The condition known as premenstrual syndrome are actually a complete set of symptoms that are distressing both psychologically and physically, and which occur 7 – 14 days before menstruation, resulting in the end of the onset of menstruation.

Cramps are linked to imbalance in hormones, although it is not exactly clear how. Symptoms like cramps, bloating, an excess of “series two prostaglandins,” a result of unregulated hormone levels) may cause mood-swings and pain, which can cause the blood vessels in the uterus to constrict and muscles to spasms. Other symptoms include self-assessed irritability, altered sex drive, tension, mood swings, anger, headache and breast fullness. It is estimated that 30% to 40% of menstruating women are affected.

Sometimes heavy bleeding is caused by high amounts of estrogen, which stimulate the lining of the uterus to grow excessively. This may also be caused by low progesterone. Other reasons for irregular menses include: changes in body weight, emotional stress, unbalanced levels of estrogen and progesterone.

Reproductive hormones play a part in the etiology of PMS. Five to 10 days prior to menses, plasma estrogens rise and progesterone levels decline. This contributes to impaired liver function; reduced manufacture of important brain chemicals that control mood, such as serotonin, decreased action of Vitamin B6, and increased sodium and water retention. These changes are accompanied by an increase in follicle stimulating hormone (FSH) six to 9 days prior to menstruation, and peak aldosterone levels 2 to 8 days before menstruation. Prolactin levels are elevated in most PMS patients.

To control hormones, the doctor often prescribes “the pill.” Another possible acne aggravator is too much androgen (a male hormone produced by both men and women.)

Dysmenorrhea (a painful period) is a widely occurring problem that negatively affects the quality of life and interrupts daily activities. In one hospital study, 80 percent of women had a prevalence of dysmenorrhea, and 90 percent report having significant menstrual cramping. Non-steroidal anti-inflammatory drugs (NSAIDs) are the treatment of choice for most women suffering from mild and severe cramping.

Symptoms

Some of the leading symptoms include:

Cravings – there is an excessive carbohydrate craving in order to get quick energy. These symptoms can include an increased appetite, headache, fatigue, dizziness, and palpitations.
Mental Symptoms – includes symptoms such as crying, depression, fatigue, low sex drive, low self-esteem, irritability, forgetfulness, confusion and insomnia. The mechanisms of depression are due to an estrogen/progesterone imbalance.
Anxiety – the ratio of estrogen/progesterone is also a factor in exacerbating feelings of anxiety and stress. There is thought to be inhibition of endorphins, hormones that are related to a woman’s mood and pain. Adrenal stress is also a factor in feelings of fatigue, irritability, mood swings, nervous tension and increased appetite.
Fluid Retention – an excess of the adrenal hormone aldosterone is the main culprit here. Aldosterone regulates the balance of sodium, potassium, and chloride. The symptoms that are caused by this hormonal imbalance include retaining fluid, swollen extremities, breast tenderness and abdominal bloating.

Causes

Some of the most common causes of a women suffering from PMS symptoms include:

Plasma estrogen levels – that are usually elevated and plasma progesterone levels are reduced about 5-10 days before menses.
Stress – depletes serotonin and dopamine, two mood-enhancing hormones involved in the prevention of PMS symptoms such as breast tenderness, depression, and lack of motivation. Stress also raises the hormone aldosterone that contributes to water retention, loss of magnesium and inflammation.
Follicle Stimulating Hormone (FSH) – levels are elevated 6-9 days before menses.
Prolactin – a hormone from the pituitary gland in which levels are elevated in most PMS patient. High prolactin causes OMS symptoms including breast tenderness and swelling, anxiety and irritability.
Hypothyroidism – identifying and treating possible subclinical hypothyroidism may reduce the complications of PMS. Symptoms include hair loss, low energy, low libido, body temperature changes, dry skin, and foggy thinking. It is possible that adrenal stress is a primary factor in causing PMS symptoms.
Poor dietary factors – especially consumption of “inflammatory-prone” foods such as meat, refined sugar, colas, dairy products, artificial sweeteners, and junk food may be a contributing factor.

Types

Although many women do not experience the same symptoms, there are generally 5 known types of PMS. They are characterized by distinct symptoms relating to their underlying causes, although many symptoms overlap. Presentation of one or more PMS types is possible.

