Do you have to live with PMS symptoms?

Most women grow up believing that PMS – the pre-menstrual syndrome – is an inevitable and normal part of being a woman. After all, so many of us experience PMS symptoms on a regular basis, it totally makes sense that we believe that that’s just the way things are supposed to be. We just accept that we’ll keep experiencing symptoms that severely diminish our quality of life. But most women don’t know? PMS is not normal. Menstruating individuals don’t have to suffer over and over again before their period. When it comes to PMS, the main thing you’ll want to do is to uncover and heal the underlying causes of your symptoms.

PMS stands for ‘pre-menstrual syndrome’, which implies the time before your period, but it can actually occur any time after ovulation, during the luteal phase. It involves a group of different physical, psychological and emotional symptoms. Experts believe that PMS is triggered (at least partially) by the cyclical hormonal changes that occur during the menstrual cycle. What is striking here, however, is that problems usually only occur when the hormones are out of balance – for example, when there is too much estrogen in the body relative to progesterone (also known as estrogen dominance), or when there is not enough progesterone.

Let’s recap: Cyclical hormonal fluctuations are normal and to be expected. However, they should not be considered the root cause of the problem, but rather a symptom of an underlying hormonal imbalance. Experts also believe that nutrient deficiencies may play a role in PMS symptoms. Research has shown a link between low vitamin D, calcium and magnesium levels and PMS symptoms. If you’re still thinking about why you should learn more about your cycle: Please consider that research has shown that regular ovulation protects women’s health long term, especially when it comes to preventing osteoporosis, heart disease, heart attacks, and breast cancer (all of which are leading causes of death in women). In short, ovulation is incredibly important, not just if you’re trying to get pregnant.

There are many different ways PMS can manifest. Symptoms include, for example:

• Acne
• Bloating and digestive issues
• Sensitive, tender breasts
• Cravings
• Mood swings
• Irritability, moodiness and/or depression
• Tiredness and/or fatigue
• Headaches and/or migraines
• Difficulty concentrating
• Lower back pain
• Cramps

PMS can be categorized into 5 different types:

The English word ‘anxiety’ stands for fear and restlessness. The key symptoms can be: feeling overwhelmed, feeling more sensitive than usual (especially to perceived rejection or criticism), nervousness or irritability.

The possible causes are: hormonal imbalance, insufficient neurotransmitter synthesis: low serotonin levels, adrenal fatigue as well as cortisol dysregulation.

The main symptoms can be: intense cravings for carbohydrates and sugar, an increase in appetite, fatigue, headaches.

Possible causes are: low serotonin levels (carbohydrate intake temporarily increases serotonin – that’s why sweets, for example, make us feel good for a short amount of time), adrenal fatigue causes low cortisol levels, which can cause cravings for sugar.

The word ‘hyperhydration’ refers to too much water in the body. The main symptoms can be: bloating, breast tenderness/swelling, weight gain of 1-2 kilograms.

Possible causes are: an excess of estrogen, increased stress, which causes the adrenal glands to release an excess of the stress hormone cortisol and aldosterone, which then leads to salt and water retention.

As the name suggests, this PMS type is about depression and depressive episodes. The main symptoms can be: Depression coupled with lethargy, forgetfulness and confusion.

Possible causes are: hypothyroidism and low serotonin levels.

In this PMS type, you experience different symptoms from all categories. So, several symptoms of the different PMS types may occur together.

Cravings are a PMS symptom that an incredible amount of women struggle with. During the luteal phase and just before their period, they feel like it’s impossible to keep up their otherwise healthy eating habits. Well, the intense cravings that PMS sometimes brings can throw off all of us. Again, it’s very important to eliminate the root causes of cravings.

A drop in hormone levels of estrogen and progesterone before your period can lead to tender, sensitive breasts. These changes can also lead to lymph node swelling, which can also contribute to breast pain.

There may also be a link between breast pain and a hormone called prolactin. This hormone stimulates the production of breast milk in women after giving birth. However, it can also affect the breasts if you have not yet given birth. In the context of PMS, tender, swollen breasts are usually a sign of hormonal imbalance.

Many women notice a connection between headaches and hormonal changes in the menstrual cycle. The hormones estrogen and progesterone can also affect brain chemicals associated with headaches. Balanced estrogen levels can relieve headaches, while declining or wildly fluctuating estrogen levels can worsen headaches. Although hormonal fluctuations can affect headaches, you are not completely at the mercy of your hormones. In most cases, you can prevent unwanted symptoms by simply living in tune with your cycle.

A hot flash is a sudden rush of heat, often in the upper body and face. Doctors don’t know exactly what causes it, but they believe that hormonal changes also affect the body’s temperature regulation.

According to the ‘Center for Women’s Mental Health’, some women are hypersensitive to the natural hormone changes that occur during the menstrual cycle. This hypersensitivity can predispose a person to premenstrual mood swings. Severe premenstrual mood swings, however, may indicate an underlying medical condition and/or hormonal imbalance.

