It’s almost that time of the month, you know it’s coming because you are feeling irritated at the world. You are bloated, your breasts are sore and you are probably craving sweets. If this is you, keep reading because you might be struggling with PMS.
What is PMS
PMS is the abbreviation for Premenstrual Syndrome. It can be recognised by the physical and psychological symptoms occurring for up to two weeks before menses. It can start anytime from ovulation and lasts until the start of menses or into the first few days of the flow.
Causes of PMS
The precise cause of PMS remains unknown. However, there are many proposed theories, which include:
- Cycling of hormones: hormonal levels change during the menstrual cycle which may affect some women. These disappear during pregnancy and menopause.
- Abnormal hormone levels or hormonal imbalances: this is particularly the case when there is an excess in oestrogens and/or a deficiency in progesterone, or an oestrogen deficiency and thyroid disorders may be responsible.
- Inconsistency in prostaglandins or neurotransmitters: prostaglandins are hormones created at the site of an injury or problem. Prostaglandins cause pain, fever, and inflammation which assist with the healing process.
- Chemical changes in the brain: Serotonin is a chemical (neurotransmitter) in the brain which plays a crucial role in your mood state. When serotonin fluctuate it could trigger PMS and may contribute to depression, fatigue, food cravings, and sleep problems.
- High levels of prolactin: Prolactin is responsible for breast milk production, and plays a role in ovulation, reproduction and blood cell formation. When levels are too high (hyperprolactinemia) you may experience irregular or an absent menses, menstrual cycle irregularities and side effects.
- Abnormal stress response system (Hypothalamic Pituitary Adrenal (HPA) axis): The bodies response to stressors plays a vital role in the menstrual cycle and hormonal levels.
- Nutrient deficiencies: Especially Vitamin B6, E and A, calcium and Magnesium. Your body cannot function correctly and make hormones if it doesn’t have the nutrients it requires.
- Inappropriate diet: Poor quality nutrients affects the way your body works. Too much sugar, salt, caffeine, alcohol, red meat, processed or fatty foods can influence your menstrual cycle and it’s symptoms.
- Environmental factors: Pollution, Xenoestrogens (synthetic or natural compounds that imitates oestrogen), pesticides, plastic etc.
There are also factors that may worsen your symptoms, these include:
- High stress levels: Any stressful situation such as a bad relationship, life changes, poor or stressful work environment, and so forth may worsen your PMS symptoms.
- Depression: Women who suffer with depression may have more severe PMS symptoms. Although, depression alone does not cause all the symptoms.
- Physical factors: Being under or overweight affects your hormonal levels and function of your menstrual cycle. PMS may also be made worse by other conditions such as endometriosis, thyroid disease, or IBS.
- Psychological factors: Negative attitudes towards menstruation, a history of sexual abuse and a sense of personal disempowerment or low self-esteem may worsen your symptoms.
- Cultural/Society factors: Cultural/social expectations and the idea that menstruation is seen as dirty or disgusting may lead to a negative or embarrassed attitude towards menstruation which again may lead to an increase in symptoms.
- Lifestyle: Smoking and not enough exercise or sleep may also play a role.
Symptoms
There are many different ways in which PMS shows itself. The symptoms differ between each woman. There are physical and emotional symptoms and a woman may only experience a few of these at a time. These symptoms may even change over time.
Physical symptoms include:
- Dizziness or fainting
- Fatigue and weakness
- Headaches
- Insomnia or excess sleepiness
- Poor motor coordination (clumsiness)
- Change in bowel movement/habits including constipation and diarrhoea
- Abdominal distention, bloating and discomfort (cramps)
- Abnormal appetite such as craving sweet and/or fatty foods or alcohol
- Breast swelling, pain, discomfort and/or lumps
- Fluid retention
- Cyclic weight gain
- Altered libido
- Joint pain or backache
- Pelvic discomfort or pain
- Palpitations
- Acne or skin blemishes
- Hair changes
Emotional and mental symptoms include:
- Tearfulness
- Restless
- Aggression
- Irritability
- Angry outbursts
- Mood swings or moodiness
- Anxiety
- Confusion
- Forgetfulness
- Loneliness or social withdrawal
- Hyper reactiveness
- Depression
- Feeling overwhelmed or out of control
- Lack of concentration
- Nervous tension
- Poor judgement
- Insomnia
Diagnosis
There is no test for PMS. A doctor will look at your symptoms, when they happen and how they affect your life.
If your symptoms occur every time a week or two before your menses and lasts a day or two into the menses as well as prevent you from enjoying or doing some of your normal activities, you probably have PMS.
It’s important to keep track of your PMS symptoms and how severe they are. There are many apps out there to help you to do so. This can help you diagnose and compare your symptoms so you can notice when it gets worse or even better (especially when starting treatment).
Risk Factors
Almost half of the women who suffers with PMS have other health problems which may increase the symptoms of both conditions. They include:
- Irritable Bowel Syndrome (IBS): IBS symptoms including cramping, bloating and gas may get worse during PMS time.
- Bladder pain syndrome: Women with this syndrome are more likely to experience painful cramps during PMS.
- Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME): CFS and ME symptoms have been reported to be worse during PMS time. Research has also shown that these women may also be more likely to experience heavy menstruation and premature menopause
- Depression or Anxiety Disorder: They are the most common conditions that overlap and may worsen with PMS.