PMS A – deals with anxiety, paranoia, crying, emotional instability, mood swings and nervousness. This is usually caused by a progesterone deficiency. Also, the Chinese herb chaste tree (Vitex agnus-castus) can be used in combination with progesterone for heavy bleeding, spotting, infertility, and shortened cycles.

PMS C – is akin to cravings (especially sweets, chocolate, and refined carbohydrates), an increased appetite with insatiable hunger. Other symptoms include fatigue, hypoglycemia (low blood sugar between meals), and headaches. PMS C can be treated best with balancing blood sugar to reduce cravings and hypoglycemia. Eating smaller meals more often with a protein shake in between. Magnesium, chromium, potassium and zinc are useful. Consumption of green tea can also be beneficial.

PMS H – is mainly due to water retention and a heaviness and swelling caused by edema. Headaches, breast tenderness, bloating, and weight gain are common. Treatment should be similar to PMS A, although the emphasis is to balance sodium and potassium (aldosterone). Include dandelion tea to relieve water retention, and eat foods high in potassium including bananas, apricots, avocados, and broccoli.

PMS D – deals with severe depression, confusion, clumsiness, withdrawal, insomnia, and in severe cases, thoughts of suicide. PMS D is helped with foods (soy, flaxseeds, and fennel) and herbal supplements such as black cohosh, red clover, angelica, and licorice. These products have high levels of phytoestrogens, which can improve estrogen deficiency. For depression, try using 5-HTP at bedtime to raise serotonin.

PMS P – signifies pain caused by a pro-inflammatory chemical called prostaglandins. Pain and inflammation occurs in the joints, lower back, abdomen, and wrists. Headaches are common. PMS P can be managed with using anti-inflammatory herbs (curcumin, feverfew, devil’s claw, white willow bark), or by taking OTC non-steroidal products.

Pros And Cons Of Birth Control Pills

PRO: Women taking birth control pills have lighter and more regular periods, fewer cramps, and a reduced incidence of iron deficiency. Other benefits may be a decreased risk of ovarian cancer, endometrial cancer, ovarian cysts and benign breast disease.

CON: Side effects of taking the pill include breast tenderness, bloating, cessation of menstruation, depression, migraine, nausea, spotting, breakthrough bleeding, and weight loss or gain. Other risks (especially if you smoke) are blood clots, heart attack, high blood pressure, breast cancer, gallbladder disease, cervical cancer and benign liver tumors. The pill will also deplete Vitamins C and B complex from women’s body.

Diet

Nutrition always plays a role in health. There is little doubt that dietary choices play a role in the severity and duration of PMS. Some published facts show that women suffering from moderate to severe PMS have diets 62 percent higher in refined carbohydrates, 275 percent more refined sugar, 79 percent more dairy products, 78 percent more salt, and 55 percent less iron and zinc. PMS-prone women also have lowering intake of essential fatty acids (flax seed and fish oil), and lack adequate levels of magnesium and B-complex vitamins. Here are some general healthy recommendations:

Consuming an Acid-Alkaline Balance has a dramatic effect on health. The bulk of the diet should be alkalizing foods such as yellow, orange and green leafy vegetables; fruits; lentils and legumes; nuts and seeds; and spices. An average of 60-80 percent of food choices should be from the alkaline side.
Try to limit intake of refined carbohydrates such as sugar, breads, and pastas made from processed flours, cola, coffee, bananas, bagels, and other high-glycemic index foods because they may directly aggravate acne by stimulating insulin, which influences androgen metabolism. Follow an “anti-Candida” diet.
Limit or cut back on consumption of dairy foods, red meat, and other high saturated fats. They induce inflammation that exacerbates PMS symptoms. Drink plenty of pure mineral spring water daily.
Increase your intake of phytoestrogens, especially soy foods (tofu, tempeh, Miso, soy milk, soy beans). Decrease salt intake, especially if water retention is a problem.
It may be advisable to cut back on caffeine-containing products such as coffee, soft drinks, chocolate, and some pain relievers. Alcohol depletes B vitamins, magnesium and zinc, and damages liver cells.
Avoid eating feed-lot meat (eat range-fed, organic meats free of drugs, hormones, antibiotics and pesticide residues.) Avoid eating rancid unsaturated oils and hydrogenated fats.

