Premenstrual Syndrome

Another topic that I get asked a lot about is premenstrual syndrome–that complex of symptoms that includes water retention,  moodiness or irritability,  weight gain,   breast tenderness and bloating.   To qualify for premenstrual syndrome,  this does have to occur prior to the period–up to 2 weeks before the period.   The severity of symptoms can vary from person to person–some that are very miserable for 7 to 10 days prior to the menses, and others notice minor changes for just a couple of days.    I have found that in some people, these symptoms occur and a young age, and in others,  the symptoms do not begin  until they are done having children and are in their late 30′s or 40′s.

There are several theories as to what causes prementrual syndrome  (PMS).   One theory involves the function  of the kidney such that there is a change in the ability of the kidney to eliminate the excess water and so this contributes to the water retention.   Another theory  involves  a depletion of certain neurotransmitters   in the brain so that this contributes to the moodiness and irritability and problems with anger management.    The third theory  involves an imbalance between estrogen and progesterone such that there is estrogen dominance and less progesterone production.  This theory actually encompasses what happens with the other 2 because when there is excess estrogen it contributes to water retention and it contributes to changes in metabolism of the neurotransmitters in the brain.   With replacement of the progesterone these  symptoms frequently resolve.  Progesterone has diuretic effects,   anti-depressive/calming effects,  and  then would balance the estrogen.    Natural progesterone,  20 mg in topical form  is easily used on days 12  to 26.

Now before recommending any form of  “medical therapy”,  I usually counsel my patients to start making a few changes in their life–this is after documenting some sort of cyclicity to the symptoms.  The  first change that I recommend is to avoid processed sugar and the high glycemic index carbohydrates such as white bread,  white rice,  white potatoes, and sugar,  also eliminate artificial sweeteners, flavorings and colors.    Plus it is important to get plenty of rest   (so go to bed a little earlier and get up a little later ).  reduce the  amount  of  caffeine in the diet as well and start a regular exercise program.    These measures help with eliminating and dealing with daily stressors,  which then decreases the severity of the PMS   symptoms.      Now for someone who tries this consistently for several months    and still does not notice any improvement,  then natural progesterone would be the first line of therapy in my opinion.   If is far safer than starting antidepressants or diuretics which may have potential side effects.  You can get natural progesterone from my web site:

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