The menstrual phase is known to affect sleep stage 2 and REM sleep. In women, independent of PMS, it has been found that during the mid-luteal phase, compared to the early follicular phase, the N2 stage (NREM 2) increases and the Rapid Eye Movement (REM) stage decreases. However, slow-wave sleep has been found to increase in women with PMS compared to women without PMS as melatonin levels decrease. Research has attempted to correlate sleep in PMS with polysomnographic findings. Only subtle EEG changes were reported, which included an increase in theta and a decrease in delta brain waves during the late luteal phase. However, despite comparable nighttime awakenings and other EEG parameters, women with PMS do seem to have poorer sleep. Women with PMS showed a lower response to melatonin in the luteal phase than in the follicular phase. Consequently, this disruption of the circadian rhythm could also be the cause of the development of mood disorders in the late luteal phase. 

In addition, increased levels of progesterone and decreased levels of its metabolite (allopregnenalone) exacerbate sleep disturbances in the luteal phase. In women with PMS, the concentration of allopregnenalone decreases even further in the luteal phase, leading to an increase in gamma-aminobutyric acid (GABA). Elevated GABA levels are in part responsible for mood swings, anxiety, depression, and sleep disturbances during the luteal phase in women with PMS.

The prevalence of major depression in studies was 11.3% of women who screened positive for moderate PMS and 24.6% of women who screened positive for severe PMS. Women who reported taking antidepressants and oral contraceptives were at higher risk for major depression than women without either of these conditions. Women who reported job dissatisfaction also had a higher risk of PMS. A higher relative risk of both PMS and major depression than women without PMS or major depression was related to factors such as high psychological distress, use of psychotropic drugs, and bad (self-rated) health.

A study of 720 women aged 15 to 49 years examined how premenstrual syndrome was associated with aggression. The PMS prevalence was 48.75%. There was a statistically significant difference between groups in anger and anger control. The scores of women with PMS for constant anger and aggression were significantly higher. The scores for anger control were at a significantly lower level. Women with PMS had higher scores for anger and lower scores for anger control.

Many women report experiencing gastrointestinal symptoms during menstruation, but there are few studies that quantify the prevalence or nature of these symptoms or consider the factors associated with them. The few studies that have examined the occurrence of gastrointestinal symptoms associated with menstruation have addressed a narrow range of symptoms (for example abdominal pain, bloating) or focused on individuals with pre-existing gastrointestinal conditions. 

We live in a society where being busy and productive all the time seems to be highly praised. Fact is, however: we need to fundamentally change our attitude towards stress. Research shows that the more stressed we are, the worse PMS symptoms become – and that stress reduction techniques can be effective and natural PMS relief measures. So grab your yoga mat, download a meditation app, or simply make more time for any activity that relaxes you.

Inflammation in the body is most often a response to injury or stress and can be triggered by a variety of environmental factors. From an unhealthy diet and lack of exercise to toxic health and personal care products. Prostaglandins also play a role in this: prostaglandins are hormone-like substances that control the body’s inflammatory response. Experts believe they can trigger a variety of PMS symptoms. 

Sugar is one of the most pro-inflammatory foods – and more inflammation means more PMS. Less sugar and healthy alternatives are a must if you’re trying to manage your PMS.

We probably don’t need to say it, but we’ll say it anyway: smoking is bad for your overall health, including your hormone balance. And: Women who smoke are twice as likely to get PMS. We say: No to cigarettes!

Coffee promotes the production of prostaglandins and can increase the risk of cysts, fibroids and period pain. Coffee also depletes the body of important nutrients for hormone balance, such as magnesium. 

By now you’ve probably heard about the importance of the circadian rhythm and how important it is to sleep well, get natural light during the day, and so on. But maybe you haven’t heard about the importance of living in harmony with your infradian cycle – for women, this cycle is actually just as important as the circadian rhythm. If you don’t support your body’s shifting needs during each of the four phases of your cycle, your long-term health and quality of life will suffer as a result.

When it comes to treating PMS naturally, aligning your lifestyle with your cycle should be your first step of action. Through targeted strategies in the areas of nutrition, exercise and lifestyle, it is possible in most cases to alleviate PMS and proactively prevent unpleasant symptoms. A 2016 meta-analysis published in the ‘Journal of Chemical and Pharmaceutical Science’ also concluded that vitamin B6 could be good support for PMS symptoms. Other researchers have concluded that vitamin D and calcium may reduce both the severity of symptoms and the risk of PMS.

Vitex Agnus Castus is native to the Mediterranean region and western Asia. The plant is traditionally used to relieve symptoms of a number of disorders, including those associated with PMS, and is widely used, especially in Europe. The berries are the most commonly used part of the plant and contain a wide range of potentially active ingredients. The mechanism of action has been studied in human, animal and in vitro studies. It has been shown to bind to dopamine receptors and act as an agonist (that means it stimulates the receptor) in vitro. In humans, it has been shown to decrease FSH levels and increase LH, resulting in a decrease in estrogen and an increase in progesterone and prolactin levels. Several studies have shown a decrease in prolactin levels after a high-dose treatment with Vitex Agnus Castus. The effects of the plant on PMS have been the subject of numerous clinical reviews, but no meaningful systematic review or meta-analysis has yet been published demonstrating that it really is helpful for treating PMS. In the end, we can only repeat that when it comes to treating PMS it is necessary to eliminate the root causes.