PMS - "Its
Not Just in Your Head"
PMS is a real sydrome
with real treatment options.
By: Karlene Karst, Dietician
Source: Health N Vitality Magazine
Date Published: May 2002
Bloating, cramps, fatigue,
breast tenderness, and mood swings, does this sound familiar? If so,
you are not alone. More than 150 symptoms have been linked to premenstrual
syndrome and studies have shown that up to 90% of women may experience
some physical, emotional, or behavioral symptoms, with 5% suffering
from extreme PMS.
Understanding PMS
PMS was first described in
the 1930¹s, with a variety of explanations being offered for its cause,
one of which was psychological. Women were left with feelings of desperation,
anxiety, guilt and embarrassment. PMS is no longer considered a ³psychological²
problem, and there are now many theories offered as potential causes.
Although doctors are still unsure of the actual causes, there is an
association between PMS and the hormones related to the menstrual cycle.
We now know, PMS is a recurrent cyclic disorder most often occurring
seven to ten days prior to menses, and disappearing at the onset of
menstruation. Other theories include chemical changes in the brain relating
to serotonin, a brain chemical crucial in mood states, especially depression.
Deficiencies in progesterone, vitamins, and minerals as well as an oversensitivity
to prolactin have also been proposed. Some PMS symptoms have been linked
to nutrition. Diets high in salty foods, alcohol and caffeine, are associated
with mood and energy disturbances. Another interesting theory is that
many symptoms of PMS may be a result of a deficiency of gamma linolenic
acid (GLA). Whatever the cause of PMS, there are options available to
help ease the symptoms.
Conventional Medicine
Over the years, physicians
have recommended many drug treatments for PMS, including antidepressants
like Paxil, nonsteroidal anti-inflammatory drugs such as ibuprofen,
and oral contraceptives. The success of medication in relieving symptoms
varies from woman to woman. Many women believe doctors either don¹t
take their problems seriously or do not have the knowledge to adequately
treat their PMS symptoms. Women who seek professional medical treatment
for their PMS symptoms claim only one in four doctors provide them with
helpful treatment options. Therefore, many women rely on over the counter
remedies with nearly half of American women with PMS taking drugs to
treat their symptoms.
Conventional medicine is
starting to go beyond over the counter remedies and pharmaceuticals
with research proving vitamin and mineral supplements as effective treatments.
A study of 500 women published in the American Journal of Obstetrics
and Gynecology reported that 1200 mg of calcium carbonate reduce the
physical and psychological symptoms of PMS by nearly 50 %. Women taking
200 mg of magnesium a day noted reduced fluid retention, breast tenderness
and bloating by 40%. Vitamin E is thought to help reduce PMS symptoms
through regulating the production of prostaglandins that help reduce
cramps and breast tenderness. Dosage varies but most doctors recommend
400 IU/day.
Natural Medicine
Many women are seeking alternative
health care solutions from the conventional medicines for many different
reasons, some of which are unwanted and long term side effects. Although
many supplements are natural, it is a good idea to check with your health
care provider or pharmacist before taking any herbal product to ensure
there is no risk of drug, or nutrient interactions with your current
regime.
Research on natural products
is on the rise, with many studies proving their efficacy. Here are some
natural products that have positive benefits for relief of PMS symptoms.
Gamma linolenic acid-
as mentioned earlier, one theory for the cause of PMS is due to low
levels of GLA. GLA is an essential fatty acid found in oils such as
borage, evening primrose, and black currant. A healthy body creates
GLA by converting dietary linoleic acid (LA) found in many processed
foods, margarine and vegetable oils. The body metabolizes GLA into hormone
like compounds that regulate body processes at the cellular level. In
many people, especially women suffering from PMS, the conversion to
GLA is often impaired. The result is a lower level of GLA and its metabolites.
Research in the last 20 years
has shown that women deficient in GLA are over sensitive to the hormone
prolactin which may result in breast pain. Supplementing with GLA creates
a hormone-like compound that helps to ³switch off² some of the effects
of prolactin resulting in decreased breast pain.
GLA deficiency may also be
responsible for many other PMS symptoms such as depression, irritability
and fluid retention. Supplementing with GLA is a good choice for women
who suffer from PMS. GLA is a naturally derived supplement that has
been proven safe and effective. Dosage varies for each woman, but the
general recommendation for PMS is two to four grams of borage oil every
day of your cycle.
Alpha linolenic acid-
Flax oil is an excellent source of ALA, an essential fatty acid which
has been associated with menstrual symptoms. ALA has numerous health
benefits, including the ability to improve blood flow and relieve symptoms
such as cramping, nervous tension and bloating.
Black cohosh root-
contains phytoestrogens which exert beneficial physiological effects
relating to the menstrual cycle and menopause. A double blind German
study in 1982 showed 80 women found more relief with black cohosh from
hot flashes, headaches, joint pain, sleep disturbances, and depression
than with synthetic estrogen. Research recommends a dosage between 20
mg and 40 mg per day, but women should discontinue use after six months
due to its effects on hormonal balance.
