PMS is one of the most common hormonal conditions affecting younger women. PMS is a hormonal disorder that includes physical and psychological symptoms that occur on a monthly basis, usually during the 2 weeks prior to menstruation. Typically, once menstruation starts, these symptoms subside.
Common PMS Symptoms include:
- Abdominal bloating
- Appetite changes
- Weight gain
- Mood swings
- Weight gain
- Water retention
- Breast swelling and tenderness
- Cravings salty or sweet foods
- Crying spells
- Decreased sex drive
- And many others!
As if having to experience PMS was bad enough, it is frequently misdiagnosed as a psychological problem, which means many women don’t get the proper support and care that they truly need. Misdiagnosis can include:
- Anxiety disorder
- Seizure disorder
- Panic attacks
- Eating disorders
- Various personality disorders
What makes PMS so difficult is that there are no definitive diagnostics tests that can confirm PMS, but it can be treated by a well training clinician with a better than 90% success rate. Ideally, to determine the cause of PMS, we would run some advanced lab tests such as a 28 day salivary female hormone panel to track hormones over the course of a woman’s monthly cycle. Unfortunately, most doctors won’t run such a test, leaving women suffering from PMS frustrated.
Precipitating Factors for PMS
- Oral contraceptives (ie. birth control) use due to the progestin
- Low thyroid function
- Nutrient deficiencies
- Hormonal imbalances
- Excess estrogen
- Blood sugar imbalances
- History of miscarriages and abortions
- Tubal ligations
- Partial hysterectomies
Many women aren’t aware that there are many ways to go about beating your PMS naturally.
Low Blood Sugar and PMS
Due to hormonal changes, a woman’s body becomes more sensitized to drops in blood sugar the last 2 weeks of the cycle. Symptoms of hypoglycemia are very much like PMS symptoms. Luckily, it can be very easy to manage low blood sugar induced PMS by following these easy steps:
- Eat 6 small protein rich meals per day
- No refined sugars
- Supplement with a B Complex and Vitamin B6
- Avoid caffeine and alcohol
Caffeine and PMS
Caffeine can increase the body’s production of prostaglandins, which during the premenstrual period can cause breast tenderness, arthritis, abdominal cramping, headaches, and backaches. Caffeine also acts as a diuretic, which depletes the body of important minerals, like magnesium, which can worsen cramping, as well as vitamins B and C. Caffeine also causes the release of adrenaline, which can lower blood sugar.
Migraine Headaches and PMS
Some migraine headaches can be hormonally related. The key is to track when they occur. Do they occur around ovulation, or just before menstruation begins? There are 4 main mechanisms of hormonally related migraine headaches.
- Estrogen and Progesterone increases at time of ovulation, which can precipitate a headache.
- Hypoglycemia or low blood sugar
- Changing estrogen levels
- Estrogen dominance
How to Decrease PMS Related Water Retention and Bloating
- Avoid foods with high sodium content
- Eat foods that are natural diuretics like strawberries and parsley
- Evening primrose oil
- Increase water intake to help flush out the water
- Use progesterone, which is a natural diuretic
- Spironolactone is a prescription diuretic, but tends to try out the skin
Acne and PMS
Acne is often due to elevated testosterone, which can be tested on a salivary female hormone panel. If this is the issue, steps can be taken with nutrition, botanicals, and nutrients to lower testosterone levels.
If testosterone is low or normal, the problem is likely in due to poor gut health. The best way to evaluate gut health is with a specialized lab called a GI Effects test.
Magnesium Deficiency and PMS
Many women with PMS are often deficient in magnesium. Simple ways to increase magnesium levels are to eat foods high in magnesium like nuts and seeds, and to supplement with oral or IV magnesium. The best test for magnesium levels in the body is the RBC magnesium test.
Vitamin A and PMS
Vitamin A can be helpful in PMS because it is a diuretic, combats stress and fatigue, and is an antioxidant. We typically use high doses for short periods of time for PMS relief.
Exercise and PMS
Exercise helps to relieve painful muscles and joints, tension headaches, lower body bloating, tiredness, and irritability.
Herbal Therapies for PMS
Black Cohosh has a balancing effect on estrogen, is a relaxant, sedative, and anti-spasmodic, which can decrease cramping.
Chasteberry can decrease LH and prolactin and raises progesterone, and acts as a diuretic.
Bio-identical Hormone Replacement of Progesterone
PMS is commonly due to a low progesterone state. Progesterone can be very effective in treating PMS and can be given around days 14 – 25 of the cycle.
Some symptoms of low progesterone include:
- Mood swings
- Racing heart
- Bladder problems
- GI disturbances
The symptoms of low progesterone and high progesterone are the same, so taking progesterone just based on symptoms can actually make PMS worse. This is why we always want to measure the level of progesterone in the body with an expanded salivary female hormone panel or a urinary hormone panel. Too much progesterone can actually cause weight gain around the back area and blood sugar imbalances. We always want estrogen and progesterone to be in a balance in the body.
We can give progesterone trans-dermally via the skin, or orally. Giving progesterone orally is helpful if there are symptoms of insomnia or anxiety, because oral progesterone can cross the blood brain barrier easily and act on the GABA receptors in the brain, giving a calming response. The best places to use transdermal or topical progesterone (15 – 40 mg) are the thighs or buttocks, not the abdomen as this can result in GI symptoms. It should be noted that progesterone increases fertility, so women who do not want to get pregnant should be cautious. Progesterone can also be used in women with PCOS or infertility.
Cortisol and PMS
It’s also very important to look at cortisol levels when managing PMS (and even PCOS and infertility). The best way to measure cortisol is with a four sample salivary cortisol test.
The best way to get an accurate treatment for your PMS is to get a 28 day salivary hormone panel run. Having a accurate picture of exactly what your hormones are doing each month is key to getting relief, fast. As I like to say, “Test, Don’t Guess !” I hope this guide was helpful and you feel inspired that beating PMS naturally is possible. Please leave your questions and comments below.