What is PMS?
PMS stands for Pre-Menstrual Syndrome, referring to a group of symptoms that women can experience in the week or so leading up to the beginning of the menstrual cycle. PMS symptoms include puffiness, bloating, cramps, headache, migraine, insomnia, changes in appetite, weight gain, back pain, lower back pain, swelling and tenderness of the breasts, nausea, constipation, anxiety, irritability, anger, fatigue, restlessness, mood swings, and crying.
PMS can affect the quality of life with varying levels. About 50% of women of reproductive age worldwide are affected by PMS. Among these, about 20% of women experience symptoms severe enough to disrupt their daily activities, and the remaining have mild to moderate symptoms. Even though PMS is pretty common, it is not actually biologically normal! Let’s explore why.
Causes of PMS
In short, the absolute or relative imbalance between estrogen and progesterone is the cause of the symptoms of PMS. Progesterone and estrogen are the two main hormones involved in the menstrual cycle. Absolute balance here means high estrogen level with moderate progesterone, and relative refers to moderate estrogen with low or absent progesterone.
Going one level deeper, there are three top contributors to this imbalance known as Estrogen Dominance. But note that the absolute or relative high estrogen level is not because the body is making a mistake and producing too much. So what are the main contributors to this imbalance?
1. Exposure to xenoestrogens
Xenoestrogens are synthetic compounds that have estrogenic-like effects within the body, mimicking the strong type of estrogen that easily bind with the cell receptors in our bodies and cause hormonal imbalances. Xenoestrogens come from pesticides, herbicides, conventional makeup, nail polishes, birth control, plastics, BPA, conventionally raised meat, etc.
2. Poor detoxification function in the liver
As part of natural hormonal balancing, the body regulates circulating amounts of hormones and neurotransmitters by producing them, then breaking them down, and excreting them from the body through the methylation and detoxification process.
The liver’s detoxification process requires ample amounts of nutrients such as B vitamins, minerals (like magnesium), and amino acids. The liver cells and the whole digestive system needs to be healthy and functioning optimally for this process. Detoxification is also important to maintain a balanced level of estrogen circulating in the body.
3. Low progesterone or receptor ability to bind with progesterone
This can occur for a variety of reasons such as high or ongoing stress state, blood sugar imbalances, insulin resistance, and toxic exposure.
How to Manage Your PMS Naturally for Relief and Prevention
You might have noticed already that the underlying reasons for hormonal imbalance have many factors that are actually in your control. Here are 10 tips to manage your PMS.
1. Ensure good hydration
Estrogen and progesterone influence your body’s hydration levels, especially at the late luteal phase before the period starts, so you will need more fluids at that time. Another point to note is that dehydration – with or without menstruation – is known to cause fatigue, bloating, constipation, and headaches. By drinking water during menstruation, you can reduce the severity of common unpleasant symptoms and discomforts of PMS.
2. Eat quality and balanced variety of foods
Quality: The foods we eat play a big role in hormone balance. Our hormones are made using amino acids from proteins and fatty acids from fats. The better quality materials we use, the better quality hormones our bodies create. Eating mostly real whole foods (versus processed) makes a big difference.
Balanced variety: Every type of food has a different structure and offers a different group of micronutrients. To keep our systems balanced, we need everything in the right amount. Too much of one micronutrient can throw off the balance of another. The Healthy Eating Plate by Harvard Education is a great guide to making balanced meals so that you’re getting the nutrients you need for healthy organs and optimal liver detoxification function.
3. Reduce refined carbohydrates and sugar
Eating too many refined carbohydrates and sugar for your unique body raises blood sugar, which triggers an excess insulin response. And this hyperinsulinemia state affects your hormonal balances, leading to lower progesterone, which is one of the dynamics causing PMS symptoms. Following balanced meal guidelines, as mentioned in the second tip, is a great resource. Keep in mind that natural sugar is still sugar, so consume it mindfully with balanced meals.
