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Wellness Club

PMS: Decoding Your Symptoms

By: @drmelissacugliari

Premenstrual Syndrome (PMS) is common, but not normal. While PMS is normalized in our society, a balanced, healthy period can actually result in little to no symptoms. PMS symptoms are messages from our body telling us something within needs some TLC. 


Below is a short guide to some common symptoms and what they may be telling you from a Naturopathic and Traditional Chinese Medicine perspective.

Breakouts: if you break out cyclically (around the same time each month), your hormones are likely a part of the problem. Often women who have this concern will see a temporary improvement if they are put on the birth control pill. However, the birth control pill isn’t healing the underlying “root cause” of the symptom. Typically, excess androgens (ie. male hormones like testosterone) or insulin are involved. Your hormones and insulin levels can be assessed with lab work and rebalanced accordingly using herbs and other natural therapeutics to achieve long-term, lasting improvement in the skin. 

Breast Tenderness: excess estrogen and a congested liver are often at play here. Increasing your daily consumption of leafy green vegetables is a great place to start to support liver detoxification. Try consuming two cups of organic, cooked, leafy greens like spinach or kale each day. Certain nutrients can also be supplemented with alongside the help of your Naturopathic Doctor (ND), including DIM, I3C and B vitamins. 

Cramping: cramping can be indicative of many underlying imbalances. Most common are mineral deficiencies and blood stagnation. In Traditional Chinese Medicine terms, cramps are often seen as a symptom of “internal cold”, which involves a stagnation or imbalance of energy. How can you combat cyclical cramps? Walking daily, supplementing with magnesium glycinate, and regular acupuncture are excellent tools to help alleviate a "crampy" period. Be sure to speak with your Naturopath or Functional Medicine Doctor about proper testing to address potential underlying causes as well. 

Cravings: this usually indicates nutrient deficiencies (certain minerals, for example) and blood sugar instability. Eating regular meals each day throughout the month, minimizing sugar, alcohol, breads, pastas & other grains, and fasting 12 hours between dinner and breakfast are simple ways to help combat cyclical cravings. To dig deeper, have your fasting blood sugar, HbA1C and fasting insulin assessed by your ND. 

Fatigue: while a slight dip in energy is normal around your period, fatigue is not a symptom to be ignored. This could indicate an imbalanced thyroid, low iron levels, and other nutrient deficiencies. Nutrient deficiencies can also indicate that your gut is not equipped to properly absorb nutrients and your digestion needs support. Lab testing is necessary to determine what exactly is going on prior to pursuing further treatment. With that being said, I counsel my patients on eating cooked whole foods, organic bone broths, and resting as needed around their cycle regardless of whether they’re experiencing fatigue or not.

Headaches: in Traditional Chinese Medicine, this symptom relates to a stagnated liver. Eating a diet rich in fruits and vegetables, creating a daily meditation practice or “deep breathing” practice, and stress reduction are great ways to promote liver health. 

Mood Changes: fluctuations in mood can indicate imbalanced hormonal changes (ie. estrogen, insulin, thyroid hormones) or a general lack of emotional expression in your life. Often when you’re withholding emotions or are failing to acknowledge and tend to your emotional health throughout the month, intense emotions can manifest prior to your period. I recommend taking a few moments each day to “visit” your emotional self. Journaling or meditation are great tools to do this. This is a very simplified explanation and you should always talk to your ND about this as more severe mood swings around your cycle may indicate Pre-menstrual Dysphoric Disorder (PMDD) which would be treated more specifically. 

Night Sweats & Hot Flushes: this can sometimes indicate lower estrogen levels or imbalanced progesterone levels. Try supporting your hormones by eating an adequate amount of healthy fats, moving daily (but not over exercising), and ensuring you maintain a healthy body weight. Organic sage tea is also an excellent daily addition.. 

Although most PMS symptoms indicate an underlying imbalance, some “normal” symptoms can include feeling the desire to slow down and an increased appetite. It takes a lot of energy to produce a period and women’s caloric requirements increase just before menstruation. Sometimes slowing down is necessary to accommodate your body’s needs at this time.

Remember, in order to alleviate PMS, you have to be consistent with a healthy diet and lifestyle throughout the month. When taking a holistic approach that addresses the “root causes”, it can often take up to three cycles before you start to see any improvement in the above realms.

Naturopathic medicine is an excellent way to further explore your unique period presentation and receive care that is individualized to your physiology. Remember, just because a symptom is common does not mean it is normal; don’t suffer in silence. Do your own research and talk to your ND or Functional Medicine practitioner if you suffer from symptoms around your period.