Women make up 55% of the world's population. This percentage is set to steadily increase over the next three decades. It is recognized that women with premenstrual disorders experience markedly compromised quality of life and ability to function in daily life. One study showed that PMS was associated with reductions in health-related quality of life, specifically in the Mental Components Scale. This, in turn, leads to higher indirect medical costs for increased physician visits and laboratory tests, and higher costs to employers through lower productivity at work.
Research has also shown that women with PMS had greater work productivity impairment than women without PMS, netting four additional days with reduced productivity per month. Symptoms of premenstrual disorders can also be related to other conditions, such as ovarian cysts and uterine fibroids, therefore contributing to the pervasiveness of women's health concerns. Taking into consideration the prevalence of women's health-related conditions and the high cost of treatment, it is critical to examine alternatives to standard options provided by conventional medicine.
Nearly every Canadian woman suffers from some form of PMS. The most common symptoms include headaches, bloating, irritability, mood swings, and changes in appetite.
Standard treatments include pain medication, oral contraceptives and antidepressants; severe forms of PMS are actually classified as mental disorders! For many women these treatments have limited effectiveness, and they continue to suffer from at least some of the detrimental effects of PMS. And many women seek no treatment at all, not realizing that there are alternatives to conventional treatments. These alternatives help rebalance hormone levels and eliminate symptoms of PMS.
PMS is a hormonal disorder, characterized by recurring symptoms that last from two to 14 days before a women's menstrual period, and by a symptom-free time in each monthly cycle. The consistent recurrence and timing of the symptoms characterize PMS.
The best way to determine if a patient is suffering from PMS is to review a chart of her symptoms. No blood test or hormonal measurement can pinpoint PMS specifically. If a patient has not yet charted her symptoms, these guidelines will help her keep the most accurate records:
- Note the physical and emotional symptoms that are most severe or disruptive. Examples include irritability, headache, bloating, mood swings, fatigue, acne, anxiety, depression, and food cravings.
- Use a daily calendar or Daily Symptom Record forms
- Keep the notations simple.
- Set aside a time to chart symptoms every day.
A symptom chart provides you with a record of which and when symptoms occur, and how closely symptoms are related to the menstrual cycle. Te chart also provides a helpful look at symptom severity and duration.
PMS is associated with hormonal imbalances, blood sugar fluctuations, and nutrient deficiencies, all of which are preventable. These short-lived symptoms are apparently caused by too much estrogen (the female sex hormone) and lack of progesterone (another hormone secreted by the ovaries). Decreased levels of the neurotransmitters (brain chemicals) dopamine and serotonin are other factors.
Not surprisingly, women in Western societies suffer from the symptoms much more than those in more primitive societies. This is mainly due to diet and lifestyle. According to The Woman's Encyclopedia of Natural Healing, the widespread consumption of refined foods, sugars, caffeine and alcoholic beverages are the primary culprits of the modern woman's monthly woes.
The chemical serotonin is also a key player in a woman's menstrual health. It is produced by eating carbohydrates. This is one main reason why so many women reach for the sugary or salty treats: they increase serotonin and endorphin levels, but salt, especially table salt, increases water retention, and sugar causes a rapid rise and decline in blood sugar, which actually aggravates PMS symptoms. If you're like me, the prospect of giving up some of your favorite foods, even in the name of better health, seems daunting. But worry not, my fellow PMS sufferers! I have here a list of delicious foods you can eat that will actually decrease your symptoms, if not eliminate them.
Self care is the formation of any PMS management program. A healthful diet, regular exercise, stress reduction, and supplementation provide significant relief from PMS symptoms, according to over 65% of the women who contact PMS Access (a national resource on premenstrual syndrome for women and healthcare providers, located in Madison, WI). For many of these women, the first step toward good health is getting reassurance that their symptoms are real, hormonally related, and eminently treatable.
The second step in the self-care foundation is regular exercise.
