A guide to understanding what your PMS symptoms mean


What are your PMS symptoms telling you?

Cramps, mood swings and acne

By Dr Kiran Sethi  May 28th, 2020

The blessed amongst us get their periods like clockwork every month, and it’s just a normal part of life, but for many it also brings along mood swings, severe pain, and PMS symptoms. Several women visit me with complaints of zits and rosacea flares triggered by hormonal imbalances as well. While in-clinic treatments and products offer some help, the real problem lies deeper within. To demystify the problems, I spoke to two top hormone experts Dr Jessica Peatross, (MD GPR), a functional medicine naturopathic doctor Dr Jolene Brighten, who is also the author of Beyond the Pill.

 

What causes abnormal hormonal variation?

Dr Jessica Peatross, says, “It is the ratio of estrogen to progesterone that truly matters for moods, PMS and pain. Our estrogen and progesterone levels surge right before our cycles, or mid-cycle at ovulation. We also have three different types of estrogen: estrone, estradiol, and estriol. Each of these can go down a different pathway in the liver and can cause varying symptoms for different women. Testosterone is relatively stable throughout the month, but can swing occasionally. Both progesterone and testosterone can increase the chances of oily skin and sebum, which lead to breakouts for many women”. While Dr Jolene Brighten counters, “Acne can often be the result of excess estrogen or testosterone in the body”.

 

Is PMS-in normal?

Interestingly, both Dr Peatross and Dr Brighten say that PMS is not normal. And here, most of us have been dealing with it as a regular part of life. In fact, it’s telling you that something is off, but luckily it’s not so hard to figure out the issue at play. Dr Jolene recommends watching your symptoms closely. “If you notice you’re feeling anxious, having trouble sleeping, and retaining water before your period then this may be a sign of low progesterone. If your periods are heavy, you have breast tenderness and you’re experiencing irritability then this could point to high estrogen. Oily skin and acne may point to excess testosterone.”

Unfortunately, when it comes to hormonal imbalance, the gut, liver and adrenals may be affected as well. So how do you know which hormone or hormones are disrupted? “Our drainage pathways keep us safe and eliminate the toxic exposures we might come across daily. For the gut, you should have at least two bowel movements per day that are not hard or too loose. You should not see undigested food in the stool. You should be able to tolerate caffeine and alcohol if you choose to consume it. You should be able to fast without your blood sugars dropping too much. You should feel rested after a night’s sleep, and not feel wired but tired or too exhausted every day,” says Dr Brighten. At my clinic I usually recommend patients take a series of blood and ultrasound tests to get a better idea for their hormonal issues.

 

How do we naturally balance hormones?

Both experts and I agree that oral contraceptives should be the last resort. Diet, exercise and lifestyle changes are an absolute must. “I recommend women start optimizing their diet, improving sleep quality, reducing stress, and getting enough physical activity every day. For example, physical activity helps activate the thyroid hormone, which supports a healthy mood, metabolism, and menstrual cycle. Quality sleep and stress management help balance cortisol and progesterone levels, which results in easier periods, less anxiety, and a healthy weight. Bringing in nutrients by way of your diet can supply your body with what it needs to build healthy hormones, and also eliminate those your body no longer needs.

“Aim to fill half your plate with vegetables, especially leafy greens at each meal. A quarter of your plate should be carbohydrates, like whole grains, root vegetables, or legumes. The other quarter should be dedicated to protein to help stabilize blood sugar and support liver detoxification,” advises Dr Brighten. Dr Peatross recommends to “decrease stress, toxic people and products in your life. If women knew how many endocrine disrupters are out there in soap, shampoos, and make-up skewing hormones, they would be more mindful about what they are putting in and on their bodies. Check labels, please.” However, don’t forget that supplements can also be useful. “Adaptogenic herbs, like ginseng, rhodiola, or maca are also extremely helpful as the adrenals and thyroid are often involved in this together,” says Dr Peatross. In India, ashwagandha is a great adaptogenic herb to use in case the above aren’t easily available. Ultimately, changing your life won’t give you immediate results. It can take 1-3 cycles to start seeing a change, but it’s definitely worth the work.

 

There may be several factors at play when dealing with hormonal issues, but the right lifestyle and diet can go a long way to improve them. So start balancing and feel at one with your body.

 

Dr Kiran Sethi MD (@drkiransays) is an integrative wellness and skin expert and the founder of Isya Aesthetics (www.isyaderm.com)

 

Photograph: Rid Burman