Premenstrual syndrom (PMS) & premenstrual dysphoric disorder (PMDD, which is considered a more severe form of PMS) are multi-layered issues. I have heard some people say that PMS & PMDD don’t actually exist, that the terms were coined as a way to profit off of women’s discomfort by making them believe they have a disorder, and need pills. This may be true on some level, but I don’t think making this argument serves us in any way; I think that it in fact hurts women to pretend like there is no such thing as PMS when so many women experience very real emotional turmoil & physical discomforts in the last week or two of their menstrual cycles. I have a lot of thoughts on PMS, and since this is something many women ask me about, I have decided to finally write down recommendations and advice for you.
Bleeding is a reset
The first aspect of PMS that I always think of is that the first few days of our bleeding time is a time of physical, emotional, and spiritual reset. On days 2 and 3 of our cycles, while we are bleeding, all our hormones are lower and are at the most neutral point they will be all cycle long. This is pretty powerful stuff when you think about it. And so most women experience relief from their PMS symptoms by the first or second day of their bleeding because of this. That’s the reset button. Others, like myself, don’t have PMS but experience emotional waves during those first few days instead, while the reset is taking place.
As the cycle nears it’s end, the body knows that it is time to reset, and I believe our emotional bodies have a way of bringing things to the surface during this time that we have been previously ignoring or stuffing away. It’s a sort of house cleaning – our bodies want to get rid of these heavy emotions we have been carrying deep within us. Emotions are powerful things, and when they are suppressed and held inside they can cause a lot of problems. Our bodies know that, and want to let them go. It is in fact a favor our hormones are doing to us, they are trying to bring our attention to aspects of our lives that we may need to focus on. I know, it may sound crazy, be thankful for having mood swings? Yes! Slow down, take a deep breath, and realize that these emotions are there for a reason. You may not be able to snap your fingers and feel better, but you can feel compassion for yourself, and not let yourself feel guilty for how you feel.
Generally, when someone tells me they are suffering from PMS, I ask them what kind of emotions are coming to the surface – is it anger? anxiety? depression? sadness? It varies a lot, and the causes vary. I then ask them to try to trace those emotions back to their origins. Most women actually know exactly where they come from – sometimes it is something current and very raw that they feel they cannot face head on, sometimes it is a past event that is still alive within them. Regardless of the source, or of whether or not we fully understand where these feelings come from, the next step is allowing ourselves to take an honest look at those emotions, allowing ourselves to feel them, and then release them. Let them go. If it does not serve you, let it go!
Listen to what your body is telling you
I know it may seem on the surface that embracing these big emotional waves would be counterproductive, or even make things worse. But I promise you it is actually quite healing. Like physical pain in the body, big emotions that seem to come out of nowhere are a way for our bodies to speak to us. We need to listen. And the way in which we need to listen to affect change can take many different forms.
It could be that writing about how you feel in a journal would be a great way to let things go. Write it all down, leave nothing behind, even the thoughts & feelings that may scare you. Write poetry, or write yourself a letter. You could even burn the pages once you are done writing. Or you could create art that represents how you are feeling at the time, or art that represents how you wish you felt, creating visual goals for yourself. Anything that will let you express yourself and let these emotions out in a way that feels safe.
Another great option that I recommend to all women is taking 10-15 minutes to sit quietly and meditate. Sit or lay down in a comfortable, quiet place. Breathe naturally, relax your body. Slowly let those emotions come to the surface, without judgement, without thinking about any of it with your intellect, just feeling it within your body, looking at those feelings, and then letting them go. Clear your mind, let the emotions well up, and then watch them blow away in the wind. It is so very freeing!
It could also be that you are really in need of some alone time and PMS is your soul’s way of making you painfully aware of how irritating everything around you is so that you will want to retreat to a safe place for a few hours, or even a few days. This seems to be the case for mothers especially, who really need some space for themselves on a regular basis. Find ways to make this happen ladies, you need it! Needing time alone is not selfish! It is a very real need! Whether it is a 30 minute hot bath, or going for a walk for an hour by yourself, do something that makes you feel happy and peaceful. You deserve it.
What causes PMS?
Underneath all these emotions, there can be some very real hormonal imbalances causing the PMS. Many women experience physical discomforts in addition to the emotional symptoms. Physical symptoms vary a lot from one woman to another, and can vary from cycle to cycle too. They include such things as: abdominal bloating, weight gain, breast tenderness, fatigue, and headaches.
