A Natural Approach to PMS

You may know the feeling. About a week before the start of your period you become unaccountably irritable, anxious or sad. You snap at co-workers and loved ones at the slightest provocation, or you feel depressed or tearful for no good reason. You’re bloated and tired all the time.

It may be pre-menstrual syndrome, or PMS as it is commonly referred to. What is it, and why do some women get it while others don’t? PMS is a range of symptoms (a “syndrome”) that occur in response to hormonal changes that happen in the body during the menstrual cycle. Symptoms can be emotional or physical and can include breast swelling and tenderness, bloating, water retention, weight gain, acne, or cravings for sweet or salty food. Many women also experience pain in the form of headaches, migraines, low back pain and abdominal cramping. Most symptoms disappear as soon as menstrual bleeding begins.

The exact cause of PMS is not known, but some medical experts believe that the symptoms are a result of hormonal changes that occur after ovulation. These chemical changes are not limited to the reproductive system. They affect the functions of other hormones in the body such as insulin, which helps maintain normal blood sugar, and serotonin. Low levels of serotonin, the “feel good” hormone, are linked to emotional depression.

Traditional Chinese medicine (TCM) looks at the causes of PMS in a different way. TCM is based on the theory that a constant flow of energy, called "Qi," is vital to the life and health of the body and mind. Qi is basically life energy. To breathe, walk, talk, eat, or do anything we need Qi. Without Qi there is no life. When Qi is insufficient, or becomes blocked or stagnated, illness occurs or we feel pain. This Qi energy flows in specific patterns called channels or meridians. Meridians flow through and energize the organs of the body, and are named after their respective organ. For example, the Stomach meridian flows through the stomach and connects with other organs of digestion such as the large intestine and the spleen. Another example is the Lung meridian which energizes the Lungs and is responsible for respiration and the body’s immune resistance.

In TCM, one organ that is closely related to a woman’s menstrual cycle is the Liver. According to TCM theory the Liver’s many functions include storing the blood and controlling the free movement of Qi. Both of these functions are essential to menstruation.

Physical and mental health are connected, and each organ is associated with a particular emotion. The Liver is ruled by the emotion of anger. Anger can take many forms including annoyance, irritation, resentment, rage and depression. If we are physically and mentally balanced we experience these emotions within reason when they arise, and are able to deal with them in a healthy manner. When work, stress, personal issues or physical health concerns become overwhelming the emotions tend to tip out of balance. Over time this imbalance can build up causing stagnation of the Liver’s Qi. Liver Qi stagnation is a very common cause of PMS symptoms. Of course, Liver Qi stagnation is not something exclusive to menstruating women. It is common to women of all ages and men as well.

If left unchecked, this type of problem can lead to further imbalances including digestive upset, irritable bowel syndrome (IBS), high blood pressure, severe emotional depression or uncontrollable rage.

So what are some ways to treat this?

I like to start first with the diet. You will want to focus on foods that are good for your energy, and that are less congesting. Foods that tend to congest, or cause energy to get stagnated or “stuck,” are usually those that are harder to digest. Some examples are greasy and fried foods, excessive dairy and meat, processed foods and sugary snacks.

Spicy foods can also be a problem for someone with longer-standing Liver Qi stagnation. When the Liver is consistently out of balance, the stuck Qi tends to create heat that rises to the head and upper body manifesting in headache, dizziness, red irritated eyes or a flaring temper (think of the way fire rises upwards!). The heat of spicy foods can contribute, making the situation worse.

Eat foods that are cooling and soothing, increasing your fruits and vegetables. Bitter greens such as dandelion, watercress and arugula are excellent for decongesting the Liver, and sour foods help nourish it as well. Soy foods are also a good choice as they have a cool nature. Nourishing soups, stews, wild-caught fish, whole grains and yogurt are just some of the many food choices available. An omega-3 supplement is something I recommend to nearly all my patients, especially if fatty fish is not a big part of the diet (salmon, tuna, mackerel, sardines, etc.), and most certainly if someone is prone to Liver Qi stagnation. Studies have shown that omega-3 fatty acids are helpful for people with depression and heart disease.

Exercise is an absolute must, at least every other day or more often if your schedule allows. The benefits of regular exercise are amazing: increased cardiovascular health, improved digestion, flexibility, pain reduction, mood elevation, weight management, improved sexual function, and you’ll sleep better! I know it can be hard getting started on a regular exercise routine but the benefits will be worth it, I promise. Try to do something you enjoy like swimming, walking or dancing. If you discipline yourself to just get out there and do it, after a week or so you may be surprised to find yourself looking forward to it. As your body begins to heal itself it will crave that exercise!

Finally, know that acupuncture can do wonders for PMS symptoms. Acupuncture works by unblocking the stagnated energy using thin needles. I see a number of women in my practice who suffer from PMS and for many, the improvement is fairly immediate especially if combined with good diet and exercise habits. If necessary, there are safe herbal formulas available that can supplement the process.