Premenstrual syndrome is physical, psychological and emotional complaints which affect up to 40% of women.
PMS can be classified into different categories. Keep reading and see if you identify with any of them. If you do, I have some effective options that may help.
PMS Pain (PMS-P) – Pain in areas like the lower back, joints, abdomen or other areas of the body.
PMS Hydration (PMS-H) – You might be consuming a lot of water and also retaining it in your body which can be seen as oedema.
PMS Depression (PMS-D) – Depressive symptoms can be associated with forgetfulness, confusion, insomnia, tearfulness and withdrawal.
PMS Anxiety (PMS-A) – You can feel worried, feel anxious about certain situations, irritable, have difficulty sleeping and impaired concentration.
PMS Cravings (PMS-C) – Cravings refer to the urge you might have towards sweet foods like chocolate or other sweets near the end of your cycle.
The “normal” menstruation cycle
In this section here, I’m going to break down the menstruation cycle to help you understand what happens during each stage of the month.
The break down will help you understand why the 11 tips I’m going to give you work. Alternatively, you can scroll down to the bottom and read them right now.
I will admit, this bit will get confusing, and there is no way around it. To try and counter that confusion, I’ve included a diagram with the different stages of your cycle.
Have a quick look at it then scroll down when you’re ready. If you get confused at times, just scroll back up to this image and refer to the section on the menstrual cycle you need.
There are different phases of the menstrual cycle with each stage involving the activation and deactivation of various hormones.
Day 1 to 13 is considered the follicular phase. During this time, progesterone and oestrogen levels are at their lowest which is detected by the hypothalamus.
Progesterone and oestrogen communicate to the hypothalamus because it tells it how much of a particular hormone is in the body. The hypothalamus needs to know this information because it relies on a negative feedback loop.
Once your hypothalamus has detected that your progesterone and oestrogen levels are low, it then liberates gonadotropin releasing hormone which then activates the pituitary gland to release follicle stimulating hormone (FSH).
The release of FSH allows the follicle to mature. The follicle is a casing that surrounds the egg.
While the egg is maturing, your oestradiol levels are rising too, which then activates the release of luteinising hormone (LH) from you pituitary gland.
The release of LH into the bloodstream induces ovulation and an increase in temperature. The process of ovulation involves the release of the egg from the follicle. The remnants of the follicle are then called the corpus luteum which has a significant role.
After ovulation, the next stage of your cycle is the luteal phase. During the luteal phase, oestrogen and progesterone are produced by the corpus luteum which gives a signal to your uterus wall to grow and thicken with nutrients for implantation by the egg.
If conception fails to happen during your cycle, then the corpus luteum breaks down and become Corpus albicans which then triggers the beginning of menses.
I get it, this all a bit confusing, but if you understand the above section then you will be able to figure out what potentially could be causing your PMS and why the natural remedies work.
What’s the cause of PMS?
The exact cause of PMS is not known, but there are many aggravating factors which I will discuss.
Progesterone and estradiol
One of the reasons why you may feel anxious or nervous around the luteal phase is due to the calming effects that progesterone has on the body.
The progesterone metabolite allopregnanolone (don’t worry about that big word) has an influence on the gamma-aminobutyric acid (GABA) system in the neurones which allows you to be more relaxed by inhibiting neurotransmission.
If you are suffering from increased severity of PMS, it could be because of increased levels of oestradiol and decreased levels of progesterone during the luteal phase.
However, this isn’t always the case in people who suffering from anxiety related symptoms of PMS as shown with studies on subjects who consumed progesterone with no cessation of PMS symptoms.
One of the most common PMS symptoms, mastalgia or tender breasts is found to happen due to an increase in prolactin within a 24-hour window. This large spurt of prolactin occurs in approximately 70% of women experiencing tender breasts.
PMS has been shown to overlap with reduced serotonin activity in the neurones. In case you don’t know, serotonin helps to balance your mood and a deficiency in this hormone can lead to depression.
Other symptoms of serotonin deficiency can be aggression, decreased pain threshold, difficulty concentrating, and carbohydrate cravings.