Physical activity benefits just about everyone, particularly women with PMS. In two studies, PMS sufferers reported a significant decrease in symptoms with moderate exercise. The release of opiate-like endorphins during exercise helps reduce feelings of nervousness or anxiety, and increased circulation helps alleviate bloating and breast soreness.
- That patient should start with a brisk 15 minute walk two or three times a week when they are feeling well. They can gradually work up to 30 minutes at a brisk pace three times a week.
- Patients should schedule exercise by writing it down like any other appointment. Make it a priority.
- Choose a pleasant place to exercise whenever possible: a park in good weather; an indoor mall to "people watch" and walk on rainy or cold days.
These simple strategies can help women who exercise regularly but whose motivation diminishes when they are premenstrual.
The third step in the self-care foundation of a PMS sufferers is stress relief.
For some women, premenstrual anxiety is an especially troublesome symptom. Along with regularly scheduled exercise, I advise PMS patients to begin a consistent program of relaxation, which can look as simple as this:
- Early morning: Prior to getting out of bed, suggest that patients gently stretch their bodies and take a few deep breaths before the day begins.
- Mid-day: Take 10 slow, deep breaths, and clench and unclench hands.
- Late afternoon or evening: "Prescribe" 30 to 45 minutes of a pleasurable, relaxing activity such as reading, listening to music, or writing in a journal.
Performed three times daily, these simple steps force the body to slow down. In doing so, the body's natural abilities take over, moderating blood pressure, reducing heart rate, slowing production of the stress hormone, cortisol, lowering the level of HDL cholesterol, and boosting immune response.
The last step in a women's PMS self-care foundation is a supplementation program.
Supplements for PMS
I generally recommend that women take a supplement containing a balanced combination of B vitamins, magnesium, and calcium. Studies indicate that vitamin B6 - when taken as part of a B-complex formula that also contains magnesium -- helps relieve premenstrual bloating and depression.
Women with PMS may also benefit from a two-to one ratio of magnesium to calcium. The extra magnesium increases calcium absorption; research suggests that calcium deficiency may be linked to some PMS symptoms. One study indicates that PMS symptoms may be the body's "early warning system" that calcium levels are low. Only a few multivitamin/mineral formulas contain this optional magnesium/ calcium ratio.
Another supplement sometimes used in PMS management is evening primrose oil. Oil from the evening primrose flower contains linoleic acid, which boosts the body's output f PGE1 prostaglandin. Some studies suggest that PGE1 lowers the hormone prolactin to alleviate PMS symptoms. Oil of evening primrose is best absorbed when taken with a B-complex vitamin and at least 600 mg of vitamin C daily.
In educating patients about supplements for PMS, I explain that they will get maximum benefit only if a supplement is part of an overall self-care plan that includes healthful eating, exercise, and stress management. No supplement alone will be a magic bullet for all symptoms.
Below are a few of the nutrients that are major players in a woman's menstrual health and help to fight against physical and emotional discomfort associated with PMS.
¨ Magnesium - Low levels can cause women to experience migraine headaches.
¨ Calcium carbonate - helps decrease moodiness, behavioral problems, and general pain.
¨ Vitamin A, B6, copper, & zinc - Women who suffer the most from pre-menstrual syndrome have low levels of these nutrients.
¨ Tryptophan - This is a common amino acid, and a lack of it increases symptoms, especially irritability.
¨ Ferritin - (A globular protein which is attached to iron) Low levels of this are linked to increased mood disturbances.
¨ Vitamin E - Provides general PMS relief with consistent use.
These nutrients and their importance in women's health are only a small part of taking back control of your body, even during the days leading up to your period.
Less than 20 years ago, PMS was as yet an unnamed disorder in the United States, and cyclical symptoms were presumed to be "all in a woman's head." Treatment options were limited to hysterectomy, antidepressants, or tranquilizers.
Today, thankfully, the picture has changed. Increased understanding of hormonal influences on the body and mind, along with creativity and collaboration among patients, providers, and pharmacists, ensures that women can feel their very best all month long.
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