Controlling PMs

You can take the pain out of your monthly cycle—naturally.

Susan Weiner

March 2010


Bloated? Irritable? Stressed out? If your breasts feel like punching bags, you’re eating your weight in chocolate and your co-worker’s typing is driving you mad—and it’s that time of the month—there’s a good chance you’re suffering from premenstrual syndrome, or PMS.

PMS is a hot topic on the joke circuit. But each month at least 30% of all women in their childbearing years endure symptoms that include tension, irritability, depressed mood, headaches, breast tenderness, bloating, lack of energy, food cravings and sleep difficulties. While some women have symptoms for only a few days each cycle, others are affected for up to half of each month (Journal of Affective Disorders 4/05). Other studies indicate that about 80% of women report at least mild premenstrual symptoms (Journal of Psychiatry & Neuroscience 7/08).


Medical practitioners don’t completely understand PMS, dubbed premenstrual dysphoric disorder (PMDD) by psychiatrists, although they know the underlying explanation is that women are sensitive to the hormonal shifts that occur during the menstrual cycle. Serotonin, a brain chemical that affects mood, also appears to be involved. Family history, high caffeine intake and tobacco use have been identified as risk factors.

Historically women experienced multiple pregnancies beginning at an early age and often lacked proper nutrition. Extended episodes of amenorrhea, or cessation of periods, protected women from the long-term cycles of fluctuating estrogen and progesterone levels linked to premenstrual symptoms. Nowadays, healthier women with fewer children are more likely to suffer from PMS.

Massage and Movement

As a young girl in Andrews, North Carolina, Melanie Bond, a cashier in Watkins Glen, New York, endured excruciating premenstrual symptoms. “I would ball up from the pain,” recalls Bond, now 36. “They were a 10 on a scale of one to 10. My mama would run me a warm bath just so it would ease up the tension and cramping.”

To lessen the pain, Bond practiced self-massage. “I would lie down and rub my stomach in a circular motion until I fell asleep,” she says. “That would really help.” Massage therapy has been shown to reduce pain, water retention, anxiety and mood swings, all without side effects, according to a study at the Touch Research Institute, University of Miami School of Medicine (Journal of Psychosomatic Obstetrics and Gynaecology 3/00).


In combination with massage, physical activity can be an effective remedy for PMS. Many studies show that regular exercise—such as walking, biking, jogging, swimming and yoga—can help ease PMS-associated pain, stress, depression, breast tenderness and bloating. By boosting metabolism and improving circulation, oxygen and nutrients are carried to cells more efficiently, while brain chemicals known as endorphins boost mood and cut cravings for sweets.

Nutrition Solution

Since diet affects the body’s production of serotonin and endorphins, nutritional shifts can help combat fluctuating hormones and the symptoms that ensue. Dietary management of PMS symptoms involves eating to regulate blood sugar, maintain energy levels and avoid depression, and incorporating dietary supplements known to diminish PMS symptoms. Reduced symptoms should be apparent within one to three cycles.

“I had PMS most of my life. The only thing I changed was my calcium/magnesium levels and it was gone in a month and never came back,” explains Nan Kathryn Fuchs, PhD, editor-in-chief of the Women’s Health Letter (www.womenshealthletter.com). “Magnesium causes muscles to relax.” By adjusting calcium/magnesium dosages, women can get enough calcium while relieving PMS symptoms with a boost in magnesium, Fuchs says. “One of the signals for PMS is a craving for chocolate before the menstrual cycle,” she adds. “Chocolate is higher in magnesium than any other food, so a craving for chocolate is a sign of a magnesium deficiency.” Fuchs also urges clients with PMS to take a B-complex supplement every day.


Dietary changes Fuch recommends for PMS include eating less meat, dairy and caffeine, and more vegetables, whole grains and beans. “With diet, you are treating the cause,” she says. “You aren’t depending on something that’s just treating the symptoms.”

At Meadow Hill Wellness in Annapolis, Maryland (www.meadowhillwellness.com), Sara Poldmae, LAc tailors her approach to each client’s needs. “Depending on the patient’s symptoms related to PMS, as well as their general state of health, we may utilize many different therapeutic approaches,” she says. “Commonly used modalities include acupuncture, moxibustion (warmed mugwort herb), Chinese herbal therapy and dietary modifications.”

Poldmae recommends using magnesium, essential fatty acids and vitamins C and E to balance hormone levels. In addition she uses herbs such as black cohosh, white peony root and chaste tree berry, all of which have been found effective in curbing PMS symptoms. “Be sure to consult a knowledgeable herbalist before using any of these, as the right dosage is essential in supporting health,” says Poldmae.

Not all moodiness in women can be attributed to PMS. Conditions such as diabetes and depression can provoke similar signs. If symptoms continue despite making lifestyle changes, you should see your health practitioner. But supplements, exercise and wholesome foods are healthy steps towards saying goodbye to PMS.

Soothing Painful Breasts

Are your breasts lumpy, bumpy and painful at least part of the time? Welcome to the club. It has been estimated that more than 60% of all American women have experienced breast discomfort at one time or another. Doctors used to refer to such breast discomfort as “fibrocystic breast disease”; its very pervasiveness has led researchers to now use terms such as fibrocystic changes, mastalgia (Latin for “breast pain”) or mastodynia (the Greek term). Whatever term you use, this condition is marked by pain, swelling, a feeling of fullness and tender lumps that move freely within the breast. (Cancerous lumps are usually firmly fixed and not tender, although all breast lumps should be brought to a practitioner’s attention.)

Breast pain can be cyclical, flaring up right before menstruation and calming down afterwards; some women are in pain from ovulation straight through the end of their period. The lumpiness comes from cysts, or fluid-filled sacs. “With repeated cycles of hormonal stimulation, the breast cysts may become chronically inflamed and surrounded by fibrous tissue which can harden and thicken the cysts,” says noted women’s health authority Susan Lark, MD in The Women’s Health Companion (Celestial Arts). “It is then more difficult for the fluid trapped in the cysts to escape and be reabsorbed by the body.”

The best way to deal with breast pain is to keep a log for a month or two. When does the pain appear and disappear? How bad is it, annoying or so painful that even wearing a bra is difficult? Are there lumps, and where? Does diet appear to influence your breasts? How about stress or lack of sleep? Tracking symptoms over time will allow you to try different interventions and see which ones work for you.

Many health authorities suggest dietary changes. Try cutting out caffeine, salt and saturated fats, one at a time over the course of three cycles, and notice if you find any relief. Lark suggests eating a high-fiber diet rich in plant-based foods, including whole grains, saying that such an eating plan “may help prevent cyclical fluctuations in cyst size and tenderness.” Eating more fatty fish such as salmon and mackerel may be helpful, for both omega-3 fatty acids (which have also been linked to reduced breast cancer risk) and iodine, a trace element that, when deficient, has been linked to fibrocystic problems. Fish oil is available in supplement form; in addition, Lark says that evening primrose oil is an excellent source of gamma linolenic acid (GLA), which has helped ease breast pain in some women. (GLA is also present in borage and black currant oils.) Other supplements that may be useful include vitamins A and E, CoQ10 and the herb chasteberry (also known as vitex), which helps regulate hormone production.

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