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PMS symptoms and what they mean

If you dread getting your period each month thanks to the host of uncomfortable symptoms it brings, it could be a sign of a larger issue.

If you suffer from premenstrual syndrome (PMS), you’ve probably been told more times than you care to remember that it’s all just part of being a person who menstruates. But research has been mounting for a long time that PMS isn’t just something some of us have to tolerate. And, in fact, suffering from severe PMS could be an indicator of other treatable health issues, such as endometriosis or fibroids.

A new study has found that a significantly higher number of people with severe PMS symptoms reach menopause at a slightly younger age (averaging at 40.7 years).

As if they haven’t suffered enough, those people were also more likely to have worse menopause symptoms, such as hot flashes and night sweats, than those who didn’t suffer from severe PMS.

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Researchers don’t have a full understanding of the link between PMS and menopause just yet, but they think it might have something to do with pre-existing hormone levels, with PMS believed to be caused by a drop in estrogen and progesterone, and menopause symptoms being linked with a drop in estrogen. They’re hoping further research will look into the root cause of both conditions to investigate the link.

Women’s health expert Dr Amy Carmichael says, “Given the prevalence of PMS, [if you’re concerned] it’s worthwhile checking your symptoms with your health professional and possibly having some testing.”

Before you have to think about menopause, you might want to consider relieving those PMS symptoms. Dr Carmichael says treatment approaches should be tailored for each person. 

“Treatment can be complex due to the need to pinpoint the precise hormone imbalance as well as various other factors influencing the situation, including nutrients,” she says. 

“There are four distinct clinical profiles, often interconnected with the hormonal patterns we observe. Inadequate progesterone function is linked to mood swings, pain, fluid retention, and breast tenderness. Excessive estrogen leads to inflammation and pelvic congestion. Excessive testosterone is associated with amenorrhea (missed cycles) and acne. Reduced estrogen activity often relates to symptoms experienced during mid-life menopause.”

Dr Carmichael says the treatment approaches will vary as well, but common approaches include lifestyle modifications (including regular exercise, a balanced diet, and stress management), over-the-counter pain relief, and hormonal birth control pills.

“I personally use a holistic lifestyle approach,” she says, “so as well as a low-fat, high-fibre diet, which has been shown to reduce estrogen levels, I also consider nutrients like B6, magnesium, zinc, and potassium. 

“Fatty acids deserve a mention too, because a deficiency has been hypothesised to alter prolactin and other hormonal messengers promoting PMS. Evening primrose oil has been well studied as a rich source of gamma-linolenic acid which is needed for prostaglandin synthesis and balanced hormones. Chasteberry (vitex) has also been used since Egyptian times and in the past 50 years often in Western cultures for PMS.”

Dr Carmichael adds that it’s important to consider other health issues in relation to any treatment for PMS, including adrenal health (stress), thyroid issues, iron deficiency, and poor sleep. Be sure to mention them to your doctor.

Having a healthcare provider you feel comfortable with can also help you to take a longer-term approach to your reproductive healthcare. It’s also important to not be taken by surprise by menopause if you’re still considering trying to get pregnant. Dr Carmichael says having that knowledge early means you can consider your options. 

“If women are aware of the possibility of early menopause, they can make informed decisions about their reproductive health and consider fertility preservation like freezing eggs or embryos,” she says.

Dr Carmichael adds that a range of treatment approaches are available that can help ease the symptoms when menopause does hit, including lifestyle factors, diet, nutrition, herbs, and hormone replacement therapy.

And if menopause does come knocking earlier than you expert, it’s not the end of the world – it’s just a transition to a different phase of life. 

“Early menopause doesn’t mean an end to your vitality,” says Dr Carmichael. “Effective treatments and support are available. Having open conversations with healthcare professionals and seeking emotional support from friends, family, or support groups can make the transition smoother.”

If you’re experiencing pain and discomfort as a result of PMS or menopause – or you haven’t had those conditions confirmed by a healthcare practitioner, it’s important to talk to your doctor. Pain that disrupts your life, or gets in the way of your work, daily activities, or relationships isn’t normal, and you don’t have to tolerate it. If you’re not satisfied with one healthcare provider, try another one, and don’t give up until you get the help you deserve. 

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