Dr. Paul Dell’Aquila Featured in ExpertBeacon

Expert advice for reducing and treating premenstrual symptoms

Dell’Aquila, Paul

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Premenstrual syndrome, also known as PMS, is characterized by a hormonal imbalance which causes a combination of physical and emotional symptoms that typically reoccur on a monthly basis. Symptoms begin days or even weeks prior to a woman’s menstrual cycle and will usually end with the onset of her cycle. Approximately 70-80% of women may suffer from this syndrome during their childbearing years. Typical symptoms include, but are not limited to: anxiety, irritability, mood swings, cravings for sweet or salty foods, abdominal bloating, headaches/migraines, back pain, weight gain, and fluid retention. Risk factors for PMS include: high caffeine intake, low levels of vitamins, high stress lifestyle and family history of PMS. The diagnosis of PMS at times can be difficult to distinguish as there are no specific lab tests. Usually a woman is asked to keep a journal of symptoms she is experiencing. If there is a 30% increase in symptoms from the week prior to her menstrual cycle, then a diagnosis can be made. Although different factors contribute to PMS, it appears that there is an abnormal interaction between central nervous system neurotransmitters and the sex hormones. There also appears to be an elevated level of glutamate, which is an excitatory neurotransmitter, in women with PMS.

change your lifestyle habits to decrease symptoms of PMS
take your vitamins
get your hormones checked
stress reduction techniques

do nothing
use synthetic hormones without knowing their effects
take over-the-counter supplements without knowing their effects
think that birth control pills, antidepressants and antianxiety medications are the only solution for PMS

Do change your lifestyle habits to decrease symptoms of PMS

Avoid caffeine, alcohol, salty and sugary foods as much as possible as these will contribute to fluid retention, bloating and inflammation. Eat more fruits and vegetables and whole grain foods. Get out and exercise regularly which helps increase levels of hormones which make you feel good and also decrease pain.

Do take your vitamins

The addition of a good high potency multivitamin is important. Vitamin B6 which can be found in a B complex supplement is important for neurotransmitter formation such as serotonin. Low serotonin levels may contribute to symptoms of depression which is a common complaint associated with PMS. Minerals such as Magnesium, Zinc and Calcium can also help alleviate the symptoms of PMS. Vitamin E has also been shown to be helpful with menstrual cramps. Evening Primrose Oil (EPO), contains gamma-linoleic acid (GLA) which is involved in the synthesis of prostaglandins. Prostaglandins are involved with uterine contractility, fluid balance and central nervous system function. So low intake of GLA may lead to an increase in uterine contractions or “menstrual cramps” and other PMS symptoms. Calcium and L-tryptophan have also been found to be helpful. Omega fatty acids also helps reduce fluid retention, decrease psychological symptoms and cramps.

Do get your hormones checked

PMS is associated with low progesterone in some women and low estrogen in others. A 28-day salivary hormone test can help determine whether there is a significant drop in your hormone levels at a particular time in the menstrual cycle. Low progesterone levels from days 12-24 are commonly seen in patients who suffer from PMS. You can then be prescribed bio-identical estrogen or progesterone where needed.

Do stress reduction techniques

Make sure you get enough sleep as this helps decrease stress levels. Incorporate relaxation exercises such as: Yoga, Tai-Chi, Massage, Meditation or whatever tends to relax you to decrease the symptoms of PMS.

Do not do nothing

There are many modalities to help with PMS. Whether you use diet, exercise, Bioidentical Hormone Replacement Therapy, nutrient or natural herbal supplementation or a combination of these therapies, don’t feel you are trapped. Approximately 90% of women who incorporate some form of the therapies described can alleviate a significant amount of their PMS symptoms.

Do not use synthetic hormones without knowing their effects

The use of daily synthetic hormones such as oral birth control pills or patches may actually increase your PMS symptoms. Synthetic hormones deplete B vitamins as well as your natural progesterone stores which also contribute to worsening PMS symptoms. It is better to supplement with the right combination of individualized hormones which are causing PMS symptoms rather than using a “one size fits all” approach.

Do not take over-the-counter supplements without knowing their effects

As with any therapy, it is best to discuss over-the-counter supplements with a healthcare professional who is well versed in their use. There is always a possibility of medication interaction or adverse effect with any supplement taken, so checking first is a great rule of thumb.

Do not think that birth control pills, antidepressants and antianxiety medications are the only solution for PMS

In mainstream medicine, PMS is often been treated with birth control pills, antidepressants or antianxiety medications. As there is a place for each and every one of these medications in certain scenarios, treating the root of the problem is more beneficial than just masking the symptoms. Healthcare professionals trained in the treatment of hormone imbalances can recognize the difference and make recommendations that can safely and successfully treat PMS.

Premenstrual syndrome affects almost all women at some time during their childbearing years. Simple dietary changes, incorporation of a good high quality multivitamin, stress reduction techniques and when needed, bio-identical hormones may alleviate symptoms for the majority of women.

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