Many women experience PMS (premenstrual syndrome) symptoms such as mood swings, cramping, headaches, fatigue, and more. It’s a prevalent condition, and, as such, many just get used to these symptoms, accepting them as normal. However, with a proper understanding of the cause of these symptoms an effective treatment protocol can alleviate PMS or cause it to disappear entirely. Below I’ll cover the causes of PMS and discuss PMS treatment with Functional Medicine.
So what causes PMS? To answer that question, we first have to look at the female hormones, estrogen, and progesterone.
Progesterone
Progesterone is responsible for preparing the body for pregnancy. It rises in the body after ovulation, kicking off the luteal phase. It’s also a “feel-good” hormone. It’s a natural mood stabilizer and anti-depressant. It promotes restful sleep, increases the sex drive, and relaxes muscles. You can probably tell by these functions, that low production of progesterone during the luteal phase results in PMS symptoms such as mood swings, depression, low libido, and cramps. It’s common for progesterone to increase after ovulation only to take a dive before menstruation, causing the classic symptoms before your period comes.
Estrogen
The estrogen hormones are growth hormones. During puberty, they stimulate the maturation of the breasts and reproductive organs. After menstruation, they regrow the uterine lining. They promote oogenesis and ovulation. Estrogen hormones also affect the sensation of pain. A sudden dip in estrogen hormones may cause a sensation of pain. Menstrual migraines usually occur due to these sudden dips.
Estrogen dominance
If there is a problem with these female hormones, usually progesterone starts dropping first. The ratio
of estrogen to progesterone matters. When progesterone decreases it creates “estrogen dominance” in the body. Estrogen dominance is characterized by a number of symptoms including mood swings, cravings for sweets, breast tenderness, anxiety, fatigue, and weight gain.
The Monthly Cycle of Female Hormones
Root Cause and the HPA Axis
So now that we know the major hormonal players in PMS, we can discuss how they may become unbalanced. These hormones don’t become dysfunctional on their own. Rather, their dysfunction indicates that the body is undergoing stress somewhere else in the body.
The HPA axis (hypothalamic-pituitary-adrenal axis) is how the body responds to all stressful stimuli. When the hypothalamus receives information about a stress event, it sets off a series of communications that results in many physiological changes. Among these changes is an increase in the adrenal hormone cortisol. This hormone has several positive features that allow the body to adapt to stress such as increasing blood sugar levels and reducing inflammation.
It’s important to realize that if a person is under stress, the body will prioritize the creation of cortisol at the expense of other hormones. The body prioritizes survival above any other process in the body. As a result, other systems may suffer if there is consistent, chronic stress.
In the case of female hormones, progesterone is a precursor to cortisol. Under a stress response, the hypothalamus and pituitary will tell the adrenals to create more cortisol at the expense of progesterone. Also, pregnenolone, the precursor to all of the sex hormones, is diverted toward this process and away from the process of making the estrogen hormones. This is termed “cortisol steal.”
The bottom line is that when under chronic stress, the female hormones aren’t produced in high enough quantities or even at the right time, because the necessary materials are being diverted to cortisol. That’s why adrenal health is the number one factor in female hormone dysfunction and for conditions such as PMS.
If you want to know more about this topic visit my blog post on adrenal fatigue and the HPA Axis.
Emotional Stress
We now know that negative thoughts can produce an inflammatory response in the body. So, your thoughts alone can create inflammation, resulting in higher cortisol (cortisol is highly anti-inflammatory). An emotionally stressful life event can be the major factor that causes a decline in health. A death in the family, a divorce, or a period of financial stress can all create an internal environment that sends cortisol skyrocketing and puts pressure on other body systems. Similarly, many women report that their health is never quite the same after giving birth. Childbirth is a major stress event that can deplete the adrenals and female hormones.
Gut Health
If someone has an inflamed gut, it will again cause the production of cortisol at the expense of the female hormones. Therefore, it’s important to be aware of any food sensitivities you may have. Gluten, dairy, and sugar are all possible sources of gut inflammation. A gut infection
may also be causing inflammation. Parasites, pathogenic bacteria, and yeast may be present
in the gut. It’s not always clear that this is a cause of disorder in the body as these infections do not always come with digestive symptoms. In such cases, it’s important to get tested to check for pathogens. Otherwise, they will continue to trigger the stress response and affect the production of female hormones. Additionally, the gut becomes prone to infections with consistently elevated cortisol levels. The cortisol will directly decrease secretory IgA (an antibody present in mucus membranes) levels in the gut, making it prone to infection.
