Premenstrual syndrome, commonly known as PMS, affects many women: Approximately 70 to 80 percent of women may suffer from this syndrome during their childbearing years. Characterized by a hormonal imbalance, it causes a combination of physical and emotional symptoms that typically reoccur on a monthly basis, beginning days or even weeks prior to a woman’s menstrual cycle and usually ending with the onset of menses. Typical symptoms include (but are not limited to) anxiety, irritability, mood swings, cravings for sweet or salty foods, abdominal bloating, headaches including migraines, back pain, weight gain, and fluid retention. There are several risk factors for PMS: high caffeine intake, low levels of certain vitamins, a high-stress lifestyle and a family history of PMS.

Premenstrual Dysphoric Disorder (PMDD), a related condition seen in approximately 5 to 10 percent of menstruating women, is characterized mainly by a mood change more severe and disabling than that seen in women with PMS,with symptomsoccurring the last week of the menstrual cycle and ending during the week following the cycle. Symptoms range from anxiety and feelings of sadness to severe depression, anger and even thoughts of suicide. Many women with this disorder experience a “feeling of being out of control,”and have trouble thinking and sleeping. There appears to be a genetic factor involved with PMDD, sincewomen with the disorder have a variant in the estrogen receptor alpha gene. There also is a problem with serotonin precursor levels that is affected by varying levels of the sex hormone in the luteal phase of the menstrual cycle.  The use of a daily journal is helpful in diagnosing PMDD: An increase in symptoms at the later part of the menstrual cycle followed by relief after menses is highly suggestive of the disorder.

Treatment Options

There are natural options for alleviating the symptoms of both PMS and PMDD.

• First, a balanced diet rich in whole grains, lean protein, good fats and cruciferous vegetables is essential for overall wellness, but it’s especially important in maintaining a healthy menstrual cycle.
• Exercise is also a great way to reduce stress and address some of the physical effects of the hormonal shifts that occur in PMS. 
• A high-potency multivitamin is an easy way to supplement a healthy diet, since most of usdon’t get all the nutrients we need from food sources.
• Other vitamins, minerals and herbal supplementshave been found to help women deal with some of the physical and emotional symptoms of PMS/PMDD. Magnesium and calcium reduce tension, cramps and fluid retention. Omega 3 fatty acids lower the production of prostaglandin 2, which is an inflammatory substance associated with fluid retention and cramps. Vitamins B6 and B3 as part of a B-complex supplement are very useful as they have a natural diuretic effect. They can also ease cramps and aid in the formation of neurotransmitters, which affect mood and brain function.
• Borage seed oil, evening primrose oil and chasteberry are herbal supplements commonly used to help alleviate symptoms of PMS and PMDD.
• Avoidance of alcohol and caffeine may also help alleviate symptoms. 

Traditional medicine includes therapies such as antidepressants, which can increase serotonin levels since these levels are generally low in women suffering from PMS/PMDD. A 28-day saliva test is an important diagnostic tool because it can help pinpoint at what portion of the menstrual cycle estrogen or progesterone levels are low. Once that’s determined,then treatment with bio-identical hormones can be added to alleviate the symptoms of PMS or PMDD.

For more information, consult with Dr. Paul Dell'Aquila of the Preventative and Restorative Center of New Jersey in Nutley, NJ. PRCNJ.com