In a survey of over 45,000 menstruating women in the UK, 63% women reported often suffering with PMS, severely affecting the quality of life in up to 10%. Causes of PMS are multifactorial but have often been linked to an imbalance of oestrogen and progesterone, more specifically oestrogen dominance. The amino acid methionine, found in meat, fish, beans, eggs and onions may help facilitate the removal of excess oestrogen via the liver.
Recent studies have also looked at alterations in brain chemistry and neurotransmitter levels in PMS sufferers, particularly serotonin. Low levels of this important neurotransmitter are associated with PMS symptoms hence the approach by timing carbohydrate intake to help mitigate the typical ‘craving’ symptoms. The supplement 5-hydroxytryptophan (5-HTP), a precursor to serotonin, may also help provide support in cases of mood swings, carbohydrate cravings and irritability. Other nutrients associated with influencing serotonin levels include omega-3 fatty acids and vitamin B6.
Dietary intervention may be a key factor as a survey of 39 women with PMS and 14 without, reported that women with PMS consumed 5 times more dairy foods and 3 times more refined sugar than those without. A low glycaemic, Mediterranean style diet focused on fibre, whole grains, fruit and vegetables, nuts and seeds, and oily fish has been suggested as an approach to help reduce PMS symptoms. Limiting sugar, refined carbohydrates and caffeine also appear to be of benefit partly through improved insulin sensitivity and reduced neuroendocrine disruption. Additionally, essential fatty acids such as gamma-linolenic acid may improve symptoms of low mood and irritability in some individuals. However, recent data suggest that omega-3 fatty acids may also reduce common mood related symptoms of PMS including depression, nervousness, anxiety and lack of concentration. They may also reduce the somatic symptoms of PMS including bloating, headache and breast tenderness. A balanced ratio of n3:n6 would appear to be an important factor in maintaining endocrine and reproductive homeostasis.
Blood levels of magnesium have shown to be significantly lower in PMS sufferers. Results from a 2012 study suggested that a combination of magnesium with vitamin B6, may be more beneficial than magnesium alone, in helping decrease the intensity of PMS symptoms.
Incorporating regular exercise into daily life and finding ‘me time’ to relax is often recommended as a method to help dispel stress hormones from the body. Some practitioners suggest being mindful of over exposure to a range of substances known as ‘xeno-oestrogens’, which act as hormone disruptors. They are largely man-made chemicals found in the pesticides sprayed on our food, plastics and detergents.