Premenstrual syndrome (PMS) is a set of unwanted physical, emotional and mental symptoms that occur after ovulation and are relieved as the period gets started. Most women (and their partners) are well aware of the changes in mood alongside minor physical complaints such as bloating just before the period, and there is nothing ‘wrong’ or unhealthy about this. However when the symptoms go on for up to 2 weeks and cause severe mental and emotional disturbance this can have a very real effect on a woman’s life – her work, her relationship and her self esteem. Women with severe PMS can feel like 2 completely different characters – and to some extent they are!
Below are some of the most common unwanted symptoms of PMS: Mood swings, Irritability, Anxiety and tension, Bloating, Breast tenderness and swelling, Water retention Acne, Tiredness, Weight gain, Headaches/migraines, Crying Spells, Depression, Sugar and food cravings, Constipation, Dizziness and Night sweats.
So whats going on in our bodies to cause all this? Typically, as with so many problems in women’s health, there is no single causative factor, but a combination of several smaller imbalances that all trigger each other off.
Firstly, just looking at our hormones – oestrogen levels are declining and progesterone is on the up. This shift can affect some women very strongly. A popular theory is that at a time when progesterone should be high, in women with PMS, their oestrogen is actually still too high in relation to progesterone. Many of the physical symptoms such as water retention, breast tenderness and bloating can be attributed to oestrogen.
Secondly, as well as regulating the menstrual cycle, oestrogen and progesterone influence neurotransmitters such as serotonin which will then fluctuate throughout the menstrual cycle. Serotonin is just one of the several mood affecting neurotransmitters likely to be involved and can explain the panic attacks and severe depression and anger that some women experience.
Thirdly, stress is nearly always involved in some way. Although it is unlikely to cause it, it will undoubtedly worsen PMS symptoms. Overworking, not enough sleep or over worrying will all cause stress to pile up. One of the stress hormones, cortisol is thought to block progesterone receptor sites, thereby aggravating the oestrogen / progesterone balance.
The Chinese medicine approach is to look at the whole menstrual cycle. What’s going on the rest of the time? – does the diet support the liver in breaking down oestrogen for elimination and is stress being managed before ovulation for example. In acupuncture the first half of the cycle is ‘Yin’ This is a time for nourishing the body and mind, eating and sleeping well. The second phase between ovulation and bleeding is ‘Yang’ which represents movement, warmth and energy. PMS in acupuncture is sometimes seen as too much Yang rushing around the body causing mental and emotional upset so the aim is to ground this energy, and to keep in circulating round the entire body in a more balanced way. We do this by building up the Yin in the first half of the cycle so it is strong and abundant – so strong that in anchors the Yang later on! In other cases there is not enough Yang – and so the Yin starts getting sticky, heavy, sluggish and obstructs the Yang from coursing through the body. This leads to stagnation such as constipation, bloating and so the aim is to get the Yang / energy of the body freed up so it can zip through the body, moving all the sludge on the way.
I work with women of all ages to help combat the PMS once and for all. We follow a plan of acupuncture twice a month in between ovulation and her period. This really focuses on getting her yang moving evenly throughout her body and head, and this is the time to keep things moving physically with yoga or swimming. We change her diet slightly to support her Yin in the first half of her cycle and ask her to spend some time slowing down just with herself. I also add in herbs alongside Andrew Chevallier to really support a healthy progesterone / oestrogen balance. After 3 menstrual cycles a substantial improvement is nearly always seen, with most women not needing to continue with the acupuncture.