Premenstrual Syndrome (PMS) is common in women, research shows around 90% of women experience at least one symptom of PMS every month and around 50% of women identify with having several symptoms. A significant number of menstruating women, between five to eight percent, experience much more severe symptoms during this time a condition that is now recognised as Premenstrual Dysphoric Disorder, also known as PMDD. Researchers do not know exactly what causes PMS, changes in hormone levels during the menstrual cycle may play a role. These changing hormone levels may affect some women more than others. Most evidence suggests that PMS results from the alterations in or interactions between the levels of sex hormones and brain chemicals known as neurotransmitters.
What are the Symptoms of PMS?
Pain areas: In the breast, abdomen, back, joints, muscles, or pelvis
Remedies: Anti-inflammatory herbs: curcumin // Dong quai root // Chinese skullcap
Gastrointestinal: Constipation, diarrhoea, nausea, passing excessive amounts of gas, or water retention.
Abdominal: Abdominal fullness or cramping
Remedies: Mint, lemon, honey, ginger, and licorice can help soothe stomach and digestive issues.
Mood: Anxiety, irritability, mood swings, or feeling down in the dumps
Remedies: Mood-elevating herbs, vitamins // Valerian, Magnesium and Vitamin B6.
Also common: Acne, headache, insomnia, irritability, lack of concentration, moodiness, painful menstruation, or weight gain.
Whole body: Appetite changes, excessive hunger, fatigue, or loss of appetite.
- Your skin changes in response to hormones, like estrogen and testosterone
- If you have oily-type skin, you may notice an increase in facial oil before and during your period
- Acne outbreaks during the premenstrual and menstrual period are common
- Dermatitis, psoriasis, and other skin conditions or diseases may worsen during the premenstrual phase
Acne (acne vulgaris) is one of the most frequently reported skin ailments connected to your cycle. Period-related hormonal breakouts are very common in the perimenstrual phase (the 10 days before your period, plus days of bleeding). When high levels of androgens promote excess sebum production, the sebum can combine with dead skin cells from within the pore, causing a blockage. This blockage of the pore can trap all the excess sebum being produced and manifest as acne. These sebum filled pores are the ideal place for bacteria to live—particularly P. acnes, which can further worsen and causes inflammatory acne.
What are the symptoms of PMDD?
PMDD affects 2 to 5% of reproductive-age women with symptoms that mimic depression and anxiety, like debilitating sadness, hopelessness, and irritability in addition to physical issues like bloating and fatigue. But, frustratingly, women with PMDD have the same hormone levels of women with the more common PMS even though they react differently.
Researchers (2017) at the National Institutes of Health wanted to see if there was something different going on at a cellular level. For a study published in the journal Molecular Psychiatry, they suppressed then added back the hormones estrogen and progesterone in women with PMDD and a control group of women. When they “turned off” these hormones, the women with PMDD saw their symptoms disappear only to re-emerge when the hormones were added back.
Specifically, the differences were found in a complex that determines how cells respond to the environment, including sex hormones and stressors. Some of the genes were over-expressed and others were under-expressed in PMDD patients; exposure to estrogen and progesterone also altered their gene expression. This dysregulated cellular response could be why women with PMDD are so sensitive to the hormones.
Therapies that can help reduce PMS symptoms
Black cohosh (Cimicifuga racemosa) - Though widely used for menopause symptoms, black cohosh is also an excellent herb for PMS, especially when it comes to irritability and sleep disturbances.
Burdock - In addition to its anti-inflammatory effect, burdock is a powerful diuretic, so it can help reduce excess fluid and bloating associated with PMS.
Cramp bark (Viburnum opulus) - Effective for relaxing muscle tension and spasms in the uterus, thereby relieving menstrual cramps. A smooth muscle relaxant with similar properties to valerian, it focuses its action on the pelvic area (the ‘valerian of the uterus). Cramp bark is beneficial for ovarian and uterine cramps before and during menstruation.
Fennel seed: Fennel is actually one of the most studied herbs for dysmenorrhea, or severe period pain. In a study from 2006, researchers found that fennel was as effective at treating dysmenorrhea as mefenamic acid, the preferred prescription for period pain. Fennel was also shown to reduce nausea and fatigue and improve general feelings of well-being in regular users.
Cinnamon: Cinnamon has been shown to be nearly as effective as ibuprofen at getting rid of pain and cramping. In a 2015 double-blind placebo-controlled trial, cinnamon decreased pain from an average of seven out of ten down to a two. Like fennel, it also helps decrease nausea and vomiting associated with menstruation.
Ginger root - Ginger has been shown to be equivalent (In controlled trials) to both ibuprofen and mefenamic acid for treating period pain and is considered to be an effective alternative treatment to pharmaceutical interventions. It may also help reduce a number of different PMS symptoms like low back pain, headache, gastrointestinal disturbances, nausea, and joint and muscle pain.
Curcumin (Turmeric) - A 2015 Study where each participant received 100 mg capsules every 12 hours (totaling 200 mg/daily of curcumin or identical placebo) for 7 days prior to menstruation and 3 days into menstruation for 3 successive cycles and recorded the severity of their symptoms by daily record questionnaire. The study concluded the participants experienced significant reduction in PMS symptoms.