The deficiency is seen mainly during the luteal phase near menses. Interestingly, the amino acid tryptophan dramatically decreases in people suffering from PMS compared to those with little to no symptoms. I’ll tell you a bit later on how you can optimise your serotonin levels with tryptophan.
To add to this, your hormones oestrogen and progesterone both have an effect on your serotonin levels. Higher oestrogen levels have a protective effect against the breakdown of serotonin from reducing the enzymatic activity of MAO and COMT. Higher progesterone levels have the opposite effect and stimulate MAO and COMT which means less available serotonin.
Even though this is the case, it doesn’t mean that very high oestrogen levels are safe, nor does it mean that low oestrogen the sole reason for your low serotonin levels. I’ll talk about why you might be lacking serotonin when we get to the nutritional and herbal section of this article.
A recent study from 2016 has reason to believe that period pain is caused by acute inflammation. This is because the liver produces C-reactive protein (CRP) in response to inflammation and CRP was the marker measured in women with PMS.
Middle age women were recruited for this study and had their levels of CRP measured over a 1-year period. The study wanted to know if physical and psychological symptoms felt before their periods had an associated with raised levels of CRP.
A questionnaire was used to collected data about their PMS symptoms. Questions included a yes or no relating to severe headaches, feeling anxious/nervous/jittery, back/joint/muscle pain, increase cravings or appetite, mood changes, sudden sadness, breast pain or tenderness, weight gain or bloating, and abdominal pain or cramps.
The results showed that CRP levels above 3mg/L in women increased their odds of reporting PMS symptoms by 26% to 41%.
What this means for you is that avoiding behaviours like poor dietary and lifestyle choices can improve your PMS.
What might the doctors give me?
Non-steroidal anti-inflammatory drugs – for menstrual pain.
Selective serotonin reuptake inhibitors – for emotional and physical pain.
Birth control pills – for various PMS symptoms.
Diuretics – for water retention.
Helpful Nutrition for PMS
#1 – Calcium
A research paper wanted to test the results of other calcium studies in people with PMS by conducting their own trial. They recruited 466 women with PMS who had no difference in height, age, use of the oral contraceptive pill, or menstrual cycle length.
The 466 women were then split up into two groups, one group taking 1200mg of calcium carbonate per day, and the other group was taking a placebo.
The results showed the group taking the calcium saw a 48% reduction in their symptoms after the third cycle.
You don’t have to opt for calcium carbonate because you can obtain it from other sources. One thing to note about calcium carbonate is that it has a low absorption rate in the stomach. This means that you don’t have to consume as much from food sources to get your daily intake.
The calcium content in these foods is based on 100g servings.
- Sesame seeds – 989mg
- Chia seeds – 631mg
- Almond butter – 347mg
- Flaxseeds – 255mg
- Kale – 205mg
- Turnip greens – 190mg
- Dandelion greens – 187mg
- Garlic – 181mg
- Seaweed/Kelp – 168mg
- Brazilian nuts – 160mg
- Spinach – 153mg
- Taro – 149mg
- Hazelbuts – 149mg
- Parsely – 138mg
- Spirulina – 120mg
- Watercress – 120mg
- Beetroot greens – 114mg
- Bok choy/Pak choi – 105mg
- Pistachio nuts – 105mg
- Walnuts – 98mg
- Chives – 92mg
- Macadamia nuts – 85mg
- Okra – 82mg
- Spring onions – 72mg
- Hemp seeds – 70mg
- Yeast extract spread – 67mg
- Green beans – 61mg
- Pinto beans – 58mg
- Pumpkin seeds – 55mg
- Cashew nuts – 45mg
- Pine nuts – 16mg
- Coconut meat – 14mg
#2 – Magnesium
Magnesium has a significant role within your body as it is responsible for hundreds of metabolic processes. Specifically, in PMS, magnesium has the potential to do a lot of good.
In depressive symptoms of PMS, magnesium may be of benefit because it regulates the calcium ion flow in neuronal calcium channels. This regulation of calcium ions is essential as neuronal damage can happen which may manifest as depression.
There was shown to be rapid recovery in less than seven days with the administration of magnesium (glycinate and taurinate), at a dosage of 125-300mg just before bed.
