Naturopathic Care for PMS Relief

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are conditions that can impact reproductive-aged women, adolescent girls, and other people who menstruate. Physical and emotional symptoms caused by changes in hormone levels may begin as early as two weeks before getting their monthly period. Many may experience headache, abdominal pain, seemingly random food cravings, emotional outbursts, and feelings of exhaustion that can affect their daily activities and mood. It is estimated that PMS affects nearly 50% of people who menstruate, while some studies estimate that 80% to 90% experience at least one symptom of PMS. Furthermore, 2.5% to 3%  of women have symptoms categorized as PMDD, a more severe form with extreme mood changes.1,2 Rate of prevalence varies across studies but is important for raising awareness, particularly due to the fact that patients with ovaries can have PMS/PMDD regardless of gender identity.2

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Understanding PMS

PMS occurs in the luteal phase of your menstrual cycle, which is the time just before you get your monthly period.2 During the luteal phase, your body mainly produces progesterone, which is a hormone secreted by the ovaries to prepare the uterus for pregnancy. However, when pregnancy does not occur, progesterone is broken down into substances that may affect your brain’s chemical messengers together with estrogen, affecting your mood and bodily functions. Mood swings during the luteal phase may occur because fluctuations in progesterone and estrogen affect serotonin, which is known as the “happy hormone.” These changes can make daily activities more difficult and affect your overall well-being.
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Signs & Symptoms

Symptoms can last for only 2 days or the full 2-week span of the luteal phase, with the worst symptoms usually occurring 2 days before your period.1 Symptoms of PMS may include: 

• Acne
• Back pain
• Fatigue
• Mood swings or irritability
• Headaches
• Bloating
• Constipation or diarrhea
• Breast tenderness
• Brain fog
• Crying spells
• Anxiety or depression

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Allopathic Pharmaceutical Treatment

Many factors contribute to the development of  PMS/PMDD, including genetic predisposition and fluctuations in estrogen and progesterone levels.1,2 However, the reason as to why PMS/PMDD occur is still unknown. The diagnosis of PMS is entirely based on self-reported signs and symptoms, with no specific diagnostic tests available to confirm it.3 Interestingly, selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, are sometimes utilized for PMS/PMDD treatment to increase serotonin levels and boost mood. Hormonal contraception is another pharmacological treatment method that blocks the rise of estrogen and progesterone during the luteal phase, minimizing symptoms which high levels of these hormones can cause.2 However, long-term use of hormonal contraceptives may increase your risks of having fatal blood clots and hormonal imbalances due to its effects on how your body naturally produces hormones.
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Natural Ways to Remedy PMS

“Regardless of the specific type of exercise, regular physical activity appears to be effective in alleviating pain, constipation, and breast sensitivity, as well as psychological symptoms such as anxiety and anger...” - Liguori et al.

On average, a woman will have 450 periods during her lifetime.4 For those with PMS/PMDD symptoms, alleviating discomfort is important for improving quality of life. It is important to remember that certain conditions like chronic fatigue syndrome, depression, and irritable bowel syndrome (IBS) can have similar symptoms. Talking with your naturopathic doctor about your symptoms helps to rule out other conditions. 

Lifestyle factors greatly influence PMS symptoms. Regular intake of fast food, fried meals, sugary drinks, and alcohol, as well as limited exercise and sleep, may exacerbate your discomfort. Additionally, stress can amplify the sympathetic nervous system, which is responsible for your fight or flight response. Its activation may increase the intensity of uterine contractions, leading to heightened pain.2 Inflammation in the body additionally influences how you respond to stress. While estrogen and progesterone have anti-inflammatory effects, their levels decrease after ovulation, resulting in increased inflammation and potentially worsened symptoms.1 

