PMS & PMDD

Using your period app to treat PMS

by Dr. Lara Briden
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Today we're thrilled to have a guest post from Dr. Lara Briden. A naturopathic doctor with nearly 20 years experience in women's health, she is also the author of Period Repair Manual: Natural Treatment for Better Hormones and Better Periods.

As a doctor, I love period apps. Most of my patients now know, and can tell me—to the day—when their last period came. They know when they had a headache, and when they experienced symptoms such as spotting, breast tenderness, and sugar cravings.

Those details help me to interpret what is going on with my patients' cycles. More importantly, they help me to find the right treatment. PMS is the perfect example. Far from being an inevitable part of having a period, premenstrual symptoms such as irritability can be eliminated. It's not unusual to hear my patients say: "I was surprised when my period just arrived. I didn't even feel it coming."

What is the right PMS treatment? It all depends on the pattern and underlying cause of your PMS. That's where your app comes in.

Is it really PMS?

First of all, your app can help you decipher if it really is PMS. Not every negative emotion or symptom deserves the label of PMS, even if it occurs in the second half of your cycle. Your symptoms are genuinely premenstrual if they occur during the ten days before your period, and if they occur at roughly the same time every cycle. Make a daily symptom entry into your period app: Irritability, sugar cravings, fluid retention. Is there a pattern?

Decoding Your PMS

Once you have determined that your symptoms are premenstrual, you can start to think about which hormones are involved. You can use your app to track symptoms such as spotting, breast tenderness and amount of blood flow. Those are your clues. They give you information about how much estrogen you have, and how much progesterone. They can even tell you about inflammation, which is another common cause of PMS. I ask my patients about all of those symptoms, and we consult their apps to look at the pattern. I sometimes also order blood tests to confirm hormone levels, but in most cases, the symptom clues tell the whole story (even without blood tests). Let's have a closer look.

High Estrogen PMS

Estrogen stimulates mood because it boosts serotonin and dopamine. That's generally a good thing, but too much estrogen in the second half of your cycle can cause irritability—a classic premenstrual symptom.

Is this you? If your estrogen is too high, you suffer pronounced irritability about seven days before your period. You also have breast tenderness and heavier than average bleeds.

Best treatment: Reduce alcohol because it impairs the detoxification of estrogen. Eat plenty of fruits and vegetables because plant starch feeds healthy intestinal bacteria, which play an important role in escorting estrogen out through your bowel. You can further enhance estrogen detoxification with nutritional supplements such as vitamin B6 and diindolylmethane (DIM) (a phytonutrient from broccoli).

Low Estrogen PMS

Estrogen normally dips at the end of the cycle and it can sometimes dip too low. This causes the less common low-estrogen type of PMS.

Is this you? If your estrogen is low, you suffer depression and insomnia during the three or four days before your period. You may notice other low-estrogen signs such as hot flashes, vaginal dryness and lighter than average bleeds.

Best Treatment: Maintain a healthy baseline estrogen by avoiding things that deplete estrogen such as stress, cigarettes, and excess soy products.

Low Progesterone PMS

Progesterone is supposed to be high in the second half of your cycle. Progesterone calms your nervous system because it converts to a special neurosteroid that works a bit like the neurotransmitter GABA in your brain (like a hormonal Valium).

Is this you? If your progesterone is low, you suffer anxiety throughout most of the second half of your cycle. You may experience other symptoms of low progesterone such as premenstrual spotting (light bleeding) and clots with your period.

Best Treatment: Enhance your progesterone production with the herbal medicine Vitex, which has done well in clinical trials for premenstrual syndrome [1].

Inflammatory PMS

Hormone imbalance is not the only cause of PMS. You may have normal levels of hormones yet still suffer PMS symptoms because of chronic inflammation. Chronic inflammation is a kind of long-term immune activation caused by lifestyle factors such as bad diet, stress, and smoking. Inflammation causes PMS because it impairs the health and resilience of hormone receptors, which makes you hyper-sensitive to the normal rise and fall of your hormones.

Is this you? If you have chronic inflammation, you suffer fatigue and flu-like symptoms during the second half of your cycle. You may also notice a premenstrual magnification of existing symptoms such as headaches, digestive bloating, and allergies.

Best Treatment: Avoid inflammatory foods such as concentrated sugar (desserts) and deep-fried foods. Eat more anti-inflammatory foods such as berries, spinach, and kale. You can also supplement with anti-inflammatory nutrients such as magnesium and turmeric.

Monitor Your Improvement

Your app can do one more thing for PMS treatment. It can track your improvement month by month, so that you look back to see just how far you've come. For example, your app can remind you that your breast pain used to be so bad that you could hardly bear to walk down stairs. Now, it's just a little mild tenderness the day before your period. Next month, you may not notice anything at all!

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