Did you know that as many as 80% of women experience premenstrual syndrome (PMS)? Some tend to be moodier, while others tend to have more physical issues like bloating, tender breasts and skin breakouts. In some, PMS is followed by heavy menstruation. In case of heavy bleeding, iron supplementation can lessen PMS. Let’s see how changes in the diet, lifestyle and supplement plan can help ease this “time of the month”.
PMS refers to a sum of physical and emotional symptoms which occur each month in the second half of the cycle, after ovulation. In some women, this lasts two to three days before their period and, in others, it can last as many as 14 days.
PMS is due to the increased levels of reproductive hormones during this phase of the cycle and a relative drop of oestrogen to progesterone. Once menstruation starts, hormone levels drop again with symptoms improving quite quickly. Symptoms of PMS can range from emotional to physical complaints:
There are actually five sub-groups of PMS. Any woman may have some or all of these:
PMS is caused by fluctuating hormone levels. It worsens during times of hormonal instability, such as perimenopause, and when the thyroid or adrenal glands are not functioning optimally. It is also more prominent in women with hormonal imbalances such as PCOS, endometriosis, and fibroids. It is majorly affected by an unhealthy diet, lifestyle, stress and anxiety.
Oestrogen dominance can be due to PCOS, endometriosis, and fibroids, but it can also be due to high-stress levels and a suboptimal diet, with lots of processed foods and a lack of fibre. Some of the symptoms of oestrogen dominance are heavy, painful periods, irregular periods, breast pain and swelling, water retention, cellulite, mood swings and irritability.
Hormonal levels and oestrogen metabolites can be measured with functional testing, such as a dried urine test that can be done in the comfort of your own home. A dried urine test is the most accurate test when it comes to measuring hormonal levels, as it shows the levels of the free-form hormones.
Serotonin, in particular, a brain chemical that affects appetite, mood, energy and sleep, is found to be low in the second half of the cycle of women with PMS. A comprehensive hormonal panel (dried urine) measures the levels of the neurotransmitters serotonin and dopamine too.
Pro-inflammatory molecules trigger the uterus to contract during menstruation. Having too much of those prostaglandins due to generalised inflammation (diet, lifestyle) or due to excessive oestrogen results in extreme pain, headaches and possibly migraines.
Elevated histamine levels (as seen in atopic/allergic conditions) increase oestrogen production, creating a vicious cycle, which worsens menstrual cramps and other body aches.
Risk factors for PMS:
Following a personalised anti-inflammatory diet is the best way to start. An anti-inflammatory diet contains unlimited seasonal vegetables, some fruit, a sufficient amount of quality protein (pasture-raised eggs, wild-caught oily fish, grass-fed light cuts of meat), lots of healthy fats and oils (such as nuts and seeds, avocado, cold-pressed olive oil, olives), and minimise sugar, refined carbohydrates, hydrogenated fats, alcohol and processed foods. This way of eating also promotes balanced blood sugar, which addresses food cravings, water retention and mood swings.
Dairy and especially cow’s dairy promotes inflammation and can worsen PMS symptoms. Try going dairy-free for three consecutive cycles and notice any changes. Other sources of calcium are sardines, green leafy vegetables, sesame seeds, tahini, broccoli, and almonds.
Speak with your practitioner to make sure you are getting enough vitamin B6, fish oils, zinc, magnesium and calcium- if your diet is deficient, you will need to supplement appropriately. Magnesium, B6 and zinc are found to be lower in women with PMS. Ironically, in women that have been on OCP magnesium and zinc levels are used up.
Studies have also linked PMS severity to vitamin D deficiency. The amount of vitamin D that is obtained from the diet is minimal. If you are not sunbathing, you need to supplement! Your practitioner will tell you how much extra you need based on the season, your diet, your skin colour, and your location.
Boost omega-3s, to fight systemic inflammation, by consuming more oily fish (sardines, anchovies, mackerel, wild salmon, herring, trout), walnuts, hemp/chia seeds, freshly ground flaxseeds, flaxseed oil, grass-fed meats, grass-fed eggs, dark green leafy veg, algae. For some women, a 3-6-9 supplement is more appropriate.
Gamma-linolenic acid (GLA) in particular, more widely known as evening primrose oil, converts (with the help of magnesium, zinc, B-complex vitamins and vitamin C) to the anti-inflammatory prostaglandin E1, which has been shown to reduce all PMS symptoms.
Quite interestingly, iron is involved in serotonin production, no wonder why low iron levels often lead to low mood. Some women only need to supplement during menstruation, while others seem to be OK on an iron-rich diet.
If you are not sure if you are lacking all the above nutrients, your practitioner will guide you towards appropriate testing.
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