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Hyla Cass, M.D.

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You Don't Have to Live with PMS!

Posted: 07/16/10 09:00 AM ET

Confused about hormones? Beset by PMS or menopausal symptoms? Wondering about HRT versus herbal remedies? Dr. Cass explains what's going on in your body, and gives you healthy solutions that work.

--Uzzi Reiss MD, author of Natural Hormone Balance for Women

Our mothers once called them "women's problems." Now we know that these mood swings and physical changes, from PMS to menopause, are all part of a delicate balance among our various hormones. In my years of practicing integrative medicine, I have helped hundreds of women overcome PMS and menopausal symptoms naturally, and here's how.

Let's start by defining hormones. They are chemical messengers secreted by any one of the body's endocrine (ductless) glands. They travel through the bloodstream, telling various systems what to do. Besides reproductive functions, hormones affect virtually every body system from digestion to metabolism to hair growth.

All women have the same hormones but in varying quantities, making your own hormonal profile as unique as your fingerprint. When your hormones are in harmony, you will have predictable menstrual cycles --and moods. When out of balance, you will have irregular cycles and a host of symptoms, from bloating, cramps, weight gain and acne to food cravings, irritability and depression. Perimenopause, the transition to menopause, which can start as early as your late 30's, often causes an increase in PMS. In fact, many women report experiencing PMS for the first time at that point. Also common in peri-menopausal women, is a loss of libido, due to a dip in testosterone which governs sexual desire, and of course, those hot flashes and night sweats, which make sex the last thing on your mind!

Medical Management

For a full picture of your hormonal status, we need to check levels of estrogen, progesterone, DHEA-S and testosterone in blood, saliva, or urine, taken on day 19-21 of the cycle. For perimenopausal women, I also order FSH (follicule stimulating hormone) and LH (luteinizing hormone) blood tests to assess ovarian function. I will check cortisol levels (saliva test) and thyroid hormones (blood test), too, since they are a part of the overall hormone symphony.

You can find home testing kits online. Take these tests on days 19-21 of your cycle, with day one being the first day of your period. If you are post-menopausal, it won't matter when you take the tests. If you're irregular, do your best to estimate the appropriate date.

Hormone Therapy

If testing reveals that your hormone levels to be below the normal range, it may be due to perimenopause or other physiological factors. Faced with fluctuating hormones, doctors have traditionally prescribed synthetic hormone replacement therapy (HRT), such as Premarin (from pregnant mares' urine) and Prempro (Premarin plus synthetic progesterone), to correct imbalances. The recent Women's Health Initiative study showed that women taking this form of HRT had 27 percent more heart attacks, a higher rate of breast cancer, 38 percent more strokes and double the number of blood clots. There are safer ways to balance hormones successfully, ranging from supplements and herbs to bio-identical hormone therapy.


Natural Ways to Balance Sex Hormones

The first step to balancing your hormones is a clean diet:

• Eat fewer animal products, with lots of vegetables, including raw broccoli and other
cruciferous veggies
• Reduce or eliminate caffeine, alcohol, nicotine and sugar.
• Reduce or eliminate high-fat dairy products.
• Eliminate as much processed food as possible
• Reduce salt intake.
• Eat small, regular meals.

Yoga and meditation are helpful for PMS sufferers because they work on the nervous system to help balance hormones.

Supplements for PMS:

I give my patients magnesium (100 mg two to three times daily) and vitamin B6 (25-100 mg) to relieve irritability and tight muscles as well as premenstrual water retention.

Another important nutrient is GLA, an omega-6 fatty acid which also helps reduce the water retention, breast tenderness and moodiness associated with PMS, likely by it's action on the hormone prolactin. GLA is found in borage oil (1500 mg of borage twice daily), black currant seed or evening primrose oils.

The herb, Chasteberry (Vitus Agnus Castus), helps to balance the hormone, progesterone, relieving symptoms of PMS and heavy or irregular periods as well. Dose is 50-200 mg daily depending on symptoms. Do not take if you're pregnant.

The herb, Dong Quai, helps to balance the hormone estrogen. Like Vitex, the dose is 50-200 mg daily depending on symptoms and also do not take if you're pregnant.

