It’s a story girls are told from the time they hit puberty: you’re going to get a period and it’s not going to pleasant. You’ll have cramps, bloating, fatigue, cravings, and mood swings, so just pop a Midol and power through it.

It’s a story I know all too well. While in college, I was told I had Premenstrual Dysphoric Disorder (PMDD), which involved debilitating anxiety, confusion, lack of focus, and insomnia before each period. My doctor offered me birth control and an anti-depressant, the two “cure-alls” in today’s allopathic medicine. I declined, intuitively knowing they were not the solution; but I continued to struggle for years.

Now, I’m happy to say that I experience no symptoms whatsoever. My period just comes and goes, quietly and comfortably.

That’s how it’s supposed to be. A whirlwind of pain and emotion around your period is a sign that your body isn’t functioning properly. And despite the enigma that sites like WebMD make PMS out to be, the physiological reasons are quite evident.

1. Nutrient Deficiencies

Nutrient deficiencies can have a number of causes, including:
• Poor diet
• Stress
• Infections
• Toxins
• Medications
• Modern farming techniques
• Digestive dysfunction

Given the prevalence of all of the above, it’s no wonder our population is so nutrient-deficient.

Magnesium, which is involved in over 300 essential metabolic reactions, is depleted by stress, exercise, alcohol, sugar, coffee, MSG, food processing, excess calcium supplementation, and common medications like oral contraceptives, hormones, acid blockers, antacids, corticosteroids, cholesterol agents, ACE inhibitors, and diuretics. Ironically, low magnesium can actually cause or contribute to the conditions these medications are prescribed to treat, like high blood pressure.

As magnesium is essential for muscle, blood sugar, and brain health, deficiency can cause PMS symptoms like cramps, cravings, depression, tearfulness, irritability, anxiety, and insomnia. In PMS that is characterized by sugar cravings, increased appetite, and indulgence in sweets, for example, magnesium has been shown to decrease symptoms and improve glucose tolerance. Another study found that the combination of magnesium and B6 most effectively reduced PMS symptoms when compared with placebo and magnesium alone.

Which brings us to our next little powerhouse, Vitamin B6.

Vitamin B6, or pyroxidine, is essential for mood stability, sleep regulation, energy production, and nerve health. Without it, you can’t properly synthesize important neurotransmitters like serotonin, GABA, and dopamine. This can cause those infamous mood and sleep issues associated with PMS. B6 even helps regulate your hormones. A deficiency can result in substantially increased estrogen gene expression, which would cause symptoms like heavy flow, irregular bleeding, and breast tenderness. One study found that 200-800 mg/day reduced blood estrogen, increased progesterone, and improved PMS symptoms. Women with symptoms of bloating, weight gain, breast pain, and water retention also experienced relief with high doses due to its ability to suppress aldosterone.

Vitamin B6 is depleted by stress, alcohol, smoking, high protein intake, rancid fats, food coloring, and medications such as acid blockers, antacids, cholesterol agents, ACE inhibitors, diuretics, oral contraceptives, hormones, and diabetes drugs.

Zinc is needed to activate B6, so a zinc deficiency is problematic for this reason and more. It’s an essential mineral for 100 enzyme reactions, along with fertility, immune function, hormone synthesis, mood health, and stomach acid production. Ironically, people who take acid suppressors for reflux often make the problem worse by reducing zinc absorption from food.

Other zinc zappers include stress, exercise, smoking, caffeine, MSG, vegan/vegetarian diets, food processing, and medications like ACE inhibitors, diuretics, cholesterol agents, copper IUDs, oral contraceptives, hormones, and corticosteroids.

Women with low zinc and PMS frequently experience debilitating mood issues like panic attacks, anxiety, depression, mood swings, and poor concentration. Ironically, the oral contraceptives prescribed to treat these problems can actually exacerbate them further by disrupting the balance between copper and zinc. High copper means low zinc. In addition to magnesium and B6 mentioned above, they deplete calcium, selenium, tyrosine, other B vitamins, most minerals, vitamin C, and vitamin E. If that weren’t enough, they also encourage the overgrowth of harmful intestinal flora like yeast, which will only further deplete you of nutrients, destroy your gut, and promote overall inflammation. It’s essential that women know this before opting in, yet they aren’t told.

2. Liver Function

Nutrient deficiencies will also impair your liver function. B vitamins, amino acids, vitamin A, vitamin E, antioxidants, and minerals like zinc, selenium, and manganese are needed for your liver to properly detoxify AND metabolize hormones like estrogen and testosterone. With the unprecedented amount of toxins in our environment, food, cosmetics, cleaning products, and medications, your liver has a HUGE job to do and needs all of the help it can get.

