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" Where Health and Wellness Begin"

Premenstrual syndrome or PMS is a disorder derived its name from the time of the cycle in which it occurs. Basically it is a term describing abnormal symptoms one to two weeks prior to menstruation. The physiological cause of PMS is a hormonal imbalance in which estrogen levels are excessive and progesterone levels are inadequate. This differs from other female disorders in which estrogen and progesterone levels are low or nonexistent. Physical symptoms accompanied by mood swings and depression are the classic signs demonstrated by PMS victims. Its estimated that 5-10 percent of all women have PMS so severe as to be incapacitating while another 30-40 percent of all women report that PMS interferes with their daily lives.

The brunt of many jokes PMS is no laughing matter. Its physical symptoms may include abdominal bloating, acne, back pain, breast swelling and tenderness, cramping, depression fatigue, headaches, insomnia, dermatitis, water retention, and personality changes including depression, mood swings, fits of anger, and violence. Its hard to believe that a hormonal imbalance can be responsible for so many varied physical and emotional symptoms. This is one disorder where measurable laboratory testing and physical findings may not be a means of measuring the intensity and severity of the disorder. In fact until the mid seventies PMS was dismissed as a psychological disorder and the hormonal connection was a mere theory or myth. Today it is recognized, but all too often treatment is merely symptomatic and doesn't address the real cause.

Many premenopausal women suffer from symptoms of premenstrual syndrome (PMS) at the end of a monthly cycle and are frequently relieved when the next menstrual cycle begins. Specific problems--cramping, bloating, mood changes, and breast tenderness--may vary from woman to woman. Women with breast tenderness should see the section on fibrocystic breast disease.

Hormonal imbalances of this type are usually chronic or long term and exogenous, meaning they can be influenced through life style changes. The bottom line cause to these hormonal imbalances tends to be derived from carbohydrate metabolism. Blood sugar variations and swings cause a disruption in hormonal production and distribution. If low blood sugar persist then progesterone needs to be utilized to help bolster blood sugar levels. If blood sugar swings or fluctuates dramatically estrogen levels may increase as a buffer. This blood sugar instability also interferes with neurotransmitters and may contribute heavily to mood swings and depression. One in particular is dopamine and another is beta-endorphin. So again, controlling dietary habits will contribute greatly in controlling blood sugar and hormonal levels.

Dietary changes that may be helpful: Women who eat more sugary foods appear to have an increased risk of PMS. Alcohol can effect hormone metabolism, and alcoholic women are more likely to suffer PMS. Tea consumption in China is strongly related to PMS. The same is true for coffee and other caffeine-containing beverages in the U.S. The more coffee women drink, the higher their risk. Therefore, many nutritionally oriented doctors recommend that women with PMS avoid sugar, alcohol, and caffeine.

Hydration
Believe it or not, the entire endocrine (glandular) system depends on proper hydration and dehydration is a major factor in hormonal deficiencies. It is now becoming obvious that as the years role by our thirst for water becomes chronically and increasingly less sensitive and a state of dehydration develops. In fact as we age, the water content of the cells of the body decreases. This is a drastic alteration from normal. Since the water we drink provides for cell function and its volume requirements, the apparent decrease in daily water intake affects the efficiency of cell activity and adversely effects the ovaries. In fact, water or proper hydration habits is a significant factor in restoration for the female reproductive system. Poor hydration is one of the chief factors behind fibrocystic breast disease because the lymphatic system becomes sluggish and tends to pool in breast tissue.

So, more than the usual attention needs to be placed on proper hydration. This is easily accomplished by increasing water intake. It is a slow process and generally takes 4 to 7 days before there is a noticeable effect. How much water? Eight to ten, 8oz. glasses a day, every day, that is a bare minimum. Other fluids may also be added, such as non sweetened soft drinks, teas, and limited amounts of coffee. Any alcoholic beverage will dehydrate, not hydrate, so will not contribute to daily fluid intake.

Coffee should be decaffeinated or limited to two cups of caffeinated coffee a day. Alcoholic beverages need also to be limited, to no more than two daily. Sweetened soft drinks, those with added sugar, need also be limited to two daily, and artificially sweetened soft drinks, are not limited, but caution should be applied, as carbonation creates too much phosphorus, which can interfere with proper calcium absorption. Also many soft drinks contain caffeine and should be limited. (Therefore, no more than two caffeinated beverages - coffee, tea, soft drinks - per day.) Juice is also a good source of fluids, but may provide too much sugar in your diet.

Several studies suggest that diets low in fat or high in fiber may help to reduce symptoms. Many nutritionally oriented doctors suggest diets very low in meat and dairy fat and high in fruit, vegetables, and whole grains. Eat eight to nine servings of fruit and vegetables daily. This in itself is a panacea. Research has confirmed this to be the most beneficial dietary change, in regards to overall health.. Health benefits in all systems will be felt. The added trace minerals, fiber and enzymes cannot be replenished with supplements alone, so dietary enhancements, such as adding these extra portions of fruits and vegetables can improve all biological functions. So eat all the fruit and vegetables you desire, just eat.

