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Mark Hyman, MD

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Eliminate Suffering From PMS In 5 Simple Steps

Posted: 06/19/10 09:00 AM ET

"Seventy-five percent of women suffer from headaches, mood swings, bloating, and other problems that threaten their relationships, work life, and well-being." It's a statement that most of us unconsciously accept without a second thought. But it doesn't have to be this way ...

It's true that the symptoms of premenstrual syndrome (PMS), like mood swings, irritability, depression, anxiety, fluid retention, bloating, breast tenderness, sugar cravings, headaches, and sleep disturbances, affect 75 percent of women. And in 20 percent of those women, the symptoms are so severe that they need medical treatment. About eight percent have such extreme symptoms that the problem has been given a new name: premenstrual dysphoric disorder (PMDD).


But just because you're a woman doesn't mean you have to live with these symptoms. The real fact is that suffering related to menstrual cycles is unnecessary -- and not caused by bad luck, but by bad habits, environmental toxins, and stress.

Of course, the drug companies don't want you to know that! So the conventional treatments for PMS range from anti-inflammatory drugs such as Advil or Aleve to birth control pills. And then there are the big guns ...

These include prescription medications such as danazol, a drug that suppresses ovulation and causes increased facial hair, acne, and a deep voice. Newer, very expensive drugs called gonadatropin-releasing hormone (GnRH) analogs actually change brain chemistry to turn off the ovaries' production of estrogen and progesterone -- but they also lead to osteoporosis.

Sometimes, diuretics like spironolactone are used to treat fluid retention. A drug called bromocriptine can be used to stop prolactin production and is used to treat breast tenderness.
No wonder the drug companies want you to believe that PMS is inevitable. Recently, they even helped create a new disease -- PMDD -- and a new indication for a drug whose patent was running out: Prozac (now called Sarafem). What's wrong with this picture?

It's based on the assumption that the symptoms of PMS are an inevitable part of being a woman and require "medical intervention" with serious medication to correct them. Nothing could be further from the truth!

To think that 75 percent of women have a design flaw that requires medical treatment to live a normal life is just absurd.

If you are one of the many women that suffer from PMS, you can end your suffering using five simple dietary and lifestyle interventions. In today's blog I will explain how to do that. But first, I want to tell you a story.

Curing PMDD Without Medications

This is the story of a patient of mine with PMDD who was barely able to work or function in her family -- suffering three weeks out of the month. She was thirty-seven years old (many women feel worsening PMS symptoms as they get into their later reproductive years). She was severely depressed, fatigued, and anxious, and suffered severe food and sugar cravings, which led to overeating and weight gain.

She also had joint pain, breast tenderness, heavy bleeding, hot flashes, dry skin, acne, hair loss, memory problems, poor sleep, and no sex drive. She also complained of gas and bloating.

What about her diet?

Well, she didn't drink alcohol, but was a big coffee drinker. And she started the day with a bagel and cheese, ate a cafeteria lunch, snacked on chocolates in the afternoon, and had a healthy dinner but binged later on ice cream, chips, and Cheerios. She also ate a lot of dairy.

Hers is a story that I hear all too often. But the good news is that I was able to give her a simple solution that didn't involve taking medication.

We know that sugar, caffeine, alcohol, stress, and lack of exercise all contribute to worsening PMS. It is also true that dairy consumption can worsen hormonal imbalances because of all the hormones in milk.

So I had her change her diet, take a few supplements and herbs, and start exercising -- and within just one cycle, her life changed. The results were dramatic. All of her symptoms resolved, she lost weight, and dramatically increased her energy. Her mood stabilized and her acne and dry skin cleared up.

The approach I used to treat this patient is part of an approach called systems, or functional, medicine. That means that I define the imbalance (in this case, severe hormonal imbalances), address the causes (diet and lifestyle), and then help the body repair and regain balance. Once this is done, the body's natural intelligence takes care of the rest.

So what is the REAL underlying cause of PMS?

The Real Causes of PMS

Th real cause for PMS is simply this: Your hormones become unbalanced, your estrogen levels increase and progesterone levels decrease, either relatively or absolutely.

There are many things that promote these hormone imbalances, such as a high-sugar, refined carbohydrate diet, caffeine, stress, dairy, hormones in dairy products and meat, and estrogen-like toxins from pesticides and pollution. Alcohol also contributes to problems because it damages the liver and prevents it from excreting excess estrogen.

Constipation and imbalances in the gut bacteria can worsen the situation, because they lead to the reabsorption of estrogen from the gut back into your blood, even after your liver has tried to get rid of it.

Your body also needs exercise to help balance hormones. So if you aren't moving your body enough, it's likely this is part of the problem as well.

