Perth PMS/PMDD Naturopath

PMS (premenstrual syndrome) is a group of symptoms that some women experience before and sometimes during their period. PMS is very common but should not be considered ‘normal’ or untreatable. PMS responds quickly and well to naturopathy, and I often find my clients see results within their first menstrual cycle, surprised that they experienced no ‘lead up’ to their period.

PMS symptoms usually begin 3 to 7 days before the period starts and subside during or shortly after the period and include:

• mood fluctuations including anxiety, irritability, and teariness

• fatigue and sleep problems

• breast tenderness

• premenstrual spotting

• fluid retention and abdominal bloating

• migraines

• food cravings

• acne.

A common misunderstanding is that the female hormones oestrogen and progesterone themselves are what cause PMS, particularly mood disturbance.

Oestrogen and progesterone are both beneficial for mood. Oestrogen boosts the ‘feel good’ neurotransmitters, serotonin and dopamine. Progesterone boosts GABA, a calming neurotransmitter.

Problems only arise when there is an imbalance of the oestrogen to progesterone ratio, usually excess oestrogen coupled with low progesterone.

Excess oestrogen can occur when you have difficulty detoxifying and removing oestrogen from your body.

Oestrogen decreases in the few days before the period, the time when PMS symptoms are most often reported. If you have excess oestrogen, this fall can feel like you are going down a hormonal rollercoaster, exacerbating PMS symptoms.

Excess oestrogen can cause PMS symptoms such as irritability and breast tenderness.

Progesterone protects you against the symptoms of both excess oestrogen and the fall of oestrogen. To alleviate PMS symptoms, you need to make enough progesterone during your luteal phase of your menstrual cycle, between ovulation and your period. Unfortunately, progesterone is hard to make, and many factors, including stress, can lower its production.

Low progesterone can cause PMS symptoms such as premenstrual spotting and migraines.

Premenstrual dysphoric disorder (PMDD) is a hormonal and psychological health condition that affects up to 8% of women.

PMDD is often underdiagnosed, or it is misdiagnosed for mental health conditions such as generalised anxiety disorder, major depressive disorder, and bipolar disorder.

PMDD:

• causes extreme premenstrual mood fluctuations, including depression, anxiety, rage, and thoughts of self-harm

• can often include PMS symptoms such as fatigue, headaches, breast pain, and insomnia

• symptoms can start as early as ovulation and continue through the period, lasting up to half of your monthly menstrual cycle

• symptoms can be debilitating, causing you emotional distress and should never be dismissed as ‘normal’

• can impact all areas of your life; making performing at work or school, enjoying hobbies and social activities, navigating relationships, managing home life and practising self-care, extremely difficult whilst you are symptomatic.

As a naturopath, I want to reassure you that PMDD mood symptoms are not your fault, and that they can be treated with both naturopathy and conventional medical treatment.

Emerging research suggests that PMDD could have several potential causes including:

• an abnormal response to normal hormone fluctuations that reduces the feel-good neurotransmitter, serotonin

• elevated histamine, a neurotransmitter that can worsen PMDD mood symptoms

• nutrient deficiencies

• high prolactin

• progesterone sensitivity.

PMDD is conventionally treated with antidepressants that increase the neurotransmitter, serotonin. They are only taken during the luteal phase of the menstrual cycle when symptoms occur. Whilst they can be very effective for many women, some can experience unwanted side effects.

As a naturopath, I can recommend dietary and lifestyle modifications as well as prescribe herbal and nutritional supplements that work safely alongside antidepressant therapy, if you find it works well for your PMDD.

Alternatively, I can prescribe naturopathic treatment alone if you don’t wish to take antidepressants or want to stop taking them due to side effects.

The combined oral contraceptive pill is also commonly prescribed for PMDD. However, I do not recommend it as a treatment for PMDD as it can cause other equally severe mood symptoms and suppresses ovulation which is essential for your reproductive hormone health.

The role of histamine in PMDD is an emerging area of research, with recent anecdotal evidence suggesting that over-the-counter antihistamines may help reduce PMDD mood symptoms.

Naturopathy can treat PMDD by helping to:

• balance your oestrogen levels and optimise progesterone levels to help regulate hormone fluctuations and stabilise serotonin levels

• reduce mast cell activation to lower histamine production

• correct nutritional deficiencies

• balance your pituitary, reproductive and adrenal hormones and regulate neurotransmitter and hormone receptors.