"Why Am I So Angry?"- Understanding Premenstrual Syndrome (PMS)

!±8± "Why Am I So Angry?"- Understanding Premenstrual Syndrome (PMS)

When it comes to PMS and other menstrual disorders, women are often frustrated with the lack of understanding and proper care they receive from conventional sources. "One week before my period, I'm so irritable I could rip my husband's head off" is a frequent statement. Oral contraceptives seem to be the one-stop treatment of choice for many of these complaints and although artificial stabilization of hormones can bring relief for the issues of PMS, it does not help to find the cause of the problem.

Natural medicine has much to offer for PMS sufferers as it targets the root of the problem. In my practice in Brisbane, I help women unravel the cause of their particular PMS symptom picture

Let's take a look at what's going on.

PMS is defined as the well known myriad of symptoms which start 1-2 weeks before the period. These include

Breast pain mood changes such as anger or depression headaches acne digestive complaints such as bloating, constipation, or diarrhea weight gain and water retention sugar cravings fatigue often 1-2 weeks before the period.

All symptoms MUST resolve with the onset of the period to be classified as PMS or something else is going on.

Hormonal Balance

From the first day of the period to ovulation (typically around day 14), oestrogen rises slowly and declines after the egg is released from the ovary. In a normal menstrual cycle, progesterone is the main hormone after ovulation-it helps to offset some of the strong effects of oestrogen.

A common finding in PMS sufferers is an elevated oestrogen/progesterone ratio in which oestrogen is abnormally elevated compared to the level of progesterone. This can be due to an inefficient liver clearance of oestrogen or mild progesterone deficiency.

Another reason why progesterone is low in the 2nd half of the cycle is stress. Stress raises a hormone called cortisol. When stress is continuous, progesterone is taken from the menstrual cycle to convert to cortisol. This is a protective mechanism --as the body thinks it is running from a tiger it considers cortisol more important than the reproductive hormone progesterone.

Irritability and Depression

Not only can high oestrogen cause all of the symptoms of PMS, but an elevated oestrogen/progesterone ratio has also been shown to impair proper neurotransmitter synthesis such as the "feel-good" serotonin. This may be due to oestrogen depleting B6 levels which is a necessary vitamin to produce proper serotonin levels.

B6 levels are frequently low in depressed patients, especially those taking oestrogens such as the birth control pill or menopausal medication such as Premarin.

Anger is also often experienced by women with PMS. Energetically, anger can be a frequent sign of liver congestion and oestrogen overload.

Oestrogen Dominance

The total amount of oestrogen in your body is determined by

how much you make yourself (technically, all oestrogen starts as testosterone and is converted in the ovaries or fat tissues-known as endogenous oestrogen) how much comes from the outside (from hormones in animal products, chemicals in cosmetics etc-known as exogenous oestrogen) and how well you detoxify both

Too high oestrogen is known as oestrogen dominance, a condition associated with PMS, breast cancer, uterine fibroids, and endometriosis.

Other hormonal influences

In addition to the above mentioned effects, excess oestrogen has also been implicated in a rise in aldosterone secretion from 2-8 days prior to menses, causing fluid retention, a common complaint in PMS. Endogenous and exogenous oestrogen can also increase prolactin secretion by the pituitary gland. Elevated prolactin has been linked to progesterone deficiency, breast pain, fibrocystic breast disease, and hypothyroidism.

Hypothyroidism affects a large percentage of women with PMS, and should therefore not be underestimated. If symptoms persist, a simple blood test can identify blatant thyroid dysfunction.

Natural Approaches to PMS

It is always important to know what type of PMS you are experiencing before embarking on a treatment plan. The suggestions below are just examples of a wide variety of professional treatments.

Diet: In my practice, diet and lifestyle recommendations are always the foundation on which I build my treatment plan. I often start the treatment with a cleansing diet for 2-4 weeks, after which I focus on specific diet changes. Depending on the symptom picture, a typical dietary recommendation for a patient with PMS may be to reduce all animal products to decrease exogenous oestrogens as well as saturated fats. To put this into context: vegetarian women excrete two to three times more oestrogens in their faeces and have 50% lower free oestrogens than their omnivore counterparts. Overall reduction of fat, sugar, and salt all has been shown to significantly improve PMS symptoms in some women.

Liver Detox: the liver is a very important organ of detoxification. Oestrogens are detoxified through the 2 main detox pathways of the liver. Abstaining from alcohol, caffeine, chemicals and processed foods can lower the total detox burden of the liver. Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage) contain Indole-3-carbinol-a potent compound that aids in the liver detoxification of oestrogen. This is also available in pill form from a qualified naturopath.

The Gut: Another important aspect of PMS treatment is to establish proper bowel flora. To detoxify oestrogens, the liver binds it to glucuronic acid which prevents the reabsorption of oestrogens from the bowel. Certain undesirable gut bacteria produce the enzyme beta-glucuronidase which cleaves this bond and allows these oestrogens to re-enter the circulation, adding to the total oestrogen pool. Increasing fibre and adding probiotics to the treatment protocol can be very beneficial.

Exercise and stress reduction have been clearly documented in the literature for reducing symptoms of premenstrual syndrome.

Specific Herbs and Nutrients

A professional naturopath has many herbal remedies and nutrients to design an individualized treatment plan.

By far the most commonly used herb in PMS is Vitex agnus-castus (Chaste tree berry). It is so effective in regulating menses and lowering prolactin it has been written up in Europe's prestigious "German Commission E" --a scientific database on herbal substances

B6 and Magnesium are important for proper serotonin production especially in cases of oestrogen dominance. It also seems to help with sugar cravings before the period.

"Why Am I So Angry?"- Understanding Premenstrual Syndrome (PMS)

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!±8± URAP Luke Snelling presentation

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Foods For Menopause Symptoms

!±8± Foods For Menopause Symptoms

Foods to Avoid

In general, the typical Western diet of white flour, and full-fat dairy and meat is not only unhealthy but also contributes to hot flashes.

Avoid chemicals that mimic estrogens (xenoestrogens) found in pesticides or herbicides by eating organic foods.

Intensively reared animals have often been treated with antibiotics and hormones, another reason to eat organic meat and chicken.

Minimize your exposure to foods stored in plastic containers and never heat or microwave food in plastic containers - as they will leach xenoestrogens.

Cut down on all caffeine, fizzy cola-type drinks, sugar, chocolate and too much alcohol, which all act as stimulants and trigger blood sugar problems,

Friendly Foods

Increase your intake of fresh, locally grown and preferably organic fruits and vegetables.

Fermented soya-based foods are truly one of the best foods for managing the symptoms associated with the menopause. Soya contains isoflavones (phyto-estrogens), which have estrogen-like effects on the body and block the harmful effects of estrogens and xenoestrogens. There has been much misinformation written about about soya, but soya foods in their traditional forms of miso, soya sauce and tempeh (a fermented form of soya) are all rich in isoflavones which have been proven to reduce the risk of developing cancers. But they are best eaten cooked.

Eat more organic tofu and use soya, rice or almond milks.

Isoflavones are also found in chickpeas, lentils, alfalfa, fennel, kidney beans, sunflower, pumpkin and sesame seeds, Brazil nuts, walnuts and linseeds. All seeds and their unrefined oils are rich in essential fatty adds which also help reduce joint pain, risk of heart disease.

Foods from the brassica vegetable family also help protect against estrogen-sensitive cancers, including breast cancer and cervix cancer, and balance hormones. These include cabbage, broccoli, pak choi. Brussels sprouts, cauliflower, kale, kohlrabi, mustard, rutabaga and turnips.

Brazil nuts and sesame seeds are a better source of calcium than cows' milk.

Live, low-fat yoghurt increases healthy bacteria in the gut, which aids absorption of nutrients from your diet.

Vitamin B12 has been shown to reduce irritability, bloating and headaches associated with the menopause and is found in oily fish, eggs and meats.

Potassium and pantothenic acid (vitamin B5) help support adrenal function. They are found in wholegrains such as brown rice, amaranth, barley, quinoa, salmon, tomatoes, broccoli, cauliflower, avocado, dried apricots, banana, cantaloupe melon, oranges and fish.

Use dried seaweeds such as kombu in your cooking and stir-fries, as seaweed is rich in iodine (which supports the thyroid) and calcium.

Eat organic foods including meat, chicken, vegetables and fruits to avoid ingesting too many toxins from herbicides and pesticides.

Folic acid found in wheatgerm, eggs, leafy greens, calves' and chicken liver, dried yeast and boiled beetroot is very important during the menopause to protect the bones.

Include garlic in your diet, which helps to keep cholesterol levels in check.

Drink more spring water which helps to regulate body temperature.

Avoid very hot drinks and hot spicy foods.

!f you have trouble sleeping, try valerian and passionflower teas.

Foods For Menopause Symptoms

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New Study Finds Vegetables Can Prevent Bladder Cancer

!±8± New Study Finds Vegetables Can Prevent Bladder Cancer

At buffets, not everyone rushes to grab Brussels spouts, cauliflower and turnips. That could change since researchers at the Maryland Anderson Cancer Center report that cruciferous vegetables like broccoli, kale, collards, radish and watercress may offer protection against bladder cancer.

Investigators theorize that a compound called isothiocyanates (ITC) in these crunchy veggies activate detoxifying enzymes that prevent cancer formation.

In a study featured in the International Journal of Cancer, researchers compared 697 newly diagnosed bladder cancer patients to 708 controls matched by age, sex and race. After comparing the dietary intake of the groups, examiners found that the healthy volunteers consumed substantially more vegetables than the bladder cancer patients.

However, this anti-cancer effect do not extend so readily to the women in the study. Evidence of this sexist cancer protection appears in other investigations.

For example, in 2005, researchers reviewed the lifestyles of 237 bladder cancer patients who helped make up the 88,796 women enrolled in the Nurses' Health Study. After evaluating the patients' diets, examiners find no link between consumption of fruits and vegetables and bladder cancer risk. Incidentally, taking multivitamins or vitamins A, C or E did not influence bladder cancer risk among the women.

Notwithstanding, three years earlier a study presented in the American Journal of Epidemiology found that vitamin E reduced bladder cancer risk.

In this study, scientists examined the association between use of individual vitamin C and vitamin E supplements, and bladder cancer mortality among 991,522 adults. Researchers monitored the study participants via questionnaires from 1992 to 1998.

During the follow-up, 1,289 bladder cancer deaths occurred (962 in men and 327 in women). Upon comparing the lifestyles of the cancer group to age, sex and diet matched cancer-free controls, the examiners found no link between vitamin C intake can bladder cancer.

Yet, regular vitamin E supplement use for at least 10 years was associated with a reduced risk of bladder cancer death. Based on these results, the investigators concluded that long-term vitamin E supplement use may reduce the risk of bladder cancer.

Overall, consuming fruits and vegetables does seem to reduce the risk for bladder cancer as a study involving 130 bladder patients in Serbia found. While the results are mixed, bladder cancer studies increasingly suggest that adding a little crunch to your meals with antioxidant rich vegetables will chop away at chances of developing bladder cancer.

Sources:

Holick, Crystal et al. Intake of Fruits and Vegetables, Carotenoids, Folate, and Vitamins A, C, E and Risk of Bladder Cancer Among Women (United States). Cancer Causes and Control; December 2005, vol 16, no 10, pp 1135-1145.

Jacobs, EJ et al. Vitamin C and Vitamin E Supplement Use and Bladder Cancer Mortality in a Large Cohort of US Men and Women. American Journal of Epidemiology; December 2002, vol 156, no 11, pp 1002-1010.

Radosavljevi, V; S Jankovi, J Marinkovi & M Doki. Diet and Bladder Cancer: A Case-Control Study. International Urology and Nephrology; June 2005, vol 37, no 2, pp 283-289.

Sanchez-Ortiz, Ricardo. Compound Found In Cruciferous Vegetables Associated with a Decreased Risk of Bladder Cancer. UroToday; May 17, 2007.

New Study Finds Vegetables Can Prevent Bladder Cancer

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