PMS – Pre-Menstrual Syndrome

The complex interplay of hormones is often taken for granted until disruption manifests itself. PMS occurs when there is an imbalance in the levels of hormones, namely oestrogen and progesterone. As Christiane Northrup states in her book Women's Bodies, Women's Wisdom, "No modern disorder points to our need to rethink our ideas about menstruation and reclaim the wisdom of our cycles more directly than ...PMS". PMS and PMT are really interchangeable terms. More than 3/4 of women suffer from some form of premenstrual syndrome, PMS, occurring cyclically each month 7-14 days prior to their period. Hormonal changes can play a significant role in the worsening of some diseases premenstrually, eg. asthma, migraines, diabetes, depression, epilepsy. PMS has been associated in studies with physical and mental impairment, work absenteeism, relationship problems and difficulties with role acceptance.

Symptoms
It is characterized by irritability, depression, anxiousness, weepiness, aggression, forgetfulness, confusion, insomnia, headaches, breast swelling and pain, sugar and chocolate cravings, abdominal bloating, fatigue and weakness, weight gain of 2 or more kg, fluid retention as well as acne. There have actually been over 150 recorded symptoms of PMS but it is the timing rather than the type of symptoms that is the most important indicator of PMS.

PMS can be classed into five different subgroups. PMS-A: anxiety, nervousness, irritability; PMS-C: cravings for sugar, hypoglycemia; PMS-D: depression, withdrawal, weepiness; PMS-H: fluid retention, bloating; PMS-P: pain. Women may have symptoms is more than one subgroup but each subgroup has a different hormonal, biochemical and/or nutritional cause.

Causes
There are numerous theories of causation of PMS with many of the all playing a causative role.

  • A relative excess of oestrogen in relation to progesterone to balance it as these two hormones work together to regulate our fertility and menstrual cycles. Oestrogen increases irritability, aggressiveness and anxiety via increased noradrenaline in the brain. Fluid retention is caused by a relative progesterone deficiency. The digestive system plays a role in oestrogen excretion, by needing adequate fibre to keep your bowels regular. Otherwise, with constipation, the oestrogens are reabsorbed back into the bloodstream.
  • Progesterone receptors functioning poorly to normal hormonal levels. Hence, progesterone is unable to be utilised. Adrenaline and adrenal hormones from stress block these receptors, making them less responsive to progesterone.
  • Adrenal hormones may be communicating abnormally with hypothalamus and pituitary glands. Cortisol and aldosterone are implicated in many of the symptoms and are secreted by the adrenal glands. Stress increases cortisol and aldosterone secretion.
  • Increased prolactin or sensitivity to prolactin causes breast swelling and soreness.
  • Endorphins are natural opiates produced in the brain which cause a sense of wellbeing but when too low, may cause PMS.
  • Adrenaline triggers anxiety, noradrenaline induces hostility and irritability, serotonin causes nervous tension, inability to concentrate and fluid retention, dopamine induces relaxation and mental alertness. Oestrogen inhibits the deactivation of adrenaline, noradrenaline and serotonin but increases the deactivation of dopamine. Low dopamine results in anxiety, irritability, tension, mood swings as well as elevating prolactin levels.
  • Inflammatory prostaglandin excess causes inflammation, irritation and constriction of tissues. Women with PMS have been shown to have higher levels of inflammatory PG (fried oils and animal fats) and low levels of anti-inflammatory PG (Omega 3 oils)
  • Candida overgrowth will exacerbate pre-menstrually due to the relative oestrogen excess.
  • Nutrient deficiencies will exacerbate certain symptoms and the hormonal imbalance. Compared to symptom-free women, PMS patients consume 62% more refined carbohydrates, 275% more refined sugar, 79% more dairy products, 78% more sodium, 53% less iron, 77% less manganese & 52% less zinc.
  • Imbalanced blood sugar levels will cause PMS symptoms with a change in glucose tolerance and insulin sensitivity. This is linked with the luteal rise in oestrogen levels causing sugar cravings, hypoglycemia, faintness, weakness, fatigue, irritability.
  • Social and psychological factors will predispose women to and exacerbate PMS. Some women have their symptoms present all month but worsen pre-menstrually. This really is not hormonal but needs treatment for the underlying state eg. anxiety, depression.
  • Inadequate exposure to sunlight or natural light which directly influences the hypothalamus and pineal glands.

Diagnosis
There are no blood tests that can diagnose PMS so the best tool is to use a menstrual symptom diary to show when you get PMS symptoms (eg. 3 days before period), what particular symptoms you experience (eg. irritable, pimples) and how severe they are, so we can see what exactly we are dealing with, the progress and any triggers.

Treatment:
Healthy eating is the foundation of all good health so treatment must always start here for all PMS conditions. Extensive information and resources are given to help you make healthier choices. You will be referred to your doctor or GP for extensive blood tests unless these have already been done.

Normalising insulin and blood sugar levels is an essential part of treatment including weight management, exercise, stress reduction techniques, dietary advice, nutritional supplements and herbal medicines.

Hormonal regulation is achieved using specific herbal medicines and nutritional supplements which are individually prescribed to:
  • Balance hormones to improve the relative oestrogen excess and correct the underlying hormonal imbalance
  • Balance mood swings as well as calm and nourish the nervous system and adrenal glands
  • Ensure normal menstrual flow and uterine function
  • Decrease constriction of blood vessels and muscular spasm, thereby decreasing pelvic congestion and pain
  • Improve integrity of blood vessels so as to decrease fluid retention
  • Improve liver function which breaks down and removes excess oestrogen, other hormones and toxins
  • Improve bowel function to prevent constipation or other digestive disturbances

Claudette provides comprehensive advice and resources regarding lifestyle, exercise, creativity, personal hygiene products, environmental factors, pain relief packs and referrals to complementary and supportive therapies.

Using the work of Christiane Northrup, author of Women's Bodies Women's Wisdom, and the work of Vianna Stibal, ThetaHealing(R), the emotional connections to PMS are discussed to address any underlying emotional issues or creativity blocks so as to create healthy boundaries in all areas of your life. 
Claudette's supportive approach makes this journey towards optimum health and balance rewarding and empowering.
 
 

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