Avoid hydrogenated and partially hydrogenated oils. These contribute heavily to free radicals by their altered structure. They are difficult to break down by normal digestion, so these large undigested protein and fat particles create havoc in joints and in the arterial system. Free radicals from hydrogenated oils can damage the lining of your arteries and can contribute to poor glandular function especially the ovaries. Products containing hydrogenated oils include margarine, homogenized peanut butter, prepared cake mixes, frostings and some canned goods, which can be identified through proper labeling.

Be selective about cooked fats found in red meats, avoid when possible and limit servings to two or three times a week. Poultry is a good substitute for fat laden red meats. Avoid all processed or luncheon meats. Their fat content is high and they also carry large amounts of sodium nitrate and sodium nitrite.
Avoid fried or deep fried food in oils or fat. Again, the free radical content is high and will contribute to undesired inflammation. Yes, this includes French fries! Of course, baking, broiling and boiling are good substitutes. Even wok cooking, with soy or very light oil, is a good substitute.

Essential fatty acids are necessary commodities for this program. Simply, essential fatty acids are basic fats, which the body cannot manufacture and needs to be obtained through diet. Omega 6 oils are found in nuts, seeds and legumes and omega 3 oils are found in fish and certain vegetables, such as canola and flaxseed. These oils can be supplemented to assure basic requirements and are vital for hormonal transport.

Use whole grain breads, cereals, etc. Whole grain products contain needed fiber, vitamins and trace minerals, not found in processed grains. Health food stores, specialty bakeries, and in most grocery stores, prepared breads and desserts made with whole grains are available.

Processed sugars may also cause undesired symptoms. First rule concerning any sugar, is some self restraint. When sweetening foods try using honey, molasses or fruit concentrates. When cooking or using dessert recipes, it does not matter as much, but if using honey or molasses, some adjustment in the dry ingredients need to be made. Again, health food sections in grocery stores, health food stores and specialty bakeries do a fine job of using natural sweeteners or sugar substitutes.

Eat at least three or more servings of fish per week. This will help assure an adequate supply of the omega 3 fatty acids and is the easiest form of animal protein to be digested. Poultry is also a good source of protein and can be eaten as often as desired but again keep portion size down to 3-4 oz. Of course, white meats are preferred, because of less animal fat content. Legumes, such as beans, peas, nuts and seeds, are also great sources of protein, and can be also consumed without limitation. Soy protein is a common meat substitute, and can be found in many health drinks and protein powders. They are good, but if gas or bloating occur, they may not be agreeable, because of their high density and difficulty in digesting.

Special note: Please do not restrict diet to be uncomfortable. Soups, stews, ethnic foods can all be enjoyed at home or eating out. Just use wholesome ingredients and flavorful spices with foods prepared at home. Watch fat content, as high content can cause undesired health problems. It is generally regarded as safe to consume 15to 25126703700f total caloric intake, in the form of fat, or about 20 grams in a typical 2,000 to 2,500 caloric diet. Check labels and get a fat counter booklet if in doubt.

Lifestyle changes that may be helpful: Six months of jogging (averaging less than two miles per day) was reported to lower breast tenderness, fluid retention, depression, and stress in a group of women with PMS. Nutritionally oriented doctors frequently recommend regular exercise as a way to reduce symptoms.

Nutritional supplements that may be helpful: Vitamin B6 can reduce effects of estrogen in animals, and excess estrogen may be responsible for PMS symptoms. A number of studies show that 200-400 mg of vitamin B6 per day for several months can relieve symptoms of PMS. Although the amount of vitamin B6 is sometimes too low, or the length of the trial too short, some studies have not found vitamin B6 helpful. Most nutritionally oriented doctors feel that vitamin B6 is worth a try and suggest 200-400 mg per day for at least three months. This amount can cause side effects. See the contraindications section below.
Many years ago, research linked B vitamin deficiencies to PMS. This work has only rarely been followed up, but some nutritionally oriented doctors still recommend the B-complex vitamins. Women with PMS show abnormalities in the processing of fatty acids. In theory, these problems should resolve with evening primrose oil, or EPO. Of the double-blind trials, some report that EPO is quite helpful, while others find it no better than placebo. While the issue remains unresolved, many nutritionally oriented doctors consider EPO to be worth a try, suggesting 3-4 grams of EPO per day. EPO seems to work best when used over several cycles and may be more helpful in women with PMS who also experience breast tenderness or fibrocystic breast disease.

