“I think my boyfriend thinks I’m crazy,” says Jessica, a New York City boutique manager. She laughs as she recalls her premenstrual syndrome (PMS) at its worst. “What’s really amusing is that I don’t notice it until I get really agitated. The thought of getting on the subway starts to upset me, and then I know—my period is coming.”
Andrea, a middle school teacher and mother of two young children, finds her PMS to be emotionally draining. “It’s honestly like I become a different person. The normal me is gone for five days a month, and the new me rears its ugly head, cries, wants her husband to validate her and doesn’t want to get out of bed,” she says. “I wish I could gain better control.” She tried taking antidepressants, but they made her feel even worse. Changing her diet helped with the bloat, but the rest, she feels, is inevitable. “There is such a stigma around being on your period. I feel it’s sort of useless to even complain.”
Like Jessica and Andrea, many women have PMS symptoms—the array of physical, emotional and behavioral symptoms that a large number of woman suffer from in the days and sometimes weeks leading up to menstruation. Recent studies have shown that as many as 80% of American woman suffer from PMS. Although there are almost 150 PMS symptoms, the most common are fluid retention, fatigue, weight gain, breast tenderness, mood swings, irritability, depression and food cravings. PMS typically affects woman during their childbearing years, but can occur any time between menarche and menopause. Although there is no definitive cause of PMS, researchers believe that PMS symptoms occur because of hormonal and neurochemical changes within the brain. From menarche to menopause, the ovaries produce two main hormones, progesterone and estrogen, which prepare the uterus to fertilize eggs, help control menstrual cycles and can affect a woman’s mood. Studies have shown that PMS is most likely to occur when there is a decline in progesterone. Also, elevated levels of estrogen during ovulation has been shown to cause the sluggish feeling many women complain of.
The combined decrease and increase of both hormones affect many neurotransmitters—especially serotonin, which regulates sleep cycles and is lacking in people with depression. Woman with PMS tend to have fluctuating or low levels of serotonin. Serotonin can also cause an increase in appetite because it regulates carbohydrate metabolism. Women with low levels may also experience delayed ovulation.
“There are two major areas of the brain affected by PMS: One is the prefrontal cortex, where you get the impulsivity, aggression and forgetfulness. And the other part is in the limbic system, which is where you get your moodiness, your depression and negative internal self-dialogue,” says Dr. Lilly Somner, a psychiatrist who helps treat PMS by studying brain activity and hormone levels at the Amen Clinic in Reston, Virginia. The clinic specializes in neuropsychiatric studies and brain health by studying single photon emission computed tomography (SPECT) to help pinpoint neuropsychological problems. Somner prefers a noninvasive approach and using natural remedies to help with treating symptoms.
“We measure what the structure of the brain looks likes to see what areas are overworking and then integrate nutrition, lifestyle and medication,” Dr. Somner says. “You have to look at what’s going on with the person as a whole. Whenever you have a hormonal problem, it’s usually in the context of bigger issues.” Dr. Somner monitors hormone levels over the course of a month to see the bigger picture. “What I find is that very often there is an insufficient amount of progesterone. The pattern is significant to behavioral changes associated with the menstrual cycle.” After making an adjustment, she says, most people will be fine.>>*<<
