What is PMS and how can Naturopathy Help?

What is PMS?

In the days leading up to a period (menstruation), up to 30% of women experience emotional and physical symptoms, often called premenstrual syndrome (PMS). Most women experience one or two symptoms that can be managed. Symptoms start about 4-10 days before a period and usually stop after bleeding begins. Hormonal fluctuations contribute to these symptoms (such as dips in oestrogen with rising progesterone), among other factors. 

Symptoms can range from any of the following:

• Poor concentration

• Low mood

• Iriitability

• Anxiety

• Libido changes

• Hot flushes/night sweats

• Fatigue

• Constipation

• Bloating

• Acne

• Fluid retention

• Breast tenderness/swelling

• Cravings/increased appetite

• Hot flushes

• Headaches

• Joint/muscle pain

• Diarrhoea

Here are some risk factors known to be associated with PMS,
Including:

• 𝗪𝗲𝗶𝗴𝗵𝘁 𝗱𝗶𝘀𝘁𝗿𝗶𝗯𝘂𝘁𝗶𝗼𝗻: women with higher BMI’s are more likely to experience pre-menstrual symptoms
  History of 𝗺𝗲𝗻𝘁𝗮𝗹 𝗵𝗲𝗮𝗹𝘁𝗵 𝗰𝗼𝗻𝗱𝗶𝘁𝗶𝗼𝗻𝘀 and trauma

• 𝗦𝘁𝗿𝗲𝘀𝘀: some studies have identified a relationship between stress and menstrual cycles; women who experienced more academic stress (Nigerian study from 2011) were approximately two times more likely to suffer from menstrual disorders such as PMS.

• 𝗟𝗶𝗳𝗲𝘀𝘁𝘆𝗹𝗲 𝗳𝗮𝗰𝘁𝗼𝗿𝘀 (smoking, drinking, diet, caffeine and exercise).
  Age at menarche (early onset of period) has also been postulated to be related to PMS, but the evidence is conflicting.

While these are factors that contribute to PMS, the true cause is not well known is often attributed to multifaceted variables related to the changing levels of reproductive hormones and how the body perceived these changes. The changes in progesterone levels can impact neurotransmitters (brain chemicals that affect mood), thus resulting in mood changes and appetite. Certain nutrients/deficiencies can also play a role here. 

The following lifestyle factors are worthy considerations when combatting PMS:

Decreasing caffeine, salt, and simple refined carbohydrates, and focusing on small frequent meals to help reduce irritability, insomnia, fluid retention, breast tenderness and bloating.

Exercise; Studies have found that women who exercise regularly are less likely to suffer menstrual pain, cramps and mood disturbance, postulated to be a result of the impact exercise has on neurotransmitters (your mood chemicals). Get moving!

Increasing omega 3 (fish and seafood); contains compounds such as EPA (and a stack of nutrients) which lower inflammation and the production of prostaglandins associated with period pain.

Stress reduction: the Biocycle study which incorporated a survey of a range of symptoms across the menstrual cycle in 259 women found that women who reported high levels of stress in the two weeks before they got their period were two to three times more likely to experience depression, sadness, and crying spells as well as physical PMS symptoms such as body aches, bloating, low back pain, cramps, and headache, compared to women who did not feel stressed. Yoga, exercise, meditation, spirituality, support and connection are all tools to manage stress which should be considered for women experiencing PMS.

Higher dietary intake of both calcium and Vitamin D through foods and supplements has been associated with reduced risk of PMS. These two nutrients are thought to influence PMS through their relationship to estrogen. A recent systematic review found a significant improvement in PMS subjects and calcium, however some subjects were also found to have lower levels of serum calcium and more research is required. Best food sources: nuts, dairy products, fish with bones such as salmon and sardines, tofu, dark leafy greens & fortified food products.

𝗩𝗶𝘁𝗮𝗺𝗶𝗻 𝗕𝟲; influences hormones that contribute to PMS (progesterone and prolactin) and is a precursor to the production of brain neurotransmitters, including GABA, dopamine, and serotonin. Best food sources: fish, eggs, poultry, avocados, baked potato with skin, bananas, nuts. A 2016 meta-analysis demonstrated that B6 is an effective treatment for PMS; as usual, always talk to a practitioner about supplements. B6 in high doses or long-term can adversely impact nerve function.

If you have Brest tenderness: Iodine. Another one that impacts oestrogen metabolism/interacts with oestrogen-sensitive tissue- HOWEVER, caution must be advsied around supplementation and if you have a thyroid condition. This is one best sourced through the diet: seafood, iodised salt (400 mcg per teaspoon) and seaweed products. I like to increase consumption of these foods consistently through the luteal phase!

There are other nutrients that may be helpful (Zinc, Magnesium, fish oils), However it is best to seek individualised advice to see what form, dosage and type is best/safest for you and your symptoms. 

Aside from diet and lifestyle, herbal medicine is also a true GEM when it comes to tackling PMS. Vitex-agnus chastus, 𝘎𝘪𝘯𝘬𝘨𝘰 𝘉𝘪𝘭𝘰𝘣𝘢, 𝘊𝘳𝘰𝘤𝘶𝘴 𝘚𝘢𝘵𝘪𝘷𝘶𝘴 (saffron), 𝘔𝘦𝘭𝘪𝘴𝘴𝘢 𝘖𝘧𝘧𝘪𝘤𝘪𝘯𝘢𝘭𝘪𝘴 (lemon balm) and 𝘏𝘺𝘱𝘦𝘳𝘪𝘤𝘶𝘮 𝘱𝘦𝘳𝘧𝘰𝘳𝘢𝘵𝘶𝘮 (St Johns wort) are commonly used: however, these herbs might not be suitable or safe for everyone, so don’t self-prescribe. Get in contact with Noor Naturopathy for herbal medicine tailored specifically to your PMS symptoms and support with implementing the correct lifestyle changes!

PMID: 22069417
DOI: 10.4103/ijpvm.IJPVM_243_19
DOI: 10.3390/nu11081939
DOI:10.1089/jwh.2009.1717