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Premenstrual Syndrome (PMS)

There is hope!
PMS is said to affect 70-90% of women of menstruating age. Up until recently, the medical establishment did not take women complaining of premenstrual symptoms seriously, and although nowadays it is a widely accepted problem, it is still difficult to treat using conventional medicine. Menstruation, and the period of time before it, need not be an unpleasant experience. Correct nutrition and herbal support offer natural solutions to alleviating a range of PMS symptoms.

What is premenstrual syndrome?
Premenstrual syndrome describes any symptoms that occur after ovulation and which are alleviated once the period starts. There are over 150 symptoms associated with PMS; they may be broadly grouped into 5 categories. Women may suffer from predominantly one type of PMS or they may have symptoms, which cover several categories.

The Pill and PMS
Taking the contraceptive pill means that there are unusually high levels of hormones in your system, particularly if you have been taking the Pill for a long time. If you suffer from PMS symptoms whilst taking the Pill it is highly likely that it is contributing towards the problem. Discuss the problem with your doctor.

Important Note: Do not take any hormonal balancing herbs if you are on hormonal medication such as the contraceptive pill.

Changing your diet to alleviate PMS
To really get to the bottom of PMS symptoms it is essential to take a good look at the kinds of foods you eat on a day-to-day basis. Many people may feel that they eat healthily, but on closer examination they fall short of an ideal wholefood diet. The importance of changing to a wholefood, predominantly vegetarian diet, cannot be emphasized enough. Follow the guidelines below and you will be giving your body the phyto-nutrients it needs to bring your hormones back into balance, naturally. You will also be nourishing and strengthening your body to protect it against a whole host of other ailments too.

Foods to emphasize to encourage hormonal balance

  • Eat whole grains rather than white pasta, rice and bread: whole grains contain many more nutrients than their refined versions, they also take the body longer to convert into sugar providing a slow release of energy rather than a quick release of sugar into the system.
  • Eat a wide variety of legumes, including soya but take care not to rely on it too heavily. Chickpeas, lentils, mung beans, aduki beans etc all provide phyto-oestrogens which help to balance the hormones, as do seeds, grains and some herbs. See our recipe section for some delicious bean based recipes. We also stock a selection of Mrs Gill's frozen dahls made with a variety of different pulses.
  • Eat plenty of vegetables and some fruit: we should be aiming to have at least five portions of vegetables and fruits per day. Try to rely on vegetables predominantly, as they are less likely to cause digestive upset. Vegetables from the cabbage family in particular, can increase the rate at which the liver changes oestrogen into a water soluble form which is easily excreted. The cabbage family includes: all cabbages, broccoli, brussels sprouts, and radicchio. Eat fruit at room temperature to help digestion. Produce grown organically is generally tastier, higher in vitamin and mineral content and is not sprayed with synthetic pesticides.
  • Include oil rich foods such as oily fish, ground linseed, nuts, pumpkin seeds and fresh cold pressed oils olive, hemp seed, pumpkin seed. To ensure adequate intake of Omega 3 essential fatty acids, take a supplement or use linseed (also known as flaxseed) oil to pour over vegetables and salads.
  • Drink plenty of water

Foods to avoid or reduce to encourage hormonal balance

  • Reduce intake of saturated fats particularly from meat and processed and refined foods such as biscuits, cakes, pre-prepared frozen meals.
  • Completely eliminate hydrogenated fats, often found in margarine and other processed foods.
  • Avoid refined sugar (including fructose and artificial sweeteners) use small amounts of natural sweeteners such as honey, Rapadura, maple syrup and brown rice syrup instead.
  • Cut down on your consumption of salt and use sea salt instead of table salt, which is more refined.
  • Reduce caffeine beverages to one a day. If you suffer from lumpy or painful breasts, cut out caffeine completely.
  • Reduce alcohol intake, in the week before your period is due avoid it completely. If you do choose to drink, alternate each alcoholic drink with a large glass of water. Restricting alcohol allows your liver to function more effectively; the liver is responsible for clearing excess hormones (which cause hormonal imbalance) from the bloodstream. Alcohol consumption contributes to blood sugar imbalance, which is implicated in PMS and other symptoms of hormonal imbalance.

