Pre-menstrual Syndrome (PMS) - It Can Get Better!

July 21, 2021

Premenstrual syndrome - what is it?

 

PMS is characterized by a change in physical or psychological symptoms in the lead up to menstruation. For some menstruating people, this can be a couple days before bleeding, or it can last a whole week. For people who experience PMDD (premenstrual dysphoric disorder), severe anxiety, irritability and depression can hit quite strongly in the 1-2 weeks before menstruation.

 

Some symptoms of PMS include:

 

• Irritability
• Anxiety
• Lowered self-esteem and confidence
• Depression/low mood
• Poor memory, concentration.
• Social withdrawal
• Digestive issues (constipation, nausea, bloating, gas)
• Fatigue
• Increased appetite
• Headaches and/or migraines
• Menstrual cramping prior to menses
• Low back pain
• Breast tenderness
• Acne
• Clumsiness

 

In a natural menstrual cycle (no hormonal birth controls or IUD), the hormonal shifts that occur throughout the month can cause differences in how we feel physically and emotionally. In the follicular phase (day one of menses to ovulation), estrogen levels gradually increase, and we feel more social and have more more energy. Testosterone also increases prior to ovulation, increasing our libido. Estrogen causes proliferation of the lining of our uterus, which sheds during menses. It also causes our cervical mucus to change from non-fertile (dry, white, sticky) to fertile (egg white consistency, slippery and stretchy). Tracking cervical mucus, cervical position, and basal body temperature throughout the cycle will tell you when and if you’re ovulating. Our bodies are quite amazing!

 After ovulation, progesterone starts to be the dominant hormone for the remaining 12-14 days leading up to menstruation. This hormone is naturally sedating, causing us to feel like we want to withdraw from the world, rest more and sleep better. Progesterone slows our digestion down, meant for our bodies to extract more nutrients for a potential growing fetus. It raises aldosterone levels, causing fluid retention and bloating. Progesterone (pro-gestation) is meant to support a healthy environment for a potential developing embryo, which is why it causes us to slow down, sleep and eat more. If the egg is not fertilized, our progesterone levels will drop and we will get our period.

 If you experience increased anxiety, breast tenderness, heavy menses, and sleep issues in the lead up to your bleed, you may have either have estrogen dominance, or progesterone deficiency. If we don't ovulate, progesterone is not produced, leading to increased unopposed estradiol (a form of estrogen). This hormone imbalance causes disturbances in the menstrual cycle and fertility. 

Estrogen dominance can also be a result of our diet and lifestyle (high in dairy, refined grains and sugar, and poor-quality meat), environmental estrogens (xenoestrogens), poor liver function, lack of regular excretion, high stress, or excessive alcohol consumption.

If you’re coming off the birth control pill or hormonal IUD, your body may take some time to re-regulate a menstrual cycle again. There are some supplements listed at the bottom we recommend people start on after coming off the pill or hormonal IUD, as these can become deficient during that time (specifically B-vitamins, magnesium, zinc, and vitamin C).

 

There are also particular disorders that can be helped immensely with herbal medicine, nutrition and lifestyle changes, including:

 

• Dysmenorrhea is characterized by intense menstrual cramping and pain, nausea, and vomiting at the beginning and/or throughout your bleed. There are increased inflammatory prostaglandin levels in dysmenorrhea, leading to irregular and intense menstrual cramping as the lining sheds. Treatment includes finding the root cause, reducing inflammation, supporting hormone balance and reducing symptoms.

• Endometriosis is when the lining that sheds during menstruation, grows outside of your uterus, causing cyclical bleeding, intense pain/cramping and inflammation. The cramping and pain can really affect one's life, by having to take sick days or leave work early and rely on pain medications. Fertility and digestion can be greatly affected as well. Treatment involves symptomatic relief, modulating the immune system, supporting the liver and hormone balance, tonifying the uterus and reducing heavy bleeding.

• Fibroids are benign tumours that can grow in various different locations inside the uterus. They are believed to be estrogen dominant, and can cause increased menstrual bleeding, pelvic discomfort, and pain during menstruation. Back pain is common as well. Treatment involves reducing endogenous and exogenous estrogen, helping liver function, reducing pain and heavy menstrual bleeds, and supporting regular excretion.

• PCOS (polycystic ovarian syndrome) is a complex metabolic disorder that can cause menstrual cycle irregularity, ovarian cysts, excess testosterone levels, irregular blood sugar, acne/hirsutism, as well as infertility. Treatment involves supporting blood sugar balance, initiating ovulation, and supporting hormone balance and gut health.