Fortunately, good research shows that there many ways to get hormones back in balance -- without drugs. Here's my plan for preventing PMS and PMDD. Even though some of my suggestions may seem severe, science shows that they work. Give them a try and you will see in just one or two cycles how much better you feel.

Five Simple Steps to Eliminate PMS

1. Clean Up Your Diet

This means:

• Stop eating refined flour, sugar, and processed foods.

• Cut out caffeine.

• Stop drinking alcohol.

• Balance your blood sugar by eating protein, such as a protein shake, eggs and nut butters, for breakfast.

• Eat evenly throughout the day and don't skip meals.

• Don't eat within three hours of bedtime.

• Cut out all dairy and consider eliminating other common allergens for a few months, especially gluten.

• Increase fiber in your diet from vegetables, fruit, nuts, seeds, beans, and whole grains. Two tablespoons of ground flax seeds a day are especially helpful in correcting constipation and balancing hormones. Put them in a shake or sprinkle them on salads or food.

• Increase omega-3 fats by eating more wild fish like sardines, herring, and wild salmon, as well as omega-3 eggs and walnuts.

• Eat organic food, especially animal products, to avoid environmental estrogens from pesticides.

2. Take Supplements

A number of supplements have been shown to help ease PMS symptoms by improving metabolic function and hormone metabolism. Here are the superstars:

• Magnesium citrate or glycinate -- Take 400 to 600 mg a day.

• Calcium citrate -- Take 600 mg a day.

• Vitamin B6 -- Take 50 to 100 mg a day along with 800 mcg of folate and 1,000 mcg of vitamin B12.

• Evening primrose oil -- Take two 500mg capsules twice a day.

• EPA/DHA (omega 3 fats) -- Take 1,000 mg once or twice a day.

• Taurine -- Take 500 mg a day to help liver detoxification.

• A good daily multivitamin (all the nutrients work together)

Herbs and phytonutrients can also be very helpful. Here are the best studied and most effective:

• Chasteberry fruit extract (Vitex Agnus-astus) can help balance the hormones released by the pituitary gland that control your overall hormone function. Studies of over 5,000 women have found it effective. Take 100 mg twice a day of a 10:1 extract.

• Wild yam (Dioscorea villosa) and cramp bark (Viburum opulus) can help regulate cycles and relieve menstrual cramps.

• Dandelion root can help with liver detoxification and works as a diuretic.

• Isoflavones from soy, red clover, or kudzu root improve estrogen detoxification by boosting the activity of specific detox enzymes. They can be taken as supplements or consumed in the diet.

• Flax seeds contain lignans that help balance hormone metabolism and block the negative effects of excess estrogens.

• Chinese herbal formulas may also help. One of the most effective is Xiao Yao San, or Rambling Powder. It contains: Bupleurum Root (Bupleurum chinense), Chinese Peony Root (Paeonia lactiflora), Dong Quai Root (Angelica sinensis), Bai-Zhu Atractylodes Root (Atractylodes macrocephala), Poria Sclerotium (Poria cocos), Ginger Rhizome (Zingiber officinale), Chinese Licorice Root (Glycyrrhiza uralensis),and Chinese Mint Leaf (Mentha haplocalyx)

• Replacing healthy bacteria in the gut also helps normalize estrogen and hormone metabolism. Take 5 to 10 billion live organisms in a daily probiotic supplement.

• For intractable cases, I will occasionally use topical, natural bioidentical progesterone in the last two weeks of the menstrual cycle. The usual dose is 1/2 tsp (20 to 40 mg) applied at night to thin skin areas for the last two weeks of the menstrual cycle.

3. Get Moving

Exercise is very important for balancing hormones. Aim for 30 minutes of aerobic exercise, four to five times a week.

4. Address Stress

Dealing with stress is also critical. Take a hot bath at night, get a massage, try yoga, learn deep breathing or meditation. These techniques and others can help balance hormones.

5. Try Alternative Therapies

Therapies such as acupuncture and homeopathy may help. One clinical trial showed that individualized homeopathy is effective in treating PMS. Five homeopathic medicines were used: Lachesis, Natrum muriaticum, Nux vomica, Pulsatilla, and Sepia.

If my patients are any indication, a plan such as this can have impressive effects on premenstrual symptoms.

Remember, women are not defective. You can thrive and be healthy by paying attention to a few natural laws of biology. You don't need drugs to survive!

Now I'd like to hear from you:

Do you suffer from PMS or have been told that you have PMDD?

If so, how you do treat these conditions?

How do your diet and lifestyle affect your premenstrual symptoms?

Please leave your thoughts by adding a comment below.

To your good health,

Mark Hyman, M.D.

Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is a pioneer in functional medicine. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.

