Premenstrual syndrome (PMS) is characterised by recurring physical and psychological symptoms during the late luteal phase of the menstrual cycle. The luteal phase begins after ovulation on day 14 then finishes the day blood flow begins.

PMS symptoms usually dissipate a few days after menses begins; they can be mild or severe and some months can be worse than others. Around 85 per cent of women experience PMS and 7 per cent suffer from severe symptoms. Women who experience severe and debilitating PMS are said to have premenstrual dysphoric disorder (PMDD).

Common psychological symptoms associated with PMS include mood swings, irritability, crying, anger, anxiety, depression, dysphoria, inability to cope with stress, loss of control, poor concentration, forgetfulness, loneliness, low self-esteem, aggression and social withdrawal. Some women with severe PMS have undiagnosed depression.

Painful menstrual cramps (dysmenorrhea) are experienced by many women each month and can range from mild and uncomfortable to extremely painful and incapacitating. Menstrual cramps are caused by the uterine smooth muscle contracting, causing pain and cramping. Women who experience significant pain should consult their doctor as it may be a sign of some underlying condition such as endometriosis, uterine fibroids, ovarian cysts or pelvic inflammatory disease.

Other common physical symptoms associated with PMS include fluid retention, swollen and tender breasts, bloating, headaches, weight gain, swelling of the extremities, nausea, vomiting, heavy menstrual bleeding, stiff joints, change in bowel habits (constipation or diarrhoea), low libido, sugar and carbohydrate cravings, increased appetite, acne, weakness and dizziness.

Fortunately, nutritional and herbal medicine is very effective at resolving PMS complaints. However, it is important to first identify the root of the problem.

Causes of PMS

Hormonal imbalance

Hormonal imbalance, especially oestrogen dominance, is a major cause of PMS. Oestrogen dominance doesn’t necessarily mean the body is producing excessive amounts of oestrogen; it usually means that oestrogen levels are higher in proportion to progesterone that helps keep things in balance.

Oestrogen is a steroid hormone primarily produced by the ovaries and to a lesser degree by the adrenals and fat tissue. During the first half of the menstrual cycle, or follicular phase, oestrogen grows and matures the uterine lining, which is shed during menstruation. Oestrogen helps the ovaries produce an egg, which is released during ovulation. Oestrogen levels should be dominant during the follicular phase.

Oestrogen and progesterone usually work together harmoniously to maintain the perfect environment for a fertilised egg to implant and develop if conception occurs.

Progesterone balances the effects of oestrogen. Progesterone is produced after ovulation occurs by the corpus luteum, the sac the egg comes out of. Progesterone levels should be dominant during the second half of the menstrual cycle, or luteal phase.

Progesterone’s main job is to build and maintain the uterine lining in case a pregnancy takes place. If a pregnancy doesn’t occur, progesterone levels will drop and menstruation

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