by Sinead Fine (MAHA)

Pre menstrual syndrome is a range of one or more symptoms that occur in a woman’s body in the latter stage of the menstrual cycle (day 14 - 28).  Symptoms can appear as early as ovulation (approx. day 12 - 14) or only appear a day or two before menstruation begins.  Symptoms can be severe or simply annoying.  Once menstruation begins, most symptoms disappear quickly (thus the name PRE - menstrual syndrome).

Some researchers have categorised PMS into four main types, which are…

PMS A

Anxiety, nervous tension, mood swings, irritability,

PMS H

Hormonal weight gain, bloating, swelling, sore breasts.

PMS C

Cravings, Headaches, tiredness, fainting, dizziness.

PMS D

Depression, forgetfulness, crying spells, insomnia.

From the above, we can see that a woman experiences PMS not just physically, but also mentally, emotionally and spirituality.

See end of article -  Chart A and B for supplement, diet, lifestyle and homeopathic solutions to PMS.

Physically the days leading up to menstruation can involve painful cramps up to 48 hours before actual bleeding begins, accompanied with an aching lower back.  (It is important to note that pain could be a sign of a more serious ailment such as fibroids endometriosis or hormonal imbalance and these should be ruled out first).   There could be nausea, vomiting, headaches, sore muscles, tender breasts and night sweats.  Many women feel them selves gaining kgs in water retention before they bleed, which means a quarter of the month your clothes may feel very tight! Blood flow may be painful (dysmennorrhoea) with cramps and spasms, absent (amenorrhoea), heavy (menorrhagia) or irregular.  These abnormal flow patterns indicate that some thing is wrong in the health balance of a woman.

Mentally and emotionally there can be a sense of a lack of control, with fits of weeping, bouts of depression, panic attacks or intense hatred and anger!  Sometimes women cannot judge right and even co-ordination can go strange!  There may be paranoia, a feeling of being unattractive, stupid or irrational. A woman may feel totally alone, without guidance, with a lack of faith and hope.  A feeling perhaps of being wounded and controlled by others.  Nightmares may indicate when there is internal unrest. 

Why such a range of symptoms?  What causes PMS?  To understand and thus answer these questions, a woman must look deeper into her chemical endocrine system, her emotions, desires, lifestyle and diet. 

PMS never usually has one single cause but can be caused by hormonal imbalance, suboptimal liver function, nutritional insufficiency, disturbed gut microflora and of course stress amongst other factors.

 Another cause of PMS and hormonal imbalance is polycystic disease of the ovaries.  Here the main signs are ovarian pain around ovulation or all month around.  There are symptoms of excess facial hair, acne, depression and mood swings.  Follicles which did not mature properly become cysts.  It is believed polycystic ovaries are caused by lack of progesterone and though common, if left too long can make a woman sterile.

Let us first look at the delicate balance of the female hormone cycle.  The hypothalamus controls hormone levels in the female body.  When a woman bleeds once a month, the hypothalamus responds by sending Gonadotrophin releasing hormones to stimulate the cells in the pituitary gland.  The pituitary gland then manufactures FSH (follicle stimulating hormone) which allows follicles to swell and produce oestrogen.  Oestrogen has many functions but one is to stimulate the lining of the womb to grow.  Around day 12 / 14 the hypothalamus releases LH-releasing hormone, which in turn stimulates the pituitary gland to produce LH (Luteinizing hormone).  LH induces one of the egg follicles to burst and expel its egg, which then makes its way down the fallopian tube to be fertilised.  The collapsed follicle (corpus luteum) continues to secrete Oestrogen but now also produces Progesterone, which helps to thicken the lining of the uterus.  If the egg is not fertilised, the Corpus Luteum dies and Oestrogen and Progesterone drops dramatically.  The lining now begins to shrink, crumbles and is shed.  The Uterus contracts expelling the blood through the cervix into the vagina.  Menstruation has begun.