Another useful nutrient is the amino acid, 5-HTP (5-hydroxytryptophan) 500-200 mg daily, depending on your individual needs. It helps to raise levels of the feel-good and calming brain chemical, serotonin, which is often low in PMS sufferers.

These nutrients plus wild yam a source of natural hormone production, can all be found in the formulation, PMS Balance. I have had many women report almost immediate relief upon taking this or a similar formula. Others may take a month or two to feel the full effects.

With menopausal symptoms, I may also add black cohosh and red clover extract. While there was a recent study that claimed that black cohosh didn't work, it was in fact, flawed, and contradicted numerous well-done studies that found it to be very effective. I have also discovered a remarkable new product called FemmePhase. Even the majority of my hard-core hot flashers have found relief with it.


Bio-identical Hormones

When the nutrients aren't quite doing the job, you can add over-the-counter natural progesterone cream (up to 30 mg daily) for one week prior to your period. This is a maximum of 3 percent progesterone, or 30 mg per 1 gram dose.

I may also prescribe higher dose bio-identical hormones for my patients. The progesterone is often 10 percent, which is three times as strong as the over-the counter dose. Made from highly purified derivatives of soy and wild yams, these formulas are carbon copies of your own natural hormones. Prescription strength bio-identical hormones are available only from compounding pharmacies, and are prescribed by your doctor. Doses are based on your individual hormonal needs as determined by your lab tests.

As I say repeatedly - "you don't have to live with PMS/peri-menopausal symptoms." This applies to both the woman herself and her long-suffering loved ones. This information should help you take care of most cases of PMS and peri-menopausal symptoms. I have many grateful women, and their partners, for whom PMS has truly become a thing of the past.

For more details, please see 8 Weeks to Vibrant Health

 
 
 

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Confused about hormones? Beset by PMS or menopausal symptoms? Wondering about HRT versus herbal remedies? Dr. Cass explains what's going on in your body, and gives you healthy solutions that work. ...
Confused about hormones? Beset by PMS or menopausal symptoms? Wondering about HRT versus herbal remedies? Dr. Cass explains what's going on in your body, and gives you healthy solutions that work. ...
 
 
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11:59 AM on 07/25/2010
Natural Remedies for thyroid is the Thyroid Solution to your thyroid disorder problem since the conventional medication is expensive and has side effects and weighs heavily on your wallet.
Why not try different types of diet which will solve your thyroid disorder problem. Would not you be fascinated by that idea?
http://www.natural-remedies-for-thyroid.com
01:59 PM on 07/20/2010
There are a whole lot of fabulous tips...I must try the more natural alternatives for my severe cramping and pain.
12:03 PM on 07/20/2010
I just recently read an article about sage and its benefits. I read how it can the relief of cramps and symptoms of PMS. Sage also has some other great benefits, if interested, you can read the full article: http://www.marksdailyapple.com/this-weeks-herbalicious-sage/
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meirelle
geek girl
10:17 PM on 07/18/2010
I take Calcium, Magnesium, and Vitamin D for PMS, and it works like a charm.
06:09 PM on 07/17/2010
Seriously. There are so many hormones and antibiotics (and pesticides) in those products that the accumulation,
http://health-actuary.blogspot.com
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12:07 AM on 07/17/2010
You Don't Have to Live with PMS!

That's right--you can move out anytime! Badda bing! ;-)
11:27 PM on 07/16/2010
Have a few beers and ride a bone. Problem solved for all concerned.
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10:54 PM on 07/16/2010
I love my wife, therefore the title of this article is wrong.
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12:08 AM on 07/17/2010
I got it, even if no one else did!
10:47 PM on 07/16/2010
No, you don't. Just stop eating meat and dairy and it will go away. Seriously. There are so many hormones and antibiotics (and pesticides) in those products that the accumulation, over time, will cause massive PMS problems. Just go vegan. It will change your life.

http://www.youtube.com/watch?v=YvEH7W_w1NA

http://vegansofcolor.wordpress.com/

http://www.youtube.com/watch?v=RIO4sJA0EAo
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laaambchop
Cheerfulness is a sign of wisdom
07:40 PM on 07/16/2010
"You Don't Have to Live with PMS"

but your spouse does!
07:32 PM on 07/16/2010
Shame on all you men for mocking what is a stressful and difficult time for women!


