Premenstrual Syndrome (PMS)

PMS is defined as a collection of symptoms that occur after ovulation and disappear on arrival of menstruation. There are over 150 different types of symptoms, although there are many common symptoms such as tension, irritability, depression, breast tenderness, backache, bloating, water retention, diarrhoea and constipation, headache and acne.

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It has been estimated that 70-90% of women in their childbearing years suffer from PMS and of these, 30-40% suffer symptoms so severe they interfere with their daily lives.

The frustrating thing about PMS is that despite a lot of research, the exact cause has still not been identified. The predominant view is that PMS symptoms are related to an imbalance of the hormones oestrogen and progesterone, however many studies have been unable to support this theory. Perhaps, it is not just our hormones, but also our general health that affects our PMS? Certainly, sub-optimal health can compromise our body’s ability to produce the right balance or hormones and to utilise these hormones properly. The good news is that simple dietary changes have been found to dramatically reduce the incidence and severity of PMS symptoms; there is no need to just accept PMS as “a woman’s lot”.

A brief overview of the Menstrual Cycle and the Important Hormones

Follicle stimulating hormone (FSH) is responsible for the maturation of the egg within a follicle. As the egg matures, it begins to produce oestrogen. Luteinising hormone (LH) is produced in response to increasing oestrogen levels and is responsible for ovulation. After ovulation, the follicle becomes a corpus luteum and produces progesterone and oestrogen.  If fertilisation does not occur, the corpus luteum degenerates, hormone production decreases and menstruation begins.

 

Excess Oestrogen

  • Reduces bile flow and excess and old oestrogen accumulates in the blood.
  • Impairs the synthesis and activity of neurotransmitters and endorphins impacting on mood and pain.
  • Negatively affects B vitamin function (particularly B6). B vitamins are important for oestrogen detoxification by the liver. B6 is important for the production of neurotransmitters and anti-inflammatory prostaglandins.
  • Increases aldosterone hormone secretion which increases retention of sodium and water.
  • Increase prolactin hormone secretion which is implicated in breast pain. Vitamin B6 and Zinc also lower prolactin levels.

Dietary Management of PMS

Luckily there are a few things we can do to limit the effects of PMS.

  1. Dietary Recommendations for Balancing Hormones
  • Eat plenty of fruits and vegetables as these provide vitamins and minerals, including the antioxidant vitamins (A, C, E) and minerals (zinc and selenium) as well as fibre and phytoestrogens. These are essential for optimal health and well being.
  • Eat complex carbohydrates (wholegrains like brown rice and wholemeal bread) to provide energy. These foods also contain high amounts of the essential vitamins and minerals and fibre.
  • Increase fibre as this plays an essential role in balancing our hormones. Fibre binds the excess oestrogen and old hormones that are excreted into our gut for elimination. It also helps prevent reabsorption of these hormones back into the blood stream. It has been found that women with diets low in fibre (low vegetables and high meat consumption) reabsorb much more oestrogen than those with a high fibre diet.
  • Eat foods high in phytoestrogens (beans, lentils, flaxseeds, chickpeas, soya products). Phytoestrogens are natural substances in foods that are similar to our body’s own natural oestrogen. They fit into our cell oestrogen receptors and exert a mild oestrogenic effect. If our body is producing too much oestrogen, phytoestrogens lessen the effects of our natural oestrogen. Conversely, if our body is producing too little oestrogen (for example when going through menopause), phytoestrogens exert a mild oestrogenic effect when binding to oestrogen receptors.
  • Eat oily fish, nuts and seeds as these provide “essential fats” or the “omega 6” and “omega 3” fats.  Omega 6 fats are found in nuts and seeds and help to prevent blood clots and keep the blood thin. Omega 3 fats are found in linseeds and oily fish. They soften the skin, increase immune function, help maintain blood sugar balance and increase metabolic rate and improve energy. Prostaglandins are hormone like chemicals made from essential fats. Some prostaglandins are useful for reducing inflammation, water retention and pain and are therefore important in relieving PMS symptoms. They also play a role in blood clotting and help reduce the amount of bleeding if you suffer from heavy periods.
  • Drink enough fluids as water is essential for helping transport nutrients and waste products in and out of our cells.
  • Reduce saturated fats, refined foods, alcohol, sugar and caffeine. The body produces “bad” prostaglandins from saturated fats such as meat and dairy which may cause inflammation, swelling and pain and worsen any PMS symptoms. Saturated fats also stimulate oestrogen production which may lead to a hormone imbalance due to excess oestrogen. Caffeine has a dehydrating effect on the body and is also an anti-nutrient; depleting valuable stores of vitamins and minerals that are essential for hormone balance. Caffeine in tea (including green tea), coffee, caffeinated soft drinks and chocolate also acts to imbalance our blood sugar. In particular, caffeine consumption is associated with breast tenderness. Alcohol also contributes to blood sugar imbalances, is an anti-nutrient and places strain on the liver as it is detoxified. Oestrogen is produced by the fat cells in our body and therefore the more fat cells you have, the higher your oestrogen production is. Excess sugar is often converted to fat and it is therefore best to avoid.
  • Buy organic where possible and avoid additives, preservatives and artificial sweeteners. Organic foods contain higher levels of the important nutrients and are free from many of the antibiotics, pesticides, fungicides, insecticides and other chemicals routinely used on non-organic foods.

