guest post by lara rickard RD
In this guest post, Lara Rickard RD shares her top tips for improving PMS symptoms as well as your period using a holistic approach. She covers what causes PMS symptoms, including how to improve them using natural strategies, lifestyle and diet changes you can make to boost your quality of life!
A full-life approach to understanding and addressing Pre-Menstrual Syndrome (PMS)
Did you know that there are more than 150 different symptoms that are attributed to PMS? That’s everything from heightened irritability, anxiety, tearfulness, breast tenderness, acne and headaches to bloating, abdominal cramps, loose stools and/or constipation. And sometimes, symptoms are so severe that they can leave women debilitated in every area of their existence each and every month.
But you probably already know this, because I’m yet to meet a women who hasn’t experienced at least one PMS symptom of some degree at some point in their menstruating life (truth be told, we all do on Day One). So no, you’re not crazy (even though certain societies would have you believe otherwise through undermining the severity of PMS).
Before we go any further though, let’s consider:
What Causes PMS?
When I work with clients struggling big time with PMS, I’m always going to be asking “What’s going on in there? What’s brought you to this point of an imbalance in sex hormones, stress hormones and neurotransmitters?”
It is usually a combination of the above that form part of the PMS picture. PMS can be considered more of an oestrogen “dominant” condition. This is where there’s more oestrogen in relation to progesterone so even if oestrogen is “low” (which can be the case for many women with PCOS, or polycystic ovarian syndrome), if there isn’t enough progesterone to balance it out, it can then manifest as certain physical symptoms.
So this is when I’ll pop my detective hat on and begin with these six main factors that can either contribute to or exacerbate PMS symptoms:
Blood Sugar Dysregulation.
High Histamine because oestrogen increases histamine (by stimulating the production of it and by interfering with the enzymes required to break it down), and histamine increases the production of oestrogen so it’s a double whammy, especially when it comes to PMS.
Nutrient deficiencies, the main ones that come to mind are magnesium, vitamin B6, vitamin E and vitamin A.
Stress (which comes in every shape and form in this modern-day living).
Exposure to Environmental Toxins.
What can we do to address PMS symptoms?
First and foremost: Track your Cycle.
Now imagine that I’m saying this holding pompoms in one hand and a sign with bright red, neon lights that has sparkles flying out of it in the other, while a Spice Girls song booms in the background.
Not only is tracking your cycle all-singing, all-dancing important for better understanding your body and your period, but it will also save your actual sanity. Because when we know when to expect our period we can give ourselves all the grace and gentleness in the world in the lead up to.
“when we know when to expect our period we can give ourselves all the grace and gentleness in the world in the lead up to.”
So instead of feeling as though we’re losing our minds, we can instead breathe a big ol’ sigh of relief. Because here’s the thing: those couple of days before your period is a time of naturally heightened awareness so we can actually expect to feel slightly more tender in every regard. And when we know this, we can plan around it.
BUT, all the emphasis is on the word “slightly”. You do not have to endure PMS symptoms that send you for a six out the park (that’s where the below recommendations come in) but knowing that you could feel a little more lonely, or emotional, or sad, or not quite as motivated, can take you from a place of judging & criticising yourself, to be gentle and gracious. Our periods are a time to remind us what it means to rest & replenish in this go-go-go masculine dominated world.
There are loads of different apps available for tracking these days. And depending on your individual period needs and concerns, you can find one that best suits you. To be honest though, I’ve gone back to basics and track using a little notebook. At the end of each day, I jot down where I’m at in my cycle (as in which day), any symptoms experienced and my overall mood. It takes all of three minutes and keeps me anchored in the ebbs and flows that our cycle naturally brings.
Food and PMS
One of my most favourite ways of supporting myself and clients with any hormonal concerns is using food. Not just because I’m a Registered Dietitian with a functional approach (so I have profound respect for its impact on our body) but also because food plays such an integral part in our daily life. And that means that we can use food as this incredible way of untangling from the grip of PMS symptoms. A beautiful opportunity to heal every single time we eat.