Blood sugar imbalance
Problems associated with blood sugar imbalance are on the increase. The culprit as usual is the typical modern diet, which includes high amounts of refined sugars, refined carbohydrate foods (white rice, pasta and bread) and moderate to high alcohol intake. The practise of skipping meals due to lack of time, further compounds the problem.
Symptoms of blood sugar imbalance include: irritability, temper tantrums, fluttering feeling in the chest, anxiety, nervous tension, sweating, dizziness, restlessness, headache, lack of concentration, fatigue, craving for sweet foods, lack of appetite or constant hunger, depression and crying spells. They are remarkably similar to many symptoms of PMS.
If you suffer from blood sugar imbalance it is even more important to follow the guidelines in the two previous sections. In addition, eat at least four to six small meals a day following the wholefood guidelines given above. Always be sure to carry a wholefood snack such as fresh fruit, nuts, trail mix, oatcakes or pumpkin seeds around with you, which you can eat if you feel your blood sugar levels dropping. Cut out citrus fruits (as they lower blood sugar) and all fruit juices and do not eat large amounts of other fruits. For more information on supplements to alleviate blood sugar imbalance see PMS-C Supplements.

Making sense of the symptoms
Doctors treating women with PMS have found it easier to group the many and varied symptoms into several categories. Many women will suffer from symptoms from two or more categories, in this case follow the guidelines for the most troublesome symptoms. It is very important to follow the dietary guidelines, don't rely on herbs and nutrients alone. Dietary change alone can often bring about great benefits to sufferers of PMS.

Important Note: If you:

  • are pregnant, breast feeding or plan to become pregnant
  • have a medical history of hormonal imbalance
  • have a long standing illness
  • have undiagnosed health problems
  • are on medication

it is always best to seek advice from a professional health practitioner before taking herbal supplements. If taken as directed, herbal remedies are very safe, but they are powerful medicines. Do not use them lightly; do not exceed the recommended dose. When self-prescribing, be aware that you are responsible for your own actions, watch carefully how you react to the remedies. If you notice any adverse reaction, stop taking the remedy and seek professional advice. See also .

PMS-A symptoms
The most commonly occurring PMS symptoms fall into this category, namely: anxiety symptoms such as mood swings, irritability, mild depression, anxiety and tension. It is thought that these symptoms occur due to a high oestrogen and a relatively low progesterone count.
The common occurrence of PMS-A symptoms could be due to increased levels of oestrogen in our water supplies (from women taking hormonal medication) absorption of xeno-oestrogens from the environment (e.g. from plastics and chemicals) and a reduced ability of the liver to clear excess hormones from the system.

PMS-A suggested supplements
As well as considering taking the following supplements, be sure to commence the dietary changes outlined above. We recommend food state nutritional supplements which are more bio-available and better tolerated as they are closer in structure to normal food.
A food state multivitamin and mineral complex is highly recommended, as it will provide you with a baseline of nutrients, ensuring that you absorb any other supplements you take more effectively.
A food state magnesium supplement is recommended to help with tension as well as hormonal and blood sugar imbalance.
Food state vitamin B6 taken 10-14 before your period or if you have general stress symptoms take the food state vitamin B complex on a daily basis.
Red clover tea can help to lower the effect of excess oestrogens in the system take three cups a day or take the PMS A Tea suggested below. Vervain tea has a wonderfully calming and relaxing effect on the nervous system and also works to strengthen the liver. It is very useful helping to ease tension and has a grounding quality. Take three cups a day or the PMS A Tea.
Liquorice taken as a tea in the second half of the cycle is said to reduce oestrogen and increase progesterone levels. It also nourishes the adrenal glands, which are put under extra pressure when suffering from stress. Do not take liquorice if you have high blood pressure or suffer from severe water retention. In mild cases of water retention it may be beneficial if taken in moderate amounts.
PMS A Tea take 1 part red clover; 2 parts vervain, 2 parts scullcap, half a part liquorice half a part ginger powder. Mix the herbs together and take one heaped teaspoon per cup, infuse for 15 minutes. Take 3 cups a day, before meals, a week or two prior to your period.
Agnus castus is a very useful herb, yet it should be used with care. Use only if you have an uncomplicated medical history in regards to hormonal imbalance. If you suffer from pain around the time of ovulation or you have a family history of ovarian cysts - do not take this herb unless under the guidance of a medical herbalist. Regular use of agnus castus is not suitable for women under 20 years of age. If you feel safe to take this herb it is a fantastic remedy for the classic symptoms of PMS A. Take the tincture for three months from the middle of your cycle (ovulation) until when you begin to menstruate. For best results take in the morning before rising. If you wish you may take a smaller dose in the afternoon. Take for 4 cycles. If symptoms still occur after this time, consult a medical herbalist.