 
 
 

Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd

"Seventy-five percent of women suffer from headaches, mood swings, bloating, and other problems that threaten their relationships, work life, and well-being." It's a statement that most of us unconsci...
"Seventy-five percent of women suffer from headaches, mood swings, bloating, and other problems that threaten their relationships, work life, and well-being." It's a statement that most of us unconsci...
 
 
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MicheleMoore-Happy1
Whistleblower and creator of the Happiness Habit
01:57 PM on 07/24/2010
Excellent article, many thanks!

How about another posting describing how women can use specific dietary regimes for female hormone replacement therapy both during the change of life and afterward in the golden years?
12:04 PM on 06/25/2010
Dr. Hyman, I absolutely think you are the best nutritional writer on the web, and I can't wait for your next posts. I just wish you were on the west coast so I could be a patient. I am a nutritionist, and your writings are so in tuned to mine, but I love learning more from you; and I wish there would be more and more doctors like you to tell their patients the truths about health and disease, and help release people from their ties to doctors from the old school.
03:40 PM on 06/21/2010
Recently my PMS symptoms started halfway through the month and this past month started only one week after my last period ended. I got my period a week later. Obviously, this is not good. Has anyone had a similar problem? In terms of diet, I eat whole grain, vegetarian, very little dairy. Last week, I cut out my morning cup of coffee and evening glass of wine. The amount of supplements are extremely intimidating. I am seeing my gyno this week, but even more freaked out at the prospect of him suggesting any of the pharmaceuticals described above. Curious to hear if anyone had this problem with their periods coming every two weeks.
01:22 AM on 07/24/2010
Yes! I think it's bleeding during ovulation. I asked my gyno about it because I was concerned about endometriosis, which I'd read could cause bleeding at odd times, but she didn't think that was the problem. I've been blaming it on having an IUD, as that most definitely can cause unusual bleeding. It doesn't happen every month, but it's *incredibly* annoying when it does happen.
03:10 PM on 06/21/2010
Not having experienced PMS, I can't say, but as a teenager I saw a correlation between mother's attitudes towards "periods" and the behavior of the daughters. It was not concerned a "big deal" in my home..my mother never mentioned "PMS," and my sister and I never had any symptoms. It would not be even considered to stay home from school those days, but I had classmates who did. I have always believed the whole idea to be overblown...cramps, yes, but personality changes...highly suspect.
From my experience, I do believe that diet can have a major effect on menopausal symptoms. Ten years ago, I began following a very low-carb, no processed food lifestyle. I can't tell you when I went through menopause, but it was sometime in the past ten years. My periods stopped. I don't know when, because I had no other symptoms. I realized after a few months that I must have gone through menopause because I realized I hadn't had a period in a long time. It was absolutely a non-event. I credit that to my good health and diet.
01:24 AM on 07/24/2010
Lucky you. Don't negate the highly unpleasant experiences of many, many other women just because it hasn't been your experience. I'd be SO HAPPY not to have this problem.
02:14 PM on 06/21/2010
I eat a healthy diet. I don't take the HUNDREDS OF DOLLARS worth of supplements this doctor recommends, but I still have PMS. Sorry doctor, but it seems to me that the general advice to eat healthier, unprocessed foods etc. is good, but are you funded by the vitamin or supplement industry? Another perfect example of being told to do a lot of things to be healthier- many of which the average person cannot afford!
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jacquelinenh
HuffPo Addict
11:08 PM on 06/29/2010
ReesieKitty- Here's another great article on solving PMS symptoms naturally from Women to Women -- like Dr. Hyman, lots of helpful tips... http://www.womentowomen.com/menstruation/understandingpmsandpmdd.aspx
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HUFFPOST COMMUNITY MODERATOR
MossyOak
12:45 PM on 06/21/2010
Progesterone cream. Simple, cheap, works.
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HUFFPOST COMMUNITY MODERATOR
helenwheels
SEDAGIVE?!?
11:44 AM on 06/21/2010
Quit white flour, gluten, coffee, alcohol, eat a ton of fresh vegetables, legumes, fruit, and lean protein and that should take care of it. I had PMS fairly bad, until I just happened to be trying this diet called 'Fat Flush" years ago. I had ZERO PMS after being on it for about a week. Simply amazing what diet wil do.
This user has chosen to opt out of the Badges program
09:36 AM on 06/21/2010
Thank goodness we've come miles from "You whiny, nervous women...it's all in your head!"

