There are a lot of myths out there about women’s health and hormones. And we want to clear up the confusion. Here are five fast facts on premenstrual syndrome (PMS), straight from the experts.
PMS is real
PMS has its doubters – people who deny its existence or shrug it off as ‘no big deal’. In 2012, Canadian researchers even claimed there was no clear evidence of it.
But PMS is real. Around 20% to 40% of women experience the condition, and the impacts of it are very real, too.
“PMS can dramatically affect quality of life for some women. It can affect their ability to function, maintain relationships and work."
“PMS can dramatically affect quality of life for some women. It can affect their ability to function, maintain relationships and work,” explains Jean Hailes Endocrinologist Dr Sonia Davison.
Symptoms differ from woman to woman and can include difficulty in concentrating, lower coping ability, lower libido, sadness, anger, irritability and mood swings. Then there are the physical symptoms – bloating, breast tenderness, headaches, fluid retention, food cravings, muscle aches and period pain.
PMS is caused by normal hormonal changes
Dr Davison says many women mistakenly believe their PMS is due to a ‘hormonal imbalance’. While no one knows the exact cause of PMS, we do know that it’s linked to hormonal changes that occur before your period.
“PMS happens when there are normal variations in the hormones oestrogen and progesterone.
“It tends to occur at a time in the menstrual cycle when both of these hormone levels are declining,” she explains.
These changing hormones interact with certain chemicals in the brain, which leads to symptoms.
“Women affected by PMS have normal levels of these hormones but they have an increased sensitivity to them.
“This means that some women will have symptoms of PMS, which may be anywhere from mild to debilitating, and some women will not notice any bothersome symptoms within the cycle,” explains Dr Davison.
Natural therapies may improve PMS (but there’s a catch)
Vitamin B6 is often first on the list for treating PMS, according to Jean Hailes Naturopath Sandra Villella. “Among its actions, it is an important vitamin for the production of healthy brain chemicals which are believed to be involved in episodes of PMS,” she explains.
Ms Villella recommends B6 in the form of a B complex (a combination of B vitamins). However, high doses of this vitamin (more than 50 mg) can be dangerous, so it’s important to take it under the guidance of a health professional.
Calcium has also been found to be effective in improving the PMS symptoms of anxiety and depression. “I commonly recommend 500 mg of calcium, preferably as calcium citrate, once a day with the evening meal,” says Ms Villella.
“I commonly recommend 500 mg of calcium, preferably as calcium citrate, once a day with the evening meal.”
One of the best-researched herbal medicines for a range of PMS symptoms is called Vitex (also known as ‘Vitex agnus castus’ or ‘Chaste tree’). However, this herb is not suitable for all women – for example, it should not be taken with the oral contraceptive pill – so it’s best used only through a prescription from a qualified naturopath or health professional.
It’s important to remember that although natural therapies can be effective, Ms Villella reminds us they are often not a ‘quick fix’, so don’t expect results overnight. “Complementary medicines and therapies need to be taken for a minimum of three months [to see whether they are an effective solution for you],” she says.
And even though there might be products you can purchase yourself online or from the local pharmacy, for more tailored, effective and safe management of PMS, Ms Villella recommends seeing a qualified professional. “There’s a lot of misinformation out there,” she explains.
Medications can help
If you’d prefer to take the medical route, there are several options that can help PMS. These include hormonal treatments (such as the oral contraceptive pill), antidepressants and anti-inflammatories.
There are also medications known as ‘anti-prostaglandins’ which can help with pain and cramps, and spironolactone diuretic which can help with bloating.
Talk to your doctor about the best option for you.
If PMS impacts your quality of life, you deserve effective treatment
When it comes to your experience of PMS, you may have an inner voice telling you, ‘It’s just my hormones’, encouraging you to keep pushing through. But if you’re struggling and your symptoms are impacting your work, studies or daily activities, it’s important to see your doctor. You deserve to be listened to and supported no matter the health condition.
It’s also important to reach out for help because your symptoms could be masking another medical issue like depression, endometriosis or a severe form of PMS known as premenstrual dysphoric disorder (PMDD). Your doctor can help you to find out what’s going on.
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Words by Muriel Reddy. Illustrations by Tam Bower.
Published September 2023
This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.
Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.