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Premenstrual syndrome (PMS) is a state of hormonal imbalance that affects many women during the one to two weeks before their menstrual cycle begins. The female hormones estrogen and progesterone, as well as prolactin, ebb and flow depending on a women's cycle. These hormone level changes contribute to other chemical changes, including the feel-good-chemical, serotonin. PMS encompasses a wide array of symptoms lasting from two days to two weeks in length. These symptoms include mood swings, tender breasts, food cravings, and irritability, and fatigue, acne flare ups to bloating, weight gain, water retention, cramps, diarrhea, and vomiting. PMS can be so disabling for some women that it keeps them bedridden. Other women have extreme psychological changes during their period and are diagnosed with a condition known as premenstrual dysphoric disorder (PMDD).

To understand the symptoms that persist with a women's cycle, it is first important to understand the progression of the cycle. On Day 1, the follicular phase begins. Estrogen increases and progesterone decreases. After 13 days, generally the beginning of the menses, luteinizing hormone and follicular stimulating hormones both increase, stimulating ovulation. The luteal phase begins and if the eggs are not fertilized, the uterus sheds its lining. There is a decrease in both progesterone and estrogen at this time.

Immediately before menstruation, there is a surge in progesterone. A high progesterone to estrogen ratio is responsible for an increase in food cravings, fluid retention, mood swings, and other PMS symptoms. High progesterone also causes relaxation of smooth muscle tissue, such as in the uterus and bowels. Relaxation of the bowels leads to expansion, thus the bloated feeling in the gut. These actions are all necessary to prepare the woman's body for pregnancy and to increase weight.

The standard medical approach to alleviating the symptoms of PMS is typically through the use of oral contraceptives and hormone therapy. However, there are often more risks and side effects than benefits to these traditional treatments. Oral contraceptives can increase the chance of a Candida yeast overgrowth, leading to other disruptive symptoms like yeast infections and gastrointestinal discomfort. Hormone therapy may increase the risk for breast and ovarian cancer in some individuals. In fact, in some cases, the hormone therapy does not actual correct the hormone imbalance, but further aggravates the estrogen progesterone balance.

PMS symptoms tend to get worse for most women in their late thirties and beyond. They are often magnified after pregnancy, years of taking birth control pills and just before menopause because of hormonal shifting. But, with such a broad spectrum of symptoms affecting every system of the body, there is clearly no one cause and no one treatment. A holistic approach is far more beneficial, and self care allows a woman to tailor treatment to her own needs.


Common Symptoms

Mood swings, tension, irritability, and depression; argumentative, aggressive behavior; water retention, bloating, and constipation; headaches; lower back pain; sore, swollen breasts; nausea; heavy cramping; low energy; food cravings for salt and sweets; acne and skin eruptions.


Common Causes

Prostaglandin imbalance; estrogen excess or imbalance; poor liver malfunction; thyroid insufficiency; excess body fat; B vitamin, mineral and/or protein deficiencies; excess consumption of processed soy products; exposure to xenoestrogens; endometriosis; high consumption of non-organic meat, poultry and dairy; high intake of sugar and caffeine; stress and emotional tension.


Natural Treatment

The most effective way to treat hormone imbalance is through natural means. A natural approach will have little to no side effects and not only manage the symptoms, but more importantly, it will treat the underlying cause of the imbalance. The first objective is to rule out estrogen mimicking agents in the diet or lifestyle through a medical history and dietary analysis (online or in person). In many cases, the removal of the culprit(s) will provide significant relief, however it is often recommended to explore the exact level of hormone in the system through the use of diagnostic testing. The Female Hormone Panel is a test that provides the most comprehensive view of a women's menstrual cycle. The test is performed by taking saliva samples over the course of a month to determine the pattern of cycling hormones. As a result, it is much easier to determine the exact days of hormonal imbalance and therefore treat accordingly with natural therapeutic agents. These natural therapies have adaptogenic benefits in that they work with the body to create natural balance and healing.

PMS symptoms can also be linked to vitamin and mineral deficiencies which may be a result of a poorly managed dietary regimen (nutrition counseling online or in person). If a woman is overweight, her chances of having PMS symptoms will greatly increase. Weight affects hormones because excess estrogen is stored in body fat. The surplus of estrogen will often cause more hormonal imbalance resulting in PMS. For long-term weight management, a personalized eating plan and exercise regimen are essential. In addition, exercise helps increase the production of serotonin and reduce water retention and bloating. Including resistance training can help strengthen bones in cases of low estrogen, which normally supports bone density.



Mayo Clinic staff. Premenstrual Syndrome. MayoClinic.com. 2007. Available at: http://www.mayoclinic.com/health/premenstrual-syndrome/DS00134/DSECTION=symptoms. Accessed on October 14, 2009.

Page L. Healthy Healing: A Guide to Self-Healing for Everyone Eleventh Edition. Traditional Wisdom, Inc; 2000.

Isaac S. Hormonal Balance: Understanding Hormones, Weight, and Your Metabolism. Boulder: Bull Publishing Company; 2007: 185.


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