 

  1. Stabilise Blood Sugar Levels.

 

Out of all the above dietary recommendations, those that help to balance blood sugar are the most important for aiding PMS symptoms. Research suggests that the higher the sugar content of a woman’s diet, the more likely they are to suffer from PMS.

  • Sugary foods like chocolate and sweets, alcohol and caffeine containing drinks can imbalance blood sugar levels, so these foods should be avoided. This also applies for any food products which contain added sugar and it is important to read the label. Indeed, you might be surprised what sort of products sugar is added to when you take the time to look.
  • Eat little amounts of food often to help keep your blood sugar levels even. Generally, the more food you eat, the bigger the increase in your blood sugar levels.
  • Complex carbohydrates (brown bread, rice, pasta) are the best carbohydrate foods for balancing blood sugar. In addition, these foods help the body to produce serotonin which improves mood and reduces appetite. A carbohydrate rich meal in the evening, when you suffer PMS, can help mood related symptoms.
  • Eat protein with every meal as this helps slow down the absorption of carbohydrates.

 

  1. Ensure Adequate Intake of Essential Nutrients.
  • Vitamin B6 is important for liver detoxification and the production of neurotransmitters and endorphins as well as helping to make prostaglandins. Deficiency of this vitamin is particularly linked to acne which is associated with PMS. All of the B vitamins are important however, as they are used by the .liver to convert excess oestrogen into weaker and less dangerous forms.
  • Magnesium works together with vitamin B6 in many enzyme systems. Without adequate vitamine B6, Magnesium cannot get into our cells. Magnesium also helps to make prostaglandins.
  • Zinc is required for the proper action of many of our body hormones including the sex hormones. Zinc helps to regulate prolactin secretion, with a deficiency increasing release. Zinc also helps convert vitamin B6 into its active form and also helps to make prostaglandins.
  • Essential Fats  are important for the reasons outlined earlier.
  • Vitamin E  is helpful for breast tenderness, mood swings and irritability.
  • Calcium may help with painful muscle cramps.

 

  1. Optimise liver functioning so that excess and old hormones can be excreted efficiently.

 

The liver is our body’s waste disposal unit – not only for toxins, waste products, drugs and alcohol, but also for hormones – and if its function is compromised, these products will accumulate in our blood stream.

  • Ensure a good intake of B vitamins, vitamins C, E and the minerals selenium and zinc as these are all important for liver detoxification from fruits and vegetables, nuts and seeds.
  • Ensure a daily intake of cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts and cabbage in the diet have been shown to enhance liver detoxification, as do foods such as eggs, garlic and onions which contain sulphur.
  • Give the liver a break by ensuring that foods are organic, unrefined, unprocessed and fresh. Avoid stimulants, red meats, animal fats, sugars and refined foods.
  • Drink plenty of bottled water.
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If you would like advice on any of the points mentioned in this post or would like to find out how nutrition can support your health issues please contact me on 07967 639347 or email emily@4wellpeople.co.uk. Find out more about nutritional therapy.

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