Thank you Dr. Hyman and others who seek to find relief for those of us who have suffered from the natural hormonal rythms of just being alive.
08:00 AM on 06/21/2010
Hi, I am very impressed with Dr Hymans article.I suffer from Pms.3 days of the month I have severe headches and vomiting due to PMS.I like all the vitamins and herbs and foods and homeopathic medicines that Dr Hyma recommends but unfortunately cannot afford to buy all of these.What would be your recommendation for me to take from all these?
eva
07:57 AM on 06/21/2010
It amuses me how these naturopaths promote guzzling even more substances - and I'm sorry, but just because herbs are "natural", it doesn't mean they're not drugs - than doctors do. And what's "natural" about taking up to 8 substances at once, as in the Chinese combination? You're still artificially supplementing the body constantly.

The dietary changes may help some, but certainly not all. And rather taking that cocktail of various substances all month, I think I'll just stick to my two days of Advil, thanks.
This user has chosen to opt out of the Badges program
07:57 AM on 06/21/2010
All those supplements and vitamins are not the best way to get what your body needs. Yes, magnesium and mineral salts are important, but taking them in a supplement? Why? You just need to include alaria seaweed in your diet, and other foods high in those substances. Same for the other supplements suggested-- it's better to find the organic foods that contain those necessary substances and balance your diet.

Dairy itself isn't bad, if you get it from the proper source. I get my milk, cheese and yoghurt directly from a farmer who doesn't use any hormones or antibiotics, and who does not keep pregnant cows in the milking cycle. He also grows his own feed from non-monsanto seed. I do limit my dairy intake, but I won't eliminate it entirely. I made the switch to organic farm dairy when I was having bad and heavy periods and my periods reverted almost to their prior normal level within two cycles. It's commercial dairy, with its unnatural hormone additives, antibiotic and pesticide levels, and factory milking methods that are the issue, not dairy itself.

Knowing where your food comes from helps you avoid much toxicity that causes many of these issues.

One other thing-- most supplements these days come from China. I don't trust that supplements from China are safe, do you?
01:30 PM on 06/21/2010
Guiness is also high in magnesium, and is my preferred method of increasing magnesium that time of the month :).
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blood1
06:25 AM on 06/21/2010
IMHO, it makes sense to try every and anything before submitting one's body to a constant barrage of drugs advocated by the pharmaceutical industry. As these companies don't "cure" the problem, but only alleviate the symptoms. The Catch 22 is that the environment may be so toxic that all natural approaches may take time and most women are more willing to take a pill than actually de-toxify themselves and their environment.

Sadly, much of what we eat and drink contains "toxins" that are unknown. Each attempt by the FDA and EPA to control or at least know how safe the food and environment actually is stymied by the food and drug manufacturer's. With the increased use of genetically modified food, women who have become sensitized to certain substances will suffer more and more.
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HUFFPOST SUPER USER
StoryTime
Running on plenty/Oh j'cours toute seule ,)
11:39 PM on 06/20/2010
Many years ago I stopped dairy (I'm a vegan now) and I can tell you ladies, I tell all of you who will listen and are experiencing what I used to, pain, discomfort, heavy menses etc...and once I stopped dairy all of those were gone!! I couldn't tell you how long it took, I can't remember, it's been about 10 years I have light menses, no pain, not much discomfort, it's night and day compared to what I experienced before.
Very good article thank you.
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lotusgirl
Turned off the TV and stepped out of the Matrix
07:12 PM on 06/20/2010
I found during the three years I was vegetarian, my PMS symptoms went away. My friend, who is a vegan, still had very bad PMS.

Every approach is a crap shoot, but at least this one has promising side effects (like awesome overall health). It's worth a try.
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thatpoetchick
12:33 PM on 06/20/2010
I've done all these things and it hasn't helped at all. Of course I also have PCOS which is a whole slew of problems on its own and basically makes balancing my hormones even tougher. PMS week is the only week I don't exercise because I am in almost constant physical pain. Since I was a teenager I've had debilitating PMS -- the mood swings, cramps so severe that I can't walk ... several times I've had cramps that were so bad I threw up from the pain. I changed my diet. I exercised. I've lost some weight, which is nice, but the monthly agony is still agony.
12:38 PM on 06/20/2010
Do you know the tissue salt Magnesium Phosphoricum? This helps with all cramps and pain. It could at least bring some relief in your case, if not more.
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thatpoetchick
01:39 PM on 06/20/2010
I'd be willing to give it a try.
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sprider
Born lucky
11:51 PM on 06/20/2010
If you haven't given it a go already, consider switching to all organic cotton, chlorine/chemical free pads and or tampons. It made a huge difference for my daughter after switching. It took a couple of periods before her cramping and bleeding were less, but she feels like it made a significant difference.
Hang in there
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thatpoetchick
09:03 AM on 06/21/2010
I'll see what I can find for pads -- I normally don't use tampons because they do in fact seem to make me feel worse. At this point I'm really, really looking forward to menopause.