4. Manage stress response
A 2018 study in Saudi Medical Journal found female college students who were highly stressed were nearly three times as likely to experience worse PMS symptoms in the luteal phase and twice as likely to have painful cramps during their period. Stress can affect the immune system, adrenals, and blood pressure, which tends to amplify and increase pain, creating a vicious cycle of ever-increasing stress and pain.
Stress is a complex topic as it can be induced by mental, emotional, physical (whether trauma or excessive exercise), or physiological stressors. Physiological stressors could be due to inflammation, insulin resistance, pathogens and imbalanced microbiome, food sensitivities, messed up circadian rhythm (like working night shifts or staying up late watching movies), and many other possible reasons. Understanding your stressors and addressing them is key to wellness.
Some suggestions to tackle stress include:
- Exploring possible food sensitivities: Food insensitivities, while common, can go unacknowledged for several years, wreaking havoc by increasing inflammation and raising stress hormones. Gluten and dairy are among the top culprit foods. Try an elimination diet followed by structured reintroduction to determine if this is an issue with you. Reach out if you need support in this process.
- Supporting your gut health: Most imbalances and diseases start in the gut, and learning more about developing a healthy gut can help your overall health.
- Stress-busting diets: Stress affects your food choices, and your food choices impact your stress level. One way to tackle this is by adopting food that fights stress in your diet. This can include fermented food, oatmeal, walnuts, etc.
There are many wellness tools to manage your stress response and reduce its impact on your body. I would encourage you to make a list that works for you or that you like to try and be committed to doing them frequently. Some examples include diaphragmatic breathing (my favourite, as it is very quick in shutting off the stress response), meditation, yoga, journaling, talk therapy, laughter therapy, nature walks, uplifting music, dancing, and anything else that helps you calm your nervous system. Remember, stress affects your hormonal balance, so investing some time in relaxation techniques is vital for your health and reducing PMS symptoms.
5. Prioritise sleep
Poor sleep, with or without menstruation, induces irritability and fatigue. And not getting enough quality sleep can surely worsen your PMS symptoms, as hormonal regulations and cell repair happen during your sleep. Unfortunately, symptoms from a few sleepless nights can get you into a catch-22 situation, such as when a hormonal imbalance (like low progesterone) also affects your sleep.
Following a healthy bedtime routine can help you get better quality sleep and reduce symptoms associated with poor sleep. A healthy bedtime routine can include taking a relaxing bath in the evening, stopping screen time at least an hour before bed, going to bed at the same time each night, avoiding late heavy meals, and preparing your bedroom environment for sleeping by keeping it cool, dark, and quiet.
6. Reduce toxin exposure
We live in a world that’s becoming a chemical soup and our frequent exposure to these toxins is a huge burden on our bodies. Hormone-disrupting chemicals known as xenoestrogens are a big contributor to the imbalance leading to PMS. This list includes some key environmental chemicals. Here’s how to be mindful of these toxins.
- Reduce toxin exposure from food: Organic produce means you avoid the harsh chemical pesticides, herbicides, and fertilisers that are absorbed by plants and cannot be fully washed away. Check the annual release of the Dirty Dozen for the most contaminated produce to know what to be cautious with. Free-range chicken and eggs, grass-fed meats, and dairy have more nutrients, no antibiotics or hormones, and a natural feed. Eating real whole foods versus processed food products will help you avoid all additives like colourings, flavourings, bulking agents, anti-caking agents, preservatives, and more that your body needs to put an effort into detoxing.
- Reduce toxin exposure from the environment: Your skin is basically a giant mouth, so be mindful of what you’re putting on it. Makeup, personal hygiene products, moisturisers, body sprays, and so on get absorbed deep into your cells without the normal filtration that happens when we take in something by eating and passing it through the digestive system.
