PMS: What’s your type?

You might have noticed that your PMS symptoms aren’t the same as your friend’s or your sister’s – and that’s because not all PMS is created equal. That also means that the magic supplement/herb/essential oil your girlfriend uses to manage her symptoms might not be right for you. In general PMS can be divided in to 4 different categories, all with different symptoms, root causes and treatment options. You may fall neatly into one category, mostly into one with a few other symptoms, or be all over the map.

It’s important to track your PMS symptoms for a couple of months to get a good idea of what your main symptoms are and when they are happening – this helps us determine the root cause and determine the appropriate treatment plan for you! Not yet tracking? Head to my article “PMS: What’s a girl to do?” to download a tracking chart and get started!

Let’s go over the 4 main types of PMS together along with some common causes and a few treatment options you can get started with at home!

PMS-A (Anxiety)

If you fall within this type of PMS, you likely tend to feel more anxious in the second half of your cycle (after ovulation). This may mean you are more sensitive, prone to mood swings, feel more overwhelmed or are more irritable than usual.

PMS-C (Cravings)

This type of PMS often shows up as intense sugar or carbohydrate cravings during the second half of your cycle.  Along with the cravings, women often experience increased appetite, headaches and fatigue during the PMS window.

PMS-D (Depression)

This type of PMS can present with fatigue, insomnia or sleep changes, low mood, and crying easily. Women who experience PMS-D are more likely to be given a prescription for an anti-depressant medication, so it is important to determine the frequency and severity of these symptoms if you experience them so we can differentiate between PMS-D and true depression. Another condition that may need to be considered here is PMDD (Premenstrual Dysphoric Disorder) which is a severe form of PMS-D associated with extreme shifts in mood in the second half of your cycle and greatly interferes with your daily life (difficulty or inability to work, affecting relationships, etc.). Treatment for PMDD is often different, and more comprehensive than treatment for PMS.

PMS-H (Hyper-Hydration)

Women presenting with PMS-H experience bloating, water retention, breast swelling/tenderness, and weight gain during the second half of their cycle. These symptoms can be mild, or more severe to the extreme of change clothing and/or bra sizes.

The Root Cause of PMS

As with any symptoms, conditions, or illnesses, naturopathic doctors are trained to look beyond the “what” and find the “why”. Once we know why you are experiencing a certain symptom, it makes it a whole lot easier for us to work together to address this root cause and stop your symptoms from happening, rather than simply suppressing them (I like to use the over-simplified example of taking painkillers for foot pain vs taking the rock out of your shoe).

PMS is no different, however there can be many different root causes of PMS. Tracking your symptoms is the most helpful way to give us clues as to what your root cause is. Some of the main root causes for PMS symptoms include:

• Estrogen dominance (estrogen levels are too high in relation to progesterone levels)
• Dysbiosis (unhappy gut microbiome, or gut bacteria)
• Thyroid dysfunction
• Vitamin/nutrient deficiencies
• Excess cortisol (stress hormone)
• Insulin resistance/blood sugar imbalance

5 Starting Points for Combatting PMS:

1) Optimize Sleep – Ensure you are getting 7-8 hours of sleep every night. Keep bed/wake times consistent. Keep a consistent bedtime routine. Avoid screens 1 hour before bed. Keep your room dark and cool. Avoid caffeine (especially in the afternoon/evening). Exercise in the morning vs evening.

2) Manage Stress – Mindfulness, meditation, journaling, yoga, walking in nature, deep breathing…explore different options and find the one that work best for you (sorry ladies, wine doesn’t make the cut here!)

3) Exercise – Choose something that gets your heart rate up (dancing, jogging, circuit training, etc.) Bonus if it also gets you outdoors! Aim for 30 minutes of movement every day. When you have your period, choose something less intense like yoga, or a nature walk!

4) Eat a balanced diet – This can look a little bit different for everyone, but in general aim for your plate to contain 50% non-starchy vegetables, 25% protein, 25% starchy vegetables or whole grains, and a source of healthy fat at each meal. For snacks, make sure to include protein and fat to keep your blood sugar balanced all day long.

5) Reduce exposure to hormone disruptors – Hormone disruptors are chemicals found in everyday products that are structurally similar to, and can interfere with the hormones we produce naturally in our body. These products include shampoo/conditioner, body wash, soap, deodorant, make-up, household cleaning products, plastic containers/water bottles, etc. The Environmental Working Group is a great resource to help you determine to your products contain these chemicals, as well as to help you find safer alternatives.

While I always start with the above lifestyle recommendations, there are some key herbal and nutritional supplements, as well as diet changes that can enhance your treatment plan.

*This is by no means a complete list, as specific recommendations should be made based on individual symptoms. Be sure to consult a Naturopathic Doctor before starting any supplements to determine if they are right for you*

• Nutritional and Herbal Supplements:  
  • Vitamin B6
  • Magnesium glycinate
  • Vitamin D
  • Omega 3
  • Chastetree
  • Ashwagandha

• Specific Dietary Modifications:
  • Reduce or eliminate dairy, caffeine, alcohol, sugar, and refined/processed carbohydrates (think bagels, cereal, toast, muffins, etc.)
  • Add ground flax seeds (1 tbsp) daily
  • Add cruciferous vegetables (broccoli, cauliflower, brussel sprouts, kale, etc.) daily
  • Ensure 25-35g of fibre daily
  • Minimum 2L of water daily

• Acupuncture – This can be a great addition to your treatment plan to help manage stress, bloating/digestive issues, improve sleep, and reduce pain.

If you’re struggling month after month with PMS symptoms thinking that it’s normal and “just part of being a woman” – I’m here to tell you, you don’t have to! Start tracking your symptoms and see a naturopathic doctor to help put together your individualized treatment plan to combat PMS.

-MC