Additionally, low magnesium levels accompanied by high calcium levels can lead to hyperexcitability, delirium, hallucinations, headaches, sleeplessness, confusion, irritability, agitation, anxiety or weakness and lack of energy.
During the follicular phase, there is an elevation in magnesium and a decrease in calcium. After ovulation during the luteal phase, there is less serum magnesium as well as calcium which is linked to increased progesterone concentration.
A study was done on three groups for four months who all had diagnosed PMS. The first group was assigned magnesium, the second group magnesium and vitamin B6 and the third group was taking a placebo.
After the intervention and analysis of data, they found groups taking magnesium (250mg a day) or magnesium (250mg a day) with B6 (40mg a day) had significant improvement in their PMS symptoms.
To reap the benefits of the improvements, you have to take magnesium on its own or in combination with B6 for at least two months before you notice a difference.
The magnesium content in these foods is based on 100g servings.
- Hemp seed – 700mg
- Pumpkin seeds – 592mg
- Flaxseed – 392mg
- Brzilian nuts – 376mg
- Sesame seeds – 356mg
- Chia seeds – 335mg
- Cashew nuts – 292mg
- Almonds – 270mg
- Pine nuts – 251mg
- Spirulina – 195mg
- Yeast extract spread – 180mg
- Hazelnuts – 163mg
- Walnuts – 158mg
- Shiitake mushrooms – 132mg
- Pecan – 132mg
- Macadamia nuts – 130mg
- Kelp – 121mg
- Pistachio nuts – 121mg
- Navy beans – 101mg
- Kale – 88mg
- Spinach – 87mg
- Lima beans – 74mg
- Beetroot greens – 70mg
- Globe artichokes – 60mg
- Pinto beans – 60mg
- Lima beans – 58mg
- Taro – 51mg
- Parsley – 50mg
- Potatoes – 43mg
- Chives – 42mg
- Okra – 40mg
- Coconut meat – 32mg
#3 – Zinc
An interesting study split subjects into two groups of people. The groups were divided into those with PMS and those without PMS. The results showed that those in the healthy group consumed more fruits and vegetables and had higher levels of zinc in their body. The other group with PMS has their diet assessed and were found to be consuming more hydrogenated oils which come from deep fried and off the shelf products.
The zinc content in these foods is based on 100g servings.
- Oyster – 78.6mg
- Beef steak – 11mg
- Pumpkin seeds – 10.3mg
- Sesame seeds – 10.2mg
- Hemp seeds – 9.9mg
- Shiitake mushrooms – 7.5mg
- Pine nuts – 6.45
- Cashew nuts – 5.8mg
- Pecans – 5.05mg
- Chia seeds – 4.6
- Pecans – 4.5mg
- Yeast extract spread – 4.2mg
- Brazil nuts – 4.05mg
- Almonds – 3.1mg
- Spirulina – 2mg
#4 – Tryptophan
Tryptophan, I said I’d get into more detail about this amino acid. I’ve included the simplest diagram which I could find that gives you all the information you need in one picture.
If you have a look, you will see that you need the amino acid L-tryptophan which is acquired from various meat and plant based sources. Beside each of the arrows on the left sit cofactors that are required to help transform the amino acid into serotonin.
You need all of those cofactors to produce serotonin, if you lack them, you will not be able to produce it.
The tryptophan content in these foods is based on 100g servings.
- Sesame flower – 1.1mg
- Spirulina – .9mg
- Cod – 0.7mg
- Cheese – 0.5mg
- Chia seeds – 0.4mg
- Beef – 0.4mg
- Chicken breast – .4mg
- Fenugreek – .39mg
- Pork – 0.39
- Lamb – 0.37mg
- Avocados – 0.03mg
- Apricots – 0.03mg
- Plums – 0.03
- Apricots – 0.01mg
#5 – Dietary alterations
A study wanted to investigate whether or not a vegetarian, low-fat diet reduces pain and PMS by affecting serum sex-hormone binding globulin (SHBG) concentration and oestrogen activity.
33 participants were required to follow a strict vegetarian, low-fat diet and were also given a placebo pill to take daily. The researchers measured the participant’s pain, SHBG and oestrogen before commencing. The results of dieting were compared to their original results and saw a significant improvement in all parameters with a reduction in body weight.