There are many naturopathic, non-pharmacological options including diet modification, massage therapy, exercise, and light therapy.1 Diet modification is particularly essential since common deficiencies associated with PMS symptoms include calcium, vitamin B, vitamin K, vitamin E and magnesium. Some strategies to help prevent or reduce symptoms include:​
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• Increase weekly exercise to at least 150 minutes of moderate activity. Whatever kind of physical activity (swimming, yoga, aerobics, walking, etc.) works best for you. The important thing is to make it a consistent habit.5  
• Drink a minimum of 64 ounces of water each day. You could spice up your water bottle with some lime, lemon, or cucumber slices. 
• Limiting alcohol and caffeine can improve sleep quality for overall health and alleviate PMS symptoms. Avoid drinking caffeine after 2 p.m. to help prevent sleep disruption. 
• Reduce salt intake by choosing fresh ingredients to help alleviate some symptoms of PMS. Processed foods often contain large amounts of salt that can contribute to bloating, swelling, and breast tenderness. On the other hand, leafy greens provide magnesium, iron, calcium, and vitamin K, which may help reduce cramping during menstruation. 
• Boost vitamin D levels by eating vitamin D-rich foods, such as egg yolks and salmon. And don’t forget about natural sunlight! 
• Increasing calcium intake through dairy foods can help reduce fluctuations in mood. Calcium-rich foods also include kefir, broccoli, yogurt, and kale. Furthermore, complex carbohydrates like sweet potatoes and unprocessed oats can help stabilize mood and reduce cravings.
• Consuming high-fiber foods can help reduce gastrointestinal symptoms. At least 30 grams of daily fiber is an important component of the female diet. Regular bowel movements also help your body to clear excess hormones.
• Eating foods rich in Omega-3 fatty acids, such as  fish and some nuts, lessen inflammation that can exacerbate PMS symptoms. Chia seeds are a great source of Omega-3 and fiber. 
• Indulge in your chocolate cravings by eating dark chocolate made with small amounts of minimally-processed sugars (such as honey, maple, raw cane sugar, and coconut) which contains  magnesium, manganese, theobromine, antioxidants, and fiber. These are several great benefits to adding a little sweetness!  
• Using essential oils, diluted in a carrier oil and applied topically to the abdomen, may also help to alleviate symptoms. Some helpful combinations include:
  • Clary sage oil for hormone balance
  • Cypress oil to prevent cramping and improve circulation
  • Lavender oil to limit tension and cramping ​

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Some of our favorite menstrual cycle supplements

To reduce bleeding

For cramping

For extra iron

​Naturopathic Care for Improving Your Menstrual Health

General education concerning reproductive health is an important component of promoting menstrual health.1 Naturopathic medicine offers the tools to help you understand and address your menstrual cycle and potential PMS/PMDD symptoms. Furthermore, your team can assist you in learning about holistic supplementation and herbal remedies that can alleviate discomfort you may be experiencing prior to menstruation. The tips provided in this article may offer some relief, but often cannot substitute a personalized health plan due to the unique nature of your case. Your team at Natural Path to Wellness can guide you on a more specific course of action towards improved health. Explore the naturopathic approach to improving your menstrual health today!   

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Author

Daelyn Quinn is a graduate of the University of South Florida, Class of 2024. She studied Cell and Molecular Biology, as well as Spanish, and has been accepted into a nationally accredited Doctor of Naturopathic Medicine program. Outside of academic and professional pursuits, she enjoys exploring cities with friends and family, running outdoors, and reading next to one of Florida’s many bodies of water.

Edited by Kate Nemenzo.
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This article is for educational purposes only and is not intended as medical advice. Please consult your licensed naturopathic physician or other licensed healthcare provider before making changes to your medications or supplements. Disclosures & Policies: This and other blog posts may contain affiliate links. Please view our disclosures page for more information. 
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References

1. Gudipally PR,  Sharma GK. Premenstrual Syndrome. StatPearls. 2023. Published 17 July 2023. https://www.ncbi.nlm.nih.gov/books/NBK560698/ 
2. Tiranini L, Nappi RE. Recent advances in understanding/management of premenstrual dysphoric disorder/premenstrual syndrome. Fac Rev. 2022; 11:11. Published 28 Apr 2022. doi.org/10.12703/r/11-11 
3. Zehravi M, Maqbool M, Ara I. Unfolding the mystery of premenstrual syndrome (PMS): an overview. Int J Adolesc Med Health. 2022;35(1):9-13. Published 2022 Sep 19. doi:10.1515/ijamh-2022-0023
4. Chavez-MacGregor M, van Gils CH, van der Schouw YT, Monninkhof E, van Noord PA, Peeters PH. Lifetime cumulative number of menstrual cycles and serum sex hormone levels in postmenopausal women. Breast Cancer Res Treat. 2008;108(1):101-112. doi:10.1007/s10549-007-9574-z
5. Liguori F, Saraiello E, Calella P. Premenstrual Syndrome and Premenstrual Dysphoric Disorder's Impact on Quality of Life, and the Role of Physical Activity. Medicina (Kaunas). 2023;59(11):2044. Published 2023 Nov 20. doi:10.3390/medicina59112044