 

Getting some testing done by either a naturopath or medical doctor can help verify if you have one of the above conditions.

 

Lifestyle and Nutritional Recommendations to Help Reduce PMS:

 

Our goals as medical herbalists and holistic nutritionists are to always find the root cause of the symptoms you’re experiencing, so booking a full consultation is usually recommended! Below are some tips we usually tell our clients to help support hormone balance and reduce PMS symptoms:

 

• Maintain blood sugar balance: Eat a variety of fresh, whole foods, and balance each meal with protein, fat and complex carbohydrates. Avoid processed snacks and beverages that are high in sugar, as well as decrease coffee and alcohol which will spike your cortisol and lead to a blood sugar dip. This is important for adequate hormone balance, as high insulin levels can cause a decrease in sex hormone binding globulin, a protein produced by the liver that helps to bind to sex hormones. If this protein is low, there are increased levels of free sex hormones, leading to hormone imbalance.

 

• Healthy Gut: Maintaining a diverse microbiome will help with hormone balance, reduce menstrual pain, promote regular excretion and support liver health. Getting plenty of fermented foods (sauerkraut, kimchi, yogurt, miso, etc), taking a probiotic, and eating foods rich in prebiotics to help feed the healthy gut bacteria (leeks, onions, garlic, bananas, oats, lentils and legumes, asparagus, etc) and reducing processed sugars and alcohol. Eat an anti-inflammatory diet, and avoid foods if you think you’re sensitive or intolerant to them (like gluten, dairy, soy, eggs, etc).

 

• Hydration: Adequate hydration will help with regular bowel movements, which are important for hormone health. Aim for at least 2-3 L a day.

 

• Liver Health: To help with phase 1 and 2 of liver detoxification, get plenty of fresh, bright vegetables and fruit (antioxidants) daily, as well as cruciferous vegetables like broccoli, kale, cabbage, brussel sprouts, etc). Taking bitters (either in herbal or food) will help increase bile release from the gallbladder, supporting digestion and regular bowel movements. Avoid excess alcohol to support the liver, and reduce exposure to toxic household cleaners and plastics. Switch to natural products for the house, and for what you put on your body/skin. We absorb everything!

 

• Movement: Moderate exercise has been shown to reduce physical and psychological PMS symptoms. Finding one that you enjoy and going into nature as much as you can heighten the benefits. Over-exercising can cause hormonal imbalances, so it’s important to know your limit and rest when you’re tired.

 

• Sleep: Maintain a regular, consistent sleep cycle, and practice sleep hygiene methods (dim light, meditations, reading, decrease technology, avoid caffeine and alcohol).

 

• Stress Management: Excess cortisol levels will disrupt our blood sugar and hormones. Finding ways to manage your stress in a sustainable way will help immensely. Get into nature, exercise, get together with friends, laugh, cry, and get creative to help complete the stress cycle in our bodies. Even if you can’t control the stressor, you can reduce stress in your body!

 

• Herbs: There are many herbs that can support premenstrual syndrome and hormone balance. Some that we love to use include Cramp Bark, Corydalis, Ginger, White Peony, Black cohosh, Dong Quai, Schisandra, Milk thistle and Rosemary! You can find the first three in our Cramps Relief Tincture !

 

Supplements for PMS:

 

Magnesium bisglycinate: Helps reduce menstrual cramping and pain, supports sleep and mood! 

 

B-Complex: Taking a good B-complex will help with energy, mood, reduce menstrual pain and support blood sugar balance! B vitamins are decreased in times of physical and psychological stress, and support our livers detoxification pathways.  

 

DIM: Helps normalize estrogen metabolism to support healthy hormone balance.

 

Omega 3 fatty acids: Anti-inflammatory support to help reduce severe menstrual cramping and pain. Can get in fatty fish (wild salmon, herring, sardines), as well as freshly ground flax or chia, walnuts, hemp, etc. An omega 3 fatty acid supplement can be helpful (higher EPA, AquaOmega is a great affordable brand found at most health food stores). 

 

Zinc: Supports regular ovulation, which we need to produce progesterone to support a healthy menstrual cycle and pregnancy.

 

Vitamin D: Found to reduce menstrual pain in studies, helpful to support mood, immune and bone health.

 

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Written by,

 

Riley Craven

Holistic Nutritionist & Medical Herbalist

(Focus: Hormonal & Mental Health)

 

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