PMS & Dysmenorrhea: What Is Going On With Me?
[A short educational article for woman about their monthly cycles, symptoms of two common disorders, Eastern & Western treatment differences and some tips & tricks for managing the stressors of hormonal fluctuations.]
What is PMS?
Premenstrual Syndrome (PMS) is the term used to describe the large set of emotional and physical symptoms that occur 1-2 weeks before menses. There are vastly different statistics floating around regarding the number of woman who suffer with PMS, anywhere from 25%-85% of woman ages 25-40; and while it’s difficult to track actual statistics; it’s not hard to find that Western medicine has a very difficult time understanding the exact causes for such varying degrees of suffering. What they do know is that estrogen and progesterone fluctuations and by-products are to blame for most of the depressive and uncomfortable feelings. However, the reasons for the dramatic fluctuations one month to another, or from one woman to another, is far from being pinned down. Diagnosis is self-apparent and treatment options don’t really exist in the Western model.
Mood swings/ Crying/ Anger/ Starting Fights
Tiredness/Fatigue(Can be severe)
Constipation/Diarrhea/ or Both/ Bloating
Pressure/Pain/ Cramps (abdomen, pelvis, back, breasts, head, whole body)
Heart Palpitations/ Chest Fullness/ Shortness of Breath
Appetite Changes/Loss/Gain/ Weird Cravings
Difficulty Concentrating/ Memory Loss/ Foggy Brain
Not feeling like you’re in your own body/ Major disconnect
*Note: PMDD is a more severe form of PMS, 5-10% sufferers - all symptoms are more extreme.
What is Dysmenorrhea?
Painful menstruation (dysmenorrhea) is the pain that occurs in the pelvis before or during menstruation; there are two types, Primary and Secondary. Primary dysmenorrhea is the cramping pain that occurs before the start of the period. A hormone called prostaglandin (which aids in childbirth) is secreted before menses causing pelvic congestion, painful uterine contractions and blood vessel constriction. Primary dysmenorrhea affects up to 75% of all women and in severe cases (10%) symptoms can include nausea and vomiting. Diagnosis is self-apparent and treatment usually consists of rest and anti-inflammatory medicines. With Secondary dysmenorrhea the symptoms are similar to Primary, but the cause of the pain is “organic”, meaning the congestion is caused from something inside the person. These organic causes are things like endometriosis, fibroids, PID, cervical stenosis, and even implanted birth control devices (IUD). Secondary dysmenorrhea is diagnosed with ultrasound scans, CT’s, cultures and colposcopy. More aggressive treatment is usually necessary & sometimes even surgery is reccomended.
Treatment Options: The Eastern Model
The Western medical world doesn’t have too many answers for “Why” PMS occurs and with such wide variability and severity; except to say that it’s a hormonal fluctuation that may or may not even exist. Chinese medicine on the other hand can and does proffer answers and solutions to this very common affliction. In fact we have not one, but many differential diagnoses available for patients. Each with a different treatment plan & set of herbal formulas. Everything that a patient may report as a complaint is something that "makes sense" to Eastern physicians and helps them to narrow down the proper diagnosis and treatment protocol they will use. TCM practitioners listen very carefully when patients speak because everything matters when coming to a conclusion in regards to the patient’s condition. The diet, lifestyle, physical constitution, genetics, emotional state, past history and each and every physical symptom will be carefully noted before the practitioner decides on their diagnosis.
Example: MaryLou Age 30F car accident (age 15), mother died (age 16), 2 abortions (ages 23 and 25), lives at the beach and is a surfer, pain better with warmth/ worse on exertion, abdomen feels cold to the touch, feels feverish in the afternoon, feet get super warm at night, menses: dark clots, irregular & unpredictable (sometimes late, sometimes early), she has been crying a lot lately, bad cramps, distension & bloating in abdomen, pulse: tight, tongue: dark with white coat Diagnosis= Cold in the Uterus with Blood stagnation and Pain.
WendyLou Age 24 in college, athlete & runner, lives with boyfriend, thinking about getting pregnant someday but only has her period 4- 6 times a year, pale pink blood, menses lasts 2 days, she feels dizzy a lot, tired even though she sleeps 8+ hours, doesn’t feel like she used to, bloating, distension pain, depression, pale face and lips, pulse weak, tongue: pale with white coat. Diagnosis= Qi (energy) & Blood Deficiency.
Both of these women would be diagnosed the same in Western medicine, bloating+cramps+crying+menses= PMS, and then they would be given the same medical advice and treatment protocols. In Chinese medicine each woman would be seen as an individual and her symptoms looked at as part of a whole picture. They each would be given completely different diagnoses, treatments and lifestyle advice. This is a prime example of how different Western and Eastern approaches to disorders can be. When it comes to PMS specifically, there are many options for women who are seeking relief with Eastern modalities, all of which have been used for centuries with great results. Acupuncture, acupressure, tuina (massage), cupping, warm therapy, herbal supplements (perhaps one of the best options to rebalance the bodies homeostasis), and plain old TLC from someone who understands what you’re going through & who can give you more than 6 minutes of their time. I highly recommend that every woman find a licensed practitioner that they can bond with to help them with their non-emergency medical needs. You will be amazed at how many things will fall into place & how good you will feel once your body gets a little boost & a little help.
