Dealing with the monthly pain of Premenstrual Syndrome (PMS) can be frustrating for many women. From physical discomfort to emotional rollercoasters, PMS symptoms can significantly disrupt a woman’s health and well-being. This article will delve into the contributing causes of PMS, sharing The Wellness Way approach to balancing hormones and alleviating PMS symptoms.
What is PMS?
PMS stands for Premenstrual Syndrome. PMS is a common set of symptoms that affects many menstruating women and girls, typically occurring in the days or weeks leading up to their menstrual period. PMS encompasses a wide range of physical, emotional, and psychological symptoms. 
According to the Merck Manual, between 20 and 50% of women of childbearing age have PMS, and 5% have a severe form of PMS known as Premenstrual Dysphoric Disorder (PMDD). 
Symptoms of PMS
Premenstrual symptoms can vary in severity and include physical symptoms as well as emotional symptoms. Some common symptoms of PMS women experience include: 
- Breast tenderness or swelling
- Menstrual cramps
- Bloating and water retention
- Muscle aches and joint pain
- Abdominal cramps or pelvic discomfort
- Constipation or diarrhea
- Mood swings
- Changes in appetite or food cravings
- Difficulty concentrating or focusing
PMS symptoms can differ from person to person, and some women may experience more severe symptoms that interfere with their daily activities and overall quality of life. The exact cause of PMS isn’t fully understood by the medical field, but fluctuations in estrogens and progesterone, in particular, are believed to play a significant role.
How is PMS Diagnosed?
A healthcare provider will base a Premenstrual Syndrome (PMS) diagnosis on a clinical evaluation of symptoms and the menstrual cycle pattern. These criteria include specific physical and emotional symptoms in the luteal phase (the second half) of the menstrual cycle, with symptom relief shortly after the start of menstruation.
It’s important to note that PMS is a diagnosis of exclusion, meaning the medical provider must rule out other medical conditions with similar symptoms before confirming the diagnosis. The more severe form of PMS, labeled as Premenstrual Dysphoric Disorder (PMDD), has more specific diagnostic criteria and may require further evaluation. 
The Fireman vs. The Carpenter in Healthcare
At The Wellness Way, we talk about the mainstream perspective on healthcare versus our perspective, referring to these methods as the “fireman approach” versus the “carpenter approach.”
Mainstream “fireman” doctors have two tools (treatment options) to take care of people: an axe and a hose. The axe represents cutting things out during a surgical procedure. The hose represents the use of medications to extinguish the “flames”: inflammation, pain, and other symptoms.
The Wellness Way doctors are more like carpenters: They assess the current state of the body with testing and then create a personalized plan to rebuild using nutrients from foods and supplements. Sunshine, rest, and positive relationships are some other natural therapies that help with healing.
While these things are considered “complementary medicine” or even “alternative medicine,” scientific research backs up their effectiveness in healing.
Mainstream Medicine’s Approach to PMS
Mainstream healthcare professionals say it’s unclear what causes PMS; however, they also say genetics, low serotonin, mineral deficiencies, and hormone issues may play a part. They typically recommend following a healthy diet, exercising, and taking medications to reduce symptoms.
Medications given for PMS focus on alleviating associated symptoms like low mood, pain, and water retention. Doctors may also suggest taking hormonal contraceptives to stop ovulation. 
- Antidepressants: Doctors may prescribe selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil, Pexeva), or sertraline (Zoloft) with the intent to affect serotonin levels and manage symptoms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Doctors may prescribe NSAIDs like ibuprofen (Advil, Motrin IB) or naproxen (Aleve) to help with cramping and other discomfort associated with PMS.
- Diuretics: If exercise and avoiding salty foods aren’t enough to prevent water retention and weight gain, providers may prescribe diuretics to flush out excess fluid.
- Hormonal contraceptives: Because they stop ovulation, hormonal contraceptives like drospirenone and ethinyl estradiol (Yaz) can synthetically alter hormone levels, reducing PMS symptoms.
