Naturopath’s Guide to PMS

If you feel like your moods and emotions are on a crazy roller coaster leading up to your period then you may be struggling with PMS. Pre-menstrual syndrome (PMS) refers to the physical and emotional symptoms that some women experience about a week or two before their period (in the luteal phase). A study conducted on medical students found the rates of PMS to be as high as 89%. Less than 5% of women may experience a more severe form of PMS called Premenstrual Dysphoric Disorder (PMDD). 

There are 4 different types of PMS: 

1. PMS-A (anxiety) This one is the most common type affecting 70% of women 

Signs of nervous tension, irritability, anxiety, overwhelm, feeling on edge, mood swings, insomnia, feeling more sensitive than usual

2. PMS-D (depression)

Low mood, avoiding social situations, crying, anger, forgetfulness, insomnia, inability to concentrate, confusion 

3. PMS-H (hyper-hydration/fluid retention)

Breast pain and tenderness, weight gain, lower body swelling, bloating, abdominal discomfort

4. PMS-C (cravings)

Food cravings especially carbohydrates, appetite increase, fatigue, headaches

Fluctuations in your moods, energy levels, appetite throughout the month are a normal and healthy part of having a menstrual cycle. However having PMS that impacts your relationships, job and life although very common is NOT normal. The good news is that lots can be done to improve PMS so that you don’t have to suffer every cycle.

But firstly what causes PMS?

There is not one singular cause of PMS, there may be a combination of multiple causes and these can vary from person to person. Here are some of the possible influences on PMS: 

• Hormonal imbalances – Excess oestrogen compared to low progesterone in the luteal phase. Hyperprolactinaemia or high prolactin is another hormonal imbalance commonly associated with PMS and particularly breast tenderness and pain in the luteal phase. A simple blood test can be done to investigate your hormone levels and start addressing them. 

• Nutrient deficiencies – Especially of Magnesium and B6

• HPA axis dysfunction –Abnormal function of the hypothalamic pituitary adrenal axis function which can lead to low adrenal hormone function 

• Inflammation – Increased inflammation is associated with PMS

• Excess levels of aldosterone or antidiuretic hormone (ADH) leading to sodium and water retention 

• Abnormal neurotransmitter response to ovarian signalling 

So we know the different types and different possible causes, now comes the good part. What can you do to fix this? 

Let’s start with your diet and lifestyle because PMS is a reflection of your general health. Mastering these basics and then adding in herbal and nutritional supplements is the way to go:

What to eat for PMS- A diet high in fresh fruits (2 serves daily), vegetables (5 serves daily), nutrient dense whole foods and low in processed and highly refined or sugary foods. In particular, increase cruciferous vegetables (broccoli, cabbage, brussel sprouts) in your luteal phase to help with the detoxification of oestrogen and prevent excess build up. Eating an abundance of magnesium rich foods is another way to reduce PMS. These include leafy greens, oats, nuts and seeds, seafood and meat. It is also important to have enough Omega 3 fatty acids as these help to regulate inflammation. Foods high in Omega 3 include fatty SMASH fish (salmon, mackeral, anchovies, sardines, herring) and vegan options include chia seeds, flaxseed meal and oil, walnuts, and algae oil. Cows dairy is thought to worsen PMS as the A1 protein it contains stimulates the release of inflammatory molecules. Likewise saturated fats and deep-fried foods are also inflammatory and can therefore worsen PMS as well.

Caffeine - Caffeine intake has been strongly associated with worsened PMS. Lowering or completely eliminating your caffeine intake is important especially considering caffeine affects the absorption of Calcium and Magnesium which help to prevent PMS. 

Sleep- Try to get around 8 hours of sleep consistently by setting a regular sleep and wake time, making your bedroom dark and cool and avoiding screen time before bed. Insomnia has been shown to be significantly associated with premenstrual symptoms and painful periods. 

Stress reduction-Some ways to manage and reduce stress include talking to friends or family about it, journaling, yoga, meditation, EFT or massage. 

Exercise - Regular exercise helps with mental health not only just before your period but throughout the entire month. It can also help with fluid retention that a lot of women experience as a PMS symptom too. It is important to not over exercise so as to not deplete the body but find forms of movement that feel good, sustainable and that you enjoy. 

Now that we have covered those let’s get into the nutritional and herbal supplement options: (*Note it is best to speak to a qualified health practitioner before self-prescribing supplements you may or may not need!)

• Magnesium - Magnesium helps with anxiety, sleep issues and cramping before and during your period. It helps to enhance GABA activity in the brain which is our calming neurotransmitter. Specifically the forms magnesium glycinate (for nervous system support and sleep) and citrate (alleviates pre period constipation). Magnesium has also been shown to help with sugar cravings and fluid retention in the luteal phase. 

• B6 - Otherwise known as pyridoxine is one of the most well-known treatments for PMS. It helps to regulate production of GABA and serotonin which both have effects on mood, pain, anxiety and depression. B6 is also responsible for transporting Magnesium into cells and helping to produce progesterone which again helps with PMS reduction. 

• Zinc - A case study found that higher serum levels of zinc and total antioxidant capacity were associated with a lowered risk of PMS. Zinc also helps with acne which can also flare for some women before their periods. 

• Essential fatty acids - These help with menstrual related pain and other PMS symptoms and can be taken as a fish oil supplement or in the foods listed above. 

• Calcium - Calcium helps with mental symptoms of PMS including agitation and irritability. 

Key herbs that help with PMS:

Chastetree- This herb is used to reduce PMS symptoms including mood swings and breast tenderness. It can help to raise progesterone levels and so is often dosed in the luteal phase only of the cycle. 

St John’s Wort- This helps mostly with mood changes associated with PMS and to promote a restful sleep. St John’s Wort affects the absorption of some medications so please check with your doctor before taking this herb. 

Ashwagandha- This herb has many benefits and supports the adrenal system to assist with healthy hormone production and stress reduction. 

Saffron - This herb has antidepressant activity making it useful in women with PMS but also PMDD. 

Tumeric -Tumeric is very well studied for it’s anti-inflammatory effects but it has also been shown to demonstrate a neuroprotective effect and modulate levels of brain-derived neurotrophic factor, noradrenaline, dopamine and serotonin which might explain its role in relieving the mood and behavioural symptoms of PMS. 

By having a healthier lifestyle, reducing stress and taking advantage of herbal medicine PMS can be a thing of the past.  You don’t have to suffer in silence with PMS, get in contact with me and I can help you out!