You’ve been moody for the past few days, starting arguments over nothing, feeling irritable and anxious. Today, you wake up with cramps and an awful headache... Dammit, it’s that time of the month again! Can you call in sick to work again? It’s been four months in a row now, you really need to get this under control.
This is a common story for a lot of women.
An estimated 80% of women experience Premenstrual Syndrome (PMS) symptoms at some point during their reproductive years
Pre-menstrual symptoms (PMS) can throw a wrench into your daily routine, making it difficult to stay on track with work, exercise, relationships and other commitments. But what causes these unwelcome monthly visits, and more importantly, how can you prevent them?
The Cause of PMS
Hormonal imbalances, especially fluctuations in estrogen and progesterone levels during the menstrual cycle, are key contributors to the onset of PMS symptoms. Estrogen, renowned for its role in mood regulation, can impact neurotransmitter activity, leading to mood swings and irritability. Conversely, progesterone may worsen symptoms like bloating and breast tenderness. However, it's essential to recognise that while hormonal fluctuations are frequently highlighted as primary triggers, the complexities of PMS extend beyond estrogen and progesterone.
Progesterone is a crucial hormone involved in the menstrual cycle and pregnancy. During the second half of the menstrual cycle, progesterone levels peak to prepare the uterus for implantation and support early pregnancy. However, in the context of PMS, fluctuations in progesterone levels can exacerbate symptoms. Progesterone's effects on the body include promoting water retention, which can lead to bloating and breast tenderness, increased body temperature, and increase basal metabolic rate and energy expenditure, which when ignored can cause hunger and cravings. Additionally, progesterone can have a calming effect on the central nervous system, but for some individuals, it may also contribute to feelings of fatigue or lethargy.
Estrogen plays a crucial role in the menstrual cycle and reproductive health, with its levels fluctuating throughout the menstrual cycle, peaking during the follicular phase before declining just before ovulation. This hormone exerts diverse effects on the body, including regulating the menstrual cycle, preserving bone density, and influencing mood and cognitive function. Estrogen's impact on neurotransmitter activity, particularly serotonin and dopamine, can influence mood regulation, potentially leading to symptoms such as irritability, anxiety, and depression. Moreover, estrogen contributes to the production of collagen and maintains the elasticity of connective tissues, including those in the joints and ligaments. Consequently, changes in estrogen levels can affect the flexibility and resilience of these structures, potentially causing sensations of stiffness and discomfort, especially in the back and SI joints. Additionally, estrogen modulates the inflammatory response, and alterations in its levels may contribute to increased inflammation, exacerbating pain and discomfort in affected areas.
Mast cells are a type of white blood cell that plays a critical role in the body’s immune response. They are found in various connective tissues throughout the body, especially beneath the surface of the skin, near blood vessels and lymphatic vessels, within nerves, throughout the respiratory system, and in the digestive and urinary tracts. Mast cells are best known for their role in allergic reactions and anaphylaxis. They are part of the body’s first line of defense against pathogens and are involved in wound healing and defense against infections.
During your menstrual cycle, mast cells become activated and release various substances, including prostaglandins, inflammatory cytokines, and histamine which play a significant role in the development and exacerbation of PMS symptoms.
Histamine is a neurotransmitter and immune system mediator and plays a crucial role in the menstrual cycle and PMS symptoms. As a neurotransmitter, histamine influences mood, arousal, and cognitive function, contributing to mood swings, anxiety, and insomnia often experienced during PMS. Additionally, histamine acts as a potent vasodilator, widening blood vessels and increasing blood flow, which can lead to symptoms like flushing and headaches. Its role in regulating stomach acid secretion and gut motility can also impact gastrointestinal function, potentially causing abdominal discomfort and altered bowel habits during PMS. Moreover, histamine's ability to promote inflammation exacerbates pain and discomfort associated with menstrual cramps and headaches, further contributing to the array of symptoms experienced during this time. Understanding histamine's multifaceted effects on the body provides insight into the complexity of PMS and highlights potential targets for symptom management and relief.
Prostaglandins are hormone-like substances that play a crucial part in regulating your menstrual cycle. During your period, your body produces these compounds to help the uterus contract and shed its lining. However, high levels of prostaglandins can lead to excessive uterine contractions, reducing blood flow and causing the intense pain known as menstrual cramps. These contractions can also trigger the release of other chemicals that inflame nerve endings, amplifying the pain even more. Additionally, prostaglandins can cause the blood vessels in your brain to constrict and dilate, leading to headaches or migraines.
Cytokines are signaling molecules produced by various cells in the body, an they play a significant role in the immune response and inflammation, potentially influencing premenstrual syndrome (PMS) symptoms. Elevated levels of cytokines may exacerbate inflammation and pain, amplifying symptoms such as menstrual cramps and headaches. Additionally, cytokines can modulate neurotransmitter activity and affect mood regulation, potentially contributing to mood swings and emotional disturbances experienced during PMS.
