PMS: Which one are you?

Everything was going great until you enter that dreaded week before your period.  You felt completely fine, rational and sane the week before and now you are feeling like a complete basket case thanks to that three letter word, PMS.  Premenstrual syndrome refers to the time before menstruation when our bodies send us all kinds of signals due to the drastic fluctuation in hormones, progesterone and estrogen.  Some lucky ladies go through this phase with easy and grace while the rest of us might be stuck feeling like psychopaths. The conventional medical model often prescribes birth control pills or antidepressants to alleviate the monthly highs and lows.

As a naturopathic doctor, I look at things a bit differently.  One of the ways I address PMS, is by considering the four specific classifications of PMS.  Some women will be able to clearly identify with or combination of these types. No matter your type with a comprehensive naturopathic PMS management plan, you don't have to be swept up by your monthly cycle.

 

Everyone is driving me crazy!

Your boyfriend is 10 minutes late and you want to bite his head off or your nosey coworker won't leave you alone.  You might have the most common type of PMS and it is due to estrogen dominance.  Estrogen dominance means that you have more estrogen in comparison to progesterone. Normally I consider estrogen our "happy hormone", but in excess it can cause irritability, fertility issues and sleep problems. Why it is so common is because stress, xenooestrogens (artificial and natural estrogens from foreign sources), and liver stagnation are so rampant in our modern society particularly in New York City.  So what's the fix?  Stress management and liver detoxification are key.  As a naturopathic doctor, my favorites are DIM (Diiondolylmethane) and Calcium-D-glucarate, which support the healthy clearance of estrogen.  I also recommend cycling magnesium to easy tension and stabilize mood and sleep.

 

I can’t stop crying and I don’t know why

Maybe you are buying a baby shower gift for your friend and burst into tears or get worked up watching sappy commercials.  On the flip side of the previous type of PMS, this type is dominated by progesterone, our "sad hormone."  If you are one of those women, who felt like an emotional basket case on progesterone only birth control or the Mirena IUD, you now know why.  Progesterone is largely implicated in PMDD (Premenstrual Dysphoric Disorder), which is an extreme form of PMS associated with suicidal depression.  Though progesterone is involved it is not uncommon for these women to have normal estrogen to progesterone ratios.  This is because it is more how their body reacts or more specifically how serotonin and dopamine react to progesterone.  For these women adding supportive nutrients such as vitamin B6, tyrosine and tryptophan for neurotransmitter support can make a big difference.   Phytoestrogens like ground flax seeds can also help to boost estrogen levels and off set progesterone's power.

 

My boobs hurt and my jeans are too tight!

Every month you are shocked that seemingly overnight nothing in your closet fits and you have to resign to leaving the house in sweats.  You might like being a bit more bosomy but the girls are aching.  For women with this type of PMS, excess aldostrone is too blame.  This adrenal hormone regulates fluid in our body and when increased causes our fluid volume and retention to go up making us look bloated.  Aldostrone increases in the response to elevated stress and estrogen and low dopamine.  To prevent monthly bloating and breast pain, choose more vegetables because they are high in potassium and reduce sodium and make sure to drink enough water.   Breast tenderness can be associated with elevated prolactin so taking vitex (aka Chaste Tree berry) in the morning premenstrually can help.  I have also seen good results with herbal diuretics like dandelion leaf, nettles and cleavers.

 

Cookies, chocolate and chips are my three BFFs

You can’t stop going by your coworker’s desk with the bowl of fun size candy bars or nothing can keep you away from the bakery for a warm chocolate chip cookie.  Though you might eat healthy other times of the month, when PMS hits all bets are off!  PMS cravings for carbs and sugar are due abnormal carbohydrate synthesis causing high blood levels of insulin.  These fluctuations in addition to the cravings can make you feel irritable, tired or give you a headache.  From a naturopathic perspective, prevention is key by following a blood sugar stabilizing diet.  Having 10-20g of protein along with 3-5g of fiber from fruits and vegetables and healthy fat at each meal can really make a difference.  Some women who have impaired insulin sensitivity supplementing with chromium, alpha-lipoic acid and cinnamon can also be helpful.