Which Type are You? Dr Guy Abrahams, a gynaecologist and specialist in the nutritional aspects of PMS, has classified the different types of PMS into four categories.
• Type A, ‘Anxiety’, is the most common, affecting up to 80% of women. Symptoms of type A PMS include mood swings, irritability, anxiety and tension.
• Type C, ‘Cravings’, as the name suggests involves cravings for sweet foods, increase appetite, fatigue and headaches. This can affect up to 50% of women before their period.
• Type D, ‘Depression’, is often found in combination with type A, and while depression is the main symptom of this group, it can also include forgetfulness, clumsiness, loneliness and lack of co-ordination.
• Type H, ‘Hyperhydration’, relates to water imbalance. This affects up to 40% of women pre-menstrually and involves water retention, bloating, breast tenderness and weight gain. Each type is likely to be linked to a different hormonal imbalance.
Type A is due to excess oestrogen and not enough progesterone, whereas type D is the opposite with too much progesterone and not enough oestrogen. As most women will experience symptoms from each of the four types at some point throughout their cycle, or from month to month, it is hard to determine an individual’s exact hormonal imbalance without a simple saliva test, which I recommend you do (via a nutritional therapist).
How to treat PMS with diet
As with all health problems, having a well-balanced diet is essential for providing the nutrients, vitamins, minerals and antioxidants needed for the body to work effectively.
Don’t be afraid of carbs
One of the most important dietary factors for balancing hormones is to keep your blood sugar level even. Eat plenty of complex, unrefined carbohydrates such as wholegrains (oats, brown rice, wholegrain bread and pasta, millet), beans (lentils, soya beans, kidney beans etc) and plenty of vegetables. Cut out all refined carbohydrates such as white bread, white pasta and rice, cakes, biscuits and sweets and any foods containing added sugar (check labels as this will be more foods than you think).
Get the right 5 a day
While eating plenty of fruit and vegetables has many benefits, vegetables such as broccoli and cauliflower are especially beneficial for PMS sufferers as they contain a substance called di-indoly-methane (DIM). DIM has been shown to mop up excess oestrogen and therefore relieve the associated problems such as weight gain, PMS, acne and menopausal symptoms.
Out with the bad, in with the good
Cut back on ‘bad’ saturated and hydrogenated fats (found in meat, dairy products and processed foods such as cakes, biscuits and junk food) as these have no nutritional value. Replace these fats with the essential fats found in oily fish, nuts, seeds and vegetable oils. These good fats are especially important for menstruating women as they help to prevent inflammation and reduce abnormal blood clotting.
Cutting out saturated fats should also help to reduce headaches, menstrual cramps and endometriosis discomfort. In fact it has been shown that diets high in saturated fats increase oestrogen production and prevent the absorption of the beneficial essential fatty acids.
Not only does fibre help with digestion and reduce cholesterol levels, but it also plays a key role in balancing female hormones. Fibre found in vegetables, fruit and wholegrains can absorb excess oestrogen in the gut and prevent it from re-entering the blood.
Cut the caffeine
Caffeine not only removes vital minerals and vitamins from your body due to its diuretic effect, but it’s linked to PMS, in particular breast pain and tenderness. Caffeine in tea, coffee, chocolate, soft drinks and headache tablets is a stimulant, which means it will also affect blood sugar levels and lead to rapid peaks and troughs in energy levels. I would recommend cutting out all caffeine and replacing with alternatives such as herbal and fruit teas and coffee substitutes such as Caro or Barley Cup. …
...And the alcohol
While it has been all-too-easily accepted that red wine is ‘good for the heart’, research has actually shown that these effects are only evident in women post-menopause. The liver is one of the key organs for controlling and balancing hormones as this is where excess hormones can be removed. If the liver is over-taxed by a poor diet and alcohol, this elimination will not occur.
Fight symptoms with phytoestrogens
Phytoestrogens are oestrogen-like, plant-derived substances which are found in high amounts in soya products and various vegetables such as peas and beans. However, despite being similar to oestrogens, they can actually reduce the problem of oestrogen dominance. This is because they lock onto and block the body’s oestrogen receptors, so protecting against the negative effects of too much oestrogen.
