I have treated many patients with PMS over the years, and the interesting thing is that we don’t always dive in with a hormone assessment. In cases of clear hormone imbalance, a close look at hormone levels makes sense. This includes absent or very long cycles, severe acne or very heavy flow. But in cases where the menstrual cycle is quite regular, usually the cause of PMS is not really a problem with hormone production.
Our bodies are integrative systems, where systems communicate with each other. For example, the health of your gut affects your mood and immune system, not just digestive function. Therefore, in most cases of PMS, we need to look for what else is out of balance in the body – stress, gut health, nutrition, activity levels and liver function, as these will all affect hormone expression, and importantly how you feel.
5 possible causes of PMS:
1. Too much sugar
When your diet contains too much sugar, it can impact your hormones in many ways. First of all with blood sugar regulation and insulin levels, which can result in higher androgen expression. This will show up as anger, irritability and acne. Secondly, too much dietary sugar increases estrogen dominance by impacting how effectively your are breaking down your body’s estrogens. This leads to hormonal symptoms such as breast tenderness, anxiety, foggy thinking, heavier menstrual flow, water retention and mood swings. So before you consider supplements to balance your hormones, take the simple step of removing all refined sugar from your diet.
2. Imbalanced gut flora
Hormones are broken down and detoxified in two steps in the body: first in the liver, and second in the colon. When the digestive tract is out of balance, your estrogens especially are not detoxed properly, leading to symptoms of estrogen dominance. The most important step to support gastrointestinal function is to rebalance gut flora, and especially clear out yeast. I have found this step to be the most profound in dealing with my patients’ PMS. There are three main steps to rebalancing the gut: 1) a diet plan that doesn’t feed yeast (avoiding sugar, white flour, yeast and fermented foods); 2) anti-microbial supplements; and 3) probiotics.
3. Not enough exercise
Our bodies need to move! When we have a sedentary job and minimal activity outside of work, it can affect your overall circulation and metabolism. Studies show that one of the best tools to manage stress and balance your mood is to exercise regularly, and that this will also reduce or eliminate menstrual cramps. If you have cramping with your period or significant moodiness with PMS, look for ways to build regular exercise into your life.
4. High stress levels
Stress has a profound effect on your hormone balance: it reduces progesterone production, can raise prolactin levels, increase androgen expression and impact thyroid hormone production. If your hormones are out of balance, you may experience any classic PMS symptom: spotting before your period, moodiness, anger and irritability, breast tenderness, bloating and water retention, food cravings, brain fog and more. Pay attention to your stress, and take regular steps to lower it, such as a meditation practice, yoga, acupuncture, massage, downtime throughout the week, or whatever else you find effective in managing your stress. Sometimes the PMS window makes our stresses more clear and big, so that we are able to see what needs to change in our lives.
5. Too much coffee and alcohol
If irritability is your main PMS symptom, or if you experience significant breast tenderness, you need to seriously consider giving up the coffee. Many women find that their PMS irritation drops dramatically when they are caffeine-free. The extra push on your adrenal glands amplifies the stress response, and coffee is difficult for the liver to process. Similarly alcohol affects liver detoxification, causing more difficulty breaking down estrogen and other hormones, and also affects blood sugar regulation.