PMS is influenced by a multitude of factors, including immune responses, hormonal fluctuations, neurotransmitter activity, and inflammatory processes. Mast cells, histamine, prostaglandins, and cytokines collectively contribute to the complexity of PMS symptoms, impacting mood, pain perception, and overall well-being during the menstrual cycle.
Breaking the Cycle: How to Ease or Prevent PMS
While completely eliminating these symptoms might not be possible for every woman, there are effective strategies to minimise their impact and help you maintain your healthy routine.
Nutrition plays a crucial role in preventing and managing PMS symptoms by providing the body with essential nutrients needed for hormonal balance, inflammation reduction, and overall well-being. A balanced diet rich in whole foods, including fruits, vegetables, lean proteins, whole grains, and healthy fats, can help stabilize blood sugar levels and regulate hormone production. By incorporating dietary strategies such as consuming anti-inflammatory foods, increasing magnesium intake, including calcium-rich foods, boosting vitamin D levels, adding vitamin B6, staying hydrated, and reducing histamine-rich foods, women can effectively prevent and manage PMS, promoting overall menstrual health and well-being.
Consume more of:
Magnesium: Spinach, almonds, cashews, peanuts, avocado, whole grains, dark chocolate.
Calcium: Dairy products (milk, yogurt, cheese), fortified plant-based milks (soy, almond, oat), leafy greens (kale, collard greens, broccoli), almonds, sesame seeds, tofu.
Vitamin B6: Chickpeas, tuna, salmon, chicken breast, potatoes, bananas, fortified cereals.
Vitamin D: Fatty fish (salmon, mackerel, tuna), egg yolks, fortified foods (milk, orange juice, cereals), sunlight exposure.
Anti-inflammatory foods: Fatty fish (salmon, mackerel, sardines), walnuts, flaxseeds, chia seeds, hemp seeds, berries (blueberries, strawberries, raspberries), dark leafy greens (kale, spinach), turmeric, ginger, olive oil.
Avoid/limit:
Histamine: Aged cheeses, smoked meats (sausage, bacon), alcohol (especially red wine), fermented foods (sauerkraut, kimchi), vinegar-containing foods (pickles, mustard), canned fish (tuna, sardines), processed meats (salami, pepperoni), certain fruits (citrus fruits, strawberries).
Alcohol: I shouldn't have to explain why this toxin/poison should be avoided at all costs, but if you really must know you can refer back to a post that will explain why this is the number one reason for all of your problems.
Exercise can be highly beneficial in preventing and easing symptoms of PMS, considering its multifaceted effects on the body. Firstly, regular physical activity helps regulate hormonal fluctuations, including those of estrogen and progesterone, potentially mitigating their impact on mood swings and other PMS symptoms. Additionally, exercise promotes the release of endorphins, the body's natural painkillers, which can alleviate discomfort associated with menstrual cramps, back pain, and joint stiffness. Moreover, exercise improves circulation, delivering oxygen and nutrients to tissues while aiding in the removal of metabolic waste products and inflammatory substances. This enhanced circulation may help reduce inflammation and alleviate pain in affected areas. Furthermore, engaging in strength and hypertrophy training can be particularly beneficial for women. Strength training not only helps build muscle mass but also strengthens connective tissues, reducing the risk of injury and improving overall joint stability. Aim for at least two to three sessions of strength or hypertrophy training per week, focusing on compound movements like squats, deadlifts, and presses. Building muscle through strength training can also support bone health and prevent the loss of bone density, which may be affected by hormonal fluctuations during the menstrual cycle. Incorporating strength training into your exercise routine can provide long-term benefits for managing PMS symptoms and promoting overall health and well-being.
Aim for:
Daily walking or increased movement throughout the day.
Strength/resistance training 3+ times per week.
Mobility training &/or HIIT 2-3 times per week.
Heat therapy, like saunas, is a valuable tool for managing PMS symptoms by increasing blood flow, muscle relaxation, and pain relief. Saunas induce sweating, aiding in toxin elimination and reducing inflammation. However, hormonal fluctuations can affect heat sensitivity, so timing sauna use to other phases may be more beneficial. It's crucial to stay hydrated during sauna sessions to prevent dehydration, especially during menstruation when fluid needs are higher. Replenishing electrolytes lost through sweating, such as sodium and potassium, helps maintain proper hydration levels. Sauna's, heat therapy and heat packs can be beneficial in both the prevention and easing of symptoms.
Sauna: 4+ times per week for 20+ minutes is optimal (achieve all of the benefits).
