By on August 18, 2015

150819NaturalMedI recently had two patients with severe PMS symptoms. This is something I’ve been seeing more frequently.

Premenstrual syndrome, or PMS, is defined by a variety of symptoms including mood swings, breast tenderness, food cravings, irritability and depression prior to your menstrual period. While the severity of PMS can fluctuate, it can become acute enough to interfere with your life. At this stage, many women simply endure the symptoms, assuming that little can be done, but this is not the case. Debilitating PMS need not be tolerated — it can and should be treated.

My two PMS patients were treating their symptoms with Aleve and Advil and both used birth control pills. Analgesics (pain pills) can successfully relieve PMS pain in the short term, but as a naturopathic physician, my training is to identify and treat the cause of disease. The cause of PMS is an imbalance between two hormones: estrogen and progesterone, specifically, an increase of estrogen levels relative to those of progesterone. This imbalance can result from a reduction in progesterone or an increase in estrogen, but the result is the same: PMS symptoms.

What causes estrogen dominance?

Estrogen dominance can be either exogenous or endogenous. The exogenous (external) sources of estrogen can be found in animal products that are not organic specifically in the form of growth hormones fed to the animals you eat. Estrogen-like compounds are also found in plants sprayed with certain pesticides and herbicides. When you eat these compounds and hormones, your body absorbs them, sometimes with less-than-ideal consequences.

Endogenous (internal) sources are those that we create and are unable to get rid of. Our liver is where our estrogen is conjugated, a process where the more toxic estrone hormone is converted to a less toxic estradiol and estriol. Substances that are hard on our livers, like alcohol, caffeine and high fructose corn syrup all increase estrogen. The other factor to consider is our ability to eliminate these substances. If you are constipated or have imbalanced bacterial flora, you will be more likely to reabsorb the estrogen that you are trying to eliminate.

Here are a few steps to significantly reduce PMS symptoms:

Change your diet. First, give your liver a break by decreasing your intake of caffeine and alcohol. Eat protein throughout the day from non-meat sources. Increase your vegetable consumption to get more fiber. Go organic, especially with the “dirty dozen” — apples, strawberries, grapes, celery, peaches, spinach, sweet bell peppers, nectarines (imported), cucumbers, cherry tomatoes, snap peas (imported), potatoes, blueberries and hot peppers. In non-organic form, these foods have some of the heaviest pesticide loads.

Take a probiotic to change gut bacteria and decrease your reabsorption of toxic estrogen.

Take supplements that support the breakdown and elimination of estrogen like B6, magnesium and zinc. Detox your liver, I wrote a three part series on detox for The Planet last year, which you can find online:

Stress management is also essential to help deal with PMS. Your adrenal glands shunt progesterone to cortisol if you are under too much stress.

Mild PMS may consist of emotional sensitivity, slight irritability and possibly some cramping, but if it is interfering with your relationships or causing you to take a sick day, your body is telling you something. Listen to it. Your body gives you signals of imbalance. In naturopathic medicine, if you have some form of dis-ease, meaning your body is not at ease, you need to make a change. PJH

Monique Lai, ND, has been practicing in Jackson for 15 years after graduating from Southwest College of Naturopathic Medicine in 1996 and practicing In Washington DC. She treats everything from gastrointestinal issues to menopause, allergies, thyroid disorders, auto-immune diseases and depressed immune systems. Learn more at

About Dr. Monique Lai

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