This seems fairly straight forward - but I’ve explained the hormonal cycle in extremely simple terms.  The adrenals also produce sex hormones and the whole pattern is much more complex, so much so that nobody is 100% sure how it all works.  Yet so much can disrupt this delicate balance.  Stress can prevent ovulation, as can starvation.  If the ovaries are not functioning properly, there may be no ovulation thus leading to oestrogen dominance in the latter part of the cycle. 

PMS usually (though not always) is a sign of oestrogen dominance.  Oestrogen dominance leads to increased risk of cancer, ovarian cysts and endometriosis.  Early signs of Oestrogen dominance are depression, sweet cravings, heavy periods, irregular periods, weight gain, water retention, sore swollen breasts.  One must be careful to avoid estrogenic influence from the environment also.  Estrogenic like substances can be found in meat, dairy, soft plastics, hormonal treatments like the Pill and HRT.  DDT and DDE are pesticides, which can lead to hormonal imbalance.  Tampons (with traces of Dioxin) and condoms with spermicidal lubricant (estrogenic effects) should also be avoided. 

To avoid estrogenic substances do some or all of the following…

  • Eat organic food as much as possible
  • Avoid hormone fed animals such as factory chicken 
  • Grow your own food if you have the time and the land space. 
  • Use natural cleaning products which can be found in most supermarkets and health food stores. 
  • Avoid Hormone treatments such as HRT and the contraceptive pill if necessary. 
  • Use filtered water for cooking and drinking. 
  • Use organic tampons such as the “Naturacare” range.
  • Use natural face creams, cosmetics, body lotions and perfumes and make sure there are no paraben chemicals in them (e.g. methyl paraben, propyl paraben) as research has shown that parabens can have a hormone like effect on the body. 

The more natural your lifestyle and diet the less risk of hormonal imbalance.

Conventional treatment for Premenstrual Syndrome would include the contraceptive pill, anti-depressants, prostaglandin synthesise inhibitors and other such treatments. Medical doctors may also recommend to a woman that she must also look at diet, supplementation, exercise and stress management.  In Complementary medicine most therapists will recommend diet and lifestyle changes as well as incorporating their own particular modality. Above all a woman must love her body and respect its needs.  Part of healing Pre menstrual Syndrome is for a woman to come to realise that her menstrual cycle is natural - not a “curse” to be dreaded each month. 

DIET

Avoid dairy, sugar, caffeine, alcohol (which depletes important nutrients and affects blood sugar), tobacco and dark tea near meals (tannins bind to important minerals such as iron). 

Avoid high fat meats, hormone fed meats (e.g. Chicken and beef) and non organic dairy.

Avoid high glycemic foods.  High glycemic foods are those which cause a quick rise in blood sugar.  Fluctuating blood sugar puts stress on the adrenals and pancreas - and many women who suffer from PMS also suffer from blood sugar problems such as hypoglycaemia.  High index foods include some of the following… Refined white flour products, caffeine, sugar, tropical fruits, alcohol and tobacco. Eat a diet, which includes a lot of low index foods.  These include wholegrains, pulses, small amounts of organic meat, apples, pears etc.

Each day include two tablespoons of mixed seeds (pumpkin, sunflower and sesame) to your salad or breakfast cereal.  Eat plenty of fruit, vegetables and berries.  Wash fruit and vegetables before eating.  Eat foods rich in potassium, such as tomatoes, peanuts, potatoes, bananas, peach, fig, and dates.  Have protein for breakfast such as muesli and nuts, baked beans on toast, eggs or a protein shake. 

Eat regularly - 6 times a day in smaller amounts to keep sugar levels balanced with no more than 3 / 4 hours between meals.  Increase the fibre in your diet, particularly soluble such as oats, fruit and vegetables rather than too much harsh fibre (e.g. All Bran or Weetabix)

SUPPLEMENTS

Apart from taking a good multivitamin and mineral take extra B6 (if on the contraceptive pill), magnesium and essential fatty acids such as fish oils, evening primrose, borage oil and linseed oil. If periods are heavy take iron for a few months - Spatone iron is easily absorbed and does not cause constipation. 

