Premenstrual Syndrome
Premenstrual syndrome is something I see very regularly in my practice. Close to 90% of women will experience at least one symptom of it. Common symptoms include: depression, irritability, insomnia, crying spells, social withdrawal, headache, bloating, digestive symptoms, breast tenderness, etc.
2-8% of women experience PMDD - Premenstrual Dysphoric Disorder - a much more severe form of PMS which seriously impacts one’s quality of life. Both PMS and PMDD can cause difficulties with interpersonal relationships. What classifies these symptoms as PMS or PMDD is the cyclical pattern: they begin after ovulation in the luteal phase of the menstrual cycle, and end soon after menstruation starts. These symptoms should resolve completely during the follicular and ovulatory phases. (For information on these phases: menstrual cycling & ovulation).
A number of factors may contribute to PMS and PMDD including hormonal fluctuations, inflammation, lifestyle and genetic factors.
The first step to treating PMS is awareness. The Daily Record of Severity of Problems is a great tracker, and there are a number of helpful menstrual apps as well. I always encourage patients to use a tracker or app for a few reasons:
To understand if it’s truly PMS/PMDD or if it’s an exacerbation of another condition.
To monitor the effectiveness of our treatment plan over time.
To bring awareness to where we are at in our cycles. Symptoms of PMS/PMDD can feel very overwhelming and uncontrollable sometimes. If we know they are coming because we have dates on our calendar; we can prepare for them and it feels less irrational.
Many women do well at this time in their cycle with time for inward creativity. Inward creativity is usually pretty low on most peoples’ priority lists. Tracking can allow us to schedule that time in.
From a diet and lifestyle perspective, there are a number of factors to keep in mind. Research shows that lifestyle - especially healthy eating habits, stress, and smoking can influence PMS significantly.
High calorie, fat, sugar, and salt food consumption is a risk factor for PMS. A healthier diet with higher fibre, fruit and vegetable intake decreases PMS and PMD symptoms. Total coffee and tea intake, and change in tea/coffee and food intake under stress seems to correlate with PMDD diagnosis, and alcohol may exacerbate anxiety in the luteal phase.
Chronic daily stress and smoking also increase the risk of PMS. Shifting these factors can make a significant difference, especially in sufferers of PMS. PMDD typically requires more aggressive treatment.
There are a number of nutritional and botanical supplements, as well as medications which can be considered in the treatment of PMS/PMDD. If you’re suffering, reach out. These treatment options can make a world of difference!