Premenstrual syndrome has been the object of many jokes. It has also been the cause of much discomfort for many women.
PMS has over 150 documented symptoms. In fact, the symptoms are so common that PMS is no longer used, and the symptoms are considered normal. Yet describing them as normal means that many women who experience debilitating symptoms may not be getting the treatment they need.
Approximately 5% of all women experience PMS symptoms so severe that they are incapacitated for days each month. For many other women, moderate PMS symptoms can disrupt work and personal life.
What causes PMS?
PMS is due more to an imbalance in the stress hormones and neurotransmitters than it is due to hormonal imbalances.
Underlying factors:
- Nutrient deficiencies (especially B6, vitamin E, vitamin A, calcium, and magnesium)
- Low blood sugar
- Stress and adrenal dysfunction
In addition, thyroid problems can be a root cause of PMS. Make sure your doctor checks your thyroid hormones as well. You might also want to have your vitamin D and iodine levels checked. Low levels can contribute to depression and other symptoms.
On occasion, addressing one factor will improve symptoms. However, it usually takes an integrated approach of eating a better diet, changing your lifestyle habits, getting better rest, increasing your exercise, and herbal and nutritional supplements.
Natural approaches to PMS
Anticipate symptoms and be prepared
Recognizing that your premenstrual days may bring discomfort will give you greater awareness, which will help you get through it more easily. Rather than fighting against the emotions, work through them. Keep a journal. Pamper yourself with a massage, herbal tea, a hot bath, or having a night out with your girlfriends. Take time to nurture yourself each month. Eat better, exercise and move your body, and rest more. Pay attention to your mind, heart, and spirit.
Focus on diet
Focusing on a plant-based, Mediterranean diet can really help with PMS symptoms. Make sure you are getting plenty of dark leafy greens like broccoli, collards, and kale as well as high-quality fats to help ensure hormonal balance.
If you crave carbs and sugar before your period, your body is sending you a message. Before your period actually begins, your estrogen and serotonin levels drop. In response, your brain sends signals to crave sugar and carbs, which we find abundantly in our western diet including pasta and desserts. Our bodies can produce serotonin from carbohydrates.
Choose your carbs wisely. Whole grains contain B vitamins, which help support a calmer mood. Look for foods high in vitamin A as well. Eating foods high in processed sugars and grains will deplete your reservoir of nutrients while giving you a quick sugar high and subsequent crash that worsens your mood. Knowing this information in advance means you can fill your refrigerator and pantry with healthier carbs.
You can be proactive before the cravings begin. Add in healthy carbs in anticipation of the cravings. Do this during the luteal phase, which is the week before the beginning of your period. Be prepared.
You can even add some dark chocolate. It’s proven to prevent and reduce depression. Just be careful about your sugar intake and stick to high-quality dark chocolate. Consider adding a few ounces of chocolate during the luteal phase. Studies show that 4 ounces of dark chocolate daily can offset cravings for other fattening sweets. This helps you keep your weight and blood pressure in healthier ranges.
Keep dairy products to a minimum to avoid growth hormones. Add cold-water fish like salmon a couple of times a week, or take a high-quality fish oil supplement. Dietary fats should be from avocados, olive oil, hemp oil, coconut oil, and other good quality oils. Avoid vegetable oils.
Women with PMS consume significantly more sugar, dairy products, salt, and refined carbohydrates than those who do not experience it. Caffeine intake has also been linked to premenstrual discomforts, especially breast tenderness. Eliminating sugar, all white-flour products and caffeinated items such as coffee, black tea, and sodas may be hard to do but can go a long way to relieve symptoms. Interestingly, dark chocolate (62% or greater) is the exception to the caffeine rule – it can help improve mood and prevent or relieve depression.
Adequate protein and fat at each meal will keep your blood sugar at a balanced level to avoid the highs and crashes of PMS.
Rest and replenish
You must get adequate rest and moderate exercise for improving PMS symptoms. Fatigue from lack of regular sleep will exacerbate nearly all physical and emotional discomfort. Moderate exercise, even just walking or light cardiovascular exercise for as little as fifteen minutes three to four times per week can drastically improve mood and reduce fatigue.
PMS-calming supplements
In addition to a healthy diet, several supplements are beneficial in reducing PMS, particularly for improvement of mood, reduction of bloating, and reduction of breast tenderness. These include:
- Vitamin B6 (50 mg per day as part of a B-complex supplement)
- Vitamin E (400 IU per day)
- Calcium citrate (up to 1,200 mg per day)
- Magnesium citrate or glycinate (400 mg per day)
- DHA/EPA up to 2 gm combined, daily
Herbs for PMS
Herbs are powerful allies for us in many aspects of our reproductive cycles. PMS is no exception. Here are some of my favorites.
Adaptogens for mood and energy
Adaptogens including ashwagandha, reishi, holy basil, and Schisandra, for example, provide general support to the body, improving energy, sugar metabolism, mental functioning, mood, and general health. Among these are the adaptogenic herbs These can be taken alone or in combination, and for best results should be taken for a minimum of two to three months for optimal results.
Menstrual cycle and hormone support
Include herbs that help to regulate the hormones when treating PMS. Vitex (chaste berry) is a commonly used and widely scientifically supported herb for treating PMS. Dosage is 2 to 5 ml of tincture one to two times daily, with one dose typically taken in the morning and the other midday. Saffron, also used medicinally, has been shown in studies to be effective in the treatment of depression and PMS with depression at a dose of 30 mg/day (15 mg twice a day; morning and evening).
Black cohosh and peony are also used in formulas for PMS. Black cohosh can be used for treating menstrual headaches, breast tenderness, anxiety, and depression. Its effects may be due in part to its mild enhancement of serotonin reuptake. Peony has been shown to enhance ovarian function, improving levels of both estrogen and progesterone and reducing symptoms of PMS. A standard dose of black cohosh is one to two 40-mg capsules twice daily, or 2 to 4 ml of tincture one to three times daily.
Stress relieving herbs
These are herbs that support the nervous system by improving mood, reducing headache, stress, and anxiety, and promoting overall relaxation. Passionflower, motherwort, St. John’s wort, milky oats, and kava kava are good choices. Kava should be used only under the supervision of a qualified practitioner as it has been associated with liver disease, and no more than 1 ml twice daily for the week before the menses, and then discontinue. Feverfew may be appropriate when a woman experiences premenstrual headache, as it has been shown to reduce migraines, especially when used preventively.