Premenstrual syndrome (PMS) is a common disorder in women of reproductive age that is characterized by the cycling recurrence of physical, emotional and cognitive symptoms.
The symptoms typically occur in the second half of the menstrual cycle, resolve after the period begins and are often absent during the early phase of the menstrual cycle. As many as 85% of menstruating women experience one or more symptoms of PMS. Approximately 5% to 10% of women have symptoms severe enough to be debilitating.1
PMS affects women of all cultures and socioeconomic levels but types of symptoms and levels of discomfort vary from woman to woman and may have cultural influences. More than three hundred symptoms have been associated with PMS. 2
Among the most prominent and consistently described symptoms are depression, anxiety, irritability, craving for sweet or salty foods, headaches, weight gain, fluid retention, breast pain and swelling, abdominal bloating and acne flare-ups on the face and shoulders.
1 The American College of Obstetricians and Gynecologists. ACOG News Release. Accessed April 5, 2004 from http://www.acog.org/from_home/publications/press_releases/nr03-31-00-1.cfm.
2 Halbreich U. The etiology, biology, and evolving pathology of premenstrual syndromes.
Psychoneuroendocrinology 2003; 28(3 Suppl): S55-S99.
Some of the other commonly associated symptoms include:
- Abdominal bloating
- Abdominal cramping
- Accident proneness, coordination difficulties
- Acne, hives
- Aggression, rage
- Alcohol intolerance
- Anxiety, irritability, suicidal thoughts
- Back pain
- Breast swelling and pain
- Depression, withdrawal from others, emotional lability
- Exacerbation of pre-existing conditions (e.g., lupus, arthritis, ulcers, herpes)
- Fatigue, lethargy
- Fainting (vasovagal syncope)
- Food binges, salt cravings, sweet cravings
- Headache, migraine
- Heart palpitations
- Joint swelling and pain
- Sex drive changes
- Sinus problems
- Sore throat
- Urinary difficulties
Causes of PMS
The exact cause of PMS is not fully understood and may be related to a number of factors. The current theories on the underlying causes focus mostly on levels of sex hormones (e.g., estrogen, progesterone) and neurotransmitters (i.e., brain chemicals that control mood), dietary influences and emotional factors.
Dietary Factors Influencing PMS
- Diets high in animal fats have been shown to increase prostaglandin (PGE2) production and aggravate PMS symptoms.
- Increased alcohol consumption during the premenstrual phase interferes with the liver’s ability to detoxify excess circulating hormones.
- Nutritional deficiencies such as calcium, magnesium, zinc, vitamin B6, vitamin E, and essential fatty acids contribute to PMS.
- Increased caffeine consumption causes an imbalance of cortisol and blood sugar and further inhibits the liver's ability to balance serotonin, estrogen and progesterone, leading to breast tenderness and swelling.
Many factors can contribute to or trigger PMS by causing hormonal changes in the body, including:
- High consumption of dairy products
- Excessive consumption of caffeine (soft drinks, coffee, chocolate)
- Excessive consumption of high glycemic foods
- A relatively high blood level of estrogen
- A relatively low blood level of progesterone
- Diet that leads to increased levels of the hormone prostaglandin F2
- Excess body weight
- Low levels of vitamins C and E
- Magnesium and/or Selenium deficiency
- Lack of exercise
PMS has been divided into four categories according to specific sets of symptoms:
1. PMS-A ANXIETY (affects 65% to 75% of PMS sufferers)
- Tension, feeling on edge
- Irritability, anger
- Finding fault with one’s partner
- Mood swings
- Suicidal thoughts
- Low self esteem
- Sensitivity to rejection or criticism
- Feeling overwhelmed
- Too much estrogen relative to progesterone in the latter half of the menstrual cycle (luteal phase)
- Low serotonin
- Drop in TSH and cortisol (thyroid and adrenal function) during luteal phase
- High epinephrine/cortisol ratio
- Increased testosterone
2. PMS-C CRAVINGS (affects 33% of PMS sufferers)
- Cravings (sweets, chocolate, carbohydrates)
- Increased appetite
- Fainting spells, dizziness
- Heart palpitations
- Drop in cortisol causes sugar cravings
- Imbalance in body’s regulation of insulin and cortisol
- Low serotonin may cause CHO cravings — CHO ingestion can temporarily raise serotonin levels
- Deficiency in PGEI (Prostaglandin E1), a beneficial prostaglandin can cause low blood sugar with sweet and food cravings
3. PMS-D DEPRESSION (affects 25% to 35% of PMS sufferers)
- Lethargy, sluggishness, easily tired
- Withdrawal, disinterest in usual activities
- Drop in thyroid hormones during the luteal phase may trigger symptoms
- Low serotonin levels may cause low melatonin
4. PMS-H HYPERHYDRATION/WATER RETENTION (affects over 50% of PMS sufferers)
- Breast swelling and tenderness
- Abdominal bloating
- Weight gain of over 3 lbs. (1.5 kg)
- Swelling of the face, hands, fingers, and ankles
- Increased estrogen relative to progesterone (estrogen causes salt and water retention)
- Increased aldosterone and adrenal elevation during stress, which causes water retention
- Excess sugar intake causes insulin levels to rise quickly, triggering sodium and water retention
- Elevated prolactin, which may be higher when the thyroid is underactive, when dopamine levels are lower, or there is excess estrogen
Top Strategies for healing PMS naturally:
- Complete Female Hormone Testing - specialized lab testing through Dr Cobi to determine your root cause of your PMS - purchase lab testing through this link or call the clinic for more information.
- Cleanse the liver for optimal function through the steps listed here - Liver detoxification.
- sugar and caffeine.
- Pro 5-HTP (100mg 1-3 times per day- do not combine with pharmaceutical anti-depressants)
- Evening Primrose Oil (3000mg per day for 4 weeks then 1000mg per day)
- Pro Vitamin E complex (400-800IU per day)
- Vitamin B6 (50-100mg per day)
- Magnesium Glycinate-Chelate (150mg per day)
- Estro PX (1 capsule 2 times per day)
- DIM Evail (100-200mg per day)