remember stress is a HUGE underlying trigger of PMS. Magnesium is also essential for supporting stable blood sugar & insulin levels. B6 is an essential cofactor for the production of serotonin & dopamine & supports the function of magnesium in the body

Other therapeutics that have been shown to relieve PMS include:

• Omega 3
• Evening Primrose Oil
• Calcium
• Vitamin E,
• Paeonia lactiflora. 

Lifestyle

Reduce intake of inflammatory foods & beverages (sugar, alcohol, refined vegetable oils)

Include more foods which promote anti-inflammatory activity in the body such as avocados, salmon, green leafy vegetables, flaxseeds, nuts, fresh herbs & spices. Reduce intake of saturated fats (red meat, dairy, processed meats), refined sugars, alcohol & processed vegetable oils.

Maintaining healthy gut flora

Our gut flora has a significant influence over the metabolism & excretion of oestrogen. Poor gut flora is a major contributor to hormonal imbalance. One of the most powerful food groups you can incorporate to support & improve gut flora is fibre. All kinds, all types, all the fibre!!! Fibre not only ensures bowel regularity but supports the balance of microbes in the gut which have a strong influence over menstrual health.

We’ve written all about dietary fibre & how to increase it in your diet here. https://www.vivehealth.com.au/blog/2019/05/29/dietary-fibre-key-long-term-health/

Manage stress

Implementing self-care time, whether that’s 5 or 50 minutes per day, can have significant influence over your hormonal health. Include any activity you know helps you relax. Some examples may include:

• having a bath (even add a cup of Magnesium flakes an extra boost & a few drops of essential oil)
• meditating (even 5 minutes per day has been shown to have magical benefits) & deep breathing
• reading a book
• going for a walk, fresh air is always a winner.

Rest & Sleep

Having a healthy sleep routine should really be a core priority in every women’s life. Our bodies are creatures of habit & absolutely thrive off routine, hence why going to bed & rising at the same time can really improve sleep onset & quality long-term. If you are having trouble getting enough shut eye a few small changes you can make to improve sleep onset & quality include:

• At least 1 hour before bed turn off all electronic devices to reduce your exposure to blue light (i.e. try reading instead of watching T.V.)
• Avoid drinking caffeinated beverages (i.e. coffee & black tea) after lunchtime (12pm-2am)
• Have a warm shower or bath 30min before bed
• Use a few drops of lavender essential oil in an aromatherapy diffuser
• Have a calming cuppa. Some relaxing herbal teas I recommend include – Chamomile, Passionflower, Holy basil, Scullcap

Seek Assistance

Above all else, one of the very best things you can do is seek help from a professional. If you would like to get to the bottom of your PMS please do get in touch.  Book your initial consultation here or contact Vive on 3399 1002 for further information.

Mindy Pearson is a clinical Naturopath with special interests in menstrual & hormonal health, preconception & intuitive eating.  Mindy is available for consultations via the Vive Clinic on Mondays & Wednesdays.

To book a consultation with Mindy click here.

Reference available upon request!