These pharmaceuticals may alleviate some discomfort by synthetically suppressing hormones and inflammation, but they all have side effects. Those side effects are why many women seek out integrative and natural ways to alleviate PMS.
What Causes PMS? Traumas, Toxins, and Thoughts
At The Wellness Way, we think differently! The most common cause of PMS is estrogen dominance. Estrogen dominance comes from various combinations of traumas, toxins, and thoughts.
Traumas (Physical Stressors)
Traumas or physical stressors can be acute (like a car accident) or chronic (like being in a physically abusive relationship). Examples of traumas that could contribute to chronic hormone imbalance, including estrogen dominance and PMS, include:
- Physical abuse
- Neck injuries
- Sexual assault/rape
- Car accidents
- Severe illness or infection
- Witnessing violence or a natural disaster
- Military combat – PTSD (Post Traumatic Stress Disorder)
- A death in the family or a close friend
These physical traumas may set off a state of chronic stress within the body, increasing cortisol and depleting progesterone. The result may be estrogen dominance and its associated conditions like PMS.
Toxins (Biochemical Stressors)
Toxins are biochemical stressors in the body. Examples of toxins we encounter in daily life that may contribute to PMS include:
- Sugar – Excessive sugar consumption can lead to insulin resistance and metabolic syndrome. When the body becomes resistant to insulin, it has trouble regulating blood sugar levels, which can result in weight gain and increased body fat. Fat cells produce estrogen, contributing to estrogen dominance.  According to an Iranian study, there’s a significant association between PMS and metabolic syndrome 
- Non-organic food – The pesticides, chemical fertilizers, growth hormones, and antibiotics in non-organic food may contribute to endocrine disruption, increasing estrogens and inflammation. They can also overburden the liver, making the process of breaking down and eliminating hormones more difficult. 
- Medications – Certain pharmaceutical drugs, including birth control pills and hormone replacement therapy, can lead to too much estrogen in your system. 
- Phthalates – Phthalates are a group of chemicals commonly used in plastics, personal care products, fragrances, and household items. They may disrupt the endocrine system by mimicking or interfering with natural hormones, including estrogens. When absorbed into the body, they can bind to estrogen receptors, potentially increasing estrogenic activity. 
- Plastic exposure – Bisphenol A (BPA) is a synthetic chemical compound widely used in plastics, such as food containers, water bottles, and the lining of canned foods and beverages. BPA is an endocrine-disrupting chemical, meaning it can interfere with hormone regulation. BPA can also act as a xenoestrogen, binding to estrogen receptors and increasing estrogen activity. 
- Alcohol consumption – Frequent alcohol consumption can contribute to estrogen dominance by impairing liver function, increasing the conversion of male hormones to estrogens, promoting abdominal fat accumulation, and more. Women who consumed over 25 grams of alcohol daily had higher levels of circulating estrogens. (That translates to just over two drinks a day.)  A meta-analysis published in BMJ found a moderate association between drinking alcohol and PMS. 
- Food allergies – When you’re allergic to them, healthy foods can act like toxins, causing inflammation and imbalance. 
- Gut dysbiosis – Intestinal dysbiosis (imbalanced gut bacteria) may also contribute to estrogen dominance. The overgrowth of certain bacteria increases an enzyme called beta-glucuronidase. When this happens, estrogens recirculate instead of being eliminated. The result can be estrogen dominance and associated conditions like PMS. 
Traumas and toxins are made worse by negative thought patterns and emotional stress.
Thoughts (Emotional Stressors)
Don’t underestimate the power of your thoughts. Emotional stress is just as powerful (or more powerful) than physical and biochemical stressors in triggering inflammation and imbalance. When the stress hormone cortisol goes up, progesterone goes down, and you may be left with estrogen dominance and, potentially, PMS. 
Emotional stress can come from the following:
- Relationship issues – Relationships can turn toxic, leading to chronic stress. Prolonged stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, which can affect progesterone and estrogens.
- Financial stress – Financial struggles can lead to a hormonal imbalance due to the long-term effects of stress and cortisol.
