PMS or pre-menstrual syndrome is also sometimes referred to as PMT or pre-menstrual tension. PMS is such a common complaint from many of my female patients (about 75% of women suffer from PMS) and I find that many ladies see it as a ‘normal’ part of being a woman. And yes, for around a day or so while your progesterone levels are dropping before your period, a few minor symptoms might be considered normal. Tiredness, breast tenderness, sugar cravings, mild bloating and irritability for around 1 day is hard to avoid due to hormone changes that take place to bring on a period.

However any symptoms lasting for more than a few days can be a sign of an underlying hormonal imbalance. It is not ‘normal’ or something you have to put up with. A week of PMS symptoms means you are spending ¼ of every month not feeling yourself! Some of my patients complain of PMS symptoms for a whole week, others start to not feel right all the way from ovulation (mid cycle), which means 2 whole weeks of PMS. I have seen women suffering from extreme mood issues, depression, anxiety, insomnia lasting 7-10 days each month. Women who need to wear 2 crop tops for a week due to breast pain. Women whose weight can fluctuate by 2-3kgs with severe fluid retention, feet swelling and abdominal bloating. Skin breakouts and acne. Night sweats and insomnia. Extreme lethargy that makes it hard to get out of bed. I have had women report that their relationship with family members suffers immensely for that week before their period as they feel their emotions are out of control. Women who have told me that every month at the same time they contemplate divorcing their husbands, only to realise a few days later that there is no problems. If you can relate to any of this- you are not alone! And these symptoms are a sign that you have a hormonal imbalance that needs addressing.

Below outlines the different types of PMS and the symptoms associated with each:

PMS-A (ANXIETY): Nervous tension, anxiety, mood swings, irrationality and irritability. This is generally due to a high oestrogen to progesterone ratio or low progesterone. This is the most common form of PMS that I see in my clinic.

PMS-C (CRAVING): Increased appetite, sweet cravings, chocolate cravings, appetite dysregulation, headaches, dizziness, fatigue, fainting. This is believed to be due to an exaggerated insulin response to carbohydrate and is commonly seen alongside PMS-A.

PMS-P (PAIN): Aches and pains, period pain, backpain, headaches and reduced pain threshold. This is believed to be due to prostaglandin imbalance leading to an increase in inflammation.

PMS-D (DEPRESSION): Depression, crying, forgetfulness, confusion and insomnia. Biochemically, this may be due to a low oestrogen to progesterone ratio and elevated androgens.

PMS-H (HYPERHYDRATION): Fluid retention, weight gain, swelling of extremities, breast tenderness and abdominal bloating. These symptoms are due to an increased in circulating aldosterone levels. Aldosterone may be elevated due to low progesterone secretion, high oestrogen levels, or stress. Prolactin may also be elevated when breast tenderness is prominent.

For most, once the period starts their PMS symptoms disappear. However then we are left to deal with period symptoms such as headaches, fatigue and pain! This can mean that many women only experience one week out of every four that they are free of hormonal symptoms.

Common causes of PMS

Below list the most common causes of PMS and hormonal imbalance-

1. Poor blood sugar regulation- Those prone to blood sugar problems such as insulin resistance or hypoglycaemia may find their symptoms are much worse before their period. Sugar and chocolate cravings alongside dizziness and feeling light headed are common and a sign that your blood sugar regulation needs a helping hand. Eating smaller, more regular meals can help, as can increasing your protein intake.

2. Low progesterone- Progesterone is a hormone that makes us feel happy, calm and content due to its effects on some of our brain based neurotransmitters. A drop in progesterone is what signals our period to start, however if our progesterone does not rise high enough after ovulation you will be much more prone to PMS symptoms, particularly type A. We can improve progesterone levels by working with herbal medicines and nutrients like B6. This hormone is less influenced by our diet or chemical exposure, however stress can lower progesterone level due to the effect of our stress hormone cortisol, so addressing stress levels is a big help.

3. Stress- High levels of stress hormones disrupt our other hormone levels. Progesterone levels become lower due to high cortisol and adrenalin, leaving us much more prone to PMS and other hormonal problems. Meditation, relaxation and other forms of stress management can go a long way to improving hormone health.

4. High oestrogen- Oestrogen is an important hormone, but high levels can wreak havoc on our hormones. High levels can cause all sorts of PMS symptoms such as fluid retention, swelling, breast tenderness, mood swings, depression, anxiety, sugar cravings, headaches and premenstrual pain. It is a common issue as we are exposed to so many environmental oestrogens from our environment from things like chemical residue, pesticides, plastics etc. Many chemicals that act like oestrogen (called ‘xeno-oestrogens’) are prevalent in our society and are a huge problem. Improving liver clearance of oestrogen is the most effective treatment technique to combat this, as well as improving progesterone levels as these 2 hormones will always work in balance. Trying to lower your chemical exposure and ensuring you eat organic meats, chicken, dairy and eggs can also help.

5. Low exercise- various studies have shown that people who don’t exercise will have more PMS symptoms than those that do. Studies have also shown that those with PMS who begin exercising regularly can reduce their symptoms.

6. High caffeine intake has also been shown to worsen PMS, so I always start by suggesting that women cut their coffee and tea intake right back to 1 cup a day.

7. High dairy intake is another possible trigger for PMS. Reduce your intake of milk, cheeses, creams, yoghurts, ice cream etc can play a big part- especially if your PMS symptoms involve skin breakouts and digestive upsets.

The most important step you can take is to get your symptoms and hormone levels investigated by a professional.  Please email me@hayleystockbridge.com.au for more information or call our reception team to book an appointment with our naturopaths Hayley or Aimee.

Nicola Johnson

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