Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are very different conditions, but they are frequently confused and both are dramatically under supported! Up to 75% of women who have periods, and some on hormonal IUDs who are not bleeding, experience PMS. PMDD on the other hand is much less common, and more severe in nature, affecting between 3% and 8% of women. At Advanced Women’s Health we take these conditions very seriously because if you do not feel like yourself for 1-2 weeks of the month, no matter how severe the symptoms, it has a huge impact on your ability to live the life you want and achieve all that you are capable of! Not to mention, both of these conditions signify TREATABLE imbalances in the human body and research shows can be managed using various holistic treatments. 

We often receive questions regarding the causes of both PMS and PMDD and the reality is that it is almost always multifactorial. Below are the most common causes of both conditions. 

Common Causes of PMS

• High estrogen, either total estrogen or relative to progesterone, known as ‘estrogen dominance’
• Low progesterone on its own
• Fluctuations in hormones at inappropriate times, for example your estrogen or progesterone drop too early
• Inflammation and immune system changes

Common Causes of PMDD

The cause of PMDD is not completely known, theories include:

• Hormonal imbalances and inflammation as listed above
• Thyroid conditions, including Hashimoto’s thyroiditis (INSERT LINK HERE)
• Histamine intolerance or mast cell dysfunction
• Changes in serotonin signaling 

Common Symptoms of PMS

• premenstrual headaches
• bloating and bowel changes, constipation or diarrhea
• depression, anxiety, irritability/ mood swings
• breast tenderness, spotting
• acne, other skin changes including rashes
• aches and pain 
• poor sleep/ insomnia, fatigue
• food cravings and change in appetite

Common Symptoms of PMDD

• irritability, mood swings, anger that last many days to weeks
• sadness, despair, thoughts of suicide
• anxiety and panic
• lack of motivation, interest, focus in the second half of the cycle
• poor sleep/ insomnia, fatigue
• physical symptoms- similar to PMS, although more severe

Did you know that many women experience PMDD but believe that it is ‘normal PMS’?

First and foremost, no PMS is normal! You should not be able to predict your period coming for a week, or two, before because of the symptoms discussed above. In any case though, when your premenstrual experience extends beyond mild symptoms into symptoms that affect your confidence, relationships, ability to work or enact your normal day to day activities it is time to get support. 

The Advanced Women’s Health

PMS/ PMDD Program

At AWH we realize that you are unique and therefore you need a plan that is customized to your individual needs. In the case of both PMS and PMDD, the constellation of symptoms that you experience is going to be very different from what those around you may experience. That means if you have predominantly physical symptoms you need a different treatment than those who suffer with mental emotional challenges etc. We therefore spend time not only understanding, but explaining your symptoms to you, investigate further and then customize your nutrition and supplement plan to those factors in our three phase plan. We also work collaboratively with Medical Doctors and Nurse Practitioners to support those who are on anti-depressant/anti-anxiety medications, hormonal contraceptives or other medications. Your treatments should not be focused on one approach or the other, it’s foundationally about you feeling at your best!

Phase 1 – Understand and Customize

Whether you experience PMS or PMDD, the first step in treatment is to understand your unique health patterns. We do this not only through communication but also encourage extensive lab testing so that we can show you how close, or far!, you range from ideal data points.

Our Naturopathic Doctors’ goals are to help you to understand what is happening in your body so that you can understand what we will do to fix it. We don’t just tackle your premenstrual symptoms though, we are always looking for thyroid hormone issues, digestive issues, underlying infections, stress hormone imbalances, liver dysfunction and much much more! 

At the end of this appointment you can expect to leave with:

• Basic diet and lifestyle recommendations 
• Personalized herbal and nutrient recommendations
• Lab test recommendations may include FSH, LH, androgens, female sex hormones such as Estradiol and progesterone, a full thyroid assessment, inflammation investigations, insulin and glucose testing and liver and cholesterol testing. We use both functional tests and standard blood tests to come to understand your health better. 

After we receive the results of your testing your ND will explain all of the findings. No blanket normal statements here, we want to ensure you understand what it all means. From that point we will customize a meal system and supplements to your specific needs.