Complications
The symptoms of PMS may lead to a series of other events, including:
- Suicidal tendencies and thoughts
- Absence of special events or school and work
- Behavioural problems
- Eating disorders such as bulimia
- Hypertension
- Substance abuse due to severe depression or pain
- Existing medical conditions such as asthma, allergies, migraines, seizure disorders, multiple sclerosis, systemic lupus erythematosus or inflammatory bowel disease may be aggravated.
Prevention
- Eat healthy foods including plenty fresh fruits and vegetables
- Exercise regularly
- Practice stress reduction and management (Yoga, meditation, etc.)
- Maintain a healthy weight
- Keep your hormones balances (try our Natural Femina Herbal Extract)
- Stop smoking
Treatment
A holistic approach takes a multifactorial approach to treat PMS. It addresses the patients personal belief about menstruation, lifestyle factors and incorporates a physiological approach which treats both the symptoms and underlying hormonal dysregulation.
Nutrition
What you eat is what you become. Your body uses the nutrients it gets from your food to build new cells and hormones as well as make everything function correctly.
Diet changes you can make to prevent and treat PMS:
- Eat smaller portions frequently
- Eat plenty fresh fruit and vegetables
- Drink one glass of water for every 10 kg body weight
- Limit dairy products
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Eat good quality and mainly plant based or whole foods
- Avoid processed food
- Avoid artificial sweeteners and preservatives
- Reduce your sodium especially when experiencing fluid retention, oedema or breast tenderness
Important nutrients to prevent and treat PMS:
- Dietary fiber: reduce excess oestrogen by reducing the reabsorption of oestrogen from the intestines.
- Essential fatty acids: Effective in the treatment of depression and other PMS symptoms and helps to balance hormone levels.
- Calcium: Improve mood and symptom relief including headaches, pain, and cravings
- Magnesium: Improves symptoms including water retention, fatigue, irritability, tender breasts, and anxiety.
- Zinc: is needed to produce prostaglandins which help to balance hormone levels.
- Vitamin B6: has positive effects on the neurotransmitter Serotonin, Dopamine, and histamine which and is seen as a treatment for PMS symptoms including mood swings and depression. It also helps to balance sex hormones.
- Vitamin D: Controls the absorption of calcium.
- Vitamin E: has demonstrated a reduction in premenstrual nervous tension, headaches, fatigue, depression, insomnia, and breast tenderness.
- Tryptophan: Aids PMS mood changes, including depression, anxiety, and aggression.
Important Foods include:
- Whole grains: provides dietary fiber
- Nuts, seeds and fish: are rich in amino acids
Herbs
Herbal treatment can focus on symptomatic relief such as treating irritability, anxiety, depression, insomnia, acne, pain and so on. Along with the aforementioned symptomatic relief, herbal treatment can also include hormonal modulation. (See our Femina Herbal Extract). Herbs can also be used to improve physiologic and emotional stress responses in PMS.
Black Cohosh
There is a long history with Eclectic physicians using Black Cohosh for premenstrual and menstrual complaints. Black Cohosh may help to alleviate PMS symptoms especially headache, anxiety, nervous tension, pain, and irritability.
This herb is thought to have serotonergic and dopaminergic effects meaning it helps to balance out neurotransmitters.
Black cohosh is approved by the German Commission E for the treatment of premenstrual complaints, dysmenorrhea and neurovegetative symptoms of menopause.
Motherwort
Motherwort is used for the treatment of nervous exhaustion, irritability, hysteria, and nervous excitability. It may also have mild cardio-tonic actions, which may help to reduce palpitations.
Motherwort is a useful addition to PMS formulas, particularly when there are emotional lability and irritability, and if there is accompanying the pain.
The German Commission E approves motherwort for nervous cardiac disorders.
Valerian
Valerian is a well-known sedative and nerve tonic. Valepotriates are mainly responsible for its calming effects. It’s excellent for anxiety, nervous tension, agitation, panic attacks, irritability, insomnia, nervous headaches, and exhaustion. Valerian is relaxing to smooth muscles and stress-related disorders such as period pain, PMS and headaches.
Schisandra
Schisandra has a normalising effect on the entire body. It will take you from any extreme back to a balanced state. It may open you up to physical and mental exercise and protect you from environmental stress.
This herb can increase your energy at a cellular level by stimulating the central nervous system without making you nervous. It is used for the depletion from stress, chronic fatigue, anxiety, depression, irritability, dizziness, and insomnia.
Schisandra raises body enzymes which help to detoxify the body in a way that improves mental clarity. It’s also protective of the liver and helps to maintain liver function and regeneration.
It is a popular herb among women for its ability to make the skin soft, smooth and beautiful by balancing fluids in the skin.
Stress management
It’s important to understand that stress affects your hormone production. Learn how to manage your stress in our blog How to take control of your stress and anxiety.
Lifestyle changes
- Stop smoking.
- Exercise regularly: aerobic exercises are wonderful to manage stress
- Maintain a healthy body weight
Change your attitude
Change the way you think and feel about your menstrual cycle. Being a woman, and having the menses is a beautiful thing. Your body works in such an intricate way. You can conceive, grow and carry a baby to bring it into this world. You wouldn’t have been able to do this if you didn’t have a menstrual cycle. The survival of our species is dependent on it.
Women who feels self-empowered and in control of their own lives experience less severe PMS symptoms and less frequent. Practice self worth and improve your self-esteem.
