by Crystle Harcar – I am a board certified Nurse Practitioner, working in women’s health for the past 14 years. I am passionate about my work in reproductive, prenatal, and postnatal health care. As a nursing educator, I aim to help shape the minds of our future healthcare providers. I have been married to my husband for 9 years and we have two amazing children together.
“It’s time to break down the types of PMS to determine which one you have, and what changes you can make to improve your symptoms.”— Crystle Harcar, Board Certified Nurse Practitioner
Approximately 90% of women experience some, if not all, premenstrual symptoms before or during their period each month, assuming those women actually have a monthly period. PMS is a right of passage all women have the joy of experiencing. It is normal for us to experience symptoms of:
- breast tenderness
- heavy bleeding
- painful cramping
- food cravings
and the most popular feminine symptom of all
- sensitivity and mood changes
Or is it normal?
PMS is influenced by a number of factors including diet, stress level, exercise, and nutrition. When one of these is off, a hormonal imbalance can occur, therefore causing one or more PMS symptom(s). Do you ever wonder why in middle school, some of your friends suffered from acne while others did not? Or why some girls seemed to have heavier periods than others?
Let’s break this down. A normal period cycle ranges from every 25-35 days. For this explanation, let’s use the average 28 day cycle. In the first half of your cycle (day 1-14), estrogen and seratonin levels are elevated. Estrogen and seratonin are responsible for your mood. This is why women feel great during the first half of their cycle. Mid cycle, your progesterone level increases following ovulation to help sustain a pregnancy if one should occur. Increased progesterone can cause breast tenderness, bloating, constipation, fatigue, food cravings, and headaches. The last week of your cycle, right before your period begins, your progesterone falls if a pregnancy did not occur as well as your serotonin and estrogen levels, which will induce the mood changes.
So what makes some women more sensitive to these hormonal changes than others? A women’s physiological and psychological well being and lifestyle habits can and does dramatically affect how they react to these hormonal changes.
Now, it’s time to break down the types of PMS to determine which one you have, and what changes you can make to improve your symptoms.
High Estrogen PMS
- Irritability about 7 days before your period
- Breast tenderness
- Heavier periods
Why: We need our estrogen to boost our mood. But too much estrogen in the 2nd part of your cycle can cause symptoms such as irritability and heavier periods.
- Reduce alcohol as this impairs detoxification of excess estrogen through your liver.
- Increase fruit and vegetable intake. The plant starch feeds healthy intestinal bacteria which play an important role in escorting estrogen out through your bowel.
- Take a vitamin B6 supplement. This vitamin can enhance estrogen detoxification in your body.
- Some foods associated with lowering the amount of estrogen in the body:
Low Estrogen PMS
- Insomnia during the days leading up to your period
- Hot flashes
- Vaginal Dryness
- Lighter than average periods
Why: Estrogen normally dips at the end the menstrual cycle but it can sometimes dip too low. This can cause this less common PMS symptoms.
- Maintain healthy baseline estrogen by avoiding things that deplete your estrogen such as stress, nicotine, and excess soy products. Soy is “estrogen mimicking” the body think it has enough estrogen and therefore it will not produce more.”
Low Progesterone PMS
- Anxiety in the 2nd half of the menstrual cycle (following ovulation)
- Premenstrual spotting (before your period begins)
- Clots with your period
Why: Progesterone is supposed to be high in the 2nd half of the cycle. It is responsible for calming your nervous system. It converts to a special neurosteroid that works a bit like a neurotransmitter GABA in your brain (kind of like a hormonal valium).
- Enhance your progesterone production with an herbal supplement called Vitex. Vitex has done well in clinical trials for PMS.
- While foods don’t contain progesterone, certain foods can help stimulate the body’s production of progesterone. These include:
- Brussel sprouts
- Whole grains
- Chronic inflammation/associated autoimmune disorder(s)
- Flu-like symptoms during the 2nd half of your cycle
- Digestive bloating
Why: Hormone imbalance is not the only cause of PMS. You may have normal levels of hormones yet still suffer from PMS due to chronic inflammation. Chronic inflammation is caused by lifestyle factors such as poor nutrition, stress, and smoking. Inflammation causes PMS because it impairs the health and resilience of hormone receptors, which makes your hyper-sensitive to the normal rise and fall of your hormones.
- Avoid inflammatory foods such as concentrated sugar (deserts) and deep-fried foods. Eat more anti-inflammatory foods such as berries, spinach, and kale. You can also supplement with anti-inflammatory nutrients such as magnesium and turmeric.
Tracking your cycles and your symptoms can help determine if you have normal cycles, which type of PMS you have and the best way to manage your symptoms. Hormone testing can definitely play a role in diagnosing your PMS issues but if you don’t mind doing the work and being patient by monitoring your cycles and symptoms – you can simply (and cheaply) manage your PMS with lifestyle modifications alone.
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