Women with PMS are often deficient in magnesium. Supplementing with magnesium may help reduce symptoms. While the ideal amount of magnesium has yet to be determined, some doctors recommend 400 mg per day. Women who consume more calcium from their diets are less likely to suffer severe PMS. Double-blind research has shown that supplementing 1,000 mg of calcium per day relieves symptoms in women with PMS.

Progesterone may relieve some symptoms of PMS and vitamin A appears to increase progesterone levels Very high doses of vitamin A7100,000 IU per day or more7have reduced symptoms of PMS, but such an amount is dangerous. Women who are or who could become pregnant should not supplement with more than 10,000 IU (3,000 mcg) per day of vitamin A. Other people should not take 100,000 IU without the supervision of their nutritionally oriented doctor.
Although women with PMS don't appear to be vitamin E deficient, double-blind research shows that 300 IU of vitamin E per day may decrease symptoms of PMS.

Some of the nutrients mentioned above appear together in multi-vitamin/mineral supplements. One double-blind trial used multi-vitamin/mineral supplements containing vitamin B6 (600 mg per day), magnesium (500 mg per day), vitamin E (200 IU per day), vitamin A (25,000 IU per day), B-complex vitamins, plus other vitamins and minerals In the trial, all four groups of women with PMS benefited more from supplements than from placebo. These results have been independently confirmed. See our vitamin page.

Are there any side effects or interactions? Although side effects from vitamin B6 supplements are rare, at very high levels this vitamin can damage sensory nerves, leading to numbness in the hands and feet as well as difficulty walking. Vitamin B6 supplementation should be stopped if these symptoms develop.

Taking too much magnesium often leads to diarrhea. This can happen at doses as low as 350-500 mg per day. Excessive magnesium intake is more serious but is rarely caused by magnesium supplements. People with kidney disease should not take calcium or magnesium supplements without consulting a physician. Individuals with sarcoidosis, hyperparathyroidism, or with chronic kidney disease should not supplement with calcium.

Women who are or could become pregnant should take less than 10,000 IU per day of vitamin A to avoid the risk of birth defects. For other adults, intake above 25,000 IU per day can in rare cases cause headaches, dry skin, hair loss, fatigue, bone problems, and liver damage.

Herbs that may be helpful: Vitex has been shown to help re-establish normal balance of estrogen and progesterone during a woman's menstrual cycle. This is important because some women will suffer from PMS and other menstrual irregularities due to underproduction of the hormone progesterone during the second half of their cycle. Vitex stimulates the pituitary gland to produce more luteinizing hormone, and this leads to greater production of progesterone. Studies have shown that using once in the morning over a period of several months will help normalize hormone balance and alleviate the symptoms of PMS. Vitex should be taken for at least four cycles to determine efficacy.

For more information and suggestions, visit the Women's Health Community at Pharmanex.

Hormonal fluctuations associated with the menstrual cycle influence appetite control and eating behaviour. Energy intake varies during the reproductive cycle in humans and animals, with a periovulatory nadir and a luteal phase peak. Patterns of macronutrient selection show less consistency but a number of studies report carbohydrate cravings in the premenstrual phase, particularly in women with premenstrual syndrome. The cyclical nature of food cravings are frequently, but not invariably, associated with depression. Fluctuations in appetite, cravings and energy intake during the menstrual cycle may occur in parallel with cyclical rhythms in serotonin, which can be accompanied by affective symptoms. The premenstrual phase can be considered as a time when women are especially vulnerable to overconsumption, food craving and depression; this is often associated with low serotonin activity.

The primary herbal source used has been St. John's Wort. St. John's Wort has been studied and documented to increase serotonin levels. If you wish to try this, I would recommend one of the following two sources of St. John's Wort (There are many manufacturers of St. John's Wort products, but many have since been found NOT to contain any of the active parts of the St. John's Wort plants. These are the only two products that I have found definitive evidence of their standardization and quality):
Alterra is produced by one of the leading drug manufacturers, Upsher-Smith. It is an extended release product and only needs to be taken twice a day. Retail price about 0.73 per day. Alterra is available through your pharmacist without a prescription, or can be ordered on-line through VitaCost or WalMart. The other recommended St. John's Wort products are available through Pharmanex. When ordering by phone, (800) 487-1000, please list Healthstop as your referring sponsor.

Retail costs listed on this page are for comparison purposes only. Discounted prices available on most products.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

The information presented on these pages is based on scientifically based research and current medical knowledge. Many of the supplements mentioned on these pages have been used to treat diseases for hundreds or thousands of years. The medical community is just beginning to research natural treatments. As new information develops, the information on these pages will be updated. Whenever possible, several sources for each supplement will be listed. The manufacturers mentioned within, have presented evidence that they have independent studies demonstrating standardization of potency, purity, and activity for that product. Some of the products presented are processed by Pharmanex.

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