Is PMS Normal?
Is PMS normal? is a common question, especially because so many people experience it. PMS is actually not normal, but it is common so that’s why so many people write it off as normal. Pain is never felt without a trigger.
PMS stands for premenstrual syndrome which is defined as life-disrupting physiological and psychological changes in the luteal phase of the cycle, or the second half of your cycle. After the menstrual cycle begins, symptoms typically disappear.
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Here are 6 reasons that can lead to PMS, showing that PMS is not normal, but rather a symptom of a potential imbalance in the body:
1. Prostaglandins
When people ask ‘is PMS normal?’ they refer to their life-disrupting cramps which affect many other women causing them to think the painful cramps are normal. The cramps in the uterus can be caused by high amplitude contractions, increased uterine tone, and high levels of prostaglandins. Prostaglandins are sex hormones that work in a direct relationship with estrogen. As prostaglandins rise, so does estrogen. Prostaglandins in the reproductive system aid in contractions for labor, but when you are not in labor, these contractions are labeled as cramps. Prostaglandins are pro-inflammatory hormones and can make cramps one of the more unpleasant premenstrual symptoms.
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2. Stress
Another reason people answer yes to ‘is PMS normal?’ is because stress is a common symptom. Stress can greatly induce many PMS symptoms. You may be stressed because you know menstruation is in a few days, but you are starting a new job and don’t want to worry about carrying tampons or pads with you everywhere. This stress increase is closely tied into our blood sugar balance because cortisol, our stress hormone, actually triggers a process called gluconeogenesis (making of new glucose) as a way to provide the body with glucose (energy) to literally run or fight (fight or flight). This process occurs to help us maintain a constant flow of glucose into the bloodstream by breaking down lipids (fat) into glucose. This process requires a lot of energy and is not as simple as just consuming food with carbohydrates for energy. Over time, this effect can cause us to experience fatigue, low energy which will lead to more PMS food cravings.
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3. Inflammation
Another reason that the answer to ‘Is PMS normal?’ is no because many of the common PMS symptoms are induced by inflammation. Inflammation occurs when your white blood cells sense an invader or an area of injury in the body, so they release chemicals to surge the area as well as increase blood flow there. Our stress response will release cortisol to try to reduce the inflammation, but over time this can create more harm than good. The cortisol will end up creating imbalances in hormones, raising estrogen causing many PMS symptoms. The inflammation also can irritate your reproductive organs and cause prostaglandins to increase to create more cramps.
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4. Estrogen and Progesterone Imbalances
What many people do not realize is that the question ‘is PMS normal?’ is basically the same as asking ‘is hormonal imbalances normal?’ and the answer to both is no. All of our hormones are connected and when one is low, then others overcompensate. Specifically, estrogen and progesterone cause the majority of the PMS symptoms. Breast tenderness, cramps, acne, mood swings, and cravings. Yes, our hormones do have a natural variance throughout the month, but all hormone levels should be in an accepted range.
During the start of the luteal phase, occurs after ovulation, progesterone is increasing, but if pregnancy doesn’t happen progesterone will drop by the end of the phase. This drop-in progesterone may be more extreme for some women and this causes estrogen to increase rapidly. This extreme imbalance in some women is caused by multiple different factors.
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5. Nutrient Deficiencies
Many nutrients are used in the process of regulating, producing, and secreting sex hormones. Looking into nutrient deficiencies in yourself can give you a clue into some other symptoms you experience. This is why the answer to the question ‘Is PMS normal?’ is no because you could have a deficiency in something that could be a large contributor to your symptoms.
Omega-3s are essential fatty acids that are one of the supplements for menstrual cramps. They have anti-inflammatory properties that can help balance out prostaglandins that are anti-inflammatory products produced in the body and when produced in higher amounts can mean more severe cramping.
The best-absorbed forms of omega-3s are called DHA and EPA that are found in fatty fish like salmon and sardines and fish oil. While there are plant foods that contain omega-3s like walnuts, chia seeds, hemp seeds, and flaxseeds, these contain the form called ALA which does not convert to DHA and EPA that well.
Zinc deficiency can occur during the luteal phase of the menstrual cycle. Zinc has been shown to help improve PMS symptoms and is crucial for stable moods so it can be helpful if you experience anxiety with PMS.
DIM stands for diindolylmethane and it is a naturally occurring compound in cruciferous vegetables like broccoli, kale, and cauliflower. It lowers total estrogen by improving estrogen detoxification. If we aren’t properly detoxifying estrogen and eliminating it then it can build up in the system and can contribute to menstrual cramps. This supplement is only advised to be taken if you have elevated estrogen proven from lab results.
Magnesium is a common deficiency in many people, but it goes unrecognized in clinical medicine because levels are rarely evaluated. You can think of magnesium as our calming and relaxing mineral. It helps to loosen tight muscles, maintain the health of our muscles (including our heart – the most important muscle), prevent migraine headaches, balance blood sugar, ease anxiety due to its role in our stress response, and ease menstrual cramps.
Vitamin B6 is beneficial for PMS, especially when combined with magnesium. It is crucial for helping over 100 chemical reactions occur in the body and plays a vital role in mood, anxiety, and hormone balance, specifically by helping to balance estrogen and progesterone levels. B vitamins are also crucial for the adrenal function or supporting our stress response. If we’re overly stressed all of our hormones can feel the impact. Include foods like organic chicken or turkey, chickpeas, salmon, and avocados. In supplement form, I usually recommend taking as part of a high-quality multivitamin or B-complex.
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6. Gut Issues
Gut issues, constipation, and bloating are all other reasons some may answer yes to ‘is PMS normal?’. Bloating is when our outer skin expands in response to water retention or aggravation in the gut. It is due to a water balance shift that can make you appear larger than a week ago which can lead to a common false conception that gaining weight is just part of what is premenstrual syndrome. If bloating is one of your menstrual cycle symptoms, this can be caused by estrogen dominance and/or gut issues. High estrogen or estrogen dominance has been associated with increased water retention. This happens because the estrogen lowers the osmotic threshold for which water is reabsorbed in the body.
Additionally, if we have low stomach acid (hypochlorhydria) or decreased functioning of the pancreas resulting in a low output of digestive enzymes we can experience bloating. This is because adequate stomach acid and digestive enzymes are needed to break down and digest our food. If they are low bloating can occur. Imbalances in gut bacteria can also contribute to bloating.
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