But I equally appreciate the pressure that so many of us often experience with that statement because if food is an opportunity to heal every time that we eat, then the opposite is true too. So it then feels like a guilt-laden yoke that we place around our necks that stops us from even starting to tap into its power altogether because we’re caught up in perfection, which is never the point. Coaxing, restricting and will powering your way with food with only get you so far, and likely leave you frustrated and deflated. And that’s because when our starting place is one of fear, the outcome tends to follow.
My two cents on this topic? Orientate yourself with where you’re at right now. Understand that. Start there. And then do the work so that you can come from a place of kindness when you’re using food to address and reverse PMS, or any hormonal symptoms. Coming from kindness doesn’t mean that you make excuses for your own nonsense - it means that you give yourself grace in understanding why you might have certain behaviours when it comes to food, and then do what you need to get out your own way, and fully harness the healing that can be found at the end of your fork.
“when we go deeper in befriending ourselves with kindness, and fully understanding why we’re usinG food as we are, that’s where we come to the life-changing & sustainable shifts that can free us from what feels like being a slave to our PMS symptoms.”
I say all of this because food isn’t a clear cut matter. Nor is it simply about being given “the five steps to…” Because while those approaches might work for a bit, when we go deeper in befriending ourselves with kindness, and fully understanding why we’re using food as we are, that’s where we come to the life-changing & sustainable shifts that can free us from what feels like being a slave to our PMS symptoms. [Here’s a blog post on tackling 5 reasons that make eating healthy seem hard].
My top tips beyond the above when it comes to food, lifestyle factors and PMS?
Balancing your blood sugar for reducing PMS
Firstly, get your blood sugar balanced. This is foundational when addressing any health concern, especially on the hormonal front. You’ll know you struggle with your blood sugar if you get super hangry, you notice energy dips soon after eating or throughout the day, you’re hungry even after food, you may or may not have weight concerns, you have cravings that make you want all.the.(sugary).chocolate. all the time. (There are other reasons for these symptoms and you may not have them all, but getting your blood sugar sorted is key, especially when it comes to PMS, because of its knock-on impact with sex hormones when its out of whack). Ways to do this include:
Ensuring decent protein sources in every meal you eat
Taking a step back from foods that can cause your blood sugar to sky rocket and then plummet, such as sugar, pastries, refined flours etc. This can often feel extremely overwhelming if you’re someone who eats these foods regularly and experiences an intense physiological craving for them. I’d suggest focusing only on this in the early stages, without trying to implement any other recommendations, otherwise, it can all be too much, and we can end up feeling as though we’re failing and that just gets us nowhere.
Cut coffee for at least a month to see how your body responds (and do this gradually if the thought of it sends you in a right tailspin). Coffee has a direct impact on the HPA (hypothalamus - pituitary - adrenal) axis, which impacts cortisol production and can then influence blood sugar stability. Beyond blood sugar though, the research indicates that coffee could worsen certain PMS symptoms, particularly breast tenderness. And we all know we AIN’T for sore boobs! But it will come back to whether or not you metabolise coffee well (and the best way to figure that out, is clear the muddy waters by taking a step back from it completely, seeing how you feel and then going from there).
Alcohol is a biggie when it comes to impacting blood sugar negatively given how it is broken down within the body. Not only that but it is also metabolised down the same pathway in the liver as oestrogen, which is not good news because remember, compromised oestrogen metabolism worsens matters with PMS symptoms. And, and, and! Alcohol is considered a high histamine “food” so if histamine is an issue, having it will only worsen matters on the PMS front.
Tuning into your needs to establish your frequency of eating. How long can you last between meals? How do you know this and how do you experience this physically? And can you be sure that you’re not suppressing hunger simply because you’re getting caught up in busyness throughout the day, only to crash later in the evening when you’re no longer chasing your tail? Essentially what we want to do here is meet your body where it is currently at, and then gradually increase the length of time between meals to every ± 4 hours, provided that you can sustain this. Within this, we also want to get you eating at similar times each day within a similar time frame so that you can eat more in tune with your body’s natural circadian rhythm, which significantly benefits blood sugar balance, and therefore reduces PMS symptoms.