Many of these toxins are known endocrine disruptors, which increase your chances of hormonal imbalances and disorders like PMS and Polycystic Ovarian Syndrome (PCOS), as well as cancer, diabetes, and obesity. Hormones introduced via birth control or hormone replacement therapy (HRT) can also create an excess that prevents the liver from processing them quickly or efficiently enough. This can lead to high levels of estrogen and poor hormonal regulation.

Women who have difficulty eliminating excess estrogen may also have inhibited bile flow, which can only make matters worse. Bile, which is created by your liver and stored in your gallbladder, is needed to break down fats from food. This means that without sufficient bile, you cannot properly digest your fats. Fats are needed for the formation of sex hormones, control of inflammation, brain and nerve function, energy regulation, and delivery of vitamins A, D, E, and K. Without adequate supply, every system in your body will be affected.

It’s therefore imperative that we avoid xenoestrogens and toxins as much as possible. The Environmental Working Group has excellent guides and databases for selecting safe products and reducing your toxic load.

3. Inflammation

Inflammation and hormonal dysfunction tend to go hand in hand. Inflammation inhibits ovulation, overstimulates estrogen receptors, blocks progesterone and GABA receptors, impairs estrogen clearance, and depletes progesterone. A recent study found a strong correlation between PMS symptoms and inflammatory blood markers during the luteal phase (the two weeks prior to menstruation). Ensuring gut and liver health, regulating blood sugar, eating a healthy diet, and managing stress are some key ways you can keep inflammation in check.

4. HPA Axis Dysfunction

One way in which inflammation creates hormonal imbalance is through the hypothalamic-pituitary-adrenal axis. When we experience inflammation and stress, our brains tell our adrenals to produce the stress hormone cortisol. The problem is, cortisol and our sex hormones come from the same source–pregnenolone. This means that the chronic release of cortisol will deplete production of sex hormones like testosterone, DHEA, estrogen, and especially progesterone. In other words, chronic stress or inflammation can cause low sex hormones.

Another common cause of cortisol overproduction is unstable blood sugar. When your blood sugar dips too low, your adrenals produce cortisol to release the stored glycogen in your muscles for fuel. Allowing this to occur too often will again deplete pregnenolone, and consequently your sex hormones as well. Common signs and symptoms of low blood sugar are irritability (“hanger”), dizziness, shakiness, anxiety, and fatigue.

Eating a low to moderate carbohydrate diet and not skipping meals are effective ways to avoid the blood sugar rollercoaster. It is also possible to become a fat-burner (rather than a sugar-burner) and intermittent fast effectively, but fasting is not right for everyone, so I cannot generally recommend it.

It is also important to keep in mind that insulin is a hormone, which means it is part of the complex web of hormones in your body. An imbalance in one can affect the others, including big players like estrogen and progesterone. Keeping insulin in check will therefore help promote overall hormonal balance.

One last common but often overlooked cause of cortisol imbalance is excessive cardiovascular exercise. Ever wonder why some marathoners end up in such poor health? The longer you train, the more cortisol you produce, which can result in immune suppression, muscle breakdown, and serious hormonal imbalances. The solution is to keep your cardio moderate and balanced alongside strength, flexibility, and high intensity interval training. If you are struggling with fatigue and severe hormonal imbalances, however, you may need to opt for restorative low-intensity activities only, like yoga and walking.

5. Circadian Rhythm Disruption

When you exercise is actually just as important as how, as raising your cortisol too late at night will affect your circadian rhythm. Cortisol and melatonin (a.k.a. “the sleep hormone”) have an inverse relationship. When cortisol goes up, melatonin goes down, and vice versa. Your melatonin is supposed to rise when the sun sets at night, and fall when it rises in the morning. This is partly because blue light suppresses melatonin. This means that exercise too close to sunset and light exposure after sunset will suppress your melatonin, in turn impairing your circadian rhythm.

Why does it matter? Imbalanced circadian rhythms are associated with menstrual dysfunction. Teenage girls who go to bed late and sleep in late are likely to have worse PMS symptoms than those who go to bed early, while female night shift workers are likely to experience more menstrual difficulties than daytime workers.

The solution is to go to bed at a regular time, ideally before 10:30 pm, and avoid bright and blue light at night. I recommend using amber-tinted glasses, Himalayan salt lamps, and screen-tinting apps like F.lux.

If you need help rebalancing your hormones and kicking those symptoms to the curb, schedule a free 30-minute consult with me to discuss what you can do.

By Fitmo Coach, Lauren Aronstam

Lauren is a Nutritional Therapy Practitioner and Wellness Coach, who knows how to bounce back – and she’s here to help you do the same! If you have health issues, you need a coach who understands what you’re going through – Lauren is that coach. She’s here to help if you want to feel more energized, eat better, lose weight, manage stress or all of the above!

Learn more about Lauren, and working with him via the Fitmo app here.

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