What you need to know about PMS
The cause, the science, how it affects you and what you can do about it.
For 90% of the women, they started to experience premenstrual syndromes (PMS) like bloating, moodiness, headache one or two weeks before the period starts, and it became worse through age. For some people, these syndromes could be bearable, but for others, these could be severely interfering their daily routine. Women are most likely to experience PMS in our 30s, however, it is possible to relieve the syndrome through diet and lifestyle changes.
What is the cause of PMS?
To understand how it works, first we need to know about two female hormones: estrogen and progesterone. Estrogen is responsible for female physical features and reproduction. It brings out the physical changes that turn a girl into a woman - growth of breast and hip, pubic and underarm hair, and most importantly, starts of menstrual cycle. Estrogen also increases serotonin (a happy chemical) in the brain, which helps women adjust our mood, sleep and appetite. Progesterone, on the other hand, prepares women's body for conception, pregnancy and regulates the menstrual cycle, it also plays a role in sexual desire. Changes in progesterone levels can alter one's mood and sense of well-being because the metabolite of progesterone is a GABA-A (gamma-Aminobutyric acid) receptor agonist. GABA-A is the main neurotransmitter that plays a role in promoting calmness, good mood, and sleep, and the GABA function increases when progesterone level rises.
The exact cause of PMS is unknown, however, the current science shows that changes in hormone levels play a big role. Briefly saying - PMS could be the result of bad coordination of these hormone and brain chemicals. Our estrogen and progesterone peaks and troughs throughout the menstrual cycle, which influences serotonin and GABA that affect our behaviour, emotions, and thoughts.
How hormone level changes in different phases throughout the menstrual cycle?
On average, the menstrual cycle is about 28 days, but not everyone is the same, a healthy range is about 25 - 35 days. There are follicular phase, ovulation phase and luteal phase during the menstrual cycle. From day 1 to day 14 is the follicular phase which follicles in the ovary will mature and it ends with ovulation, you could see this phase as the first-half of the cycle. The ovulation phase can be different for women, but typically is from day 15 to day 18. This is the phase that a mature egg is released from the ovarian follicles into the oviduct. And after the ovulation to we bleed, is the luteal phase and this ends as we start to bleed, we could see this phase as the second-half of the cycle.
We can see our period as a body natural detox or a reset. During the follicular phase, our estrogen starts to rise, which increases the serotonin and modifies the production of endorphins in the brain. Those are the chemicals that are responsible for our happiness, make us feel important, soothe the anxiety, also diminish our perception of pain. After the ovulation, our body prepares for a possible pregnancy, therefore the progesterone is produced, peaks and then drops when the pregnancy fails, which initiates the period; as the progesterone decreases, it also affects the GABA function. GABA's job is to produce relaxation, analgesia and sleep. Poor GABA function may allow for increased excitatory neurotransmitter activity, which often results in poor sleep, anxiety, and other mood concerns.
Other symptoms such as bloating, cramping, or stomach pain are also related to other hormonal changes. Recent research suggests that the bloating may be related to progesterone inhibiting aldosterone (a hormone in the kidney) that leads to water retention. Cramping is most likely caused by an excessive amount of prostaglandins (a hormone-like compound that are released from the uterine lining as it prepares to be shed) - it helps the uterus contract and relax, so our endometrium can detach and flow out of our body. However, when they are excessive, they will cause pain when the uterus contracts strongly. The rest of symptoms and pains could be due to bad diet that leads to chronic inflammation, alcohol consumption, lack/too much of exercise, and stress. Additionally, brain and mood changes may increase the sensitivity to those symptoms.
How hormone level changes affect the skin and appetite?
A number of studies have shown that estrogen has many important beneficial and protective roles in skin physiology. It is associated with increased collagen production, skin thickness, skin hydration, wound healing, and improved barrier function. Nevertheless, during the luteal phase, there is not enough estrogen to promote its “anti-sebum” effects. Sebum is an oily substance secrets by the skin and influenced by our sex hormone, such as androgen, therefore cause more pores to be clogged and breakouts to occur. Other theories suggest that hormonal acne might be caused by a deficiency or imbalance of progesterone to estrogen ratios. However, more research is needed.
Evidence also shows that estrogen inhibits food intake by exerts major effects on leptin production (a hormone that inhibits hunger), whereas progesterone and testosterone may stimulate appetite. Most women experience raising appetite during the luteal phase, right before the period. Some women are more likely to reach comfort foods that are high in sugar, salt, fat and calories to make them feel better due to hormone and brain changes, which causes weight gain, inflammation, and bloating.
What can we do about it?
Now we know the cause, science, and how our hormones affect us, time to rethink our diet and lifestyle changes to relieve the syndromes.
Here are some little tips you can easily track and do:
Start tracking your menstrual cycle, make sure it is regular. If it is not, you might have hormone imbalance.
Give yourself the most nutritious food during the follicular phase when your body has the best absorption.
Don't over exercise during the luteal phase.
Be aware of your caffeine and alcohol during the luteal phase.
If you have a weight loss goal, now you know your body and mind is tricking you during the luteal phase!
Get enough sleep at the right time. Try to go to sleep before 23:00 when your body cells are repairing themselves.
Avoid food that causes inflammation, such as process food, trans fat etc.
During the luteal phase, give yourself food that supply you Iron, Magnesium, Calcium, Omega-3. Vitamin B-6, B-12, Vitamin C and D.
Give yourself hot baths or lymphatic massage before your period starts to help you relax.