Losing weight was a byproduct of that study, but it’s important to consider if you want to reduce your PMS. There is a significant association with being obese and having a three-fold risk of PMS. Obesity is a risk factor that you can change by altering your eating habits.
What herbs can be used for PMS?
#6 – Vitex agnus castus
An extract of Vitex agnus castus called Ze 440 was tested at three different doses in 3 groups to see which was the most effective. The three dosages were 8mg, 20mg and 30mg given over three menstrual cycles.
The participants PMS symptoms measured were irritability, anger, headaches, mood alterations, bloating and breast fullness. They found that PMS symptom severity reduced dramatically in the 20mg and 30mg groups. However, the 30mg dosage didn’t offer any further therapeutic benefits compare to 20mgs.
The reduction in breast tenderness is because of the affinity chaste tree has for dopamine-2-receptors, this results in inhibiting the release of prolactin. As you already know, the hypersecretion of prolactin is responsible for breast tenderness.
The flavonoid apigenin from chaste tree binds to beta-oestrogen receptor subtypes. Oestrogen dominant states where you’re experiencing mood swings, breast swelling, tender breasts, mood swings, fluid retention, headaches and poor sleep patterns can possibly be helped from apigenin binding to these receptors.
#7 – Cimifuga racemosa
Black cohosh can be useful to help reduce the amount of oestrogen produced. The reduction of oestrogen is due to the decrease in luteinizing hormone secretion.
#8 – Hypericum perforatum
St John’s wort influences the serotonergic system. As discussed before, serotonin plays a significant role in improving your mood as well as decreasing aggression, improving your pain threshold, improving your concentration and reducing your carbohydrate cravings.
St John’s wort anti-depressant effect comes from one of its active constituents hypericin, which inhibits the breakdown of serotonin by MAO. Additionally, hypericin inhibits the release of a substance called interleukin 6, which regulated the release of cortisol. Lastly, this herb can inhibit the reuptake of serotonin, dopamine and GABA by another constituent in it called hyperforin.
#9 – Ginkgo biloba
A study involving 90 participants experiencing PMS symptoms were required to take 40mg of Ginkgo biloba leaf extract (EGb 761) 3 times per day beginning on the 16th day of the menstruation cycle and ending on the 5th day of their next cycle.
They followed these participants for a year and reported some great results. The extract was considered to be more efficient than placebo in relieving symptoms of PMS.
Ginkgo was able to improve breast tenderness, fluid retention, psychological symptoms like aggression and irritability.
Ginkgo exerts its psychological effects by maintaining the balance of prostaglandins which improves blood circulation, inhibits the MAO and thromboxane A2 methyl esterase and by decreasing the reuptake of these molecules.
Ginkgo can benefit you further by reducing cyclo-oxygenase and lipoxygenase which are both involved in the inflammatory pathway. Ginkgo possibly exerts other effects, but those are yet to be discovered.
#10 – Taraxacum officinalis
Dandelion is very useful as a diuretic. Dandelion might be something you need if you have water retention around menses. Water retention happens because of a hormone called aldosterone. Aldosterone is required to regulate the normal amounts of sodium and water in the body and is needed to regulate blood pressure.
If there is an excessive amount of aldosterone in the body, then you will retain water giving you that bloated look. High circulating aldosterone levels have been associated with higher oestrogen dominance.
How your lifestyle choices impact PMS
#11 – Identify what causes you stress
An interesting study looked at the psychological biomarkers in psychological stress and what it does to the body. It came to the conclusion that anything which is causing you stress externally like work, low socioeconomic status, loneliness, major life events, being a caregiver, etc. will all contribute to inflammatory processes when any of this become chronic.
It’s important to mention stress as a contributor to your PMS because you may not have realised it. Take an external look at your life and try to identify what’s impacting you negatively. Some situations you can’t avoid, but there are probably some right now you can detect and weed out of your life.
After reading this article, you should have a better understanding of what they typical menstruation cycle looks like, how your hormones affect your cycle and what drugs your doctors might prescribe.
I’ve also given an insight into what changes can be made nutritionally, what herbs can be integrated and why stress has a major impact on PMS.
What’s your experience with PMS? What has worked for you?