Watch out for the ingredients in your products, avoid products with synthetic fragrances (major xenoestrogen), and choose clean beauty products. Also, keep an eye out for ‘greenwashing’ as some brands promote their products as being environmentally friendly when in reality, they still have harmful ingredients that can disrupt your health. Smoking also affects your PMS symptoms because of the nicotine content in cigarettes. Other ways to reduce toxin exposure include being careful of the materials used in food prep, storage and heating, wall paint, flame retardants on furniture, etc.
7. Reduce coffee and alcohol
Both of these have a diuretic effect, increasing the amount of water lost by the body. If not replenished as quickly as it’s lost, this can trigger dehydration, which can worsen your symptoms. Alcohol, of course, affects liver health and subsequently the detoxification process, and also affects estrogen receptors contributing to imbalances. Anything beyond one drink a day for a few nights will have an impact. Coffee raises the cortisol hormone and affects estrogen receptors, so both of these mechanisms contribute to hormonal imbalances.
8. Prioritise movement
Physical activity not only helps to keep a balanced body composition, but also produces ‘happy hormones’ such as dopamine, serotonin, and endorphins that reduce stress and anxiety. A systemic review of several studies in 2020 has shown the positive impact of exercise in reducing physical and psychological symptoms in women with PMS. Physical activity is recommended throughout the month – not necessarily just during the menstruation period. Some women are happy with light cardio exercise when their period starts, while others opt to rest for a couple of days. Always listen to and honour your body’s needs.
9. Check your vitamins
Check your vitamin D level as it’s pro-hormone and has an important role in regulating calcium. B vitamins play an essential role in mood regulation. This effect is related to the production of serotonin, and tryptophan metabolism. B vitamins are therefore particularly helpful if you suffer from headaches, irritability, tiredness, or anxiety. Good food sources of B vitamins include beef, poultry, avocado, banana, legumes, nuts, and whole grains.
If you want to go down the supplementation route, then it is better to get some lab tests done to gauge your needs and always choose quality bio-available forms of supplements (yes, you need to read the labels and ingredients of supplements). Magnesium is a mineral and one of the key nutrients that help to keep estrogen receptors appropriately sensitised. It also has a role in converting vitamin D to its active form and helps ease constipation. Check your RBC Mg level for accurate internal sufficiency.
10. Try seed cycling
Seed Cycling – also called Seed Rotation – is a method to stabilise the female hormonal balance in a natural way, using seeds and kernels to help you achieve a regular cycle and fewer PMS symptoms. The idea is to provide the body with the nutrients needed at each phase to boost production or metabolism (breaking down) excess.
- Follicular Phase – Ovulation (Days 1-14): eat 1-2 tablespoons each of raw, fresh ground flaxseeds and pumpkin seeds
- Ovulation – Luteal Phase (Days 15-28): eat 1-2 tablespoons each of raw, fresh ground sunflower and sesame seeds
A detailed guide to seed cycling is available here. Caution: You might find reviews of how amazing seed cycling is and all the amazing benefits women got from following this. However, please keep in mind that there are many factors that affect the body, and doing just one thing may not give you the results that you are looking for.
Seed cycling is not a magic fix-all solution, so I encourage you to follow as many tips as possible that apply to your case along with seed cycling to reap the benefits you are looking for. You have an amazing body that can heal itself if you give it the chance. Changing your food and lifestyle has a big impact on your illness and wellness. I understand it is not an easy journey. However, it is doable, and working with a health coach will help you change your mindset and habits into healthier ones that support your unique body.
I’ve had severe PMS symptoms along with other issues for so long that I thought that’s just my normal! Where I am now is so far from my ‘past life’ – it’s been a journey to change my lifestyle, but it was totally worth it considering the vibrant energy and the better quality of life I enjoy. Don’t accept your symptoms as “normal” and never give up on seeking solutions for you to feel better naturally – this is key to avoiding the side effects of commonly prescribed solutions like pain relief medication and birth control pills.