Women with under-active thyroids are more likely to experience PMS symptoms. Low progesterone and estrogen dominance are other big culprits of PMS, and they often cause painful cramps during menstruation as well. Elevated levels of the hormone prolactin have also been found to be implicated in PMS, especially when there is breast pain involved. The good news is that most hormonal imbalances (yes, some thyroid disorders too!) can be addressed with diet, lifestyle changes, and herbal medicine. But that information will have to wait for another post, sorry!
Besides hormonal issues, there are also nutritional deficiencies that can increase the likelihood of PMS. B vitamins, especially B6, are essential for proper luteal function during the second half of the cycle. Calcium and magnesium are also very important for smooth cycles. Magnesium deficiency causes excess aldosterone secretion, which causes the kidneys to retain salt & water, which can cause water retention and weight gain during the second half of the cycle. Hypoglycemia is also implicated in PMS, and tends to cause cravings for carbs & sweets.
Goodbye, PMS!
If you suffer from PMS in any way, shape or form, you are most likely looking for some relief. Besides the advice I gave above to help ease and process emotional struggles, there are many herbs, supplements and dietary changes that can help you. Here are a few of my favorites:
MOTHERWORT: Probably my favorite herb for PMS. I love motherwort! The tincture can be taken on an as needed basis, when big emotions take us by surprise. I tell women to keep a tincture bottle in their purse or in their pocket, and just take a few drops of tincture under the tongue when they need it. It can also be taken daily throughout the cycle to help prevent PMS altogether. Motherwort is especially indicated for irritability, anxiety, exhaustion, sleep disturbances, and heart palpitations. It is also very effective at relieving menstrual cramps, so feel free to keep taking it when you start bleeding.
BLACK COHOSH: Tincture taken during the second half of the cycle can help ease PMS symptoms, especially for those women who suffer from headaches, sleep disturbances or depression. It also can help alleviate menstrual cramps when taken before and during menstruation, as it is antispasmodic and anti-inflammatory.
RED CLOVER: A strong infusion of the dried flowers drank throughout the cycle can help regulate the cycle, balance out the estrogen to progesterone ratio, and prevent menstrual cramps. A great fertility tonic, it supports reproductive function. Reduces PMS symptoms of irritability, agitation, anxiety and depression.
CHASTE TREE (Vitex): Tincture taken throughout the entire cycle can help normalize luteal function for those with low progesterone, a short luteal phase, or estrogen-dominance. It can also reduce prolactin levels when they are elevated, which can help relieve pre-menstrual breast tenderness. Chaste tree berry can help relieve most PMS symptoms, but I would generally only recommend this herb if there was hormonal disregulation involved, for example, for women with irregular cycles. It is important to note that chaste tree has been shown to sometimes exacerbate depression.
LAVENDER: A tea of the dried plant, or a tincture, can be taken to relieve stress, restlessness, and sleep disturbances. The essential oil can also be inhaled through a diffuser, in a bath, or a few drops can be placed on the pillow or on clothing.
ST. JOHN’S WORT: Tincture should be taken all cycle long by those who struggle with mild to moderate depression as their primary PMS complaint. Studies have actually shown it to be equivalent to Prozac in it’s ability to ease depression!
DANDELION: Decoction of the root, or a tincture, can be taken during the second half of the cycle to help relieve symptoms of fluid retention, bloating and constipation. I have found it to be especially indicated when there is a lot of anger and aggressive feelings along with the physical symptoms.
B VITAMINS & MAGNESIUM: Very important nutrients that are essential for proper hormonal balance, and proper luteal function. It if always best to get nutrients directly from food, but high quality supplements should not be discounted for those who may have actual deficiencies. Always look for active forms of B vitamins, and consider using magnesium oil topically instead of oral supplements.
IMPROVE DETOXIFICATION: In general, with disruptive PMS, I immediately look to the body’s detoxification pathways and to the liver’s health. A sluggish liver is often the culprit in many hormonal imbalances, and is a big contributor to outbursts of anger and iritability that seems to come out of nowhere. You can read all about how to improve your body’s natural detoxing capabilities in this blog post.
OTHER CONSIDERATIONS: Reducing coffee and sugar in general, but especially during the second half of the cycle, can make a big difference in PMS symptoms and severity. Make sure you are getting enough quality sleep; go to bed earlier whenever possible. Sleep in complete darkness (no light whatsoever), either all cycle long, or at least from mid-cycle to menstruation, and while bleeding too.
I hope you will be able to use some of this information to assist you. Please let me know if you have found this advice helpful and have reduced or eliminated your PMS!