Cramp bark extract-
is remarkably effective for relaxing the uterine muscles. It has been
used for centuries to treat cramps and spasms of all kinds due to its
action as an antispasmodic, and is a traditional favorite with herbalists
for treating menstrual cramps.
Chaste berry fruit extract-
is one of the best-researched herbs for women. German studies show it
stimulates progesterone production and may regulate estrogen. More than
1500 women participated in this study and one-third of women experienced
complete resolution of their symptoms while another 57% reported significant
improvement. A study completed in 2001 showed chaste tree berries may
help alleviate irritability, anger, headaches, breast tenderness, and
reduce stress. The usual dosage of chaste berry extract is 175 to 225
mg daily.
Dong quai- is a traditional
Chinese medicine commonly prescribed for PMS. It helps relieve hot flashes,
painful menstruation and uterine cramps related to the menstrual cycle
or menopause. Because Dong quai contains phytoestrogens it is a powerful
hormone balancer and should not be taken while pregnant.
Flax seed- contains
lignans which have both estrogenic and anti-estrogenic activity. Menstruating
women who consume about 10 g of milled flax seed daily showed significant
hormonal changes. The changes seen are similar to those in women who
consume soy isoflavones. Lignans help reduce hot flashes, cycle changes
and ovarian dysfunction.
Soy- contains isoflavones
which naturally regulate and balance the levels of estrogens. This physiological
action helps to reduce symptoms of PMS, menstruation and menopause.
Consuming soy foods has many other healthful benefits including reduction
in cancer and cardiovascular risks.
Other research on natural
medicine
Research conducted at the
University of Saskatchewan, showed that a herbal formulation combining
borage oil, flax oil, vitamin E, bioflavanoids, cramp bark extract and
chaste berry fruit extract was clinically effective for women with PMS.
The three month study showed a reduction in 15 of the most common PMS
symptoms by 67% at the end of the trial. The study is published in the
September 2001 Journal of Obstetrics and Gynaecology of Canada.
A Danish study of 78 women
in 2000 showed women who supplemented their diet with omega 3 fatty
acids in fish oils along with vitamin B12 found relief from dysmenorrhea
(menstrual pain), fatigue and headache. Researchers reported that omega
3¹s and vitamin B12 may serve as an ³alternative treatment to NSAID
medication. The study is published in Nutrition Research 2000; 20:621-631.
Be Good to Yourself
During PMS, it is important
to treat yourself right! Lifestyle and dietary changes may help you
cope with your PMS symptoms. Here are some suggestions:
Reduce Stress- like
many conditions, stress plays a role in PMS. Effective treatment of
PMS must include stress management. When stress is extreme, it can trigger
changes in the brain, which may lead to abnormal physiological changes.
Getting plenty of sleep and or practicing muscle relaxation, yoga or
deep breathing may help ease stress.
Exercise- studies
have shown that women who engage in regular exercise do not suffer from
PMS nearly as often as sedentary women. One study assessed mood and
physical symptoms during the menstrual cycle in women who exercised
regularly and in those who did not. The regular exercisers had lower
scores on the impaired concentration, negative mood, behavioral change
and pain tests. These results are not surprising, since exercise is
known to improve physical and mental well being and enhance the ability
to handle stress more effectively. Walking, swimming, cycling, or jogging
at least three times a week are excellent ways to become more active.
Nutrition- for many
PMS symptoms, diet can make a big difference. Research has associated
PMS with specific patterns of food intake. Try eliminating sugar, caffeine,
artificial sweeteners, alcohol, salty and smoked foods as they tend
to make women retain fluid and contribute to the unwanted side effects
of PMS. Diets should be rich in whole grains, legumes, fresh vegetables
and fruit. Soy foods are nutritional powerhouses with thousands of different
soy based foods available in the market place. Try adding tofu to stirfry
or adding soy milk to shakes. Research shows that incorporating 25 g
of soy daily can have many health benefits. Consuming a healthy diet
is important for all stages in a woman¹s life.
Knowledge is the Key
PMS is not just a psychological
condition; it is a recognized medical condition even though the causes
are still unclear. Understanding the symptoms of PMS can help reduce
the anxiety that many women feel about whether their behavior or feelings
are normal. Knowledge of PMS treatments may be the best defense in easing
the symptoms.
For more information please
contact Karlene Karst at kkarst@bioriginal.com
About Karlene Karst
Karlene Karst is the clinical
research and education coordinator at Bioriginal Food and Science Corp.
She provides technical and regulatory advice on EFAs, as well as educational
seminars, lectures and presentations on the role of EFAs in nutrition
and health. Karlene holds a Bachelor of Science degree in Nutrition
from the University of Saskatchewan¹s College of Pharmacy and Nutrition.
She is also a registered dietitian and has previously worked as a clinical
dietitian.
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