Premenstrual syndrome is a term used to describe a wide array of symptoms that a woman may experience in the run-up to menstruation. Most women will experience some PMS symptoms at some point in their lives, but for some, the symptoms can be severe and disrupting to everyday life.

Each woman’s symptoms are different and can vary from month to month. The most common symptoms of PMS include:

• Mood swings
• Anxiety
• Irritability
• Tearfulness
• Tiredness
• Difficulty sleeping
• Digestive discomfort
• Water retention
• Breast tenderness
• Headaches
• Spots or acne
• Increased appetite
• Changes in sex drive

The exact cause of PMS is unknown but the symptoms are thought to be triggered by fluctuations in hormone levels, along with changes in brain chemistry. For example:

• Dropping levels of oestrogen and progesterone a few days before menstruation can allow testosterone to become more prominent. This can make skin greasier, increase feelings of aggression, and raise sex drive.
• Increasing levels of the hormone prolactin before menstruation, on the other hand, can be responsible for breast tenderness and water retention.
  Whereas fluctuations of serotonin in the brain are thought to play a role in mood changes, fatigue, food cravings and sleep problems.

Changes in hormone levels are a natural part of the menstrual cycle, however, the suffering related to menstrual cycles is unnecessary. Far from being a fact of life, premenstrual syndrome is usually related to bad habits and other imbalances. The functional medicine approach to PMS aims to identify and address these imbalances for long-term hormonal health.

• Lifestyle – sugar, caffeine and alcohol can all contribute to worsening PMS. Balancing blood sugar levels and reducing reliance on stimulants is key to managing PMS more effectively. Your functional medicine practitioner will be able to create a personalised meal plan to keep energy levels balanced through the day so you can make better choices and minimise the foods and drinks that worsen PMS.
• Excess oestrogen – just before menstruation levels of both oestrogen and progesterone are supposed to fall. However, for many women, progesterone falls and oestrogen levels remain high. This can occur for a number of reasons. There may be reduced oestrogen clearance by the liver. Constipation could be contributing to old oestrogen being reabsorbed. Or there may be extra oestrogens and oestrogen mimicking chemicals coming in for dietary sources such as dairy products and foods packaged in plastic. Dietary adjustments along with targeted liver and digestive support can be used to rebalance oestrogen levels.
• Nutrient deficiencies – fluctuations in hormones can also affect the metabolism of vitamins and minerals. This can lead to temporary signs and symptoms of nutrient deficiency associated with the menstrual cycle. Topping up levels of the affected nutrients can reduce PMS symptoms and restore hormonal and chemical balance in the body. A functional medicine assessment can help identify which nutrients you need more of. Then your practitioner can advise you on dietary changes and supplements to restore balance.
• Stress – Stress can worsen hormone imbalances, deplete nutrient levels and exacerbate all the symptoms of PMS. Managing stress naturally with lifestyle changes, herbs and nutrients can minimise PMS.