Be more sensitive.....like me, a modern understanding man.
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HUFFPOST SUPER USER
malzor
10:17 PM on 07/16/2010
It is pretty obvious chicks have to put up with a lot that dudes don't...
03:06 PM on 07/17/2010
***It is pretty obvious chicks have to put up with a lot that dudes don't...***

Indeed

It's great being male!

Woo hoo!
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07:22 PM on 07/16/2010
From the male perspective, I think Beethoven summed it up best when he wrote the 9th Symphony:

"HALLELUJA....HALLELUJAH....HALLELUJAH, HALLELUJAH, HALLELUJAH....HALLEEEEEEJUAHHHH!!"
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09:57 AM on 07/17/2010
You mean Handel's Messiah. ;)
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08:17 AM on 07/18/2010
Drat...you're right. Although the Ode to Joy is also appropriate lol.
HUFFPOST SUPER USER
directfitz
05:31 PM on 07/16/2010
If you are married you do.
07:14 PM on 07/16/2010
Oh, yeah...
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HUFFPOST SUPER USER
rjmtx
blah blah blah
12:51 AM on 07/17/2010
Not when she's knocked up.
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StThomas
Not until I see the holes of the nails....
04:04 PM on 07/16/2010
Anyone contemplating bioidentical hormones might want to have a look here.....

http://www.pharmwatch.org/strategy/bioidentical.shtml
07:13 PM on 07/16/2010
Also keep in mind that synthetic hormones (prescriptions like birth control pills, HRT, etc.) have significant side effects because they are not the natural substances the body is used to. The synthetic hormones have been altered for one reason only - to make it possible to patent them and therefore make a profit. You can't patent natural products which is part if the reason (IMO) that drug companies (and people who get most of their information from drug companies) advise the scrips every time. The doc who writes Pharmwatch has a variety of "watchdog" sights and is very much against what is considered alternative medicine (i.e. natural, holistic healthcare). I am not saying the alternative way is the only or even best way - just consider the source of your information (all of them, alternative and conventional). Also consider that there is MUCH less money available for research for natural remedies because they won't make a lot of money. Good research is expensive. Businesses today are not going to invest in something that won't give them a significant return. Patented pharmaceutical medicines do that - natural, inexpensive remedies don't. Drugs are great when you need them, but they are not the only option, particularly for chronic conditions.
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StThomas
Not until I see the holes of the nails....
07:01 AM on 07/17/2010
"Also keep in mind that synthetic hormones (prescriptions like birth control pills, HRT, etc.) have significant side effects because they are not the natural substances the body is used to"
Evidence for this?
There is no reason to expect that anyone's oestrogen receptors should care whether a hormone molecule they like started off in a plant (since these "bioidentical" oestrogens are phyytooestrogens, I believe). Oestrogens and progesterones have side effects because they have effects. Calling something natural (which is seldom precisely defined in fora like these) does not make it safe; the danger is that they may be taken by people thinking they are safe and natural, when they may come with the same predisposition to cause, say, carcinoma of the uterus. Is there research to say that drugs like bioidentical hormones are safe? If so who did it? Did they have the same degree of oversight as a conventional phramaceutical company? If not what is their incentive to be honest about risks? I dislike bigger pharmaceutical companies, but they do produce verifiably good product, and are honest if properly overseen. The 'properly' there is very important.
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StThomas
Not until I see the holes of the nails....
07:11 AM on 07/17/2010
Ps Stephen Barret who does the webpage I linked to _is_ a hate figure amongst the tinfoil hat wearers, because he outs quackery, with evidence. Do read his page (http://www.quackwatch.com/) and http://www.quackometer.net/ is worth a read. I have never seen any evidence of him putting the boot in to alt med, as such. Fraud in healthcare, quackery, is fair game to him though. The extent to which quackery and alt med overlap, may lead people to think he has it in for alt med.

For a well reasoned and quite beautiful take on the skeptical attitude, may I recommend this poem. http://www.youtube.com/watch?v=V0W7Jbc_Vhw
03:57 PM on 07/16/2010
If you are married you do