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When Should I Be Worried About My PMS?

Aug 17, 2018

Premenstrual syndrome, or PMS is said to affect 95% of us at some point in our reproductive years, right from puberty until the menopause.

You’ll probably be familiar with the most common symptoms such as low energy, a lack of motivation and mild bloating and you might even experience some cramping during your period itself. I know I certainly struggle with my energy levels!

Having said that, you also know when something’s not right.

You know when your menstrual cycle isn’t working in the same way it used too. When you find yourself feeling desperately unhappy, tearful, angry, irritated, extremely fatigued, craving all kinds of sugary foods and suffering from anxiety when your period comes around, you know something isn’t right.

The trouble is, how do you get to the bottom of it?

How do you know what is normal and what isn’t? How do you know when you have cause for concern and should see your doctor?

And most importantly, how can you do something about it so you can feel like your normal self again, no matter what time of the month it happens to be? Let me explain.

Your hormones and your cycle

Let’s start by talking a little bit about your hormones and your menstrual cycle. You see there’s much more to your menstrual cycle than getting your period every four weeks or so.

Over the course of your cycle (usually around four weeks) your three main sex hormones: oestrogen, progesterone and testosterone rise and fall in a specific pattern. I like to think of this more as a ‘flow’, or similar to the ebb and flow of the tides or the phases we see in the moon every month.

Week One

The month starts with day 1, the first day of your period. At this stage, your oestrogen and progesterone levels are relatively low and you’ll be more likely to feel more tired than usual, perhaps achy, and more like staying closer to home. At the end of this week, your oestrogen levels start to climb and you’ll notice you start feeling more like yourself again.

Week Two

During the second week, your oestrogen and testosterone levels will continue to climb until they reach their peak at around day 14 of your cycle (if your cycle is 28 days) when ovulation should occur. You’ll be feeling at your best at this time, energetic, motivated, focused and more confident than usual.

Week Three

After ovulation, your oestrogen levels decline sharply, and you might feel like you have a touch of PMS such as increased irritability, tiredness and a desire to stay in bed a bit longer. During this time, your progesterone will start to rise and you’ll feel quieter, less confident and perhaps suffer from brain fog or fatigue.

Week Four

Finally, week four is when you’ll tend to notice more symptoms of PMS. Your oestrogen levels plunge sharply, your progesterone levels continue to rise and you’re more likely to feel sad, irritable, worried, teary and also suffer from any symptoms of PMS.

Why it is important to know this? Knowing this information about your menstrual cycle is very empowering and helps to break the mystery and worry about what is happening within the body.

It can also help you to ‘go with the flow’ over the entire month. When there are days when you know your energy will be low, you can book more time in your diary to relax and take it easy (guilt-free!). Additionally, you can also take advantage of those days where you have more energy and can use it to your advantage.

Needless to say, that once you’ve learned this information about your menstrual cycle, you stand a much better chance of pinpointing the main causes of your PMS symptoms and learn how to treat them so you can start living life to the full again.

What is PMS?

PMS, or premenstrual syndrome refers to the symptoms you might experience in the week just before your period starts, and perhaps a couple of days afterwards too.

It’s very common, affecting an estimated 95% of women to some degree.

We’re far more likely to suffer from PMS through our 30s and 40s, towards the perimenopause and menopause. The good news is that it will stop once you’ve fully transitioned through the menopause.

What are the symptoms of PMS?

Symptoms of PMS change from woman to woman, and might change over the course of your lifetime. They might include any combination of the following:

  • Swollen or tender breasts
  • Constipation
  • Diarrhea
  • Bloating or a gassy feeling
  • Cramping
  • Headache
  • Backache
  • Clumsiness
  • Lower tolerance for noise or light
  • Irritability or hostile behavior
  • Feeling tired
  • Sleep problems
  • Appetite changes or food cravings
  • Brain fog
  • Tension or anxiety
  • Depression, sadness or crying
  • Mood swings

What causes PMS?

Doctors aren’t entirely sure what causes PMS, but suggest that underlying hormonal imbalances or an increased sensitivity to shifting hormones might be to blame. It appears that the steep decline of oestrogen and increase of progesterone at the end of the menstrual cycle could also play a role.

In my practice, I treat many women who have a similar group of premenstrual symptoms and which can all be treated with the right holistic approach. These include the following:

Heavily bleeding

It’s quite common to suffer from heavier menstrual bleeding once you reach your mid thirties and beyond as your body approaches the peri-menopause because of shifting levels of oestrogen, especially if you suffer from fibroids or are suffering with oestrogen dominance.

Lifestyle factors such as the foods you choose to eat and the chemicals you use on your body will also play a role.

Sadness and anger

Whilst it’s also normal to feel a little sad or ‘low’ as you approach your period, it’s not much fun if you feel like throwing a frying pan at your partner’s head every month, or lie in your bedroom crying.

Again, this could point to an imbalance in hormones such as high oestrogen levels or low progesterone levels.

It’s also worth investigating if you have an underlying thyroid problem as hyperthyroidism can cause anxiety, irritability and mood swings. If you’re concerned about this, consider taking your basal body temperature immediately as you wake. If your body temperature is much higher or lower than 97.8 to 98.2ºF, it’s worth consulting your doctor.

Brain fog  

Do you find you can’t recall common words, or why you went in to the kitchen? This could be caused by a drop in oestrogen and potentially an underlying hyperthyroid issue too. Again, check your body temperature daily (following the instructions below) and consider consulting your doctor.