PMS-C symptoms
C stands for cravings, which are associated with a blood sugar imbalance. Other related symptoms are: binge eating of sweet foods; a general increase in appetite or a loss of appetite; fatigue and headaches.
This kind of imbalance is generally due to poor dietary habits, particularly the overuse of refined sugar and salt. It is very important to follow the foods to emphasize and foods to avoid, as well as the guidelines for blood sugar imbalance.

PMS-C suggested supplements
A food state multivitamin and mineral complex is highly recommended, as it will provide you with a baseline of nutrients, ensuring that you absorb any other supplements you take more effectively.
A food state magnesium supplement is recommended to help with tension as well as hormonal and blood sugar imbalance.
Food state vitamin B6 taken for 10-14 day before your period or if you have general stress symptoms take the foods state vitamin B complex on a daily basis.
In addition, food state chromium GTF may be taken for added help with cravings for sweet foods and general blood sugar imbalance.
An essential fatty acid supplement is particularly important if you suffer from PMS-C symptoms. Hemp seed oil has a good balance of all the EFAs (omega 3,6 and 9) and has been shown to increase GLA levels in the body significantly. If you suffer from very dry skin or eczema, take linseed oil for 3 - 6 months until dryness has gone, then change to Udo's oil, Hemp seed oil or Essential Balance Oil. Take 15ml daily.
Algae such as spirulina, chlorella or blue green algae all help to correct blood sugar imbalance as they are rich in minerals and easily absorbable protein. Algae also help if you suffer from anaemia whilst menstruating. To select the correct one for you, see the Green Superfoods section.

PMS-H Symptoms
H stands for hyper-hydration, commonly known as water retention. Other associated symptoms are breast tenderness and enlargement, abdominal bloating and weight gain. It is thought that these symptoms are caused by an increase in the hormone aldosterone, which has the effect of increasing fluid retention. The aldosterone increase may be caused by increased stress, high salt intake, magnesium deficiency or oestrogen excess.

PMS-H Supplements
A food state multivitamin and mineral complex is highly recommended, as it will provide you with a baseline of nutrients, ensuring that you absorb any other supplements you take more effectively.
A food state magnesium supplement is recommended to help alleviate tension and hormonal and blood sugar imbalance.
Food state vitamin B6 is useful, or if you have general stress symptoms take the food state vitamin B complex.
Vitamin E is indicated where there is breast tenderness, take 300mcg of food state Vitamin E 10-14 days before your period
Dandelion leaf capsules or Potters Diurtabs encourage the elimination of excess water, while maintaining potassium levels. You could alternatively take 3 cups of dandelion leaf tea per day.
Evening Primrose Oil has been shown to be most helpful to women whose main pre-menstrual symptom is breast tenderness. It needs to be taken for about 3 months to be effective and the other dietary recommendations mentioned need to be adhered to (it is important to include omega 3 EFAs in your diet for example) to gain the maximum benefit. EPO will not work as well if you regularly eat meat, offal in particular.

PMS-D Symptoms
D stands for depression. Other associated symptoms include confusion, forgetfulness, clumsiness, feeling withdrawn, lack of co-ordination and crying spells. PMS D is the least common of all the categories. It is recommended that sufferers of these symptoms see a practitioner; self-treatment should not be attempted, particularly if symptoms are severe. There may be underlying problems which should also be addressed such as an under active thyroid or more complex hormonal imbalance.

PMS-D Supplements
Sufferers of PMS-D are advised to follow the dietary advice given. It is important to make sure you are not underweight for your height and bone structure, also make sure that you are not eating too much fibre (e.g. all bran or wheat germ). Fibre should not be isolated but taken in the whole grain (e.g. wholewheat bread, brown rice). It is a good idea to take a multi-vitamin and mineral complex and seek professional advice before taking any further supplements.

Sources:
Murray, Michael and Pizzorno, Joseph - Encyclopaedia of Natural Medicine (Little Brown and Company, U.K.; 1998)
Grenville, Marilyn - The Natural Health Handbook for Women (Piatkus, U.K; 2001) Tricky, Ruth - Women, Hormones and the Menstrual Cycle: Herbal and Medical Solutions from Adolescence to Menopause (Allen and Unwin, Australia; 2001)

Written by Julia Moore CHEK level 1 Holistic Lifestyle Coach.

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