PMS, short for Premenstrual Syndrome has always bothered me, for several reasons:
First of all, incidence varies. Some studies claim 30-40%. A meta analysis looking at worldwide studies showed huge variability, from 10% in Switzerland to 98% in Iran, with the pooled prevalence at 48%. (1) This says to me there are problems with the way we define PMS. It also suggests there is a complex interplay between stress and PMS, and probably social and cultural aspects. It also makes me wonder about why something is abnormal if it affects 98% of women of reproductive age in Iran and nearly half of women worldwide?
Second of all, why do we expect hormones to have no effect on our emotions? And why is it a problem that they do affect us? We are not robots, and our hormones enable us, as women, to create miracles, growing a brand new human being from just a couple of cells, and an organ to feed that baby. Without our hormones to send the right messages we cannot do this, and with our hormone changes come different feelings within our bodies and emotions.
Thirdly, the medicalisation of normal diversity has done no one good, and the medicalisation of women’s bodies has not helped with most aspects of our lives. I do not have time and space to go into pros and cons of hormonal contraceptives, medicalisation of birth, hormone replacement therapy or others, but suffice to say these progresses have not been without their drawbacks.
PMS’s more severe cousin is PMDD, or pre menstrual dysphoric disorder and can include physical and behavioural problems that also resolve with menstruation.
So let’s talk about what is happening hormonally in the two weeks before menstruation, after ovulation.
After their surges, LH and FSH are low. GnRH also begins to come down. When the follicle in the ovary releases the ovum it leaves behind the follicle- this closes up and becomes the Corpus Luteum. The Corpus Luteum produces both Oestrogen and Progesterone. Oestrogen spiked before ovulation and then fell, but now, produced by the Corpus Luteum it starts to rise again; Progesterone also begins to rise steadily again after ovulation. Towards the end of these two weeks following ovulation, also known as the Luteal phase, if the ovum has not been fertilised the corpus Luteum begins to break down (if it is fertilised then the Human Chorionic Gonadotrophin (hCG) produced by the placenta will signal to the corpus Luteum to continue producing progesterone until the placenta begins to produce it). With the breakdown of the corpus luteum, oestrogen and progesterone levels fall. This is the hormonal cause of those PMS feelings, and is also the signal that there has been no implantation and menstruation can begin to shed the body of this unneeded lining.
Homeopathic remedies to consider for PMS include:
Pulsatilla – can be irritable but this remedy is marked by its change ability- so can go from angry to tears in a short space of time. Pulsatilla is better for company and consolation when they are upset.
Sepia – wants everyone to go away, feels angry and irritable particularly with family. They can also have a tendency to thrush, and bearing down feelings in the abdomen.
Lycopodium – a strong craving for sweets and a huge appetite, as well as bloating, indigestion and flatulence. May lack self confidence.
Natrum Muriaticum – can feel sad, depressed and lonely, but holds symptoms inside until alone. May have migraine headaches or back ache, and has a craving for salty things and is very thirsty.
Lachesis – intense symptoms, irritable and can have jealousy or suspicion. Headaches or flushes of heat, and everything is better once the period arrives.
Other things to consider:
Studies have suggested that calcium and vitamin D can reduce mood swings. Many calcium supplements are equivalent to eating chalk, so if you can get it from dietary sources that is best. Dairy is the most well known source of calcium; for those who cannot or choose not to eat dairy foods, increase the intake of sesame seeds, almonds and leafy green vegetables- especially Asian greens like bok choy. Vitamin D consider how much sunlight you are exposed to, dietary sources like eggs, or supplements like cod liver oil.
Other dietary measures include reducing refined carbohydrates and sugars, and looking at caffeine intake.
Exercise often helps regulate the effects of PMS. Yoga, meditation and breathing exercises may also help.
Modalities like acupuncture, massage therapy and aromatherapy (from a qualified aromatherapist) are also worth considering.
Herbally you could consider Agnus Castus, or Chaste Tree Berry which has been shown in several studies to be beneficial for PMS. Speak to a Naturopath or Medical Herbalist for more options and information about dosage.
Reference: