What is PMS?
Premenstrual syndrome (PMS) is a broad term that includes a diverse range of symptoms. Cyclical in nature, it tends to occur during the last 7-10 days of the menstruation cycle (your period = day one) and usually disappears before or during early menstruation.
Even if not all the symptoms are experienced, it can hugely affect wellbeing, leaving women dreading ‘that time of the month’ and making it hugely challenging to be at work and maintaining a harmonious home life.
Common emotional experiences include:
- Mood swings
- Brain fog
Common physical and behavioural experiences include:
- Breast tenderness
- Swollen ankles or fingers
- Increased appetite/cravings
- Acne breakouts
PMDD is a form of very severe PMS, recognised as a mental health disorder. If you are experiencing severe or debilitating PMS (PMDD) your GP can help.
Why does PMS cause me to experience mood swings?
The symptoms of PMS start following ovulation (which happens mid-cycle) and increase in conjunction with the rise in progesterone during the luteal phase of a woman’s cycle (the stage after egg release but before your period starts).
There is still scientific discussion as to the exact reason why PMS occurs, however, it is widely thought that the fluctuations in the hormones, oestrogen and progesterone, cause body wide changes. These include affecting neurotransmitter levels, hence the occurrence of mood swings, and other emotional symptoms in PMS
However, hormone levels appear to be the same in women experiencing PMS and those who do not, and it is more likely that increased sensitivity to hormone fluctuations in some women is a driver of PMS. Moreover, PMS tends to run in families, and it is therefore thought there is a genetic predisposition to the symptoms.
The relationship between hormones & neurotransmitters
The relationship between hormones and neurotransmitters is significant which is why I often recommend hormone testing for people experiencing mood disorders.
The main players during PMS are:
Oestrogen & Serotonin
The hormone oestrogen rises during the middle of the luteal phase to prepare for possible pregnancy, before falling during the days before your period.
Oestrogen also plays a strong regulatory role in the level of the neurotransmitter serotonin, the neurotransmitter associated with calm and contentedness (and is often the target of anti-depressants), helping to explain symptoms of depression, anxiety & mood swings during PMS.
Studies have shown that women who experience PMS have lower levels of serotonin during the luteal phase and it has been suggested that these women are also more sensitive to the effects of oestrogen on serotonin levels.
Low serotonin has also been associated with cravings too, possibly explaining the frequent need for chocolate during this part of their cycle!
Progesterone & GABA
Released by the ovaries, progesterone is a hormone involved in the preparation of a possible pregnancy and its levels rise and fall during the luteal phase.
Progesterone is also involved in the production of GABA a neurotransmitter associated with tranquillity and calm mood. It has been suggested that as levels of progesterone fall in the days leading to a period, GABA is also lower, explaining the anxiety and mood swings some women experience at this time.
GABA is also involved in sleep regulation, which may also explain why insomnia can also be a problem for women experiencing PMS. You can read more about GABA in my previous blog.
Strategies to help PMS & mood swings
Trying to eat well throughout the month is a good strategy to help with PMS, rather than focusing on when you are experiencing symptoms. Here are some of my suggestions to set you up for success:
- Protein – eating adequate, lean protein such as chicken, fish, beans, nuts, and lentils, helps provide the substrates, such as amino acids, vitamins and minerals, required to successfully produce hormones and neurotransmitters. Try to eat a portion of protein with each meal.
- Regular Meals (don’t skip breakfast!) – the body loves cycles and rhythms. Skipping breakfast or eating irregularly can have an impact on blood sugar levels, which can cause mood swings. You can read more about blood sugar balance here.
- Wholegrains – wholegrains such as oats, brown rice, whole grain pasta, rye bread, buckwheat & quinoa are an important addition to a diet to combat PMS. These types of foods possess numerous benefits, including proving fibre (which helps excrete excess hormones from the body) and promoting better blood sugar control, therefore helping to reduce mood swings. Aim to eat a portion of wholegrain with every meal.
- Keep salt intake down – a high intake of salt increases the urinary excretion of magnesium, potentiating magnesium deficiency. Magnesium, often called ‘Nature’s Tranquiliser’ has calming and relaxing effects, low levels being implicated in PMS and anxiety. It is recommended that adult salt intake should not exceed 6g a day.
- Omega 3 fats – omega 3 fats are known as healthy fats and are found in oily fish, such as salmon, mackerel, sardines, and flaxseeds, walnuts and chia seeds. They have been demonstrated to alleviate both the emotional and physical symptoms of PMS. This might be because they can regulate inflammation (associated with PMS) and have been shown to reduce anxiety, reducing the potential for mood swings.
- Calcium – calcium has been shown to reduce the mood symptoms associated with PMS and it has also been noted that women experiencing PMS could be deficient in this mineral. This might be because ovarian hormones such as oestrogen & progesterone can interfere with calcium levels. For optimum hormone balance, it is best not to consume too much dairy. Calcium can also be sourced from tofu, small fish with bones, spinach, broccoli, almonds, chickpeas & kale.
- Move your body – regular exercise has been shown to reduce the emotional and physical symptoms of PMS and researchers have stated that women who exercise regularly do not have PMS as often as sedentary women. Aim to move your body for 30 minutes a day, every day. It doesn’t have to be a vigorous exercise to have a positive effect!
Finally, don’t forget to get 7-9 hours of quality sleep a night (check out my REST blog for tips on this) and drink 2 litres of water every day (check out my free guide: 8 Powerful and Simple New Habits to Boost your Happiness) for more tips on achieving this.
I hope that helps!