Updated: Jul 7, 2019
When I started charting my menstrual cycles 9 years ago, one of the biggest revelations I got was that the "crazy times" that I regularly experienced was quite consistent with my premenstrual period. Further down the road to becoming a Holistic Reproductive Health practitioner another revelation appeared: that such premenstrual problems are not necessarily a natural part of being a woman - but often connected to imbalances in my diet and my lifestyle. I came to the realization that living in a female body is not necessarily a curse, and that my hormonal system is not inherently flawed - but a delicately balanced system that needs my attentive care to function optimally. Nowadays I usually do not suffer from disturbing premenstrual symptoms - and when I do, I usually know exactly what it is that is causing them.
The menstrual cycle is a mirror of our whole-body health, and how the menstrual cycle unfolds is a reflection of things that are going on elsewhere in the body. In holistic reproductive care we look at the whole woman (or other person with a uterus) - body, mind and emotions - to identify the root causes to menstrual cycle problems.
This is usually a complex and intertwined web of causes and reactions - but to simplify things and give you a taste of how PMS can appear, I will present 5 possible causes as separate possibilities in this blog (even if they in reality are much more intertwined and often occurs together).
#1: Progesterone deficiency
The menstrual cycle is governed by the two hormones estrogen and progesterone. Before ovulation, estrogen is dominant and builds up to it's peak level at ovulation. After ovulation, estrogen is supposed to go down and progesterone is supposed to rise and become the dominant hormone. Progesterone is a magical and often forgotten hormone - which works to stabilize the somewhat intense effects of estrogen, and also acts as a natural antidepressant.
If progesterone production is disturbed - or if estrogen levels are too high in relation to progesterone - it can create symptoms of premenstrual anxiety, nervous tension, and mood swings.
Progesterone deficiency is common if we are suffering from whole body health problems like for example thyroid problems or an unbalanced diet, and is also affected by all the other factors mentioned in this blog.
#2: Nutritional deficiencies
For the body to function properly, it needs to be well-nourished with a wide range of vitamins and minerals. This goes for the menstrual cycle as well. Sometimes nutritional deficiencies can be a direct cause to premenstrual problems. Two nutrients that has been shown to play an especially important role in PMS is vitamin B6 and magnesium. But in the end - any nutritional deficiency that affects the body, will also show up as symptoms in the menstrual cycle.
#3: Chronic inflammation
Many diseases, whole body health problems and menstrual cycle irregularities are associated with a situation of chronic inflammation in the body - and premenstrual problems are no exception. Recent research has shown that heightened levels of inflammation in the body is intimately connected to symptoms of PMS. Chronic inflammation can appear due to many causes, some example being; chronic infections, exposure to allergens, an inflammatory diet, and unbalanced gut health.
There we have it - the one thing we all struggle with, and the one thing that can seem so hard to do something about. It may not come as a surprise that our stress level strongly affect how we will feel in the premenstrual period, and it can sometimes feel hard to imagine how we can reduce our level of stress. But it is a fact that stress affects us much more strongly in the premenstrual period, than it does in the beginning and middle of the cycles.
Some potential strategies for lowering our levels of stress in the premenstrual period are: using menstrual cycle charting as a tool to plan our life, and free up time for self care in the two weeks after ovulation; look at our life and see whether there are any "shoulds" and "musts" that could actually be down-prioritized; creating a daily/weekly routine of self care and mindfulness practice - and keep to it just as firmly as you would keep to any other appointment; cut back (or possibly even discontinue) coffee - especially in the premenstrual period; consider working with a therapist, in order to deal with emotional stress stemming from unresolved trauma (big or small).
#5: "Premenstrual magnification"
"Heh?" - is maybe your reaction to the above headline. And I don't blame you, this is something rarely heard of. It means that the premenstrual period can function as a magnifying glass, magnifying the symptoms of a present health condition or disease. Common health conditions that can be “magnified” premenstrually is thyroid dysfunction, depression, migraine headaches, irritable bowel syndrome, chronic fatigue syndrome, and allergies. In the case of menstrual magnification, symptoms will be present the whole cycle - but worsening premenstrually. Journaling and menstrual cycle charting are great tools to asses whether our symptoms appear only premenstrually - or also in other periods of the cycle.
When speaking about PMS it is important to underline that a slight dip in our mood is natural in the premenstrual period - since estrogen and progesterone has very different effects on our mood. This slight dip may appear for some women as a slightly more inwards mood, or more need for alone-time. There are even theories suggesting that a heightened premenstrual sensitivity to things which feels wrong in our lives, is a natural evolutionary trait present in order to safeguard healthy living conditions for ourselves and our offspring. Using our menstrual cycle chart as our tool, we can plan our life to make space for these different moods - and even use them in a way that enriches our lives. But if we have symptoms that are so strong that they interfere with our ability to function in day-to-day life, it can be a good idea to see a holistic reproductive health practitioner or other functional medicine provider to get guidance in identifying the root causes to those problems.
Last but not least, always remember: the menstrual cycle is not meant to be horrible. The female body is not cursed. Our hormones are healthy and life-giving. And with the right attention and care, our menstrual cycle can become a source of great self-knowledge and empowered attendance to our whole body health.
Matus, Geraldine, et. al. (c1987-2014) Justisse College International course curriculum Unit G.
Rosenthal, M. S. (2001) Managing PMS Naturally: A Sourcebook of Natural Solutions. Prentice Hall Canada.
Pope, Alexandra (2001) The Wild Genie: The Healing Power of Menstruation. Sally Milner Publishing Pty Ltd.