Calcium - A rencent (2017) study found that daily intake of calcium reduced PMS symptoms. Calcium supplement are an effective technique for reducing mood disorders observed in PMS. Furthermore, calcium supplementation is a cost-effective, beneficial, and effective treatment for reducing symptoms of PMS.
Chasteberry (Vitex Castus Agnus) - Is traditionally used in Western herbal medicine for the relief of symptoms of premenstrual syndrome such as tension, breast tenderness and fluid retention. Contains compounds that have been shown to affect receptors for estrogen and dopamine (one of our feel-good neurotransmitters). It can help with menstrual cycle irregularity, cramps, bloating, and breast tenderness.
Dandelion leaf (Taraxacum Officinale) - An excellent diuretic, helps eliminate excess water from the system, relieving the symptoms of bloating. The leaf contains natural potassium so does not deplete potassium in the system as do synthetic diuretics.
Dang Gui (Angelica Sinensis) - A popular herb from China that does not seem to affect hormone levels so much as it builds the blood and keeps it moving properly to nourish the female organs and reduce pain and cramping that happens during the menstrual cycle.
Evening Primrose Oil (Oenothera biennis) and Vitamin E - When taken for two–three months, have been shown to decrease the bloating experienced by women with PMS, as well as helping to alleviate depression and irritability.
Ginkgo (Ginkgo Biloba) - Primarily known for its benefit to memory, ginkgo has also proven helpful for PMS symptoms, particularly when it comes to fluid retention and breast tenderness.
Lemon balm (Melissa officinalis) - Lemon balm is known for its calming properties and can help with PMS-related anxiety and insomnia.
Maca (Lepidium meyenii) - Traditionally maca was used by native Peruvians to enhance fertility. But more recent studies have shown that it can help with stress, anxiety, mood, and low sex drive — all symptoms common with PMS.
Magnesium and Vitamin B6. This power combination can do wonders for PMS. Research shows they offer positive effects on pain, mood, and general PMS symptoms. Magnesium is especially good to take if you have chocolate cravings!
Reishi Mushroom (Ganoderma lucidum) - A powerful immune strengthener and regulator of blood sugar. It is used to counteract general fatigue or weakness that may be associated with chronic PMS and is an excellent herb for calming and relaxing women who experience irritability, nervousness, emotional excess, and sleeplessness.
St. John’s Wort (Hypericum perforatum) - Can be useful for mild depression and the moodiness that sometimes accompanies PMS. But beware that it can interfere with birth control pills in some women, so be sure to discuss with your GP.
Valerian (Valeriana officinalis) - Works as an antispasmodic, relieving menstrual cramps by relaxing smooth muscles. It is quite effective for cramps, especially when blended with cramp bark (50-50).
Wild yam (Dioscorea villosa) - Wild yam was traditionally used for intestinal problems as well as labor pains and menstrual issues. There is debate about whether wild yam can act as a precursor to sex hormones like estrogen and progesterone, but we’ve found it helpful for our patients who have high estrogen levels.
OVER THE COUNTER DRUGS:
NSAIDs a group of drugs including aspirin and ibuprofen, are somewhere around 50 percent effective at reducing period pain. NSAIDs come with side effects: stomach problems, high blood pressure, fluid retention and swelling, kidney and heart issues, and rashes.
Foods Can Help to Reduce PMS Symptoms
Plant foods – Studies have shown that women with plant-based diets high in vegetables, fruits, nuts, seeds, and herbs have fewer symptoms of PMS.
High fiber foods – PMS can cause GI disturbances, which is why it’s critical to get at least 30g of fiber daily.
Green leafy vegetables – These veggies have a diuretic effect and are also a great source of calcium and magnesium, which can reduce menstrual cramps.
Flaxseed – Helps promote healthy estrogen metabolism.
Wild-caught fish – Foods high in Omega-3 fats will help reduce pain and inflammation.
Avocado – Eating a half or full avocado daily can naturally balance hormones due to it’s nutritional profile (healthy fat, fiber, magnesium and potassium.)
My personal approach to PMS
On day one of my period I use a combination of heat packs, LED Light Therapy (Pain blocking mode) I drink Turmeric Tea, Valerian Tea and Dandelion leaf Tea. I take Magnesium, Calcium, Evening Primrose Oil and Curcumin daily. I add Maca to pancakes smoothies and porridge as a daily practice. I take St. John’s Wort for a month then have a break then take again for a month. This helps me with general mood and anxiety. Exercise is also key, after a short walk, the fresh air and nature I always feel better, gentle yoga or pilates movements can also help my abdominal pain even though this is the last thing I feel like doing often it will minimise the pain for a couple of hours. A warm bath with Epsom salts and a great book or magazine is a must! Some recommendations are made to be broken, a large glass of red wine (a powerhouse of antioxidants) is what I need to celebrate making it through a challenging day of PMS pain and distress.
Until next time
be human | be kind | be you
- Geller L, Rosen J, Frankel A, Goldenberg G. Perimenstrual flare of adult acne. J Clin Aesthet Dermatol. 2014 Aug;7(8):30-4.
- Raghunath RS, Venables ZC, Millington GW. The menstrual cycle and the skin. Clin Exp Dermatol. 2015;40(2):111-5.
- Shelley WB, Shelley ED, Talanin NY, Santoso-Pham J. Estrogen dermatitis. J Am Acad Dermatol. 1995;32(1):25-31.
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