Nutrition Almanac Online Understanding Nutrition

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Evil monster, mopey miss or bloated baby? Premenstrual syndrome affects women in different ways. Below is advice on how to best care for the body and mind whilst weathering the storm.

Why do some women get away with having no PMS while others endure anything from mild bloating and anxiety, to a Dr Jekyll and Mr Hyde personality? What type of PMS do you experience? Read on and see if you can recognise these symptoms in yourself, your friends and female family members.

Premenstrual syndrome (PMS) is something many women suffer. It can include a vast array of symptoms. Some women are lucky enough not to suffer with any PMS symptoms. This group may question its actual existence at all. Others presume that it is just a normal part of being a woman.

PMS is thought to affect around 30-40 % of menstruating women

The symptoms occur 7-14 days prior to having a period

Typically symptoms are worse as we head into our 30s and 40s as our hormones are starting to change

Stress can make your PMS much worse – so relax, relax, relax!

The most common hormonal imbalance is a high oestrogen level relative to progesterone

As a naturopath I feel there is a point at which PMS needs to be addressed. For some, this is the point at which the symptoms are interfering with a woman’s wellbeing and daily life.

For example, having the blues or fatigue are clearly going to have an impact on one’s life. For other women PMS may be severe cramps or sore breasts. These symptoms can be debilitating in some cases, and for others they are merely annoying. Each individual needs to assess their own situation and decide whether to make changes that improve their symptoms.

Exercising and avoiding bad lifestyle habits (such as caffeine, alcohol, excess sugar, smoking)

Increasing the intake of fresh fruits and vegetables, and fibre will help with the body’s natural elimination process via the bowel and inhibit the re-absorption of hormonal metabolites.

A well balanced diet will help support a healthy body. This includes fresh fruits and vegetables, whole grains breads and cereals, nuts and seeds, lean red meat, lean chicken and fish, lentils, pulses, low fat dairy and filtered water.

According to Dr. Guy Abraham, M.D., a research gynaecologist and endocrinologist, PMS can be classified into one of four types according to your symptoms. This can help you identify the best way to treat your personal “type” of PMS. The four types of PMS are:

These women suffer from mild anxiety, irritability and emotional behaviour . PMS-A is thought to be due to a hormonal imbalance; oestrogen levels are high and progesterone levels are insufficient . This hormonal imbalance is very common and is best addressed by encouraging the body to produce more progesterone.

The herb Vitex agnus-castus (otherwise known as chaste tree) is one of the main herbs used to regulate the menstrual cycle, especially where there is a deficiency in progesterone . Typically it is used from the first day of the menstrual cycle up until ovulation which falls around day 14 (in a 28-day cycle).

B vitamins are often a good idea as they play a role in the metabolism of oestrogen, as does magnesium. As the liver is where our hormones are metabolised another recommendation is to take the herb St Mary’s thistle (often called milk thistle) as it aids normal liver function and has traditionally been used as a liver tonic.

And who’d have thought your mum was right – eat your brussel sprouts, girls! Foods such as brussel sprouts, broccoli, cabbage and cauliflower help with the metabolism and excretion of oestrogen.

These women suffer with symptoms such as increased hunger, sugar cravings, headaches, fatigue, heart pounding, dizziness or fainting. They tend to have an abnormal blood sugar level response in the five to ten days prior to menstruation. They need to be careful with their diet, avoiding as much processed food, sugar and alcohol as possible, particularly during the last two weeks of their cycle which is the time PMS occurs. Nutrients that are specific for this type of PMS include:

Chromium helps to improve glucose tolerance. Foods high in chromium include brewer’s yeast, wholegrain breads and cereals, cheese, eggs, bananas, spinach, mushrooms and broccoli.

B vitamins are important for the metabolism of carbohydrates (vitamin B1 & vitamin B12), regulation of blood sugar levels (vitamin B3). Foods rich in B vitamins include whole grains, brewer’s yeast, eggs and wheat germ.

The major symptoms of this type of PMS include weight gain, fluid retention in the extremities, breast tenderness and abdominal bloating.

Again the herb Vitex agnus-castus can be used to address fluid retention and breast soreness.

Avoid eating excess salt as it contributes to fluid retention. It is also important to consume enough potassium. Potassium-rich foods include bananas and fresh fruits and vegetables.

Vitamin B6 may be useful in this type of PMS as it may relieve breast tenderness and fluid retention. This important vitamin may also help with mood changes, irritability and fatigue associated with premenstrual syndrome.

These women may experience symptoms such as forgetfulness, crying, confusion and insomnia. This is considered the least common type of PMS and may be related to an increase in breakdown of neurotransmitters in the brain in response to decreased oestrogen levels. The herb St John’s wort may be useful in this category of PMS as it helps with low mood and feelings of sadness and/or tearfulness.

Essential fatty acids such as those found in fish oil and evening primrose oil are important for our bodies. In particular evening primrose oil is a rich source of gamma-linolenic acid (GLA). Low levels of GLA have been found in women with premenstrual syndrome (PMS).

It is often worthwhile consulting with a healthcare professional such as a naturopath who can guide you in choosing the most appropriate alternative therapies for your situation.

Mild anxiety, irritability and emotional behaviour

Carbohydrate craving, sugar craving, fatigue, headaches

Fluid retention, breast tenderness and congestion, abdominal bloating

• Bad fats – takeaway foods, margarine, processed foods, fried foods and animal fats.

• Sugar – lollies, cakes, chocolates ( a little good quality dark chocolate is okay!)

• Refined white flour products (choose whole grain products instead)

1. Murray M. etal. Encyclopedia of Natural Medicine, 2nd Edition, Prima Health, USA, 1998, 732 2. Mills S. etal. Principles and Practice of Phytotherapy, Churchill Livingstone, London, 2000; 328 3. Trickey R. Women, Hormones and the Menstrual Cycle, Allen & Unwin, Australia, 2003; 453 4. Skidmore Roth L. Mosby’s Handbook of Herbs & Natural Supplements, Mosby, USA, 2001; 225 5. Braun L etal. Herbs & natural Supplements, An Evidence-Based Guide, 2nd Edition, Churchill Livingstone, Australia, 2007, p232 6. Kirschmann G. etal. Nutrition Almanac, Fourth edition, McGraw-Hill, New York, 1996; 382,384

Tony Uechtritz is the General Manager of online vitamin provider VitaminMe.

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