The Complete Guide to PMS & PMDD
✨PMS✨ is the physical or emotional symptoms that occur in the week or two before the onset of menstruation. It can include up to 150 different physical and emotional symptoms and effects up to 90% of menstruators.
✨PMDD✨, on the other hand, stands for premenstrual dysphoric disorder, and is like PMS x100. It effects 3-8% of menstruators and is characterized by debilitating physical and emotional symptoms that occur premenstrually. For example feelings of hopelessness, suicidal thoughts, bouts of extreme sadness, panic attacks, extreme lethargy/fatigue, frequent/uncontrollable crying, and loss of interest in every day activities. It is a condition that deeply effects quality of life, self esteem, and relationships.
👀How do we know if our PMS is a problem?🤔 If you feel like your PMS symptoms are disrupting your quality of life (it’s affecting your ability to work, parent, or enjoy life), then this is a problem. Mild symptoms that you notice but don’t affect your day to day life very much isn’t a huge issue. However PMDD can feel like your life is completely derailed in the week or two before your period. You may feel like a completely different person and struggle severely with your mental health.
👀How do we get diagnosed with PMDD?👩🏻⚕️ Your family doctor may be able to officially diagnose you through analyzing your symptoms. There is no official test for PMS or PMDD. There is currently no cure for PMS or PMDD. Your doctor may suggest the birth control pill or anti-depressants (either used daily or solely in the luteal phase). This may work for some people but may not be effective for others.
➡️ Causes of PMS & PMDD
Although most PMS can be attributed to hormonal imbalances and inflammation, research shows there can be a vast array of various causes that ultimately have an impact on the body and mind.
Serotonin (happy brain neurotransmitter) deficiency or excess.
Tryptophan (amino acid) deficiency or excess, tyrosine deficiency (amino acid).
Norepinephrine deficiency or excess (adrenal stress hormone).
Hypothyroidism (not enough thyroid hormones).
Low androgens (like testosterone).
GABA deficiency (anti-anxiety brain neurotransmitter).
Essential fatty acid deficiency resulting in abnormal prostaglandin synthesis.
Magnesium deficiency.
Genetic predisposition.
PMS and PMDD have similar causes, however PMDD may have more severe imbalances of the above.
➡️ Types of PMS
Anxiety (PMT-A). Feelings of anxiousness, irritability, or nervousness. Due to imbalance of estrogen/progesterone.
Hyperhydration/bloating (PMT-H). Weight gain, abdominal bloating, breast tenderness. Due to elevated estrogen and aldosterone in luteal phase.
Carbohydrate cravings (PMT-C). Carbohydrate cravings, increase in hunger. Due to blood sugar instability.
Depression (PMT-D). Depression, social withdrawal, lethargy, forgetfulness, tearfulness. Due to imbalance of estrogen/progesterone.
➡️ Lab work to get💉
Getting blood work or lab testing may be really useful in pinpointing your imbalances to more effectively and efficiently treat your PMS or PMDD symptoms.
Thyroid panel: (TSH, Free T4, Free T3, TPO)
Vitamin D
Progesterone (done 7 days after ovulation)
Prolactin
Estrogen and metabolite breakdown (2OH, 4OH, 16OH)
Cycle day 3 FSH, Estradiol, LH
Iron (ferritin)
Testosterone
DHEA-S
4 point cortisol salivary test
CRP
Fasting glucose and fasting insulin
B12
Homocysteine
➡️ How to manage PMS & PMDD
PMS and PMDD can absolutely be managed with the right investigation and tools. PMDD might require a bit more effort and time, but it’s definitely possible to reduce symptom severity. The following is what I recommend to my patients:
Reduce inflammatory foods🍔. The luteal phase, which spans from ovulation to the onset of your period, is characterized by an increased production of inflammatory molecules within the body. Therefore, reducing inflammation through diet can play a huge role. Consider reducing or eliminating gluten, dairy, refined sugar, refined flour, alcohol, artificial sweeteners, poor quality meat, processed foods, and excessive caffeine.
Support your gut health🦠. There is a huge connection between hormonal imbalances, nutrient deficiencies, and gut dysbiosis. So make sure you are eating your fiber, consider probiotics, and make sure you are having daily bowel🎢 movements. You can read more about gut health and nutrition in my Eating for Hormone Balance e-book.
Keep your blood sugar stable. Such an important way to balance insulin and cortisol levels and reduce inflammation in the body. Balanced blood sugar is essential for easing any hormone-related condition, and it’s especially important for PMDD. So eat your 20-30g of protein with each meal, plenty of fiber and healthy fats, intermittent fast for 12-14 hours, and don’t skip meals.
Key supplementation💊. Various supplements have been found to benefit PMS symptoms like vitamin e, melatonin, omega 3 fatty acids or fish oil (2000mg of combined EPA/DHA), magnesium (200-400mg) and b6 (50-100mg), calcium (1200mg), vitex, l-tryptophan (6g). Always consult your doctor before taking any supplements.
Regular exercise🏃♀️. Great for promoting healthy estrogen detoxification, reducing stress, reducing inflammation, and balancing your hormones. Try to exercise 3-5x per week for at least 20 minutes. Do a mix of cardio and strength training.
Get enough sleep😴. Important for every function in your body. Crucial for hormone balance, adrenal health, mood, and insulin sensitivity. Always aim for 7-8 hours per night.
Support your mental health🧘♀️. Reducing stress levels is important for inflammation and hormone balance. Existing diagnoses of depression and anxiety are also more common in women with PMDD. I encourage my patients to practice daily self care, take more off of their to-do list, go on nature walks, practice yoga or mindfulness, meditate regularly, try breathing techniques, engage in fun hobbies, or seek the support of a therapist or counsellor.
Support healthy progesterone levels📈. I often see people with low progesterone levels which can make them develop estrogen dominance which can worsen PMS and period symptoms. Support healthy progesterone levels by ensuring regular ovulation, reducing stress/balance cortisol, limiting caffeine, getting enough sleep, avoiding over-exercising, and supplements like: vitex, maca, melatonin, vitamin B6, vitamin D, vitamin C, and vitamin E, magnesium, zinc.
Acupuncture. Acupuncture is great for relaxing the nervous system, reducing inflammation, and hormone balance. It’s been shown in studies to be beneficial for PMS symptoms (a success rate of 77.8%!), and it’s something I commonly recommend to my patients!
Cycle Syncing🔄. Sync your diet/lifestyle/schedule/exercise with the phases of your menstrual cycle. Understanding the phases of your menstrual cycle and how your mood and energy levels may fluctuate can help you prepare for the fluctuations of your menstrual cycle. It can help you understand your physiology, have more self compassion, and personalize self care practices based on your hormonal pattern. Learn more about cycle syncing in my e-book!
Want to learn more about strategies you can use to fix your period problems?
📘Access my FREE e-book: How to Start Balancing your Hormones: Fix Your Period Without Overwhelm.
📕 Learn about syncing your diet, lifestyle, exercise, and schedule to the hormonal fluctuations of each phase of your menstrual cycle in my Cycle Syncing e-book!
📗My Eating for Hormone Balance e-book breaks down everything you need to know about diet and your hormones. Learn about the basic macros, how to support gut health, what to do about inflammation, and more!
📞 Book a free 15 minute discovery call to see if we're a good fit to work together.
👩🏻💻 Book a 60-90 min initial consultation where we work 1:1 to dig deep into your health history to figure out the root causes of your period problems. From there I provide you with an individualized treatment plan and consistent support along the way.
🏫 Period University™ is the ultimate self-paced online course that teaches you EVERYTHING you need to know about your period and hormones.