- Watching the news – The mainstream media rarely focuses on the positive. Regularly exposing yourself to bad news increases fear, worry, and overall stress.
- Feeling overwhelmed – Stress from significant life changes, like a recent marriage, a new baby, graduation, a divorce, or even moving to a new city, can lead to high cortisol, low progesterone, and estrogen dominance.
- Holding a grudge/pent-up anger – Holding a grudge creates stress in the body. Chronic stress may show up as inflammation, weight gain, and hormonal imbalance.
- Grief/feelings of loss – Grief is another form of stress that may create imbalance in the body.
According to a BMJ study, the risk of PMS (dysmenorrhea) was twice as significant in women with high stress compared to those with low stress during their last cycle.  The cumulative effect of stress in the form of traumas, toxins, and thoughts can create inflammation and increase the risk of dis-ease anywhere in the body.
The Wellness Way Approach to PMS
At The Wellness Way, we dig deeper to solve the health challenges others can’t. We don’t just address symptoms; we run tests to find out what’s going on behind the scenes. Hormone imbalance, especially estrogen dominance, is the precursor to PMS.
Essential Tests for Assessing Your Inflammation Levels and Hormone Health
- Food Allergy Test: Immuno Food Allergy Test
- Female Panel: Female Panel
- DUTCH Test: DUTCH Complete Hormone Panel
- Gut Health Test: Genova GI Effects with Parasitology
Your Wellness Way practitioner will order more tests based on what he or she considers most relevant based on your health history.
Dietary Changes for Women with PMS
First, focus on lowering inflammation in the body. That means avoiding food allergies and following a personalized nutrition program, as the Wellness Way practitioner recommends. Here are some general dietary guidelines for those with PMS.
- No sugar or processed foods – Both increase inflammation and cortisol. They can also lead to gut dysbiosis, potentially leading to hormone imbalance.
- Gluten-free, mostly grain-free – Gluten is known to aggravate the gut lining, contributing to chronic inflammation in the gut and brain. A gluten-free diet may help lower gut inflammation, allowing the body to return to balance. 
- Consume an overall low carbohydrate, non-inflammatory diet of organic whole foods, which supply nutrients, antioxidants, and food for a healthy gut microbiome.
- No cow’s milk dairy products – Goat and sheep’s milk products may be better tolerated –and even beneficial for lowering inflammation in the gut, which makes up a large part of the inflammatory response. 
- Avoid high omega-6 vegetable oils, like corn, canola, soybean, cottonseed oil, sunflower, grapeseed, and others, which can alter the omega-6 to omega-3 balance to be more inflammatory.  Instead, use fruit oils like olive, coconut, avocado, and palm oil or animal fats like beef tallow, bacon grease, and duck fat.
- Follow a Personalized Nutrition Program based on your food allergy test results.
- Add specific nutrient-dense foods: Add Liver/organ meats, sauerkraut, and microgreens for enhanced nutrition. Liver is nature’s multivitamin, according to Dr. Flynn.
- Eat plenty of leafy greens: Green leafy vegetables like kale, arugula, collards, beet greens, and Bok choy are rich in calcium and magnesium, two minerals known to ease menstrual symptoms. 
- Focus on antioxidants – Including turmeric, green tea, berries, dark chocolate, and other high-polyphenol botanicals supports the gut and helps keep inflammation under control. 
- Eat omega-3-rich foods – Wild-caught salmon, herring, sardines, walnuts, and ground flaxseeds provide omega-3s and help lower inflammation. 
A healthy diet can reduce inflammation, but supplements can support gut healing and hormonal balance.
Supplements For Those with PMS
Natural remedies like herbs and dietary supplements can support proper hormone levels. Herbs and supplements may help balance out estrogen and hormones in general, potentially alleviating PMS:
- DIM (Diindolylmethane) – DIM is a compound derived from cruciferous vegetables like broccoli and cabbage. In studies, DIM reduces circulating estrogen, potentially lowering the risk of developing estrogen dominance. 
