P.M.S. : What Your Doctor May Not Have Told You

The following is a reproduction of a Millennium Health Centre editorial article which appeared in the Seaway News newspaper in Cornwall, Ontario, Canada. The content is shortened to accommodate a newspaper space allotment. As such, it is not academically cited with references. These are available, so please feel free to email your questions.


Dr. Stephen F. Jones B.Comm., N.D.
Doctor of Naturopathic Medicine

A common concern brought to my office is the often troubling symptoms of 'Premenstrual Syndrome' or P.M.S. This condition can be quite debilitating, but women often tell me that they have been labeled as lazy, hypochondriacs, poor workers or even emotionally disturbed by friends, family, employers and, yes, even by their doctors. There is a reason for this and that is that most people and many doctors are not well educated as to the signs, symptoms, treatments and actual impact this very real condition can have for its victims. This article is intended to shed some light on this misunderstood condition.

First, allow me to say that P.M.S. is very real and not the product of a woman's imagination. In fact, it has been estimated that as much as 60 % of women suffer from symptoms of P.M.S. In the medical journal ' Journal of Reproductive Medicine' (Vol.28, no 8, Aug., 1983, pg.509-15), more than 100 clinical symptoms were reported to have been associated with P.M.S. These include emotional change, abdominal cramps and bloating, acne, anxiety, fatigue, headaches, salt cravings, and more. These symptoms gradually begin to appear about 1 -2 weeks before the beginning of the menstrual flow. On occasion, the symptoms come on with ovulation, disappear for a week and return the week before the menstrual flow.

So if these symptoms are real, why are women often ignored when they complain of P.M.S. Part of the answer comes from the actual lack of awareness of what P.M.S. is on the part of both the general public and those in the health care field. It was not until the magazine Family Circle published an article on P.M.S. in 1982 that the condition became popularized. Many doctors in practice at this time we're not prepared for patients complaining of P.M.S., as their training had not explored this condition in detail. Simply put, many did not know what P.M.S. was. That has not changed much 20 years later. The condition is actually the result of a complex set of factors, yet the common treatment is to simply prescribe a standardized dosage of the Birth Control Pill. The theory is that a 'hormone imbalance' must be the cause and the 'pill' will correct this imbalance. Unfortunately, the pill is often prescribed without doing a proper hormone assessment via blood, or ideally, saliva testing.

So what is known to contribute to P.M.S. ? Well, hormones certainly play a crucial role. Relatively high levels of estrogen and / or relatively low levels of progesterone are key considerations to be assessed. Ask if your doctors has assessed these. Blood test for estradiol, progesterone, and hormones called LH and FSH are basic starting points. More applicable testing is an examination of these hormones from saliva, as this represents the hormones which are 'biologically active' in the body.

Next, look at your diet ! High consumption of dairy has been clinically shown to worsen P.M.S. (Journ Reproduc Med vol. 83, 1982, pp.527-31), Likewise, high consumptions of caffeine in the form of coffee, soft drinks and chocolate have also been clinically demonstrated to worsen P.M.S. (Amer Journ Pub Health vol.75, no.11, 1985, pp.1335-37).

Consider the role of something called 'prostaglandin F2'. The Standard American Diet (high fat, high protein and low in fruits and vegetables) causes an increase in this prostaglandin which in turn causes worsened uterine cramps. As far back as 1943 we learned that a diet high in fruits and vegetables, low in red meat and low in saturated fat (fried food, dairy etc.) reduced the severity of painful uterine cramps experienced with P.M.S. ( Journ of Clin Endocrin and Metab vol.3, pp.227-34).

So, what can you do to lessen or eliminate your P.M.S. ? Consider some basic Naturopathic medical treatments. These include: 1) loose some weight - excess body fat causes increased estrogen 2) Work with a licensed physicians familiar with clinical nutrition to structure an appropriate diet which will assist in reducing estrogen and the previously mentioned prostaglandins 3) eliminate all refined sugar, refined flour, caffeine, dairy and wheat 4) make sure you have at least 1 bowel movement per day - estrogen can build up in the intestines if its not excreted and this can aggravate P.M.S. Work with a physician to accomplish this without laxatives ! 5) use a good multivitamin which your physician recommends 6) consider acupuncture - this has much evidence to support its ability to reduce the symptoms of P.M.S. 7) use key botanical medicines from a licensed physician such as those at Millennium Health Centre - some good examples include Viburnum opulus and Vitex agnus-castus 8) consider proper hormone testing - ask your doctor if this has been done and why not if it has not been 9) determine the type of P.M.S. ! There are actually 4 classifications of P.M.S. (which is beyond the scope of this article ) as each type has different treatments.

P.M.S. is complicated and you should insist on having a thorough assessment. Birth control pills and anti-depressants are not cures and they carry a negative implication. As always, learn the facts so that you can ensure your health is being taken and treated seriously. Stop by Millennium Health Centre for any information you require. Good Luck.