by Hyla Cass, MD
Our mothers once called them "women's problems." Now we know that these mood swings and physical changes, from PMS to menopause, are all part of a delicate balance among our various hormones. In my years of practicing integrative medicine, I have helped hundreds of women overcome PMS and menopausal symptoms naturally, and here's how.
Let's start by defining hormones. They are chemical messengers secreted by any one of the body's endocrine (ductless) glands. They travel through the bloodstream, telling various systems what to do. Besides reproductive functions, hormones affect virtually every body system from digestion to metabolism to hair growth.
All women have the same hormones but in varying quantities, making your own hormonal profile as unique as your fingerprint. When your hormones are in harmony, you will have predictable menstrual cycles --and moods. When out of balance, you will have irregular cycles and a host of symptoms, from bloating, cramps, weight gain and acne to food cravings, irritability and depression. Perimenopause, the transition to menopause, which can start as early as your late 30's, often causes an increase in PMS. In fact, many women report experiencing PMS for the first time at that point. Also common in peri-menopausal women, is a loss of libido, due to a dip in testosterone which governs sexual desire, and of course, those hot flashes and night sweats, which make sex the last thing on your mind!
For a full picture of your hormonal status, we need to check levels of estrogen, progesterone, DHEA-S and testosterone in blood, saliva, or urine, taken on day 19-21 of the cycle. For perimenopausal women, I also order FSH (follicule stimulating hormone) and LH (luteinizing hormone) blood tests to assess ovarian function. I will check cortisol levels (saliva test) and thyroid hormones (blood test), too, since they are a part of the overall hormone symphony.
You can find home testing kits online. Take these tests on days 19-21 of your cycle, with day one being the first day of your period. If you are post-menopausal, it won't matter when you take the tests. If you're irregular, do your best to estimate the appropriate date.
If testing reveals that your hormone levels to be below the normal range, it may be due to perimenopause or other physiological factors. Faced with fluctuating hormones, doctors have traditionally prescribed synthetic hormone replacement therapy (HRT), such as Premarin (from pregnant mares' urine) and Prempro (Premarin plus synthetic progesterone), to correct imbalances. The recent Women's Health Initiative study showed that women taking this form of HRT had 27 percent more heart attacks, a higher rate of breast cancer, 38 percent more strokes and double the number of blood clots. There are safer ways to balance hormones successfully, ranging from supplements and herbs to bio-identical hormone therapy.
Natural Ways to Balance Sex Hormones
The first step to balancing your hormones is a clean diet:
• Eat fewer animal products, with lots of vegetables, including raw broccoli and other
• Reduce or eliminate caffeine, alcohol, nicotine and sugar.
• Reduce or eliminate high-fat dairy products.
• Eliminate as much processed food as possible
• Reduce salt intake.
• Eat small, regular meals.
Yoga and meditation are helpful for PMS sufferers because they work on the nervous system to help balance hormones.
Supplements for PMS:
I give my patients magnesium (100 mg two to three times daily) and vitamin B6 (25-100 mg) to relieve irritability and tight muscles as well as premenstrual water retention.
Another important nutrient is GLA, an omega-6 fatty acid which also helps reduce the water retention, breast tenderness and moodiness associated with PMS, likely by it's action on the hormone prolactin. GLA is found in borage oil (1500 mg of borage twice daily), black currant seed or evening primrose oils.
The herb, Chasteberry (Vitus Agnus Castus), helps to balance the hormone, progesterone, relieving symptoms of PMS and heavy or irregular periods as well. Dose is 50-200 mg daily depending on symptoms. Do not take if you're pregnant.
The herb, Dong Quai, helps to balance the hormone estrogen. Like Vitex, the dose is 50-200 mg daily depending on symptoms and also do not take if you're pregnant.
Another useful nutrient is the amino acid, 5-HTP (5-hydroxytryptophan) 500-200 mg daily, depending on your individual needs. It helps to raise levels of the feel-good and calming brain chemical, serotonin, which is often low in PMS sufferers.
These nutrients plus wild yam a source of natural hormone production, can all be found in the formulation, PMS Balance. I have had many women report almost immediate relief upon taking this or a similar formula. Others may take a month or two to feel the full effects.
With menopausal symptoms, I may also add black cohosh and red clover extract. While there was a recent study that claimed that black cohosh didn't work, it was in fact, flawed, and contradicted numerous well-done studies that found it to be very effective. I have also discovered a remarkable new product called FemmePhase. Even the majority of my hard-core hot flashers have found relief with it.
When the nutrients aren't quite doing the job, you can add over-the-counter natural progesterone cream (up to 30 mg daily) for one week prior to your period. This is a maximum of 3 percent progesterone, or 30 mg per 1 gram dose.
I may also prescribe higher dose bio-identical hormones for my patients. The progesterone is often 10 percent, which is three times as strong as the over-the counter dose. Made from highly purified derivatives of soy and wild yams, these formulas are carbon copies of your own natural hormones. Prescription strength bio-identical hormones are available only from compounding pharmacies, and are prescribed by your doctor. Doses are based on your individual hormonal needs as determined by your lab tests.
As I say repeatedly - "you don't have to live with PMS/peri-menopausal symptoms." This applies to both the woman herself and her long-suffering loved ones. This information should help you take care of most cases of PMS and peri-menopausal symptoms. I have many grateful women, and their partners, for whom PMS has truly become a thing of the past.