On that note of nature rhythms, sleep is honestly one of *the* absolutely most fundamental ways for stabilising blood sugar balance (and reducing inflammation). Prof Matthew Walker does a deep dive into this in his book “Why We Sleep”, another highly recommended read. But beautiful starting points are: tech-free time before bed (ideally 90 minutes but remember, start where you’re at and aim for that gradually), a warm bath or shower (candlelit is even better) before bed, a regular bedtime, a dark room, a wind-down.
Be super, super, super intentional about having structures in place to help you meet and move through (not ‘manage’) stress on a daily basis. Because you can have the perfect intake for you, that should keep blood sugar stable. But if you’re stressed out your tree, that is going to overrule everything because your body interprets psychological stress the same as it would a physical stress so it responds in a similar way (through fight, flight or freezing), all of which trigger cortisol-release which then sends your blood sugar on one heck of a ride, and ultimately negatively impacts PMS. Go to yoga regularly. Make meditation a priority. Figure out your individual boundaries and stand the flip to them. Get a therapist (hypnotherapy is a firm favourite of mine - both for myself personally and for my clients). Walk in nature, regularly. Make effort with friends. Be true to yourself. Paint. Give space for trauma work, if required. Do what you need to do for you. Your mental health is essential, and have things in place to nourish your mental health will only benefit you when it comes to PMS.
Mediterranean-style meals for reducing PMS
The Mediterranean Diet has been well researched for its anti-inflammatory benefits. We want to go down the anti-inflammatory route because chronic low grade inflammation (which may, but doesn’t always show up in any of the typical inflammatory blood markers) has been associated with unpleasant menstrual symptoms, including PMS.
So what we want to look at is getting in plenty of omega 3 fatty acids (from wild caught oily fish, walnuts, flax & chis seeds - although the later three don’t convert as well to DHA), plenty of good quality olive oil, loads of colourful veg & fruit (that are packed with anti-oxidants, include berries, turmeric, ginger) and taking a step away from more pro-inflammatory foods (again things like pastries, cakes, sweets, anything that contains high fructose corn syrup), and being aware of the impact of foods such as gluten and cow’s dairy (more owing to its casein content).
In the instance of gluten, it’s really not about swapping out gluten-containing products for the “free-from” options (which are usually super processed and contain questionable ingredients) but rather opting for a whole-foods diet where a piece of fish is a piece of fish, an egg is an egg, broccoli is broccoli, berries are berries etc, and you’re not having to wade through endless ingredient lists to figure out what you’re actually eating. [Here’s a blog post on how to get started on eating a whole-foods diet].
In the instance of dairy, there’s often concern expressed when it comes to calcium but I’ve got some great news for you! Tucking into tahini, sardines (with bones) and green leafy veg (to name just a few alternative sources) yield similar quantities of calcium to dairy counterparts. However, I’d still highly recommend working with a qualified practitioner when making significant changes to your intake. And in all of this, eat organic as much as possible. [Read more on how to eat organic food on a budget].
Up your fibre for reducing PMS
Fibre is brilliant, largely thanks to its impact on the gut microbiome which plays a significant role in oestrogen metabolism. Most of us in the West have an insufficient fibre intake (which then impacts oestrogen metabolism and may exacerbate PMS symptoms); if this is the case with you (as in you barely eat any fruit, veg, nuts, seeds or legumes), then you’ll want to increase your fibre intake gradually. You’ll also want to do this by simultaneously increasing your fluid intake (either of filtered water or herbal teas) as fibre without fluid can lead to constipation and that negatively impacts PMS big time.
If you have any digestion concerns then you’ll 100% want to start there, especially if these concerns are further exacerbated by a high fibre intake - in this instance, I’d strongly recommend that you work closely with a qualified practitioner.
Specific vegetables for reducing PMS
In upping your fibre intake, you’ll particularly want focus on veg in the cruciferous family (such as cauliflower, broccoli, broccoli sprouts, collards and kale) as these contain a compound called Idonol-3-carbinole which, when broken down in the stomach, generates other compounds that modulate the expression of certain enzymes that are involved in oestrogen metabolism.
