Treating PMS with Bioidentical Progesterone
Premenstrual Syndrome (PMS) is a condition characterized by nervousness, irritability, emotional instability, depression, and possibly headaches and oedema which occurs during the 7 to 10 days before menstruation and disappears after the onset of menstrual flow. Symptoms may last from a few hours to 10 to 14 days and usually cease with the onset of menstrual flow; however, in perimenopausal women symptoms may persist through and after menses. The most common complaints of PMS are mood swings, irritability, nervousness, agitation, anger, insomnia, depression, fatigue, oedema, breast fullness and pain, transient weight gain, headache, acne and easy bruising.
The cause of PMS is related to an imbalance between estrogen and progesterone levels. During the first half of a normal menstrual cycle estrogen is the dominant female hormone. It is responsible for maturation of the ovarian follicle and ultimately causes ovulation. In mid-cycle when the egg is released (ovulation) progesterone is secreted and becomes the dominant hormone inhibiting the action of estrogen. Progesterone prepares the endometrial lining to receive a fertilized egg. If the egg is fertilized more progesterone is produced, but if not progesterone production ceases and once levels fall below a critical level the endometrial lining breaks down and menstruation occurs. In the final two weeks after ovulation if the estrogen/progesterone balance is out with too much estrogen and too little progesterone then PMS symptoms appear.
Treatments
Traditional treatments offered by conventional medicine for PMS usually involve treating the symptoms rather than the cause. These may involve reduced sodium intake or the use of diuretics to relieve any fluid retention. Tranquillisers may be used in women with irritability, nervousness or lack of control. Antidepressants may be used to treat depression and NSAID’s (aspirin) for headache and pain. Not recommended!
Treatment should involve relieving stress, maintaining healthy blood sugar levels and finally appropriate progesterone therapy.
As stress can upset hormone levels it is important to reduce stress levels.
Dietary considerations are very important as it is essential to maintain normal blood sugar levels. Insulin resistance may contribute towards lower progesterone and thus create the hormonal imbalance to begin with. A low carbohydrate diet high in protein and healthy fats can help. For more information click here.
Bioidentical progesterone may be required to improve your levels if tests find them to be low. Progesterone may be taken as cream, troche, capsule or pessary however we usually recommend the cream. It should be cycled throughout the month to mimic the natural hormone cycle. We only ever recommned physiological doses of 10 to 20mg a day in the later part of the cycle.
We also recommend to have all three estrogens tested because in many cases they may be elevated and by only taking progesterone will not fix this problem. An estrogen reduction protocol is necessary in these cases to reduce estrogens back to normal in addition to progesterone supplementation. This protocol is provided during a consultation.
If your doctor is unaware of these bioidentical hormones and are willing to learn about them they can contact us for a copy of our Comprehensive Prescribers Guide for Bioidentical Hormones.
