Premenstrual Syndrome (PMS) is a very common problem among women between the ages of twenty and fifty. The reasons for PMS are many, but the main physiological reason is that there are significant hormone level changes between the middle of a woman’s menstrual cycle and her period. The hormonal changes are to prepare the unfertilized egg to be discarded at the end of the cycle---this is why birth control pills usually comprise of one or more hormones to suppress fertilization. PMS usually occurs 1-2 weeks before menstruation, when the hormone cycle swings are the most active. Unfortunately, the side effects of this natural cycle can be very irritating and painful, both physically and emotionally. Symptoms of PMS may include: fluid retention, breast soreness, irritability, fatigue, mood swings, headaches, nausea, weight gain, and depression. In fact, there are now more than 150 identified symptoms of PMS. Up to half of all menstruating women have at least one or more PMS symptoms. PMS usually goes away before menopause, in a woman’s late 40’s or early 50’s.
The two main hormones involved in the part of the cycle between ovulation and menstruation are estrogen and progesterone. During PMS, the hormone estrogen rises and progesterone falls. Too high of an estrogen / progesterone ratio can interfere with neurotransmitters in the brain that control mood and pain. PMS may be a part of the natural menstrual cycle in women, but it can be heavily influenced by other factors, such as: vitamin and mineral deficiencies, hypoglycemia (low blood sugar), significant environmental stress, yeast overgrowth, and food allergies and/or sensitivities. Excess caffeine and/or alcohol intake can also contribute to PMS symptoms.
Different environmental influences on PMS can produce different symptoms. Some researchers theorize that there are four different types of PMS: A (anxiety), C (craving), D (depression), and H (hyperhydration, or bloating/tenderness). Some women may have only one type of PMS, some may have 2 or 3 types, and some may have all four types. PMS-A is associated with nervousness and muscle tension. PMS-C is associated with cravings for sweets, including chocolate, and simple carbohydrates. PMS-D is associated with emotional problems before menstruation. PMS-H is associated with breast tenderness and weight gain from water retention.
There are several different drugs that are used to treat PMS. Progesterone suppositories are sometimes used to control PMS symptoms. Side effects of progesterone suppository administration are generally mild, but other methods of progesterone usage (oral or injection) may cause depression. One of the most common medications prescribed to treat PMS is fluoxetine, also known as Prozac or Serafem. Side effects of fluoxetine can include: anaphylaxis (severe allergic reactions), internal bleeding, anxiety, insomnia, and dangerous interactions with certain other psychiatric medications. Oral contraceptives may help some PMS symptoms, but may worsen symptoms in others. Physicians may sometimes prescribe tranquilizers, painkillers, and diuretics (water pills) if the symptoms are severe.
Fortunately, there are many different natural supplements that can greatly reduce the symptoms of PMS, and in some women, can actually prevent the symptoms completely. One of the best supplement types to try for reducing PMS symptoms are the essential fatty acids. Supplementing with fish oil for two months markedly reduced PMS symptoms. Evening primrose oil can help people relieve fatigue, irritability, breast tenderness, and swelling. In another study, evening primrose oil (EPO) supplementation for three months helped half of the participants with otherwise treatment-resistant PMS symptoms.
Vitamin E can also be a powerful ally in the battle against PMS symptoms. One vitamin E study, which used between 150-600 IU/day for a dose, significantly improved PMS symptoms in 3 of the 4 PMS types. In another study, women who took 400 IU/day of vitamin E for three months (three menstrual cycles) had significantly less PMS-related physical symptoms. Vitamin E and the mineral zinc taken together can also help reduce many PMS symptoms. The above example underscores the importance of taking a holistic approach to chronic illnesses like premenstrual syndrome---one supplement alone may not work, but a combination of supplements and lifestyle changes have a much better chance of working.
The minerals calcium and magnesium are very important for muscle relaxation in all areas of the body. Supplementing with calcium and magnesium can help relieve cramping discomfort. Women who supplemented with 1000 mg/day of calcium resulted in 73% of women having fewer PMS symptoms. If someone chooses to supplement with this much calcium per day, they should include 100-500 mg/day magnesium, depending on their metabolic type (ask Dr. Jensen for more information about this).
The B-vitamins are also very important to help smooth out PMS symptoms. Vitamin B6 supplementation can help reduce PMS symptoms in 70% of women. Many women choose to supplement with a lot of vitamin B6, over 100 mg/day, in order to treat their PMS symptoms. However, in some people, vitamin B6 at this dose can cause some side effects, like numbness in the extremities. Fortunately, supplementing with the standard amount of 50 mg of vitamin B6 for seven months significantly reduced emotional symptoms of PMS. Another important B-vitamin is B1 (Thiamin). It can improve mood, and may be a good supplement to use in helping PMS-related emotional symptoms.
There are also many different herbs that can help reduce PMS symptoms. However, only two appear to be both relatively safe and effective. The herb chasteberry (also called chaste tree, or vitex agnus-castus) is an effective remedy for PMS in over 50% of participants. Chasteberry should not be used with any other herbs or drugs that raise levels of the neurotransmitter dopamine. The herb Black Cohosh (Cimicifuga racemosa) is used by many German doctors to treat PMS symptoms successfully, most likely due to its anti-estrogenic effects.
PMS may be a very common problem, but it does not have to be inevitable. There are many different ways to help reduce or even eliminate symptoms of the illness known in some countries as “the curse”. Lifestyle changes such as exercise, muscle relaxation, and improving sleep patterns can all help significantly. There are also several different vitamins, minerals, and herbs that can help PMS symptoms and associated pain. In fact, from a supplement point of view, PMS is one of the most treatable illnesses.
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