Tips & Tricks
Journal: For 3 Months Keep a period journal, track PMS & dysmenorrhea feelings and symptoms, thoughts and progress. This will help you to GAIN CONTROL! There are countless Apps that you can download right onto your phone that will make journaling easy!
Boundaries & Communication: Hang out with other people who understand what you’re going through. You aren’t crazy, you aren’t dramatic, and you aren’t a liar! Try to avoid altercations or interactions with the people who make you feel that way or who don’t understand you. You don’t need to justify yourself to anyone. Just calmly let the people in your life know what you’re going through and what you need. If you keep positive communication open then you won’t have to apologize for something you don’t have control over. Guilt and other negative feelings will only cause stress which make symptoms worse. With that being said, don’t expect people to just know how you feel without communicating it to them (write a letter if you need to, or give them this article to help educate them). PMS is hard on you, but it’s even harder on the people who love you. Be understanding to your loved ones and know that it’s difficult for them to grasp what you’re experiencing, all they know is that you change and they may blame themselves if you’re not good at communicating or explaining things. This alone can ruin an otherwise healthy relationship. Have a healthy boundary, but be understanding and communicate.
Stress Management: Find something you enjoy doing to blow off steam (and no, killing someone doesn’t count LOL, but you can fantasize about it). Seriously...do anything! Take a bath, pet a dog, watch a fun movie, watch a sad movie and cry your butt off, go for a run, meditate, get a pedicure, try acupuncture or go dancing. Just make sure it doesn’t cause more stress or obligation, it needs to be easy & relieve stress.
Nutrition: Salt- If you bloat and get breast tenderness try reducing your salt intake and upping your natural diuretic intake. The more you pee the less bloated you’ll be. However, if you get dizzy and lightheaded you may need to do the opposite because your salt is too low, try upping your fluid intake, having good nourishing broths and veggie juices. Here’s a great link to an article about diuretic foods. https://blissreturned.wordpress.com/2012/01/23/diuretic-fruits-herbs-and-vegetables-list-of-natural-diuretic-foods-for-weight-loss/. More Protein if you run cold, less if you run too hot. Also eat less sugar- making this change is good for your blood cells, energy levels and fluid balance. Eat at regular times every day, have your largest meal first and smallest three hours before bedtime. Our bodies prefer schedules & routines, the more predictable your life is the more predictable your menstruations will be.
Exercise: Um yeah, I hate to say it, but this does work. Anything that gets your blood moving and more oxygen to your cells will also get more nutrients to your tissues and reduce symptoms of PMS & dysmenorrhea. Choose something you enjoy and can do regularly, or just go walking with a friend. Journal it for 3 months in your period tracker to keep you motivated.
Beauty: Huh? Yep that’s right, take care of your appearance! Love yourself! Develop a soothing and strict routine of self-care. It’s about washing your face with a good organic soap, doing your make-up (if you wear it) and appreciating yourself, brushing your hair, massaging essential oil into your skin, taking herbal baths, using face masks etc. You need to really be kind to yourself, pamper yourself a little, so that your body & mind feel nurtured and cared for. When we look good, we feel better, and when we treat ourselves good we have less stress & pain. It's not about vanity, it's about appreciation.
Supplementation: Evening Primrose Oil- 2 to 3 caps per day, Fish Oil- 3 caps per day,B-complex vitamin-1 per day, plus 50 to 100 mg of B-6, Magnesium Glycinate- 100 to 400 mg per day, If you want to grow healthier hair and nails- Biotin- up to 10,000 MCG daily has been shown to be safe and promote hair growth.
Herbs: Eastern: See a licensed TCM practitioner to start you on the right herbal formula and diet for your constitution. This one decision will make the biggest difference in your life if you can be compliant and make the commitment to see it through for 3 months-1year (depending on your diagnosis). Women typically ovulate one month from one ovary and then switch to the other ovary during the next month. Due to this back and forth, it’s best to take herbal supplements until you have had 3- cycles on each side (6 months). By this time most hormone imbalances have had a chance to regulate, your bodies gone through several shifts (new blood every 10 days etc.), and deep stagnations have had a chance to move and tissues have repaired. Natural medicine isn’t about the masking of symptoms, it’s about a deep repair process, so patience & compliance are very important for permanent success. AND BOY IS IT WORTH IT!
Western- If you are interested in learning more about herbs for women’s health I recommend Rosemary Gladstar’s, Herbal Healing for Women: Simple Home Remedies for Women of All Ages. This book will introduce you to the most common female troubles and how to treat them naturally with western herbal medicine. Also chalk full of beauty recipes and general health recipes you can whip up at home.
Most imbalances can usually be resolved with the proper herbal medicine.
LAST BUT NOT LEAST…..START SIMPLE! I just gave you a long list of suggestions, it may be quite overwhelming. Please don’t let it be, in my practice, I give my patients one new thing a week to focus on. This isn’t a race, this is your life. Start slowly and incorporate the things that are easy first, make them a habit and then add in the more challenging life changes. Before you know it a year will have passed and you’ll be a totally different person, helping other people overcome their suffering. Enjoy the process of becoming a healthier, stronger more empowered person who is in charge of their own health and well-being. Contact me with any questions or stories of success -