One thing many of my clients are battling is Pre Menstrual Symptom or PMS for short. It can manifest in many ways for different women but it can occur any point in the week leading up to your period and cause any of the following symptoms:
In fact, I used to suffer these too but luckily, I studied abdominal massage, womb massage and nutrition and I am now PMS free. I have found that there are several root causes of these problems:
If you have a retroverted or retroflexed uterus which presses against your rectum or spine which is fine most of the month but when your uterus is full, for example in the week before your bleed which can cause changes in bowel movement, lower back pain and even migraines. If, alternatively, your womb it tilted forward, then you may get increased pressure, bladder pain, an increased need to urinate or a dragging sensation at this time.
2. Unstable Blood Sugar
The most common PMS symptom: mood which includes feeling upset, down or angry in the lead up to your period is pretty similar to those of low blood sugar. Funnily enough, in our luteal phase (the part of your cycle between ovulation and menstruation), we become more insulin resistant than in the earlier parts of our cycles. This means our blood sugar levels and insulin levels become less stable.
You can get an idea if this is your issue but monitoring your blood sugar levels with a blood glucose monitor. If it is an issue there are a number of nutritional ways to help such as including having some fat and protein with each meal, ensuring you eat first thing in the morning (or at least an hour of meeting up) and avoiding refined sugars and flowers. You can find out more about stabilising your blood sugar here.
One thing I have noticed with many of my PMS clients is that they often have very busy lives, not just in terms of their occupation, but they could have a lot on their plate and they are not having the opportunity to express what they are truly thinking, what they really want to say and how they feel. They are also not taking any time to rest when they need it and it is the one thing their body is trying to get them to do.
In the lead up to our period, our hormone levels are either dropping off or about to drop off and our energy level mirror this by dropping off too. This can cause us to have less resilience and tolerance both mentally and physically. Taking time to rest and clearing your diary during this period can have a massive impact on how you feel and helps support and nourish you.
Finally, when it comes to things that really upset us during your pre-menstrual phase, ask yourself, is it something that has been bothering you for a while, it just came out now or is it genuinely something that a week later, you don't understand why it bothered you so much then? If the latter, it is probably PMS but if you got upset about something that bothers you at other times too, it is likely a legitimate complaint you need to address with the person concerned, but maybe at a time when you can communicate in a more effective way (ovulation is the best time for this).
4. Hormonal Contraception
Unfortunately, after a few months of being on the pill a lot of women start experiencing PMS. If you think this is the cause of yours, it is worth speaking to a professional about this first before coming off it.
Hormonal contraception also causes you to burn through micronutrients very quickly, so if you aren’t getting enough in your diet to make up for this, then you may need to increase your vegetable intake and you are likely to need further supplementation.
There are many alternative forms of contraception such as Natural Family Planning and Fertility Awareness (you can do the intro level here) or even devices such as Daysy Fertility Monitor.
5. Hormonal Imbalances
The most common hormonal issue I see in my clinic is oestrogen dominance which is when your oestrogen levels are too high in comparison to progesterone. This is a bit of a misnomer because it could be your progesterone is low, and so is your oestrogen, or your progesterone is low and your oestrogen is in the normal range, or both are higher than the reference ranges but progesterone is still low in comparison to oestrogen. Oestrogen gives us a lift in mood, but too much can make us angry and aggressive. Progesterone has a calming and soothing effect on our moods, but when the ratio is skewed in the second half of our cycle, it an result in PMS symptoms.
There is also an understanding that low levels of GABA (a neurotransmitter) and seratonin deficiency can result in mood disorders such as PMS. A metabolite of progesterone, Allopregnenalone, known as ALLO has a calming effect on the GABA receptor on the brain and as you hopefully know by now if you have been following my blog for a while, our hormones fluctuate throughout the month. This means that both the levels of ALLO and the sensitivity to it can affect our moods throughout the month. A study showed that women with PMS had different sensitivity to ALLO than those without PMS. Resistance to ALLO could be caused by inflammation, high levels of histamines or mast cell activation.
Stress, inflammation, blood sugar levels and thyroid issues can all play into this, however, there are a few things you can do during this stage to help things such as eating more dark green leafy vegetables (ideally cooked or fermented), more vegetables to up your fibre content, especially roasted root vegetables such as sweet potatoes and squashes (these also help you to beat those PMS cravings too).
Histamine may sound familiar to those of you with allergies. It's responsible for the allergy reactions we get when we come into contact with substances that we're allergic to. It also has an interaction with the menstrual cycle. Our bodies make it throughout the month, but oestrogen both increases mast cells to release granules of histamine, and down regulates Diamine Oxidase (DAO), the enzyme that helps to clear histamine.