Asian women, who typically eat a lot of soya products, have fewer symptoms of the menopause, suggesting a beneficial effect on hormones. It has also been shown that soya can reduce the incidence of breast cancer (often due to an excess of oestrogen), and recent research has found that soya supplementation can help with many premenstrual symptoms including headache, breast tenderness and cramps. But, it is important to note that not all soya has equal benefits, and this depends on the treatment during processing. Some processing methods involve the addition of harmful levels of aluminium and nitrates. For this reason, I would recommend only buying soya products which say they are made from the whole soya bean.
Traditional fermented soya such as tempeh, miso, soya sauce and tamari are wise choices. Phytoestrogens are also found in a wide range of legumes such as beans, chickpeas and lentils, and also in seeds, garlic, grains such as oats and rice and certain fruits and vegetables. The herb red clover also contains several phytoestrogens which may help balance oestrogen dominance.
And key nutrients
The B vitamins are essential for balancing hormones and controlling the symptoms of imbalances. Vitamin B3 (niacin) is needed for energy production and sugar balance in the body. If your blood sugar levels are unstable, you are more likely to be tired, irritable, depressed and have hot flushes. Interestingly, women taking the contraceptive pill are often deficient in another important B vitamin – B6. This vitamin plays a vital role in controlling mood and depression and was first prescribed in the 1970s to treat women on the pill suffering from depression. It is also needed for clearing oestrogens from the liver.
If oestrogens are not cleared efficiently, symptoms relating to oestrogen excess will be observed. Magnesium, known as ‘nature’s tranquiliser’, is a valuable mineral for treating PMS, and magnesium levels are linked with poor appetite, nausea, tiredness, mood swings and muscle cramps. If you suffer from PMS it is likely you will have lower levels of magnesium than women without symptoms. As magnesium works together with vitamin B6, I suggest taking magnesium and a B-vitamin complex together.
As well as following a well-balanced diet with the addition of some valuable vitamins and minerals, there are a number of herbs which I recommend to help with hormonal imbalances.
• Black cohosh, originally used by the native North American Indians, may help to counteract excess oestrogen. It may also act on serotonin receptors and raise levels of the ‘happy’ neurotransmitter serotonin. This makes it a useful supplement for treating PMS-related depression.
• Agnus Castus/Chasteberry is a herb which has been shown to increase progesterone, whilst decreasing excess oestrogen levels. In women suffering with PMS, taking Agnus Castus (20mg daily) can reduce symptoms by 42.5%.
• Another herb I would recommend is Dong Quai (Angelica Sinensis), which is one of the most commonly prescribed herbs in Chinese medicine for female problems. It promotes normal hormonal balance and helps sufferers of menstrual cramps as it has muscle-relaxing qualities.
• Wild Yam, also called ‘Colic Root’, is another herb which has been used for treating menstrual cramps and post-pregnancy pains for many years. Yams are especially rich in a substance called diosgenin, from which progesterone is made. Although we cannot turn diosgenin into progesterone itself, it may have a positive effect on hormone balance.
• If you suffer from water retention, I would recommend the natural diuretic Dandelion as it not only helps with removal of fluid, but also supports the liver and can help in the removal of excess hormones.
If you suspect you have a hormonal imbalance – whether suffering from PMS, endometriosis, polycystic ovaries or menopausal symptoms – I would firstly recommend taking a quick and simple saliva hormone test (you can arrange this via a nutritional therapist). At the same time, follow a varied, well-balanced diet including plenty of wholefoods, fruits and vegetables (in particular cruciferous vegetables), swap saturated fats for essential fats and cut out all stimulants such as caffeine, alcohol and sugar. If you are suffering from menstrual cramps, I would advise taking a magnesium and a B-vitamin complex like Female Balance plus the herb Agnus Castus or Dong Quai. For bloating, dandelion can help, either in a tea or in capsule form.
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4. D Berger et al, ‘Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)’, Archives of Gynecology & Obstetrics (2000), vol 264, issue, 3, pp 150-3.