Balancing Your Hormones

Eat a high fiber, low refined carbohydrate, and low protein (meat and dairy) to reduce inflammation. Increase consumption of soy foods.
Take a high-potency multiple vitamin/mineral formula daily. Extra vitamin B6, primrose oil, magnesium, and B complex can be helpful. The herb chasteberry (Vitex agnus-castus) is probably the most popular and effective supplement for PMS.
Establish a balanced gastrointestinal flora. This will help detoxify the liver of chemicals as well as the body’s composition of hormones like estrogen (in chemicals and meats, dairy and eggs). Take a probiotic to promote “friendly bacteria.”
Support liver function by dietary intake of raw fruits and vegetables and lots of filtered water. Decrease fat intake and supplement with folic acid, betaine, vitamin B12, choline, and cholagogues like milk thistle and artichoke.
Naturally balance your hormones by addressing the underlying causative factors. Such factors may include detoxification to clear estrogen from the system or applying external progesterone cream when estrogen-dominant symptoms are apparent.
Since the thyroid gland is the principle gland regulating menstrual periods, any impairment of thyroid function (including stress on the adrenal glands) can play a major role in menstrual problems. Copper toxicity has been associated with PMS.
Exercise 20-30 minutes at least 3 times a week to reduce stress and tension. Get 7-8 hours of sleep, and try more stress-management techniques (yoga, meditation, deep breathing.)
Avoid birth control pills, unopposed estrogen, pesticides of all kinds, chronic stress, feed-lot meats, and rancid unsaturated oils and hydrogenated oils.