Stress management is integral to preventing and alleviating PMS symptoms. High stress levels can exacerbate hormonal imbalances, amplify pain perception, and worsen mood disturbances during the menstrual cycle. Implementing stress-reduction techniques, such as mindfulness meditation, deep breathing exercises, yoga, or engaging in hobbies and activities that promote relaxation, can help mitigate the impact of stress on PMS symptoms. Regular practice of nasal, diaphragmatic breathing not only provides immediate relief from PMS symptoms by promoting relaxation and reducing stress but also offers long-term benefits for symptom prevention. By incorporating nasal and diaphragmatic breathing into your daily routine, you can improve respiratory function, enhance oxygenation of tissues, and cultivate a calmer, more balanced state of mind. A systematic review of practices like Laura Mitchell and Benson's relaxation techniques proved they are beneficial in easing and preventing PMS.
Breathing Practice: Daily 10+ minutes.
Quality sleep is crucial for managing PMS symptoms and supporting overall health and well-being. Research has shown that disrupted sleep patterns, such as those experienced by shift workers, can significantly impact menstrual regularity and increase the risk of PMS and infertility in women by 30%. Chronic sleep deprivation can disrupt the body's natural circadian rhythms, leading to hormonal imbalances, increased stress levels, and impaired immune function, all of which can exacerbate PMS symptoms.
Sleep Routine:
No blue/harsh lights within 1 hour either side of sleep
Regular/same sleep time every night
Minimum 7-9 hours sleep per night
Cool, dark room
PLUS: The PMS Prevention Mix
Meeting all of our nutritional needs solely through food can sometimes be challenging, especially when it comes to obtaining the specific nutrients essential for managing PMS symptoms. Factors such as dietary preferences, food availability, and individual nutrient requirements can all contribute to potential gaps in our nutrition. When experiencing PMS, ensuring adequate intake of key nutrients becomes even more crucial for symptom management and overall well-being.
Consume this mix daily:
1000mg Omega 3
300mg Magnesium
500mg Calcium
Plus, this mix during the luteal phase:
30mg Vitamin B6
Omega-3 fatty acids have powerful anti-inflammatory properties. Studies have shown that omega-3s can significantly reduce menstrual pain by decreasing the effect of prostaglandins. In a meta-analysis, findings suggest that daily intake of 300-1800mg over 2-3 months reduces pain in women with dysmenorrhea.
Magnesium is a mineral that plays a vital role in muscle relaxation and nerve function. It enhances GABA activity, regulates the stress response, and normalises the action of progesterone on the central nervous system. Vitamin B6 is essential for the manufacture of brain neurotransmitters, including GABA, dopamine, and serotonin. It also assists in estrogen metabolism, lowers prolactin and reduces histamine. Research indicates that magnesium can alleviate menstrual cramps and headaches by reducing uterine muscle spasms and regulating the dilation of blood vessels in the brain. A study published in the Journal of Women's Health found that magnesium supplementation was effective in reducing the severity of menstrual pain and improving mood symptoms associated with PMS. A meta-analysis also found that magnesium, when taken with B6, reduces severity even further.
Calcium is essential for muscle function and can help reduce menstrual pain. A study in the American Journal of Obstetrics and Gynecology found that women who took calcium supplements experienced a significant decrease in PMS symptoms, including cramps and mood swings. Calcium helps stabilise the smooth muscle contractions of the uterus, reducing the severity of cramps. Low serum levels of calcium and vitamin D during the luteal phase of the menstrual cycle were found to cause or exacerbate the symptoms of PMS. Therefore, the administration of calcium and vitamin D supplements or the use of a diet rich in these two substances can restore serum levels and eliminate or reduce the symptoms of PMS. Calcium and vitamin D supplementation are recommended as an inexpensive, low-risk, acceptable, and accessible approach to eliminate or reduce the symptoms of PMS.
If pain persists, taking aspirin will be more effective than paracetamol (acetaminophen) or ibuprofen. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, thereby reducing inflammation and pain. Aspirin also has additional blood-thinning properties that can help reduce the risk of blood clots during menstruation and improve blood flow.
Tracking menstrual cycles and paying attention to the body's signals is an invaluable tool for preventing and managing PMS. By keeping a record of cycle length, symptoms, and mood fluctuations, individuals can identify patterns and anticipate the onset of PMS more effectively. This proactive approach allows for better preparation and implementation of preventive strategies, such as adjusting diet, exercise, and stress management techniques accordingly. Additionally, tracking cycles can help individuals become more attuned to their body's needs and recognize early warning signs of PMS, enabling prompt intervention and symptom relief. Whether using a paper calendar, smartphone app, or period tracking device, monitoring menstrual cycles empowers individuals to take control of their reproductive health and optimize their well-being throughout the month.
Effective management of PMS requires a comprehensive approach that addresses various aspects of health and lifestyle. By focusing on dietary changes, regular exercise, stress reduction techniques, adequate sleep, and hydration, women can significantly alleviate the symptoms of PMS, including cramps, headaches, and mood swings.
With these proactive strategies in place, women can better navigate their monthly cycles and maintain a higher quality of life throughout the month.
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