If that wasn't bad enough, histamine stimulates oestrogen production in the ovaries creating one of those never ending circles. So not only does this go hand in hand with oestrogen dominance causing issues, it could be that actually, it is the excess histamine causing the underlying PMS symptoms, made worse by oestrogen dominance.
7. Magnesium Deficiency
Magnesium is pretty amazing. It can help regulate our stress response (and that hormonal cascade it causes) and unfortunately the more stressed we are, the more magnesium we excrete. It can improve insulin resistance and low grade inflammation (if you have PCOS, pay attention).
It helps to calm the nervous system, and can support the act of progesterone on the body. It's so effective when used to help PMS, that many people assume that its deficiency is one of the causes of PMS. Finally, it also enhances GABA activity. Unfortunately, in today's fast pace world, most women I work with appear to be deficient in magnesium, even if they eat magnesium rich foods such as dark leafy greens regularly.
What You Can Do
Get a Womb Massage
This is a massage over the abdomen, pelvis, lower back, upper legs and feet to benefit the womb. There are a number of massage schools that do this, and you should a practitioner near you in most countries of if you are ever in Surrey, UK, you can book in with me. Or you can book in an online appointment with me and I can teach you.
When you are pre-menstrual, don’t do any heavy lifting, running or aerobics because these put a lot of strain on the ligaments that hold the womb in place and even cause injury. Stick to more restorative exercise at this time in your cycle. But do do some exercise as this can really help with PMS.
Get The Food Basics Right & Balancing Your Blood Sugar Levels
Ensure you are eating plenty of fresh vegetables, clean protein and fats. If it is a real food, then great, if it is processed from its original form into something different, then you should cut down from this. Try and ensure you get some fat and protein in with every meal to help balance your blood sugar and if you feel hungry 3-4 hours after each meal, this is a sign that you need to work on balancing your blood sugar levels.
Avoid Inflammatory Foods
There are a number of ways to reduce inflammation through foods, the key ones being to go on an elimination diet starting with gluten, dairy, soy, corn and refined sugars. I have a few videos on reducing inflammation in this blog post. Cutting down on alcohol and other histamine rich foods such as cured meat, seafood and fermented foods such as kimchi and sauerkraut may also help.
Consider Supplementing with Magnesium & Vitamin B6
If you are looking at taking magnesium as a supplement, you will see there are many many forms of magnesium. Unfortunately, some of them will have an effect on your bowel tolerance so I prefer magnesium glycinate. This form also has a bonus effect of calming the GABA receptors. Depending on the client's magnesium levels, I usually recommend starting with a dose of 300-400 mg a day, and if required, gradually increase the dosage over to a maximum of 800mg a day.
Other ways to increase your magnesium levels are bathing or having a foot soak in epsom salts or using a magnesium spray on your skin. A side, note, I have a magnesium spray handy for cramps.
Supplementing with vitamin B6 can also be very effective in women with PMS. It can help to clear excess oestrogen and histamine, help with serotonin and dopamine production, lengthen the luteal phase and lower prolactin levels.
It can be supplemented in a good quality B complex supplement or supplemented on its own. I advise starting with a very low dose and slowly increasing, however, do not go above 50 mg a day without supervision from a nutrition specialist as you may cause nerve damage. Also be careful if you decide to top up a B complex with a low dose of B6.
Some people with methylation issues may also have issues with supplementing with B6, so if you are one of them, you will need to see a nutritionist. And don't forget that B6 is found in fish and poultry.
See A Health Coach or Nutritionist Who Specialise In This Area
There are a number of skilled professionals with specific training and experience in this area. If you just want a list of yes and no foods, then a nutritionist can be great for that. A health coach trained in this area will also have the list of foods and lifestyle choices but will support you with coaching techniques to help you make sustainable changes if you need that extra support.
I offer this coaching both in person and via Skype and I have one free half an hour slot every month that I give away to someone on my e-mail list, so keep an eye out for the e-mails or sign up for them if you haven’t already.
Start Listening to What Your Body Is Trying to Tell you
Have you been ignoring what your gut instinct is telling you? Have you thought you really needed a break or a rest but not been able to take one. Have you been holding back on saying something that is important to you or do you feel that you aren’t being listened to?
Usually, when in any of these positions, I find journaling can be helpful, EFT can be great too. But I have found when I start paying attention to my feelings, instincts and intuition, my body rarely lets me down.
If you want to find out more about how to solve your own PMS issues (or other period or fertility related issues), you can sign up for my complementary video course, or book in a session with me.
Find out more about how stress affects your period
Find out more about keeping your hormones happy during the holidays
Find out more about diets that help your hormones