Supplement Protocol

MULTI-VITAMIN/MINERAL FORMULA
All women experiencing PMS-type symptoms should supplement with a high potency preferably with green foods. Dosage: As directed on package.
VITAMIN B COMPLEX, with extra VITAMIN B6
B complex vitamins help metabolize hormones and control estrogen levels. The B complex vitamins reduce stress and are needed for the adrenal and thyroid glands (both regulate hormones). Vitamin B6 helps to reduce sugar cravings, irritability, and bloating. Vitamin B6 also works synergistically with magnesium to prevent additional PMS symptoms. Dosage: 50-100 mg daily; Vitamin B6 50-200 mg daily.
CALCIUM with MAGNESIUM and VITAMIN D
Magnesium maintains bone structure, regulates muscle contraction, relaxes muscles, and improves nerve impulses. Sub-optimal levels of magnesium have been noted in women suffering from PMS. Calcium was shown to reduce the physical and psychological symptoms of PMS by nearly 50 percent in a study published by the American Journal of Obstetrics and Gynecology in 1998. Another study found that women taking higher doses of vitamin D (700 IU daily) were 41% less likely to have symptoms. Dosage: calcium 800-1,200 mg daily; magnesium 300-600 mg daily.
EVENING PRIMROSE OIL (EPO)
An herb that is an excellent dietary source of gamma linoleic acid (GLA), and omega 6 fatty acid. EPO is a precursor to prostoglandins, which have a regulating effect on hormones and other systems in the body. Used by millions of American women who suffer from PMS, EPO decreases PMS-related depression, breast tenderness and pain. Dosage: 300-500 mg twice a day, but 7-10 days before period double the dose to 1,000 mg twice a day.
CHASTE BERRY (VITEX AGNUS-CASTUS)
This small fruit of the chaste tree has relieved symptoms by increasing production of progesterone and balances sex hormones and inhibiting the release of follicle-stimulating hormone. Women who experience symptoms related to hormone imbalance, such as abnormal periods, PMS, and infertility, may be able to benefit from chaste berry’s ability to normalize the hypothalamus pituitary gland. Dosage: One capsule 3 times a day on an empty stomach and take for at least 3 menstrual cycles to determine efficacy, approximately 100-200 mg daily.
PROGESTERONE CREAM
A natural cream made from diosgenin, a compound found in some plants, this is a precursor to DHEA. Progesterone can be low due to dominance of estrogen in the body. It may also enhance memory, reduce water retention and improve energy levels. Progesterone should be applied at various external sites days 12-27 after menses. Check with a qualified health professional before starting on hormones. Try to purchase bio-identical (from natural chemicals) hormones.
VITAMIN E
Vitamin E prevents excess clotting, reduces breast tenderness, and helps maintain normal flow. Vitamin E is one of the most researched and most effective vitamins for the treatment of dysmenorrheal. Dosage: 400-800 IU of d-alpha tocopheral daily.
DONG QUAI (CHINESE ANGELICA) and BLACK COHOSH
Both herbs are well known as important remedies in Chinese medicine. These hormone-balancing herbs act as a tonic for women who feel tired, have low vitality, or are recovering from illness. They are rich in phytoestrogens and effectively reduce painful cramps and breast tenderness. During PMS when estrogen levels are elevated, phytoestrogens bind to estrogen-binding sites, leaving the endogenous estrogen to be metabolized by the liver and thus reducing the overall excess estrogenic effect. Dosage: See package for directions.
PLANT LIGNANS from FLAX SEED
Plant lignans are plant-based nutrient-like compounds that have demonstrated the ability to address symptoms of menstrual discomfort including hot flashes, reduced cramping and bloating, improve mood, decreased breast pain, reduced fatigue and less headaches. Lignans help to balance estrogen levels in the body. A common brand-name is called Brevail. Dosage: See package.
MILK THISTLE
A liver-supporting and detoxifying herb that is helping in healing PMS. Milk thistles’s active ingredient silymarin supports detoxification of the liver, playing a role in the breakdown and excretion of old, used estrogen. Dosage: 1-2 capsules daily (about 150 mg), or as directed.
IRON
It is frequently advisable for a women to get iron level checked since a deficiency has been linked to excess bleeding. Dosage: 15-30 mg daily.
SOY ISOFLAVONES
It has been widely reported that eating more phytoestrogens can help regulate and lower estrogen dominance levels. Dosage: Consume organic foods or supplement with 1-2 capsules daily.
ST. JOHN’S WORT
An herb that is famous for its anti-depressant effects. St. John’s wort supplementation can be effective in relieving mood swings, depressed feelings, and irritability associated with PMS. Dosage: 300-900 mg daily. Do not take in conjunction with prescription anti-depressant drugs unless under the supervision of a qualified practitioner.
GINKGO BILOBA
Although associated with improving short-term memory, ginkgo biloba extract has been shown to be beneficial in the treatment of congestive symptoms of PMS (e.g., painful or tender breasts, edema/water retention). In a French study, ginkgo extract demonstrated statistical significance in reducing breast pain and tenderness. Dosage: 60-180 mg daily.
KRILL OIL
Certain studies have shown significant improvement when krill oil was supplemented in comparison to fish oil for both the analgesic and emotional effects and dysmenorrhea associated with PMS. Dosage: As directed on label.
VALERIAN
This herb depresses the central nervous system and has a sedative effect that relaxes muscles and reduces anxiety and moodiness associated with PMS. Dosage: As directed on label.
VITAMIN C and BIOFLAVONOIDS
These two antioxidant vitamins are essential for adrenal function which helps to control excess bleeding and enable the body to deal with stress and anxiety. Dosage: 500-1000 mg daily.
DANDELION
An herb with effective diuretic activity (loss of excess water) in a safe manner. Dandelion also has liver-supporting and detoxifying qualities. Dosage: As directed.
TURMERIC (CURCUMIN)
Turmeric is a botanical agent that can be effectively utilized to modulate the inflammatory cascade associated with PMS and dysmenorrhea. Dosage: 400 mg 2-3 times a day.
KELP
Kelp is a good source of iodine, which may help to protect thyroid function, improve metabolism, and improve overall symptoms. Dosage: As directed on package. The product IODORAL has a high dose of iodine and should be recommended by a qualified practitioner.
MELATONIN
A hormone that may help to combat insomnia associated with PMS symptoms. Dosage: 1-5 mg before bedtime.
ZINC
Women with PMS have been shown to have lower levels of zinc. Zinc is needed for proper immune function and may help decrease copper toxicity. Dosage: 15-30 mg daily.
L-TRYPTOPHAN
In one study, a dose of 6 grams was found to significantly decrease mood swings, tension, and irritability in women with PMS. Tryptophan is an amino acid essential to human metabolism.
ADDDITIONAL HERBS
Try drinking CHAMOMILE tea for pain relief, PASSIONFLOWER for relaxation and sedation, or GINGER ROOT TEA for uterus cramping.

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