By Diana Arundell University Qualified Naturopath
Hormones play an important part in our body’s orchestra of health and wellbeing. They are important in their role in the growth and reproductive systems in both men and women but also impact many other systems of the body. Hormonal imbalance can show up as mood disorders including anxiety and depression, as well as sleep disturbance, fatigue and digestive disturbance, with symptoms ranging from mild to debilitating.
Premenstrual syndrome (PMS) refers to signs and symptoms experienced leading up to and during menstruation. 75% of women experience PMS to a greater or lesser degree and it appears rather than there being just one simple cause, there are a number of contributing factors to PMS including diet, lifestyle and an imbalanced rising and falling of hormones such as oestrogen and progesterone. PMS is common but does not need to be inevitable.
The menstrual cycle can provide a lot of information about a woman and her health. The monthly period (or absence of it) and the presence of PMS can be considered a ‘report card’ for the month on how health, wellbeing and hormones have been travelling.
The more common symptoms and signs of PMS include breast tenderness, bloating, mood swings (irritable, anxious, depressed) sleep disturbance, acne, headaches and food cravings. For some women these are noticeably mild and may last 24–48 hours, whereas for others these signs and symptoms may be so pronounced that they can hardly recognise themselves amidst it and symptoms may stretch out to 2 weeks before the period comes. It’s really important to track your menstrual cycle each month so it’s evident if the symptoms are cyclic and therefore more likely to be related to the menstrual cycle, or if there is no obvious repetitive pattern, then other causes need to be investigated.
Premenstrual dysphoric disorder (PDD) is severe premenstrual mood disturbance of depression and/or anxiety.
A woman’s menstrual cycle through each month can almost feel like passing through the 4 seasons. The monthly period and few days before feels more like winter when we tend to be a little quieter and homely. The energy improves as spring comes during which we move to the end of our period and transition into summer around ovulation. Things begin to wind down again through the autumn part of our cycle leading up to our winter period time again. It is natural to experience different levels of energy throughout the seasons of the menstrual cycle and unrealistic to expect ourselves to be bouncing out of our skin with energy 24/7 all month.
Things that may contribute to PMS include:
- Unresolved stress – physical, mental or emotional (stress hormones and reproductive hormones are intricately related)
- Weight loss or weight gain
- Low iron status (can be both a sign and a cause of an excessively heavy period and period pain too)
- Smoking (smokers are twice as likely to experience PMS)
- Insufficient intake of dietary protein and vegetables (especially cruciferous family such as broccoli, cauliflower, cabbage, brussels as these support healthy oestrogen metabolism)
- Too high intake of stimulants such as caffeine, sugar and alcohol may exacerbate PMS especially if consumed 2 weeks prior to menstruation
- Too much or too little exercise
- Hormone imbalance – the rise and fall of oestrogen and progesterone need to be in balance.
The coming and going of oestrogen through the cycle is necessary for ovulation and simulating other hormones required for a functional cycle. We need some oestrogen as it helps us feel good, but not too much as it then becomes too stimulating and can contribute to many of the PMS symptoms. Lara Briden describes oestrogen as “that interesting and charismatic friend who’s great to have around but can be become a bit overwhelming if she stays too long”. The drop in oestrogen towards the end of the cycle can contribute to moodiness as it contributes to a drop in serotonin and dopamine too which are ‘feel good’ neurotransmitters.
The ability to produce sufficient progesterone is important as it helps shelter from dramatic changes due to the rising and falling of oestrogen. It is also relaxes the nervous system by enhancing the production of the calming neurotransmitter GABA.
If changes in diet and lifestyle don’t reduce PMS signs and symptoms after three cycles then herbal medicine and supplements may be beneficial to support and nudge the body back into balance. Professionally prescribed supplements are more likely to have a positive impact than over the counter options as they will be specifically tailored to the individual, including therapeutic doses and correct timing of dosage. Nutrients that may help ease PMS include: Magnesium, B6 (pyridoxine), Iron, Zinc and the herb Vitex agnus castus.
The oral contraceptive pill (OCP) is often prescribed to ‘regulate your cycle’ or ‘balance your hormones’. Although the OCP is good for birth control, it actually does not regulate ‘your cycle’ or balance ‘your hormones’. It takes over your hormones and runs the show. The ‘regular’ period you appear to have each month is not ‘your period’, it’s more accurately a withdrawal bleed from the hormones that have been delivered to the body via the OCP during the month. Most likely when the OCP is stopped, the body will revert to it’s natural hormone state prior to the use of the OCP. With regards to giving short term symptomatic relief for PMS, some women find it helps and others find it exacerbates the signs and symptoms. In any case it doesn’t address the underlying cause.
Understanding hormones and their intricate balance can be a complicated journey so it’s always best to work with a health professional to help sift through the confusion. Lara Briden’s book ‘Period Repair Manual’ is an excellent reference book for understanding the menstrual cycle and natural approaches to treatment.
For further information or to make an appointment, contact Diana Arundell – The Avoca Naturopath and Nutritionist on 0410 465 900.
Diana Arundell is a university–qualified naturopath and consults from her Avoca Naturopath clinic. She has a special interest in fertility and pregnancy health, digestive health, immune function and family wellness programs. She was a nutrition lecturer at Macquarie University for 10 years, and is an accredited Journey Practitioner. For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.