Although the exact cause of premenstrual syndrome (PMS) is unknown, researchers do know that during PMS, hormone levels are fluctuating, estrogen levels are lower than at any other time of the month. Whether low levels of these hormones circulating in the blood stream causes the "PMS blues" or if chemicals in the brain are to blame is being investigated. As with many medical conditions, we may never know exactly what causes PMS.
"But you know we can't help it... we don't even know the cause...But as soon as this part's over then comes the menopause, " sings Dolly Parton in the song titled PMS blues. And, Dolly's right. We don't know the cause. And, for many of us, menopause is just around the corner accompanied by hot flashes, more mood swings, weight gain and decreased sex drive. Once menopause is over, we have increased health risks unique to post-menopausal women. Is it really any wonder that we're depressed?
According to the Cleveland Clinic Department of Psychiatry and Psychology, women are twice as likely to become depressed as men, due in part to PMS hormone levels and changing hormone levels that occur throughout a woman's life. Around 75% of all women deal with the PMS blues each month. Some sources say this number is around 85%. So, what is different about those lucky 15-25% that do not have PMS symptoms? Once again, no one knows, but it is likely that a number of different factors are involved.
Stress, Diet and Exercise
Researchers have conducted numerous studies about the effects of stress, nutrition, special diets and exercise on PMS symptoms, without arriving at any definite conclusions. The most that anyone can really say is that "sometimes" exercising helps. "Sometimes" dietary changes help and sometimes supplementation with B-vitamins, calcium or vitamin E help. The effect that any of these have on PMS hormone levels is unknown.
Relaxation techniques are recommended for a number of different health conditions. The condition in which it appears to be most effective is PMS, according to a study that evaluated a large number of other studies. Yoga and the relaxation response technique seem to be the most helpful.
Yoga is great, but when a woman's schedule is already full, time may be an issue. Relaxation response is something that any woman, regardless of physical condition, can practice every day or numerous times a day. To achieve maximum levels of relaxation 15-20 minutes of "quiet time" are needed. It is a deep breathing exercise that involves focusing on each muscle group of the body and purposefully relaxing those muscles, followed by breathing in deeply and exhaling completely while you say the word "one".
A complete description can be found in the book The Relaxation Response by Herbert Benson, MD. Focusing on breathing normally as a treatment for the PMS blues is further supported by a study that showed that symptoms similar to PMS are observed in patients with chronic hyperventilation.
If PMS hormone levels are not to blame for the majority of the symptoms, then serotonin, or the lack of it, may be. Serotonin is a compound that helps to transmit signals among nerve endings in the brain and body and is believed to play an important role in the regulation of mood, sleep, sexuality and appetite. Studies have shown that women who suffer from the most severe form of the PMS blues (premenstrual dysphoric disorder) have lower levels of serotonin circulating in the blood stream.
If you visited your doctor, because you were concerned about the way that PMS symptoms were affecting your quality of life, your relationships, your job, etc., he may have recommended or even prescribed an anti-depressant known as a Selective Serotonin Re-uptake Inhibitor or SSRI. You are probably more familiar with the brand names Celexa, Zoloft, Prozac and Paxil.
Rather than focusing on changing PMS hormone levels, these drugs focus on allowing the body to use serotonin more efficiently. Mostly because numerous unwanted side effects are associated with SSRI usage, researchers have investigated the effects of natural substances used by the body to create serotonin, thus, increasing the levels of serotonin circulating in the blood stream. So far, 5-HTP has yielded the most promising results. Some study participants have seen even better results than they did when using an SSRI.
PMS Hormone Levels: Low Estrogen
Because PMS hormone levels are a possible cause of the PMS blues, many doctors suggest low-dose birth control pills, which contain synthetic forms of the hormones estrogen and/or progesterone, to stabilize hormonal levels, prevent ovulation and thus eliminate most symptoms of PMS. Of course, these are not an option for women who are trying to become pregnant or cannot take birth control pills for other reasons.
Phytoestrogens are considered by many to be a natural substitute for synthetic hormones. Phytoestrogens are simply plant components that have an estrogen-like effect on the body. Found in soy beans, red clover and other plant foods, researchers believe that in women who have less PMS symptoms and a diet high in soy and other vegetables, phytoestrogens are responsible.
Relief from the PMS Blues
Soy isoflavones, red clover and 5-HTP are all available without a prescription. Herbal supplements including black cohosh and sarsaparilla may help to correct hormonal imbalances. If PMS hormone levels are to blame for the PMS blues, then they may help and are also available without a prescription. Researchers have not determined exactly what compounds in black cohosh and sarsaparilla are active and effective, but they have concluded that they relieve symptoms related to changing hormonal levels in the majority of women. For more information about natural products that relieve PMS symptoms, please visit the Menopause and PMS Guide.