So I sat down this past weekend to write blog post on PMS…. totes caus.
I thought I knew about PMS… thought. Days later… after pouring over all of the literature… My conclusion is as follows:
We don’t exactly know for sure what causes PMS and we don’t fully understand the pathology behind the symptoms. However, there are some valid hypotheses and things we can do as women to regulate our natural hormonal cycle and mitigate PMS symptoms. Today, I want to discuss the pathology of PMS as we know it. As women, I think this knowledge is empowering. Having an understanding of our hormones allows us to be in tune with our bodies and live more instinctually and be more purposeful in our journeys to wellness.
First, there seems to be differing opinions on what actually qualifies as PMS and what does not- is it emotional and physical? Or just emotional? Different areas of research say different things, but today and for my purposes, I am referring to the emotional symptoms only.
These symptoms include moodiness, irritability, weepiness, depression, anxiety and everything in between. The defining factor is that these symptoms cease when menstruation starts.
PMS affects many women during the luteal phase of our cycle- the time between ovulation and menses. PMS is thought to be a result of the changes in our sex hormones during this time. However, that is not the whole story. These hormones effect our mood by impacting our neurotransmitters- particularly serotonin and GABA.
There are some very real hormonal changes that occur post ovulation. Estrogen and progesterone levels take a sharp plummet before rising and dropping again pre-menses. Yep—they are all over the place! Progesterone is the dominant hormone over estrogen during this time. (The opposite is true in the follicular phase – prior to ovulation).
The decline in progesterone post ovulation is hypothesized to be a major culprit for PMS symptoms. You may have trouble sleeping or have decreased stress resilience. Promoting production of progesterone naturally during this time is helpful for many women. Progesterone, the sister hormone to estrogen, has calming, sedative qualities. You can see why its decline could cause some unpleasant symptoms!
Estrogen dominance may also play a role. When estrogen is high in relation to progesterone during the luteal phase, you may have aggravated PMS symptoms.
However, both of these theories fall short to explain the full picture when the research shows that women with and without PMS have comparable amounts of hormones during this time. Therefore, cyclic changes in the sex hormones can NOT be the whole story behind PMS… can they?! So what gives? Why do some women get PMS symptoms, and some do not?
The answer resides in our brain chemistry! It is hypothesized that women with PMS have an abnormal neurotransmitters responses to the hormonal changes. There is evidence that these cyclic fluctuations in estrogen and progesterone can cause changes in the GABA and serotonin systems.
Both serotonin and GABA are inhibitory neurotransmitters that are needed for a stable, sane mood, and can be affected by the hormonal changes post ovulation. Research shows that PMS women have lower serotonin levels than women without PMS. SSIRs and other medications that work by increases serotonin have been highly effective in treating PMS. (I’m not recommending them… just saying.)
Serotonin is needed to make you feel calm and give you feelings of significance and importance. It is also needed to control your circadian rhythm, curb your carb cravings, and regulate your digestion. If your serotonin is low, you will become depressed. Estrogen is needed for regulation of serotonin in the brain. It increases serotonin receptor levels, sensitivity, and production. Thus, the drop in estrogen levels post ovulation can play a role in PMS symptoms. However, like I said, estrogen dominance can also contribute to PMS symptoms by influencing the serotonin systems and reduce progesterone’s calming abilities. So its all about finding that happy middle spot.
GABA is crucial for promoting relaxation, our ability to focus, and control stress. Progesterone and its metabolites enhance GABA receptor function and create a calm, mood stabilizing affect. This could be why women low or deficient in progesterone during this time may be particularly susceptible to PMS.
As far as vitamins and minerals are concerned, the most researched based to be beneficial were magnesium and vitamin B6. Studies show that these were both low in women with PMS and supplementation is effective to reduce symptoms in some women.
In conclusion, low progesterone and high estrogen are theorized to be the main culprits of PMS due to their effects on the serotonin and GABA systems in some women. Of course, hormonal testing can give you a better idea of your particular case, but diet, lifestyle and targeted supplementation can set us up on the road to hormonal success!
Stay tuned for next week, friends!
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