What is Premenstrual Syndrome?
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. PMS can be predicted due to hormone imbalances with estrogen and progesterone, specifically high estrogen and low progesterone. 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. Additionally, this hormone imbalance can be caused by other factors such as stress. This extreme shift in hormone levels could be the cause of PMS symptoms. Here are 8 symptoms that can occur in the luteal phase of your cycle that contribute to PMS.
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1. Cramps
Cramps are one of the symptoms when we think ‘what is premenstrual syndrome?’ 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 menstrual cycle symptoms.
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2. Bloating
When we think what is premenstrual syndrome? We often associate this with ‘feeling heavier’ when really it is just bloating! 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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3. Mood Swings
Mood swings can also be a part of what is premenstrual syndrome. Mood swings can cause you to get irritated and angry at the slightest inconvenience and then super happy and joyful within the hour due to something else. Mood and cognition stability are both heavily reliant on estrogen balance. Estradiol and estrone are different forms of the estrogen molecule that we produce. It has been shown that estradiol is more beneficial to regulate stable mood patterns and has antidepressant effects when taken in normal limits, but with low levels, it can cause unstable emotions which are another one of the symptoms for what is premenstrual syndrome. Your hormones must be balanced so that depression can be avoided as one of the menstrual cycle symptoms.
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4. Acne
Acne is another symptom part of what is premenstrual syndrome due to hormonal imbalances with estrogen/progesterone, elevated androgen levels, and gut issues.
In each pore of our skin, we have sebaceous glands that produce sebum, an oil-like liquid, which helps to moisturize and protect our skin. When too many dead skin cells collect on the top of the skin in conjunction with high amounts of sebum, this can create a clog in our sebaceous glands and will result in inflammation. Our body will respond to this inflammation by sending white blood cells to the site of the clog which forms the white-headed pimples called acne.
If you have elevated androgens (male-like hormones) during your cycle this can increase acne to be one of the symptoms for what is premenstrual syndrome. Testosterone gets converted into a different form called DHT which has the ability to increase the production of sebum in the sebaceous glands to further produce acne.
When estrogen is produced too much in ratio to progesterone, called estrogen dominance, you can develop overly dry skin, which causes inflammation, irritation and the sebaceous glands will respond by producing an excess of sebum.
Poor gut health is another reason that acne is one of the signs of what is premenstrual syndrome. As mentioned before, estrogen dominance or high estrogen is a cause for acne. The gut is actually a mechanism for excreting estrogen from the body to prevent recirculation. If you are constipated, not eating enough fiber, there will be an increase in estrogen before your cycle that can cause acne.
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5. Breast Tenderness / Pain
Estrogen dominance is a root cause of breast pain. This is why it is another one of the symptoms for what is premenstrual syndrome due to an imbalance with estrogen which causes an imbalance in progesterone. Usually, breast pain occurs a little bit before ovulation around day 12-15 of your cycle. Additionally, progesterone is at an all-time low during this time while estrogen is high, causing estrogen dominance, and because of the difference in hormone levels, this puts stress on the breast tissue causing them to hurt.
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6. Hormonal Headaches / Migraines
Another one of the symptoms for what is premenstrual syndrome is headaches. When progesterone is low, estrogen is usually high and it has been shown that estrogen can interfere with cellular responsiveness and cerebral vessels. Through passive diffusion, estrogen can cross the blood-brain barrier very easily, so this causes the brain levels of estrogen to reflect the levels within the rest of the body’s circulation. When levels of estrogen are high in circulation in the body, this causes an increase of estrogen in the brain and a low level of progesterone. The high levels of estrogen and low levels of progesterone are what can cause cyclic headaches to be one of the signs of what is premenstrual syndrome.
7. Food Cravings
Another one of the symptoms for what is premenstrual syndrome are cravings. Cravings are our body’s way of telling us what we are missing in our diet. Our brain chemistry and mood chemicals can also be the driving factors behind our food cravings. We need amino acids from protein foods plus certain vitamins/minerals to build these mood chemicals, which explains a craving for a savory burger. Carbs can give us a little serotonin boost, which is why we may gravitate towards them more. Cravings for foods with fat may be due to a need for fatty acids. Omega-3s have anti-inflammatory properties and can help to balance the effects of prostaglandins – inflammatory compounds released right before your period to help shed the uterine lining.
Insulin sensitivity decreases in the luteal phase, meaning it’s extra important to incorporate protein and healthy fats at meals and snacks to help keep blood sugar balanced. Blood sugar crashes resulting from long periods of time between meals, not enough protein/fat, or overly restricting food can lead us to unintentionally overdo it.
It is also important to note that food may also be a way we have learned to manage our emotions or for comfort or numbing which is why cravings are another one of the symptoms for what is premenstrual syndrome.
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8. Insomnia
Insomnia is the difficulty of falling asleep at night. It is one of the symptoms for what is premenstrual syndrome. Balanced hormone levels are extremely important for good sleep. A study found that in both perimenopausal and postmenopausal women who were administered a low dose of estradiol there was an increase in sleep quality and insomnia was decreased. The study concluded that balanced estrogen and progesterone can have positive effects on sleep quality.
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There are main symptoms of PMS. If you’re looking to understand the root causes of your period problems or PMS, check out my hormone testing packages HERE.
