Changes in hormone levels are thought to be the main cause of PMS/PMT. More specifically, it is the decline in oestrogen and rise in progesterone for up to two weeks before the period starts.
Each month a follicle containing an egg develops and oestrogen levels rise. Once the egg is released at ovulation, oestrogen levels start to decline and progesterone levels start to rise. Progesterone works against oestrogen, and this combination of falling oestrogen and rising progesterone can result in the symptoms listed above.
During the menstrual cycle some chemical levels in the brain fluctuate, such as serotonin. When serotonin levels are low it may cause tiredness and low mood, similar to those symptoms caused by declining oestrogen levels.
If you are suffering from the above PMS/PMT symptoms, it is a very good idea to be screened for polycystic ovaries (PCOS), as there is a strong association with high sugar levels, high insulin levels and exaggerated hormonal symptoms pre-menstrually and menstrually. This screening may include a scan and possibly blood test which can be carried out here at The Surrey Park Clinic.
High sugar, high carbohydrate snacking diets make PMT worse by worsening insulin levels which inactivates circulating hormones and ‘paralyses’ their effect. Therefore, change of diet can make a great difference to PMT (see PCOS). Higher protein, low GI, no snack diets can help.
At present there isn’t a specific test which can diagnose PMS/PMT, however if you are experiencing the symptoms above and are finding that your quality of life is affected, you can make an appointment to see a specialist gynaecologist here at The Surrey Park Clinic who will assess your symptoms and recommend appropriate solutions.
You may be asked to record your symptoms and how severe they are on a monthly chart so that we can identify patterns and assess the most appropriate treatment for you.
This usually involves careful timing of the onset of symptoms and replacement of the oestrogen at the appropriate time. This is around a week before the period and during the menstrual time until a new egg starts to develop, resulting in a natural rise in oestrogen levels.
This generally means that the quality of the developing egg is different each month, so some months are better than others. In this case careful charting of symptoms is important to try and keep levels steady.
Levelling out the rise and fall of symptoms or erratic fluctuations can be very helpful. Ways of doing this include:
Natural oestrogenic products such as evening primrose oil, starflower oil and some containing trace elements such as magnesium and zinc can help.
Natural progesterone available in a cream form can calm the symptoms of PMS/PMT. Natural progesterone is very similar in molecular configuration to oestrogen, not as strong and therefore in many women is preferable. It is completely different in molecular configuration to the synthetic progestogens used in the Pill, and HRT.