A woman’s period acts like a monthly report card about the body: when all is well, it might arrive with little fanfare or warning, but when there are imbalances in the body it can come with the dreaded entourage of PMS symptoms like headaches, irritability, food cravings and so on. Oral contraceptives can help control PMS by wiping out hormonal fluctuations, but there are plenty of natural approaches that can be tried with great success.
Women’s cyclical pattern of hormones is purposeful. The first half of the cycle is estrogen dominant and the second half of the cycle, post-ovulation, is progesterone driven. Estrogen is considered the feel good hormone and boosts serotonin and dopamine. However, too much estrogen can cause irritability and overstimulation. Progesterone is known as the soothing and calming hormone and is anti-inflammatory as well, and helps smooth things out when estrogen begins to fall.
PMS affects about 40% of women of reproductive age, and is composed of a wide range of both physical and emotional symptoms in the week or two leading up to a menstrual period. Symptoms can include breast discomfort, fluid retention, food cravings, abdominal bloating, back pain, headaches, acne, anxiety, depression, feeling overwhelmed, irritability, mood swings, tearfulness, and lack of concentration. The precise etiology of PMS is not known but some theories have to do with hormone imbalance, issues with neurotransmitters, prostaglandin dysregulation, nutrient deficiencies, stress and inappropriate cortisol response, inflammatory diet, and environmental and psychosocial factors. I like to take a multifactorial approach when treating PMS and start off by looking at hormonal modulation, diet, stress, and inflammation.
Hormonal modulation usually involves enhancing progesterone production, detoxifying estrogen properly, and reducing inflammation. Having an anti-inflammatory diet full of whole, fresh foods with a reduction in wheat, dairy, and sugar leads to less body inflammation. This enables better ovulation and better progesterone production, as well as better functioning receptors for progesterone and GABA, the calming neurotransmitter. Alcohol can interfere with the calming effect of progesterone, so the less the better. Inflammation also blocks progesterone receptors and makes estrogen more stimulating. Supplements like chaste tree, selenium, vitamin B6, and magnesium can also help with progesterone production. Evening primrose oil may be helpful in reducing inflammatory prostaglandins. Preventing a build of up estrogen by helping the body detoxify and get rid of it can really help with PMS symptoms too. Reduce alcohol, avoid chemicals that are estrogen mimickers that are often found in plastics and pesticides, ensure a healthy gut and microbiome, work on any constipation issues, and eat phyto-estrogens (a weaker plant form of estrogens) such as ground flaxseeds, chia seeds, and brightly colored veggies. B vitamins, black cohosh, probiotics, and occasionally calcium-glucarate are helpful supplements for balancing out estrogen.
Stress plays a large role in PMS. Stress hormones like cortisol and adrenaline block receptors for progesterone. Stress reduction techniques and using adaptogens, stress modifying herbs like rhodiola, ashwagandha, ginseng, and eleuthero, can balance out the stress response.
Don’t feel that PMS has to be a monthly occurrence. It is a condition that responds wonderfully to nutritional and lifestyle changes coupled with certain supplements and herbs. It may take a few cycles to see results, but when that next period appears with little fanfare, the only warning will be the one in your calendar.