After your basic supplement program you can take supplements for specific reasons - B6 and Magnesium has been shown to help PMS A and H.  Essential Fatty Acids and Chromium has been known to help PMS C, while PMS D is more complicated and has to be taken on an environmental and lifestyle basis where a deficiency in many important nutrients may be indicated.

HERBS

Herbs play a vital role in the menstrual cycle and have been used since the ancient times with names like squaw root, chaste tree and motherwort being common names among those who used the healing herbs.  Please contact a qualified registered herbalist or naturopath for individualistic herbal treatment. In their treatments they may use herbs such as Agnus castus, Black cohosh and Dong quai.

AROMATHERAPY

Geranium and Rose is known to regulate hormones. Bergamot, Jasmine and Neroli help to uplift and balance emotional swings. Lavender and Camomile soothes frayed nerves.

Contact an aromatherapist for more information.

CHART A

ANXIETY/STRESS/

FEAR

Drink herbal teas such as lemon balm, chamomile and valerian.  Nettle tea or tincture tones the adrenals. Massage your belly with essential oils such as lavender and geranium.  Take Bach Flower Remedies like Rescue Remedy for all forms of tension and stress, Mimulus for fear of known things and Aspen for fear of unknown things.  Take extra B complex, and calcium/magnesium on top of your daily multivitamin and mineral.  Consider Martial Arts to tone the body and reduce fear or a gentler form such as Tai Chi. Massage and Reflexology are excellent for reducing stress.

CONSTIPATION

Eat natural foods, which increase bowel movement such as dried apricots and prunes and soaked linseeds.  Aloe Vera juice has also been shown to help constipation.  Consider a liver detox or take Milk Thistle for the last few days before menstruation if this is when constipation occurs.  Lymph drainage massage with essential oils of Geranium, Grapefruit, Juniper, Rosemary and Cypress around the pelvic area can help. 

CRAMPS

Often an unhealthy diet can be indicated by how painful the cramps are.  Cramps can also be caused by spine or hip mis-alignment also and can be treated by an osteopath or chiropractor.  Menstrual cramps seem to be more painful if there is constipation, as hormones are reabsorbed in the colon and cause hormonal imbalance.  Avoid foods high in phosphorous, such as red processed meats, instant potatoes, canned fruit, and carbonated drinks and processed breakfast cereals. Avoid alcohol and caffeine. To prevent cramps take Calcium/Magnesium on an ongoing basis.  Eat foods such as green vegetables, nuts seeds, oats, seaweed, sardines, kelp and horsetail.  For the cramps themselves take Ginger and Sage tea.

DEPRESSION/

GRIEF

Depression and grief can be common in the last few days up to menstruation.  Taken over a period of time St. Johns Wort has been shown to alleviate mild forms of depression.  The Bach Flower Remedies Mustard, Sweet Chestnut and Gorse can help.  Passionflower, Lemon Balm and Peppermint tea lightens the mood.  Sage tea especially has been known to lift the spirit. Siberian Ginseng has been shown to help where other symptoms could include fatigue.  Sunlight and laughter greatly help as does wearing more colourful clothes. 

FIBROIDS

Fibroids are non-malignant growths of the myometrium, which is the muscle lining in the womb.  Fibroids tend to occur in the later stages of life - usually just before the menopause. There is pain, discomfort and excessive/irregular bleeding. Reiki has been known to help.  Acupuncture can also help to reduce the size and also reduce the severity of symptoms.

FLOODING

Take extra Vitamin C and Iron.  Flooding can often be a sign of uterine and ovarian distress and should be checked by the doctor to rule out more serious complications.  Essential Fatty Acids can help (Evening Primrose, Borage and Fish oils) as does hormone regulating herbs taken over many months.  When flooding drink Cinnamon Bark tea every 15 minutes to check flooding and do not use Ginger for cramps, instead use Mag phos tissue salt. Use the Acupressure point (the centre point just above the upper lip and below the nose) to check flooding.

