Updated: Feb 23
If you talk to your friends who experience monthly bleeds, you will likely find that many of them report physical and emotional changes leading up to their period. Around 50% of women of reproductive age experience PMS; with 5% having a severe form of PMS called premenstrual dysphoric disorder (PMDD).
Premenstrual syndrome (PMS) is classified as reoccurring luteal phase symptoms (between ovulation and your period) that tend to subside within hours of a period arriving.
Some mild PMS symptoms are normal as your hormones fluctuate throughout the month, as they’re supposed to. These are normal, natural, cyclical, fluctuations that you will likely feel the effects of. However, debilitating PMS is not normal. Common yes, but normal, no!
Thankfully, there are many supportive options I’ll cover in this blog that can assist your PMS symptoms. Because PMS refers to a larger and varying set of symptoms. and not ‘one thing’, PMS can refer to any of the below symptoms you experience in the 2 weeks before your period.
These symptoms are categorised into:
Psychological – Irritability, anger, depression, anxiety, mood swings, crying and tearfulness
Physical – Headaches, breast pain, tenderness and swelling, period pain and cramping, back pain, bloating, fluid retention, fatigue, insomnia, food cravings, and weakness
PMS as a diagnosis has then been classified into 4 specific types:
1. PMS-A (anxiety)
Signs of nervous tension, irritability, anxiety, mood swings
2. PMS-D (depression)
Low mood, avoiding social situations, crying, anger, forgetfulness, insomnia, inability to concentrate
3. PMS-H (hyper-hydration/fluid retention)
Breast pain and tenderness, lower body swelling, bloating, abdominal discomfort
4. PMS-C (cravings)
Food cravings, increase in appetite, fatigue, headaches
Knowing which type of PMS you have will help you to determine which treatment options are best for you.
What causes PMS?
Firstly, your hormones nor yourself are to blame for PMS! Your hormones are beneficial, necessary, and are made to support you. Whether you have elevated or low levels of certain hormones will contribute to PMS symptoms, but it is not the problem of the hormones themselves. The levels, ratios, and timings of your hormonal fluctuations matter.
There is no one singular cause for the symptoms of PMS, however likely causes include:
Hormonal imbalances – excess oestrogen, low progesterone, elevated prolactin (hyperprolactinaemia)
Inflammation – prostaglandin and cytokine imbalances, underlying medical condition, insulin resistance
HPA axis dysfunction – chronic stress leading to the abnormal regulation of cortisol
Nutrient deficiencies – including magnesium, vitamin B6, calcium, and iodine
Excess levels of aldosterone or antidiuretic hormone (ADH) leading to sodium and water retention
Abnormal neurotransmitter response – deficient serotonin output, decreased GABA
Now for the good part - lets troubleshoot solutions to your PMS symptoms!
Symptom 1; Pain and cramping
If strong period pain is a symptom for you every month, I encourage you to read this blog and adopt the relevant treatment options. The section on what hormones to test and at what time of your cycle, may be relevant for you.
For pre-menstrual and day 1 cramping I suggest trying 1 - 2 of the following options:
Magnesium supplementation, 300 – 800mg in split doses
Turmeric, which has the added benefit of lightening heavy periods
Fish oil, 2 – 3g of omega 3 daily
Calcium citrate 1,200 daily
Zinc 30 – 50mg daily after food
If you have low luteal phase progesterone levels, Vitex is an option to consider
Herbal analgesics (natures pain killers!) include Jamaican dogwood, California poppy, Corydalis, and Willow bark. Speak to your Naturopath to see if these may be appropriate for you
A few of my favourite magnesium options; magnesium with taurine, Vitamin C and B
vitamins, magnesium citrate capsules, and a magnesium citrate + glycinate powder
A note on histamine: