PMS protocol released
anxiety, depression, insomnia, headaches, bowel dysfunction, acne cramps, migraines
What’s a scrappy guy like me think he’s doing writing about PMS? Good question. Yet, as a person who grew up as the only man in a household of women; I was indoctrinated at an early age about PMS. Also over the years as a husband I have learned also about this special time. Finally, as a physician I have been entrusted by many patients over the years who are desperate for relief. I am at a point in my career where I want to share my learning as I feel too many people are left without this knowledge. So here I am writing and sharing about PMS! Let’s get into the basics.
Premenstrual syndrome (PMS) is defined as a group of symptoms, both physical and behavioral, that occur in the second half of the menstrual cycle and that often interfere with work and personal relationships.
These are followed by a period entirely free of symptoms.
Premenstrual dysphoric disorder (PMDD), is the more severe form of symptoms that worsen premenstrual and is said to effect 3-8% of women
In general, somatic symptoms relate to presumed fluid retention,breast tenderness, and various pain constellations, such as headache or pelvic pain. Psychologic symptoms vary from irritability and tension to anxiety, aggression, and depression.
It is important to differentiate PMS from other illnesses with similar symptomatology. Patients with psychiatric disorders, such as different types of depression, anxiety reactions, and psychosis, may present believing that they have PMS. A differentiating aspect is that PMS patients suffer their symptoms only during the luteal phase of their cycle.
Most recent theories associate PMS with alterations in the serotonergic neuronal mechanisms in the CNS. Early theories were thought to be due to Estrogen dominance.
Vitamin B6 deficiency in PMS patients has been suggested because B6 is a coenzyme in the biosynthesis of dopamine and serotonin and the possibility that this agent may be involved in the etiology of PMS has been raised. B6 is a nutrient that is key in COMT function. COMT stands for Catechol-O-methyltransferase, an enzyme that breaks down catecholamines, catecholestrogens, and other substances with a catechol structure. This enzyme is genetically slow in some people often leading to excessive worry and anxiety especially during premenstrual time frame. This enzyme is dependent on B6 and Magnesium to run efficiently. If it is slow catecholamines (stress hormones can build up especially when the enzyme is busy also processing estrogens (ie. during PMS).
Conventionally it is usually treated by placing women on cyclic estrogen and progesterone therapy (OCP’s). Many people don’t even explore natural approaches.
I have put together a naturopathic/functional medicine protocol that I have curated over the years that addresses PMS symptoms. It is scalable and customizable based on symptoms. Check it out here.
I also suggest most women with PMS get a 24-hour urine hormone test on day 21 of their cycle. I use the Dutch Test and similar tests to accomplish this.