Headaches always seem to come thick and fast when your due your period. Sometimes it can simply be due to feeling more tired and grouchy, but usually, it’s triggered by hormonal fluctuations, low magnesium levels or gut health issues.


Constipation can be normal around the time of period, but if it continues, make sure you investigate your thyroid health by taking your basal body temp. (Again, see below for instructions).

Thyroid issues can slow down your food’s transit time through your digestive system and lead to other digestive discomfort too. Additionally, you could be suffering from digestive issues such as SIBO (Small intestinal bacterial overgrowth) which can make matters worse.

Hot flushes

Hot flushes can be very uncomfortable and very embarrassing and are a common occurrence during the peri-menopause. They’re often triggered by an imbalance in oestrogen (both high and low oestrogen could be to blame), low progesterone levels and worsened by stress, poor liver health or gut health issues.

Sugar cravings

It’s never normal to suffer from sugar cravings, even if you’ve always reached for the biscuit tin once your period approaches. This is an indication of a blood sugar imbalance and potentially insulin resistance.

Natural and holistic solutions for your PMS

#1: Learn to take your basal body temperature

I’ve mentioned the importance of taking your basal body temperature several times throughout this article because it’s a straightforward way to find out what is happening with your menstrual cycle, your hormones, and your overall health. If you’re suffering from PMS, I highly advise that you make it part of your regular morning practice.

Here’s how to do it:

  • As soon as you open your eyes in the morning, reach for your digital thermometer and take your temperature. Don’t do anything else. Don’t talk, move around, go for a wee, have sex, nothing.
  • Record your result on this basal body temperature worksheet then get on with the rest of your day.
  • Over the course of a few weeks, you’ll start to notice a pattern.
  • Remember, a normal range is 97.8 to 98.2ºF. You’ll notice a surge in temperature of around 0.2 around the time of ovulation.

If you need to visit your doctor to investigate any hormonal issues, you’ll be far better prepared if you can take along this worksheet. Download it here.

#2: Eat regularly

Don’t be tempted to skip meals, even if you’re trying to lose weight. This really messes with your cycle, disrupts your hormone balance and can worsen your symptoms of PMS. Make sure you’re including protein with every meal, whether that’s plant-based or animal protein.

#3: Increase magnesium

Magnesium is a great hormone balancer and calming minerals which many of us are deficient in. That’s why I recommend that you eat plenty of those foods which are rich in magnesium such as the following:

  • Green leafy vegetables (e.g. spinach and kale)
  • Fruit (figs, avocado, banana and raspberries)
  • Nuts and seeds
  • Legumes (black beans, chickpeas and kidney beans)
  • Vegetables (peas, broccoli, cabbage, green beans, artichokes, asparagus, brussels sprouts)
  • Seafood (salmon, mackerel, tuna)
  • Whole grains (brown rice and oats)
  • Raw cacao
  • Tofu
  • Chlorella powder

It’s also worth taking a supplement. I recommend Magistrate or using Epsom bath salts.

#4: Get more vitamin B6

Vitamin B6 is a nutrient which is essential for the production of hormones such as progesterone and serotonin and can help ease your PMS symptoms, improve your sleep and ease stress.

Great food sources include:

  • Fish & seafood
  • Lean meats and poultry
  • Eggs
  • Legumes (beans and peas)
  • Nuts & seeds (especially hemp seeds, sunflower seeds and chia seeds)
  • Bananas
  • Watermelon
  • Almonds
  • Sweet potatoes
  • Avocados
  • Prunes
  • Pineapple
  • Plantains
  • Artichokes
  • Water chestnuts
  • Squash and pumpkin
  • Brussels sprouts, kale, collards and other green leafy veg
  • Green beans
  • Figs
  • Nutritional yeast
  • Garlic
  • Sage
  • Peppers

#5: Get more fibre in your diet

Ease your PMS, rebalance your hormones and keep yourself ‘regular’ by making sure you’re getting as much fibre in your diet as possible. The best source is whole plants such as vegetables, green leafy vegetables and nuts, and seeds. Ideally, you need a minimum of around 30g daily

#6: Increase foods rich in omega 3s

Several studies have shown that supplementing with omega-3 can reduce symptoms of PMS. Although the exact reason it works is still unknown, scientists suggest that it might be because of the way in which these essential fatty acids affect hormones, hormonal receptors, and specifically, the way the hormone prolactin works in the body.

I’m a strong believer in the importance of boosting your nutrient intake with food first, so I’d suggest you include plenty of the following in your diet:

  • Fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines)
  • Nuts and seeds (such as flaxseed, hemp seeds, chia seeds, and walnuts)
  • Brussel sprouts

#7: Enjoy restorative practices

It’s also very worthwhile making a restorative practice part of your daily routine so that you can relax, recharge your batteries and let the stress of everyday life fall off your shoulders. Yoga, breathing, mindfulness, and visualisation all work wonders.

When should you get help for your PMS?

As I’ve mentioned earlier, it’s important to visit a doctor if you notice a sudden change in your symptoms of PMS, or you experience anything which you find worrying. Often, there’s nothing to be concerned about, but it can help put your mind at ease.

It’s also worth mentioning that 3-8% of menstruating women suffer from a more severe form of PMS called PMDD (Premenstrual dysphoric disorder). This disorder causes debilitating symptoms which affect your life, your job, your social life, and your close relationships. If you are concerned, please visit your doctor.

Remember that PMS isn’t a necessary part of being a woman and you don’thave to dread ‘that time of the month’.

Instead, become your own ‘health detective’; track your basal body temperature, make a note of your PMS symptoms and understand what is happening in your body. From there you can move forward and help your body rebalance and heal naturally.


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