There is no need to explain, as a woman, you know what PMS stands for, you know what it means to experience the cramping, aching and emotional distress that accompanies that monthly fluctuation of hormone levels. What you really want to know is: is there anything you can do about premenstrual syndrome? And, if you are among the 30 percent of women with PMS symptoms every month or the 8 percent of women whose PMS symptoms are so bad, it is actually diagnosed as premenstrual dysmorphic disorder (PMDD), are there options to relieve the madness?
The answer is yes.
Premenstrual symptoms generally present about 7 to 14 days before your period begins. Discomforts may include physical symptoms, such as bloating, weight gain, breast tenderness, headaches, acne, insomnia, and fatigue. Emotional symptoms may also be a factor, and for women suffering from PMDD, the distress can become deeply psychological and intense, affecting work and social interactions. Symptoms may include premenstrual mood swings, anxiety, irritability, tension, depression and anger.
The symptoms can vary from month to month and woman to woman. It is believed that there are more than 200 symptoms of PMS, so it is truly a different experience for every woman. Certain types of birth control pills can help control symptoms, but the wrong oral contraceptive or other types of them can make symptoms worse. You are the most qualified person to know when premenstrual symptoms are not normal—when you stop feeling like yourself on a monthly cadence, it’s time to take action.
Of course, it can be hard to walk into a doctor’s office and say, “I have PMS. Do something.” To make it easier to have that conversation and arrive at solutions, give your medical team (and your relief) a head start. Start journaling before your menstrual cycle and record symptoms every month. Documenting your symptoms can help your medical practitioner pinpoint your issues with premenstrual hormones.
The Physiology of the Menstrual Cycle
Understanding the physiology of your menstrual cycle can help you get a grasp on symptoms and solutions. A normal menstrual cycle lasts between 28 and 30 days. The first day of a cycle is marked by menstrual bleeding and ends the day before the next cycle begins. The first half of the cycle is the follicular phase and is characterized by high levels of follicle stimulating hormone (FSH) and increasing levels of estrogen). This primes the ovaries to prepare for the release of an egg. If all systems are functioning normally, simultaneous estrogen production will occur in the dominant follicle. This leads to a surge in luteinizing hormone (LH). The rise in LH triggers ovulation and release of the dominant follicle from the ovary, initiating the luteal phase of ovulation.
Following ovulation, the follicular remnants form a corpus luteum. The corpus luteum produces progesterone, supporting the released ovum and inhibiting FSH and LH production. If pregnancy does not occur, the luteal phase is initiated. This involves luteal degeneration and the eventual decline of progesterone levels. FSH levels begin to rise before the onset of the next menstrual period.
Hormones that Influence Premenstrual Syndrome
The rise and fall of estrogen and progesterone varies from woman to woman, which is why symptoms can be so varied and erratic. Estrogen and progesterone alter neurotransmitters in the brain. Neurotransmitters are naturally responsible for the transition of messages between nerve cells, particularly those in the brain. Mood, pain, and pleasure are influenced by these brain chemicals.
Serotonin is one neurotransmitter that is affected during the menstrual cycle. The oscillating hormones, including progesterone and estrogen, cause serotonin levels to fluctuate. This fluctuation results in appetite changes, such as carbohydrate cravings and may induce other unwelcome effects like bloating, weight gain and depression.
Gamma-amino butyric acid (GABA) and endorphins are also neurotransmitters. GABA is instrumental in regulating feelings of calm. Altering levels of this chemical can result in anxiety and irritability. Research has shown that the influence of progesterone during this time of the month may interfere with GABA receptors. Some studies have found that this can be addressed by restoring balance of that system through hormonal therapy.
Endorphins are instrumental in the experiences of pleasure and pain. High levels can relieve stress and pain, while low levels can lead to tension, anxiety and irritability. Engaging in physical activity, including yoga, running, and, yes, even sex can raise endorphin levels and ward off period pain and distress.
When to Seek Treatment for Premenstrual Syndrome
How do you know when your PMS is bad enough to warrant treatment? Your friends and family may be able to answer that question, though it may not be a subject you wish to discuss. If you suspect that your symptoms have crossed a line, journaling your symptoms and episodes of discomfort, including noting the date and time, around and during your menstrual cycle is a wise first step to getting help.
Premenstrual dysmorphic disorder is more closely associated with erratic emotional and psychological symptoms that accompany PMS. Women with PMDD will still experience the physical symptoms of PMS. Women suffering from PMDD will often have difficulty at work and the severity of emotional symptoms can even damage relationships. Medical treatment for PMDD is necessary and available. You don’t have to “just live with it.”
You can also have comprehensive lab testing to assess your hormone levels around your menstrual cycle. Advanced testing can tell a physician experienced in hormonal health if there is an imbalance of your hormones that is exacerbating symptoms. This information, coupled with your journal, medical history, and a discussion about your current symptoms and lifestyle will allow your doctor to build a custom treatment plan to address your PMS symptoms or PMDD.
The Solution to PMS
Sometimes the solution to PMS is as simple as switching methods of birth control or the type of birth control that you are using. In other cases, more in-depth treatment plans may be necessary.
Your diet and physical activity level can affect the severity of symptoms. Your doctor may recommend very specific nutritional changes to reduce symptoms. The effectiveness of physical activity varies by type and woman. Some women will benefit from incorporating a yoga class a few times a month to release tension and enhance the release of calming neurotransmitters. Others may find solace in more intensive activities like running or spinning that rev up feel-good endorphins.
Severe PMS and PMDD generally require a broader strategy—one that incorporates hormone therapy as well as nutritional changes and routine exercise. The good news is that relief is possible. No woman has to live with the distress and discomfort of PMS or PMDD every single month for life. Working with a qualified physician, like the expert doctors of the BodyLogicMD network, can help you achieve balance and reduce or eliminate symptoms of PMS and PMDD.
When you work with a practitioner of the BodyLogicMD network, you get advanced lab testing and a one-on-one consultation with your doctor, so the two of you can discuss your symptoms, medical history and lifestyle. This ensures your doctor can get a clear picture of how PMS or PMDD is affecting your life and build a treatment plan that is ideally suited for you.
If you are suffering from severe PMS or PMDD, visit a qualified BodyLogicMD hormone therapy physician to be tested. Contact the BodyLogicMD bioidentical hormone doctor nearest you to schedule an appointment and learn more about how hormone therapy can help control symptoms of PMS.