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Treating PMS/PMDD Using A Functional Medicine Approach

Do you find yourself feeling an array of negative physical and emotional symptoms the week or so leading up to your period? If so, you might be part of the 85% of women who suffer from premenstrual syndrome (PMS) or part of the 5% of women who suffer from the more serious and debilitating condition known as premenstrual dysphoric disorder (PMDD). 

According to the Mayo Clinic, common symptoms of PMS that occur in the week or two preceding menstruation are: 

Emotional and behavioral signs and symptoms

  • Tension or anxiety
  • Depressed mood
  • Crying spells
  • Mood swings and irritability or anger
  • Appetite changes and food cravings
  • Trouble falling asleep (insomnia)
  • Social withdrawal
  • Poor concentration
  • Change in libido

Physical signs and symptoms

  • Joint or muscle pain
  • Headache
  • Fatigue
  • Weight gain related to fluid retention
  • Abdominal bloating
  • Breast tenderness
  • Acne flare-ups
  • Constipation or diarrhea
  • Alcohol intolerance

The symptoms of PMDD are similar to PMS but are much more pronounced and severe- especially the psychological symptoms. For example, if you have PMS you might feel sad and irritable in the week or two leading up to your period, but if you have PMDD you might feel hopeless and possibly even suicidal, and your anxiety might be so severe you might not feel like you can even leave your house. 

Why Does This Happen?

young woman sitting in the bedroom on a bed and holding her stomach, abdominal pain
Though we don’t know the exact cause of PMS-  we do know that hormonal fluctuations the week or 2 before your period definitely play a role- especially related to progesterone (too little) and estrogen (too much).  There is also research suggesting that inflammation  plays a role in pre-menstrual and menstrual symptom severity. 

Other factors that can contribute to PMS symptoms are:

  • Poor nutrition and lack of exercise
  • Environmental toxins
  • Stress
  • Poor sleeping habits

How Can the Functional Medicine Approach Help You to Feel Better? 

Conventional medicine usually has 1 of 2 options to offer you if you are looking for relief from PMS or PMDD– take an oral contraceptive, or take an antidepressant for the 2 weeks before your period every month (which is interesting advice given that it takes antidepressants 4-6 weeks to be effective). Both of these options can have side effects– and even make some symptoms worse.  And in the end they don’t address the root cause of your PMS– stop taking the pill or the antidepressant and your PMS will come right back.  

At Nourish Health and Wellness we like to take a bit of a different approach. We want to figure out what the underlying cause of our patients’ premenstrual symptoms are and start with safer, more natural approaches to managing the symptoms. 

Effective Natural Alternatives to Treating PMS/PMDD:

We always begin with testing to assess hormone balance, nutrient deficiencies, gut health, and inflammatory markers to get a thorough picture of the various imbalances that could be contributing to your PMS/PMDD, and then create your treatment plan from there. Some of the recommendations we may make depending on your unique lab results include: 

  • Supplements: Vitamin B6 has been shown to be effective in treating PMS symptoms associated with imbalanced progesterone, while Chaste tree berry helps our body to produce more progesterone which can help rebalance estrogen levels and in turn reduce PMS symptoms. In many cases, Vitamin D deficiency has been linked to PMS symptoms and restoring those levels is imperative to hormone support. 

In fact- in a January 2020 study published in the Journal of Alternative and Complementary Medicine- 72 women with PMS were given either 80 mg of Vitamin B6 or a broad-spectrum micronutrient formula (basically a fancy multivitamin) to take daily for 3 consecutive menstrual cycles. The results were impressive– 72% of the women taking the micronutrient formula and 60% of the women taking 80 mg of vitamin B6 group identified as being in full remission from PMS symptoms after three cycles and had few to no side effects!  

Magnesium is also a key nutrient that can help ease mood swings, headaches, and the sugar cravings associated with PMS. 

  • Nutrition: Ensuring that your body is getting adequate amounts of nutrients that support hormone balance, which may include cruciferous vegetables to regulate estrogen, sources of Omega-3 fatty acids to help decrease inflammation, high quality protein to help your body make necessary neurotransmitters, and at least 25 grams of fiber per day  to ensure good gut health. Making sure you are eating in ways that help to optimize your blood sugar balance is also extremely important.
  • Lifestyle: Making it a top priority to get at least 8-hours of sleep per night  and finding ways to decrease your stress levels is super important. Stress has a huge negative impact on the body and can make any hormone imbalance you already have even worse. Regular exercise, meditation, and connection to others in your life are all ways to reduce stress levels.

There are better options out there for managing PMS and PMDD than going straight to the pill or an antidepressant. Though in the end those may be the necessary treatments for some women suffering with severe symptoms– there are many effective, evidenced-based natural solutions for managing PMS/PMDD. 

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