How to Overcome PMS and Painful Periods

woman having stomachacheYou’re crampy and crabby, bloated and bothered. You sense that it’s that time of month again, and whoops! – you better buy tampons.

Many of us view our periods as a routine nuisance. For some, the premenstrual and menstrual symptoms are particularly daunting: sore breasts, extreme mood swings, insatiable cravings, migraines, heavy blood flow, or severe cramping.

Now, here’s the truth, which might come as a surprise: If you are experiencing premenstrual or menstrual problems, your body is signaling that something is awry physiologically. Your body is crying out for help. The likely cause? A hormonal imbalance.        

If you’ve gone to see the gynecologist for any of these problems, the solution has probably been to medicate. Be it Motrin or the Pill, drugs either mask the pain or artificially add hormones. I, however, prefer individual root-cause analysis to determine the reasons for hormonal imbalance, and then trigger change organically, be it through nutrition, exercise, stress reduction, sleep, or botanicals.

To be sure, medication can be necessary in extreme cases (such as endometriosis or cancer). Note: If you experience menstrual extremes, particularly heavier bleeding, speak to your primary care physician first.  But long-term, it’s all about lifestyle. For women with non-emergency health issues, implementing natural methods to rebalance hormones usually provides relief within a few short months. Your periods normalize, and you get your life back.            

Hormones Affecting Menstruation

Here’s a quick look at the hormones involved in menstruation, and why their levels might be doing you wrong.

  1. Progesterone and its derivative, allopregnanolone, are the main culprits in premenstrual or menstrual moodiness. When you produce the right amount, their calming effect tapers rage and their sedative qualities help you sleep.[1] Too little progesterone can therefore be problematic and you’ll start feeling the symptoms of PMS – your mood and stress resilience will drop, and you may notice fluid retention and breast tenderness.[2] If your levels are low due to perimenopause, I recommend vitamin C and chasteberry.    
  2. Estrogen is the primary female sex hormone: it gives women hips and breasts, and buffers mood, and is often to blame for irregular periods. Estrogen is responsible for the first half of your menstrual cycle, and it boosts sex drive and gets you obsessing about babies until about age forty-five or fifty. Estrogen can also raise serotonin, which leads to improved mood, sleep, and appetite.[3] Estrogen is progesterone’s partner in balance: When estrogen levels are high in relation to progesterone, you may have symptoms of estrogen dominance, including PMS, and painful or heavy periods. To lower your estrogen levels, I recommend eating a pound of vegetables per day, divided between meals. The fiber from the vegetables will help excrete estrogen so it doesn’t keep circulating in your body like bad karma. Estrogen monitoring is also practical – for example, when planning a breast self-exam, do so several days after your period has ended, when estrogen levels are low and your breasts are least likely to be swollen.   
  3. Thyroid interplays heavily with estrogen and progesterone, and particularly affects menstruation, weight and energy levels.[4] We know that estrogen dominance causes thyroid hormone to be less available (that is, bound to carrier proteins), and low thyroid function can reduce progesterone levels, causing PMS symptoms to flare. To increase thyroid levels naturally, make sure you are getting enough iron, selenium, and vitamin A, which are all key to normal thyroid function. 
  4. Cortisol is the primary “stress hormone.” The higher it is, the more it affects your estrogen and progesterone levels, so it is best to keep it balanced specifically in conjunction with menstruation. Progesterone, and its pre-hormone pregnenolone, are the biological precursors of cortisol. When you are chronically stressed and in high demand of cortisol, your body will steal from your supply of progesterone by diverting pregnenolone so it can make more cortisol, in a move fittingly called the Pregnenolone Steal. Additionally, high cortisol levels can block your progesterone receptors, preventing progesterone from binding, and causing you to feel low in progesterone – hello PMS! Over time this will lead to lower levels of progesterone and eventually estrogen dominance. To keep your cortisol levels in check, schedule a massage or a workout with a friend during the week preceding your period. And, as I always recommend, reduce or eliminate caffeine intake throughout the month because caffeine raises cortisol.[5]
  5. GABA[6] and serotonin are brain chemicals that interplay in particular with progesterone, and make you feel calm and happy. PMS is the result of the poorly-synchronized interplay among four entities: progesterone, allopregnenolone (a derivative of progesterone), and the GABA and serotonin pathways in the brain.

The Gottfried Protocol: What to Do to Normalize Your Period

I frequently draw up protocols for curing common ailments. In this case, I share with you my PMS protocol which lays out ways to help rebalance your body in order to assuage PMS and other menstrual problems.

  1. Exercise. Exercising can alleviate PMS symptoms by increasing circulation. Since frequency is more influential than duration, be sure to exercise regularly for shorter time periods, rather than infrequently for longer time periods. I recommend moderate-intensity exercise five times per week for optimal results.           
  2. Reduce stress. Maintain optimal cortisol levels by staying off of caffeine and alcohol, and getting enough sleep.[7]
  3. Take specific vitamin and mineral supplements. Here is the supplement regimen I suggest for balancing the menstrual cycle:a. Vitamin B6, 50-100 mg/daY
    b. Calcium (carbonate or citrate), 600 mg 2x/day.
    c. Magnesium citramate, 150-300 mg/day.
  4. Supplement with botanicals. Botanicals, or herbs, such as chasteberry, saffron, and St. John’s Wort can be very effective in regulating the menstrual cycle. Be sure to use herbal remedies only in consultation with an expert who will take into consideration any medications, other supplements, and breastfeeding, all of which can affect the choice of recommended herbs.

When your hormones are at optimal levels, you won’t dread your period every month, rather, you can celebrate it for being a consistent, accurate measure of your health. Instead of feeling crampy and crabby, bloated and bothered, hopefully you’ll feel cool and collected, blithe and balanced.

Learn more about keeping balanced hormonally, and increasing longevity, in my newly-released book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

References

[1] Nillni, Y. I., et al. “Anxiety sensitivity, the menstrual cycle, and panic disorder: a putative neuroendocrine and psychological interaction.” Clinical Psychology Review 31, no. 7 (2011):1183-1191.

[2] Brizendine L. The Female Brain. (New York: Broadway Books, 2006).

[3] Ganji, V., et al. “Serum lipid responses to psyllium fiber: differences between pre-and post-menopausal, hypercholesterolemic women.” Nutrition Journal 7, no. 1 (2008):1.

[4] “Do You Need a Thyroid Test?” Harvard Health Publications, Harvard Medical School November 2015, http://www.health.harvard.edu/womens-health/do-you-need-a-thyroid-test.

[5] Lovallo, W. R., et al. “Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women.” Pharmacology Biochemistry and Behavior 83, no. 3 (2006):441-447.

[6] Bäckström, T., et al. “Pathogenesis in menstrual cycle‐linked CNS disorders.” Annals of the New York Academy of Sciences 1007, no. 1 (2003):42-53.

[7] Leproult, R., et al. “Sleep loss results in an elevation of cortisol levels the next evening.” Sleep 20, no. 10 (October 1997): 865-70.

 

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About Sara Gottfried MD

Sara Gottfried, MD is the New York Times bestselling author of the new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years. Her previous New York Times bestsellers are The Hormone Cure and The Hormone Reset Diet. After graduating from Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco. She is a board-certified gynecologist who teaches natural hormone balancing in her novel online programs so that women can lose weight, detoxify, and slow down aging. Dr. Gottfried lives in Berkeley, CA with her husband and two daughters.