Hormones and Health: PMS and Naturopathic Medicine

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The body’s hormonal changes define the stages of our lifecycle as human beings.  As children we grow and evolve into adulthood and the reproductive years, then Menopause ceases our ability to reproduce, and we carry out the final phase of the adult human being.  These transitions can be challenging times for the human body, as hormonal signals are strong, and have strong effects on the shape and size of our bodies.  Our environment can help mitigate the symptoms of the transitions of puberty, PMS, Menopause and male hormone imbalances.  As naturopathic doctors, we can help the patient understand what Is happening with their internal chemistry, and we have many treatment options to help them through this transition more comfortably.  Nutrition, lifestyle changes, exercise, diet, herbs,  bio-identical hormones and prescription medications can all be of aid during these times. 

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Premenstrual Syndrome PMS

Premenstrual syndrome (PMS) is a malady that can affect a woman’s health from the onset of puberty, through the childbearing years, all of the way into Menopause.  Symptoms can range in severity from mild, to completely incapacitating.  There are also a broad range of symptoms included in the PMS diagnosis.  These include headache, acne, breast tenderness, pain, mood swings, depression, irritability, fatigue, night sweats, constipation, diarrhea, hair loss, and bloating.   Symptoms can be brief or last for weeks, if not the entire hormone cycle length.  It is confusing for the sufferer until they, or a loved one, discovers that a pattern of symptoms is happening at regular monthly intervals.  Many women are aware of their cycle length, period duration, flow, ovulation, follicular and luteal phases.  Other women don’t have any idea regarding the cyclical effect on their bodies.  PMS typically happens during or after ovulation and may last until the start of the next period.

A basic overview of the menstrual cycle is important:  Day 1 of the cycle is always the first day of menstrual bleeding. Day 1 is the start of the follicular cycle and lasts until day 10-16.  During the follicular cycle, the anterior pituitary of the brain releases follicle stimulating hormone (FSH).  FSH flows through the blood to the ovaries, to stimulate the growth of an egg or follicle inside the ovary.  The follicle reaches maturity between days 12-17 and is released from the ovary into the fallopian tube, on its way to the uterus for potential fertilization.  During ovulation, the patient may notice a piercing pain, bloating, boggy lower abdominal pain, and ovulatory mucous discharge from the vagina.  This is also a time where acne might start to increase on the face.  Many women experience a higher libido, emotional imbalance or even migraine headaches.  From days 15-28 +/- a few days, the luteal cycle begins.  This is where the brain releases luteinizing hormone to signal the ovaries to increase progesterone production and the consequent build up the uterine lining to host the fertilized egg.  It is more likely during this part of the menstrual cycle where PMS symptoms become exacerbated.  It typically is a predictable pattern and is notable worse from days 21-28 of the cycle.  However, remember, it can happen at any time during the cycle, but it is usually predictable, happening at a similar time each month.  Symptoms decline as soon as the menstruation starts, and that is when many women realize that the symptoms are potentially premenstrual syndrome.

The difficulty in treating PMS is the vast symptomatology it includes. The most important thing is tracking symptoms on a monthly calendar in conjunction with menstrual cycles.  Keep track of day one of bleeding and how many days the bleeding lasts, note ovulatory or strange symptoms during the mid- cycle, and definitely keep track of how many days until the bleeding starts again.   Identifying the hormone imbalance is important to effectively treating the symptoms of PMS.  Hormones can be tested at varying parts of the cycle, and can be done via blood or saliva.  Once the imbalance has been diagnosed, it can be effectively treated with the appropriate vitamins, minerals, herbs, hormones or medications.  It is possible to treat even the severest cases of PMS effectively.  Lifestyle changes including intense exercise, good sleep patterns, limiting caffeine and alcohol, and a healthy diet all help

Improving symptoms of PMS:  Counseling, massage and biofeedback also decrease symptom severity and improve symptom tolerance.

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