by Dr. Tina Marcantel
Premenstrual syndrome, or PMS, is caused by an imbalance of hormones brought on by a woman’s monthly period. There are things women (and the doctors who treat them) can do to help alleviate the symptoms. Dr. Tina Marcantel is a naturopathic doctor in Gilbert, AZ, who also serves the East Valley cities of Tempe, Mesa, Chandler, Queen Creek, Apache Junction, Scottsdale, and the greater Phoenix area.
Premenstrual syndrome (PMS) is the term used to identify a combination of emotional, physical, and psychological changes that can occur after a woman’s ovulation and typically ending with the onset of her menses or menstrual flow. Approximately 80% of women experience some symptoms of PMS and it’s estimated that 20-30% of women have clinically significant symptoms that are severe enough to affect their normal functioning.
The most common emotional symptoms are irritability, depression, anxiety, crying, oversensitivity, and mood swings ranging from sadness to outbursts of anger. Physical symptoms may include low energy or fatigue, fluid retention (edema) leading to breast swelling and tenderness, abdominal bloating, headaches, altered libido, appetite changes, food cravings, sensitivity to certain foods, and severe abdominal cramping.
A major cause of PMS is an imbalance in the biochemistry of the body brought on by the hormonal changes associated with a woman’s monthly period. Although a monthly cycle is a natural part of a female’s biological functions, there are things women (and the doctors who treat them) can do to help alleviate the symptoms.
Some studies have detected low magnesium levels in PMS patients. Taking magnesium relaxes the muscles, causing a decrease in uterine (abdominal) cramping that is a common complaint for those experiencing PMS. Magnesium also promotes sleep and helps to relax the colon muscles, supporting healthy bowel movements that remove toxins.
Women with PMS often have high estrogen and low progesterone levels, or they may have a condition known as estrogen dominance in which the levels of progesterone may be within normal ranges but the ratio of progesterone to estrogen is low. These hormonal imbalances can be most accurately detected through a simple laboratory test called a salivary hormone panel. If clinically appropriate, a prescription for bioidentically-compounded progesterone will help balance this ratio and can lower PMS symptoms dramatically. Introducing higher amounts of fiber into the diet (for instance, ground flaxseed) also helps to reduce extra estrogen in the body because estrogen binds to the fiber and then is eliminated with other waste products.
Doctors often prescribe birth control pills to help regulate periods and control PMS symptoms. While this can effectively regulate a woman’s monthly cycle, the extra synthetic estrogen present in most BCP’s can help to promote estrogen dominance. The result may be an actual worsening of PMS symptoms, particularly anxiety, depression, weight gain, and insomnia. The use of bioidentical hormones to regulate the cycle can be a good alternative to avoid that problem, but it’s important to understand that bioidentical hormones are not used for birth control and will not protect against pregnancy.
Serotonin levels also fall after ovulation. Serotonin is a neurotransmitter that has a calming effect on the body; so lower amounts of serotonin can lead to mood swings, insomnia, anxiety, and irritability. I often recommend 5-HTP and/or tryptophan, which turns into serotonin and provides a calming and natural sedative effect that can help decrease the emotional symptoms of PMS. An added benefit is that 5-HTP has also been shown to reduce the carbohydrate and sugar cravings that many women experience during PMS.
Besides individual supplements like those mentioned above, there are a number of botanical (herbal) compounds that are designed to specifically target PMS symptoms. Products such as FemmenessencePro, Women’s Phase I, PMS Compound, and Herbal Balance contain a variety of herbs that are known to address the symptoms and some patients respond very well to them.
Because many women are sensitive to certain foods during PMS, it is advisable to avoid dairy and wheat and fatty foods that may aggravate the symptoms. A simple diet of lean meat, fish, vegetables, and fruit can be very beneficial. In addition to good foods, a regular exercise routine balanced with ample sleep time and naps, if necessary, can help reduce stress and make your regular monthly cycle much more tolerable.