In summary, eating cruciferous veg positively impacts oestrogen metabolism so if you’re struggling with PMS, don’t pass on the broccoli. Be intentional about getting it in, even at breakfast.
Supplements for reducing PMS
While I’m all about certain supplements for reducing PMS, getting the above in place first will give you way more of a solid starting point. We’re so very accustomed to popping pills, hoping that they’ll be the magic bullet solution to our PMS struggles. But give yourself the opportunity of going deeper, really setting the stage, really journey with what feeling at home within your body actually means to you. And then when you do bring in supplements, my go-tos for PMS include magnesium, B complex that has a decent dose of vitamin B6, omega 3s, potentially iodine, and potentially Vitamin E.
Please be a smart-shopper when it comes to supplements - high street stores tend to have supplements that are packed with fillers, additives, bulking agents and less-than ingredients. And in addition to this, even though they might seem to cost more, when you compare quality of nutrients used, together with quantity, more often than not, you’ll actually be spending less!
Exercise to reduce PMS
When it comes to exercise, my advice is always take stock of where you’re at, start there and figure out what feels right, keeping in mind that this will likely change with the natural fluctuation of hormones throughout your cycle. Surrender to that. If you have specific fitness goals, I’d strongly suggest working with a qualified movement specialist who understands and respects women’s bodies and physiology. Whatever you choose, keep it fun. Anchoring back to exercising to support your body, not punish it.
Histamine and PMS
High histamine symptoms (owing to an overproduction or a difficulty in breaking it down) leads to symptoms such as headaches, high anxiety, brain fog, nasal congestion, amongst others. If you find that these symptoms worsen just before ovulation and/or your period, you might be dealing with high histamine. The answer is always to figure out what’s causing the high histamine in the first place. And yes intake can be adapted (as certain foods are high in histamine, while others stimulate its production, and others interfere with the enzymes involved in its breakdown), but this needs to be done with the guidance of a qualified practitioner so that you’re not avoiding certain foods unnecessarily.
Endocrine Disrupters and PMS
I’m not going to go into it in huge detail now but again, you can be sleeping, not stressing, moving, and eating like an actual Greek goddess but another key piece to this puzzle is reducing your exposure to endocrine disrupters. These are essentially chemicals that can interfere with oestrogen metabolism. Here you’re going to want to look at things such as your toiletries, make up, cleaning products and your overall living environment.
And finally, Be Patient
It takes 70 - 100 days for the egg that’s released at ovulation to have matured. That means anything (from sleep to stress to intake) that happens in the 3 month lead up to our period can impact how smoothly we experience our period. Crazy, right?! But also, when we’ve been struggling with symptoms for the majority of our menstruating life, it’s just simply unfair to put the pressure on ourselves by hoping that symptoms will simply disappear overnight.
Using nutrition and lifestyle factors to address (and reverse) PMS (or any hormonal) symptoms is a beautiful lesson in what it looks like to lean into patience. Patience as you figure out what this all looks like for you as an individual. Patience as you make the changes. Patience as you learn what it actually means to be patient, especially with yourself.
One of my favourite quotations to come back to time and time again with any area of my life that requires patience is Rainer Rilke: “Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are written in a very foreign tongue. Do not seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”
And if you need any support along the way? I love working with women in figuring out the root cause(s) of your PMS. Feel free to contact me for a 20 minute complimentary discovery call to discuss what this will look like for you.
“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like
locked rooms and like books that are written in a very foreign tongue. Do not seek the answers,
which cannot be given you because you would not be able to live them. And the point is, to live
everything. Live the questions now. Perhaps you will then gradually, without noticing it, live
along some distant day into the answer.” - Rainer Rilke
All of the love, Lara x
Lara is a Registered Dietitian with a functional approach. She has a deep knowledge of nutrition and a profound respect for the female body. Having gone more than a decade without a period owing to PCOS, Lara was able to get it back by making adjustments with her food and lifestyle factors. She now journeys alongside women struggling with PCOS not only to reverse their symptoms, but also trust in their bodies again and ultimately, come Home to themselves.