Toxins
A growing problem that we’ll be addressing for decades to come is the effect of chemical toxicity on the body. Certainly, many toxins are inflammatory and may elicit a stress response. However, there are additional concerns with toxins that mimic hormones, called xenoestrogens. They come from a variety of sources including petrochemical products such as plastics. They are also found in some cosmetics or body care products. Some pesticides are xenoestrogens.
Hormonal birth control methods increase progesterone or estrogen or both to high degrees in the body. Hormone replacement therapy (HRT) or progesterone creams will do the same. There is an extra burden on the liver detoxification pathways in these cases, and before a healthy hormonal life can be achieved it may be necessary to aid the liver in detoxing from these high amounts of hormones.
How can I improve my PMS symptoms?
Adrenal health is the most important factor when it comes to PMS. That means that any form of stress needs to be addressed. Lifestyle factors such as diet, exercise, and sleep all impact adrenal function.
Eat Consistently
If the adrenals are stressed, it’s important to eat consistently throughout the day. Fasting can have a positive impact on your health. However, in this case, it can do more harm than good. When you don’t eat for long periods of time, blood sugar levels will drop. This signals the body to increase cortisol to raise blood sugar levels, which in turn contributes to cortisol stealing from the female hormones.
Determine Your Food Sensitivities and Remove Inflammatory Foods
Eliminate any foods that you may be sensitive to or cause inflammation. See my post on how to do an elimination diet effectively. After 4 – 6 weeks on the diet, you can slowly reintroduce some of the foods to determine if they are causing a problem. Be aware that some foods, such as gluten, can have a delayed response. It may take 2-3 days to see symptoms after reintroducing gluten into the diet.
Educate yourself on which foods are inflammatory and which foods are anti-inflammatory. Include anti-inflammatory foods into your diet every day and decrease or remove any foods causing inflammation.
Healthy Exercise
Exercise has many health benefits. However, it’s also important to make sure that you aren’t exercising excessively. Too much cardiovascular activity can exacerbate PMS symptoms if the adrenals are already strained. Muscle toning exercises help to initiate anabolic (building up) metabolism. When the adrenals are stressed, it promotes catabolic (breaking down) metabolism. Excessive cardiovascular activity can contribute to catabolic metabolism as the body breaks down proteins for energy. Make sure you have a healthy balance of muscle toning and cardiovascular exercise.
Healthy Sleep
Getting poor sleep is a huge stress event for the body. Getting healthy sleep is necessary to ensure your HPA axis isn’t overactive. Not only does it matter how much sleep you get, but it also matters when you sleep. Sleeping from 3am to 11am does not have the same quality as sleeping from 10pm to 5am. An early bedtime really does make a difference. Sleep hygiene is important as well. Make sure all the lights are turned off and keep your cell phone outside of the bedroom.
Manage Stress
Life is inherently stressful. A consistent activity that reduces stress can go a long way to keeping your hormones healthy. Consider taking up meditation, yoga, or qigong. Spending time in nature also soothes the neuroendocrine system. Go hug a tree!
Functional Medicine
With lab testing, you can find out in greater detail what your hormones are actually doing. An adrenal stress test can tell you how stressed your adrenals are. A month-long cycle test can tell you how much estrogen and progesterone your body is making throughout the month. This is beneficial because you can see if enough progesterone is being produced. If there are sudden dips in your hormones you can see exactly when it happens. From this information, a customized treatment plan can be made to address these irregularities.
These programs are meant to be temporary. Minuscule amounts of bioidentical hormones are used only to mimic healthy physiology. High amounts of these hormones actually confuse the body, and it will shut down production due to the elevated amounts. However, small dosages can retrain the body to produce healthy amounts at the right time during your cycle.
It is important to get your GI system tested to check for any infections that may be causing a problem. If a pathogen is present and causing problems, any gains made during the treatment will be short-lived as the bug continues to stress your body.
Chinese Medicine
A customized herbal formula addresses the whole body and mind of the individual. Individual herbs are used in groups, because they have a synergistic effect on each other. They are like a team of workers that each have strengths and weaknesses. A trained Chinese medicine herbalist can create a formula for your specific needs. As a whole, this form of medicine shines in the area of women’s health, and herbal formulas can help with any number of symptoms by addressing the underlying pattern of illness. I customize formulas after the initial visit, allowing you to begin the healing process while waiting for lab tests to be completed and analyzed.
If PMS has been a problem for you I can help. Through Functional Medicine PMS treatment can reduce symptoms or cause them to disappear by addressing the root cause of the dysfunction. If you’d like to start addressing these health problems then you can schedule a free 15-minute consultation online to learn more. Click below to check my availability.
Disclaimer: This website does not provide medical advice. The information contained on this website is for informational purposes only. No material on this site is intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding a medical condition and treatment before undertaking a new healthcare regimen.