FOOD CRAVINGS

The craving itself could indicate a deficiency of some sort.  Dairy deficiency could be linked with Calcium, Nuts could be lack of Zinc or Magnesium, and Bananas could be a lack of Potassium.  Are you eating healthy and taking proper supplements?  If it is sugar you crave take Magnesium and also Chromium (200 - 400mcg per day) and if you have to have chocolate, at least get good quality Organic Chocolate!

IRREGULAR PERIODS

Herbal medicine over time is excellent in regulating hormonal imbalance if taken over a period of time. Reduce stress; take essential fatty acids and drink raspberry leaf tea to tone the ovaries and uterus.  Sleep with the moon on ones face or shining into your bedroom if possible as this has also been known to help. 

LATE/SCANTY PERIODS

Anything that promotes menstruation is called an emmenaoggue. Gentle herbs such as Ginger and Marigold can help to bring on a late period.  If there is nausea from taking Ginger tea it is a traditional sign in my home country (Ireland) that one is pregnant!

SORE BREASTS

Usually sore breasts is a sign of a lack of essential fatty acids in the diet.  Taken over 3/6 months Evening Primrose has been shown to cure sore aching breasts.  Magnesium has also been shown to help. Rub Arnica and / or St. Johns Wort oil into the breasts to alleviate tenderness and the bruised feeling.

RAGE

Liver detox is highly recommended here.  In Chinese medicine, rage is considered due to toxic or imbalanced liver.  Release the anger into a pillow if possible or take up some form of vigorous exercise. Take the Bach Flower Remedy Holly for anger and Cherry Plum if you fear the anger will consume you!  But also look and see if you are justified in your anger - perhaps something that you let pass for the sake of peace becomes totally unbearable during the days leading up to your period.  But be careful to deal with your anger in an appropriate manner J

WATER RETENTION

A common irritating problem.  Avoid Caffeine and I’m afraid that includes Chocolate.  Reduce salt in the diet and eat plenty of natural water releasing foods such as melon, corn, grapes, cucumber, watermelon, and pot barley.  Drink cleavers, dandelion and nettle tea.  Take B6, Magnesium and Vitamin E all month round.

CHART B

In regards to treating your symptoms of PMS you are strongly advised to go to see a homeopath for individualistic treatment. PMS is not an acute problem that is easily solved overnight.

However for acute period pain you can purchase the below medicines in 30c potency and take one dose (see How do I take my Homeopathic medicine?) every four hours when your menses arrive for a maximum of four doses. However after one menstrual cycle if you feel there is no difference in pain levels, please contact your nearest Homeopath for treatment.

BELLADONNA

Violent throbbing pain. Pains come and go suddenly. Pupils may be dilated. Feels better sitting erect but worse for touch.

CHAMOMILLA

Pain which extends down the thighs. Pain is unbearable. Irritable and moody.

LACHESIS

Flooding, Blood is very dark, thick, and strong smelling.  Rage as a possible emotion before menses, which is gone immediately on first bleeding.  Better in all ways once flow starts. Pain is more on the left side.

MAG PHOS

Cramps and sudden shooting pains. Pain is better for application of a hot water bottle and doubling up on the sofa or in bed

NUX VOMICA

Pain may be felt all over the body. Tendency to faint with the pain. May be irritable. Constant desire to pass stool.

PULSATILLA

Feel Sensitive.  Easy to cry.  Feels better when there is company as does not want to be alone. Painful late or scanty periods.  Aching pain in abdomen and back with tender breasts. Pains constantly change location. Feels better for fresh air.

SEPIA

Irregular and frequent periods. Lower back pain, exhaustion during period.  Generally period flow is light. Unlike Pulsatilla, Sepia feels better when alone.

WARNING:  There are some contraindications for the above mentioned supplements. It is always wise to consult with your primary health care practitioner before starting a supplement program if you have any health conditions. For example those who suffer from epilepsy should not take Evening Primrose.  Those who are allergic to aspirin should not take Black Cohosh.  Fish oils can interact with certain medications. St Johns Wort should not be taken by those on antidepressants or the contraceptive pill. Therefore check before taking any supplements for all the safety precautions.