As I chat with women just like you and ask how you are feeling, I repeatidly hear cranky, short tempered, low tolerance, snappy, emotional, moody and irritable!
You may feel out of control and in some cases a completely different person in different times of your menstrual cycle. The common culprit of these cycle driven symptoms is premenstrual syndrome (PMS). As 90% of women experience one or more symptoms of PMS, it has often been accepted as a ‘normal’ part of a woman’s cycle.
Although it may seem that this is just something you (and your loved ones) may have to accept, it’s important to investigate why you may be feeling this way and what you can do to overcome it.
WHAT IS PMS
Often experienced ‘pre’ period, the symptoms of PMS occur in different patterns and times of the cycle for each woman. You can present with PMS symptoms anywhere from day 7, through to just before your period around day 21. Sometimes these symptoms come and go throughout the second half of your cycle (luteal phase), but most commonly present in the last week from day 21-28 (28 being the last day of a typical text book cycle).
SYMPTOMS OF PMS INCLUDE:
- Breast tenderness
- Low tolerance levels
- Bloating and fluid retention (swelling)
Unfortunately 20-40% of women describe their PMS symptoms troubling enough to have a negative impact on their daily life. (1) A more severe form of PMS, called Pre-menstrual Dysmorphic Disorder affects a further 2-10% of women. (2)
CAUSES OF PMS
LOW PROGESTERONE & OESTROGEN DOMINANCE
Due to oestrogens competitive nature with progesterone, heightened production, poor metabolism and increased oestrogenic activity in your body can contribute to lower progesterone activity.
The luteal phase (second half of your cycle) is when progesterone should be dominant, peaking around day 21 at 200 times the levels of oestrogen. Failure for progesterone to peak during the luteal phase, will contribute to oestrogen dominance and the symptoms of PMS. You can learn about oestrogen dominance here.
Low progesterone also contributes an increased release of the hormone aldosterone in your body. Higher aldosterone causes the body to retain salt and therefore leads to the PMS symptom of fluid retention.
An early drop in progesterone in the luteal phase of your cycle possibly and high prolactin levels (the breastfeeding hormone) could also be a major cause of the PMS symptoms of weepiness, paranoia, mood swings and irritability. In this case, periods could also start suddenly and contain clots.
Your limbic area of your brain, which controls emotions, houses the largest concentration of progesterone receptors in your body and therefore may explains many low progesterone PMS symptoms of emotional outbursts, mood swings, violent urges and uncontrolled rage.
Heres some simple way to help overcome oestrogen dominance and low Progesterone:
Here are some other causes of PMS driven symptoms.
Prolactin is produced from the anterior pituitary gland in your brain and is at heightened levels during breastfeeding. Elevated production of prolactin (which often occurs under stress) when you are not breastfeeding can contribute to PMS symptoms of breast tenderness and swelling.
Magnesium deficiency is common among oestrogen dominance symptoms of PMS and menstrual migraines. Taking the oral contraceptive pill can cause magnesium levels to deplete over time (3) and nutritional deficiencies such as magnesium, may contribute to the worsening of symptoms when the pill is eventually stopped.
When magnesium levels are low, oestrogen detoxification is compromised and oestrogen recycling in your body is encouraged. Further information on Magnesiums role in hormone health is found in my latest book Balanced, The Natural Way To Healthy Hormones.
In a state of adrenal gland stress and fatigue, the body is either over-producing or in great need for the hormone cortisol. Instead of feeding progesterone production, the mother hormone pregnenelone is stolen to make cortisol. This is known as the pregnenelone steal and indicates the need of supporting the adrenal glands upstream to regain healthy levels of the sex hormone, progesterone and therefore the prevention of PMS symptoms.
Chronic stress can also deplete levels of beta-endorphin in the brain and contribute to low opioid levels.(4) Deficient opoid production throughout the cycle and particularly in the luteal phase (from ovulation, to your period) has been linked to an extreme case of PMS, called premenstrual dysphoric disorder (PMDD).(5) This presents with severe mood changes and depression in the lead up to your period.
Low beta-endorpin levels also contribute to a heightened production of cortisol and further inhibit the conversion of progesterone to allopregnanolone (needed for GABA production- the calming neurotransmitter). Instead, progesterone is converted into cortisol.
Interestingly, under heightened adrenaline production (stress or blood sugar level drops), progesterone receptors fail to transport progesterone into your cells for you to use.
When your body is not dealing well with carbohydrate synthesis and insulin resistance is or has developed, cravings for chocolate and an overall increased appetite will be noted. Headaches, fatigue, moodiness and irritability are other PMS symptoms associated with insulin resistance.
Pro-imflammatory prostaglandins, which are often fuelled by oestrogen activity, are responsible for PMS symptoms of pain, such as joint, lower back, abdomen pain or headaches. Helping to reduce inflammation is key to overcoming these symptoms.
When symptoms of forgetfulness, confusion, tearfulness, clumsiness, withdrawal and in severe cases, risk of suicide are presenting, this can be due to either low neurotransmitter production of serotonin and/ or low oestrogen activity. Strong carb cravings anytime of your cycle can also be linked to low serotonin. This can include sweets, pasta, bread and alcohol after the body triggers an insulin surge to get your serotonin producing amino acid, tryptophan to your brain. B6 then plays an important role in converting tryptophan into serotonin.
TAKE CONTROL OF YOUR HORMONE HEALTH
Don’t just accept your PMS symptoms as normal. Identify the possible drivers of your symptoms and use holistic diet, lifestyle and supplementation support such as that found in Balanced, The Natural Way To Healthy Hormones.
(1) Bioconcepts Education Centre, Harnessing Hormonal Health, July 2016;www.bioconcepts.com.au
(2)Diagnosis and Treatment Of Premenstrual Dysmorphic Disorder. SUBHASH C. BHATIA, M.D., and SHASHI K. BHATIA, M.D. Creighton University School Of Medicine, Omaha, Nebraska Arn Family Physician. 2002 Oct 1;66(7):1239-1249
(3) Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13.
(4) Merenlender-Wagner A, Dikshtein Y, Yadid G. The beta-endorphin role in stress related psychiatric disorders. Curr Drug Targets. 2009 Nov;10(11):1096-108.
(5) Rapkin AJ, Morgan M, Goldman L, Brann DW, et al. Progesterone metabolite allopregnanolone in women with premenstrual syndrome. Obstet Gynecol. 1997 Nov;90(5):709-14.(64) Maruti SS, Li L, Chang JL, Prunty J, Schwarz Y, Li SS, King IB, Potter JD, Lampe JW, et al. Dietary and demographic correlates of serum beta-glucuronidase activity. Nutr Cancer. 2010;62(2):208-19.