- Calcium D-Glucarate – Supplementing with calcium-D-glucarate has been shown to inhibit beta-glucuronidase produced by bacterial overgrowth, which can reduce recirculating estrogens. 
- Chaste Tree – Chaste tree (also known as Chasteberry or Vitex agnus castus) supports healthy progesterone levels, which can help balance out estrogens. A systematic review of eight studies shows that Vitex may reduce PMS symptoms. 
- Passionflower – Passionflower has a compound called chrysin, a flavonoid that reduces inflammation and improves ovarian function.  Chrysin may also promote the conversion of estradiol (a potent estrogen) into estrone (a weaker estrogen), reducing overall estrogenic activity in the body. 
- Ginkgo Leaf – Ginkgo biloba is often used for brain support, as it increases blood flow. In a randomized, placebo-controlled trial published in 2009, women taking ginkgo had a more significant reduction in symptoms than those taking the placebo supplement. 
- Dandelion Root – Dandelion root promotes liver detoxification, helping it more efficiently break down estrogen byproducts and remove them from the system. 
- St. John’s Wort – This herb is widely known for its positive effects on mood. However, its serotonin-promoting ability may also help with PMS. A 2010 study of women with mild PMS used 900 mg of St. John’s Wort (SJW) extract for two menstrual cycles. The SJW significantly improved PMS symptoms, including pain and mood. 
- Gallbladder Complex – The Wellness Way gallbladder complex has ox bile, artichoke, and beet, which help promote bile availability and movement. Optimizing bile production and flow can help the body remove excess estrogen, reducing estrogen dominance-related complaints like PMS. 
- B vitamins – The B-complex vitamins, especially vitamin B6, may also be supportive. A systematic review of nine published trials found that taking up to 100 mg/day of vitamin B6 may benefit women struggling with PMS. 
- Vitamin D – Vitamin D acts more like a hormone precursor than a vitamin. In a 2018 clinical trial, high-dose vitamin D supplementation reduced PMS symptoms and occurrence in the first place. 
- Magnesium – Magnesium tends to be low in Western diets, yet it’s important for many functions in the human body, including nerve and muscle function, which may be affected in PMS. Supplementing with magnesium may be helpful for fluid retention and other PMS-related symptoms. 
- Evening primrose oil – Evening primrose is a good source of gamma-linolenic acid (GLA), a fatty acid known to reduce inflammation. In some studies, taking 500 to 1000 mg of evening primrose daily reduced symptoms. 
- Fish or krill oil – Omega-3 fatty acids found in fish and krill may help lower inflammation in the gut and brain, reducing PMS symptoms. 
Each person is different – herbal remedies that work for one individual may not work for another. Part of that is due to body chemistry, including genetics and allergenic responses, and part is due to differences in the contributing factors to estrogen dominance.
Lifestyle Changes & Complementary Therapies for PMS
- Regular chiropractic care – If your posture is poor and your nervous system is affected, it can create stress and inflammation, affecting hormone balance. A 1999 clinical trial concluded chiropractic may be able to reduce PMS symptoms. 
- Essential oils – A 2020 meta-analysis found aromatherapy was helpful for both physical and emotional symptoms associated with PMS. 
- Acupuncture – Acupuncture may also support proper levels of estrogens and progesterone. 
Be a well-informed patient! Here are some resources for learning more about women’s health and natural ways to alleviate PMS.
Educational Resources for PMS
Videos & Webinars Related to PMS
Why Does PMS Happen? | A Different Perspective | Episode 108
Estrogen Part 1 | A Different Perspective | Episode 132
Estrogen Part 2 | A Different Perspective | Episode 133
Estradiol | Living Hormoniously
Articles to Support Those with PMS`
CONNECT WITH US
We invite you to connect with us! Find an event at a clinic near you! Follow us on social media. Tune in to A Different Perspective each Saturday morning LIVE to get cutting-edge training directly from Dr. Patrick Flynn. Please set up a no-obligation health consult with one of our doctors today. The best is yet to come! Think differently – and THRIVE. To learn how best to overcome PMS and other chronic complaints, contact a Wellness Way clinic today.
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