According to the National Association of Premenstrual Syndrome (NAPS) in the UK, one in three women suffer from PMS. Critical times for hormonal imbalance occur through the luteal phase of the cycle; when ovulation occurs and in the few days leading up to a period, at which times symptoms, both physical and emotional, are likely to increase.
PMS is for sure, a complex issue, and one that most women simply live with. The diverse range of not so joyous symptoms ranges from physical to psychological and behavioral and includes bursting into tears for seemingly no reason, feeling insecure and lacking confidence, sugar cravings, mood swings, irritability and anxiety, headaches, insomnia, forgetfulness and confusion, bloating and withdrawal from social activity …the list goes on. For one in twenty, the symptoms are significant enough to effect life on a daily basis, which for some leads to violence and severe depression or attempted suicide.
For many years PMS was dismissed as a psychological problem and it is still unclear what causes it. Indeed, there’s still a lot of research to be done and things are made even more unclear because there’s no one size fits all solution. According to Nicholas Panay, consultant gynecologist and chairman (NAPS) ‘One woman’s PMS is not another’s. It is this diverse range of symptoms that makes it difficult to unravel the causes of PMS.’
One things for sure though …it’s the ratio between oestrogen and progesterone that cause hormonally related symptoms that dictates whether hormones are balanced or not and it is thought to be oestrogen dominance (when the level of oestrogen rise and progesterone decreases) that causes the problem. Add stress and a diet high in refined sugars, saturated fat, dairy and low fibre with low nutrient density and symptoms increase significantly.
Incidence of hormonal imbalance increases between the ages of 30-40.
A hormonal disruptive event such as pregnancy or miscarriage can have a significant effect on the oestrogen : progesterone ratio.
If you have a history of depression in your family, you may be pre-disposed to hormonal imbalance.
A BMI over 27.
Exercise isn’t a core part of daily life.
A diet high in sugar
Excessive alcohol consumption
A diet low in nutrients
So what to do about it…
The good news is that there are several areas of both diet and lifestyle that can reduce common PMS problems relatively quickly.
Let’s start with stressbecause you could have the best diet in the world, but if stress is present, dietary influences are unlikely to make a significant difference.
It’s widely considered that stress is a key factor in the levels of PMS women experience. Progesterone, oestrogen and the adrenal stress hormones (inc cortisol) are derived from the same source and stress will create an imbalance in hormonal patterns so that they become out of rhythm.
Stress also depletes nutrient reserves resulting in tiredness which can lead to a cycle of can’t sleep because of stress, and then feeling more stressed because of tiredness. Different solutions apply to different people so try taking some time out, yoga, meditation, taking up a hobby …just generally getting out there more and enjoying what you do.
…and moving on to diet
1. Stick to complex carbohydrates, ie choose whole grains over processed foods such as refined sugars, white rice and white flour goods, eg bread, pasta, doughnuts, cakes etc.
2. Increase dietary fibre; Oestrogen is processed by the liver and passed into the intestine. A high fibre diet ensures that oestrogen moves through the digestive system quickly and is so excreted faster; vegetarians for instance have a much higher faecal excretion of oestrogen.
3. Minimise vitamin and mineral deficiency and move to a nutrient rich diet. Choose organic over conventional and buy local and seasonal where possible.
4. Reduce red meat and dairy intake; both promote hormonal imbalance, ie excessive oestrogen and reduction of progesterone. Dairy also blocks the absorption of magnesium which has a calming influence on body and mood.
5. Increase essential fatty acids (EFAs); these help mood and symptoms of depression.
6. Exercise increases the oxygen level in the blood which helps in nutrient absorption and efficient elimination of toxins from the body. It also helps to keep hormone levels more stable.
7. Drink more water …minimum of 1 litre every day, particularly both weeks either side of a period.
Specific foods to increase:
1. Whole grains: Experiment and find what you enjoy; oats, brown rice, quinoa spelt, rye.
4. EFAs (aka the ‘good’ fats) including: Oily fish, olive oil, Flax, hemp, sunflower and pumpkins seeds and their oils.
Specific foods to reduce:
1. Alcohol is not only a depressant but it can interfere with the way the body processes oestrogen so reducing to an absolute minimum in the week running up to a period, or leaving out altogether is a smart move.
2. Reduce refined sugars …it plays havoc with blood sugar levels.
3. Reduce caffeine; it’s linked to breast tenderness and stimulates the central nervous system which can cause feels of anxiety and being ‘jittery’. It also acts as a diuretic and can deplete important nutrients.
Other options include alternative therapies such as acupuncture, reflexology, massage etc so it’s well worth trying a few sessions to see if they make a difference for you.
Supplementation is diverse and again there’s no single supplement that will fix all.
There’s an array of herbal supplements such as black cohosh and dong quai which are effective in balancing hormones. Milk thistle for instance cleanses the liver which helps improve liver function, thus enhancing the body’s ability to metabolise oestrogen.
Vitamins such as a good quality multi-vitamin and mineral increase general nutrient levels in the body; vitamin B complex often reduces stress and vitamin E can be useful if you experience sore breasts. Minerals such as magnesium is known to have calming effect along with calcium which balances hormones. Probiotics aid good digestion and excretion which helps to expel excess oestrogen from the system and omega oils in combination with amino acids such as GABA, serotonin and tyrosine can also work well with symptoms including anxiety, depression and even headaches.
These in combination with a whole food diet which includes lots of vegetables, phyto-oestrogens and omega oils can help improve symptoms significantly. It’s best to keep a diary for diet to monitor and record symptoms and this helps to figure patterns in your own cycle. Also, never under estimate the importance of balance in your lifestyle. It’s really worth putting the effort in to work on stress levels too. One thing’s for sure, we all know our own bodies better than anyone else, so it’s worth following our intuition and figuring out what works for us individually. Do your own research too, and be in control of what’s happening in your own body …that’s often so much more powerful than what any doctor can tell you.
Sarah Lantry received her training at Integrative Nutrition in New York City. She is certified by the American Association of Drugless Practitioners, leads workshops on nutrition, and offers individual health and nutrition coaching to busy professionals and families