What Is Premenstrual Syndrome (PMS)?
PMS occurs in the second half of the cycle after ovulation and usually resolves once your period starts. PMS is different for each woman but can include mood changes, irritability, fatigue, sleep disturbances, changes in bowel habits, bloating, weight gain, breast tenderness, changes in appetite, decreased concentration and headaches. Hormone imbalance can also lead to painful menstrual cramping and absent or irregular cycles.
PMS is caused by the effects that estrogen and progesterone have on the nervous system, not by the levels of the hormones. When the hormones interact with our nervous system, it results in lowered serotonin, dopamine and GABA activity, which can result in low mood, irritability, and feelings of restlessness and tension. This also affects other hormones that balance fluid in the body, resulting in fluid retention.
Estrogen Dominance
Estrogen dominance doesn't mean that estrogen is high enough to be abnormal if you were to test it. If you were to do a test, you may see that both estrogen and progesterone are within normal ranges. In the second half of the menstrual cycle, progesterone should be rising and get to higher levels than estrogen, but when it doesn't, and estrogen remains high in comparison to progesterone, that's when there is estrogen dominance.
Estrogen dominance can be caused by synthetic estrogen use (birth control), not ovulating, liver or digestive issues that interfere with estrogen metabolism, smoking, alcohol use, poor diet, stress, and exposure to xenoestrogens.
Nutritional Strategies to Balance Hormones
A healthy dietary strategy for hormones looks much like a general healthy diet. I'll highlight different nutrients to emphasize or avoid when it comes to reproductive hormones.
Fiber: Our body metabolizes hormones in the gut through our beneficial bacteria. These bacteria need fiber to thrive. We also excrete excess hormones through the stool so supporting this process by getting enough fiber in the diet is key. Good fiber sources include fruits, vegetables, whole grains, flax seeds, chia seeds, oats, and psyllium.
Omega-3: These anti-inflammatory fats are needed from our diet because our body can't make them. Good sources include fatty fish like salmon, seaweed, and flax, chia and hemp seeds.
Omega-6: These fats are usually considered to promote inflammation but there's a specific one called gamma linolenic acid (GLA) that is anti-inflammatory. This fat may also help to ease breast tenderness. Sources of this fat include evening primrose, borage seed, and hemp seed oils.
Antioxidants: Having enough antioxidants in the diet protects the ovaries and follicles from damage by free radicals. When the follicles are damaged, they produce less progesterone and this may lead to symptoms of estrogen dominance. Antioxidants in the diet include fruit, vegetables, whole grains, nuts, seeds and healthy fats like avocado and olive oils. Supplement forms include vitamins C and E, selenium, coenzyme Q10 (CoQ10), N-acetyl-cysteine (NAC), and alpha-lipoic acid (ALA).
Magnesium: Women with PMS may have less of this mineral in their body. It may help with emotional mood swings and painful periods. Magnesium comes in many forms and the best absorbed forms are magnesium malate, succinate, fumerate or citrate. These are also less likely to lead to diarrhea/loose stools. Magnesium oxide isn't the preferred form and can have a laxative effect.
B vitamins - This group of vitamins are involved in many enzyme reactions and in supporting the neurotransmitters involved in PMS. They work well with magnesium and may help to ease mood symptoms. Food sources of these vitamins include meat, eggs, dairy, legumes, greens and seeds.
Caffeine: Caffeine causes a release of cortisol. Cortisol is made from progesterone so when your body needs lots of cortisol, it uses up progesterone. Low progesterone, especially in relation to estrogen, can cause estrogen dominance and symptoms of hormone imbalance. If you tend to have breast tenderness or mood changes try avoiding caffeine.
Seed Cycling diet - This involves eating different seeds in different parts of your cycle. The goal is to reduce inflammation and the production of pro-inflammatory compounds. In the follicular phase (day 1- 14), eat 1-2 TB of ground flax and pumpkin seeds. In the luteal phase (day 15-28), eat 1-2 TB of sesame and sunflower seeds. You can put them in smoothies, sprinkle them on salads or mix them in non-dairy milk and drink them. Try to get organic, raw seeds. Grind enough for a day or two and store them in the fridge to stay fresh.
DIM (diindolylmethane) - This isn't a food exactly but a compound that comes from broccoli, cabbage and cauliflower. It helps to metabolize estrogen and may reduce symptoms of estrogen dominance. Get it in supplement form or from eating vegetables in the broccoli family (cabbage, kale, Brussel's sprouts, bok choy).
Vitamins and Minerals - Various nutrients like zinc, chromium, manganese, vitamin E, and vitamin D can be beneficial for PMS. Eating a healthy diet and taking a good quality multivitamin may be helpful to get enough of these important nutrients.
Summary
PMS occurs in the second half of the cycle after ovulation and usually resolves once your period starts. PMS symptoms include mood changes, irritability, fatigue, sleep disturbances, changes in bowel habits, bloating, weight gain, breast tenderness, changes in appetite, decreased concentration and headaches. Estrogen dominance happens in the second half of the menstrual cycle when progesterone should be rising and get to higher levels than estrogen. Foods and nutrients to include in your diet include fiber, omega-3 and omega-6 fats, magnesium, antioxidants, B vitamins, reducing caffeine, seed cycling diet, DIM from the cabbage family, zinc, chromium, manganese, vitamin E, and vitamin D.
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Dr. Jamie
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