Pre-Menstrual Syndrome

Premenstrual syndrome is a phenomenon that results in the cyclic recurrence of stress. The distress experienced interferes with the normal activities and interpersonal relationships of women. PMS occurs from two to ten days before menses begin.

Symptoms of PMS

More than a hundred and fifty symptoms are attributed to PMS. They include abdominal bloating, head and backaches, food craving (carbohydrates, sweets, and chocolates), fatigue, and irritability. Up to a third of women are reported to have some of the symptoms. Fortunately, only a small percentage of them find them as disabling or severe.


To be diagnosed with PMS, a woman’s symptoms must manifest themselves during the luteal phase of the menstrual cycle (high progesterone level required) and be completely absent during the follicular phase (estrogen) of the cycle. The timing and appearance or disappearance of symptoms leads to the diagnosis of premenstrual syndrome (PMS). Although the exact cause of PMS is unknown, hormones are most likely the cause.  This is probably due to the levels of estrogen and progesterone that changes the week before menstruation. Prostaglandins, blood sugar levels, food allergies, nutrition and hormonal fluctuations can contribute to PMS symptoms.

Management of PMS

Exercise. Regular exercise, especially aerobic exercise, is believed to play an important therapeutic role in the management of PMS. Studies indicate that physically active women tend to suffer less severe symptoms than sedentary women, and in general possess improved levels of concentration, irritability and mood. It is suggested that vigorous exercise ameliorates PMS through an increase in progesterone levels.

One study demonstrated that PMS subjects had lower levels of plasma beta-endorphins during the luteal phase of menstruation. Beta-endorphins are a chain of 31 amino acids that bond with specific receptors (opioid) in the brain producing analgesia, mood elevation, and when stimulated produce a feeling of relief from the burdens of daily life. Exercise has been shown to increase the level of beta-endorphins. Beta-Endorphin is produced by the anterior pituitary gland as a component part of beta-lipocortin, the parent molecule.  Beta-lipocortin is synthesized along with adrenocorticotrophic hormone (ACTH), a promoter of the stress hormone cortisol.


Nutritional Therapy

Premenstrual syndrome results from biochemical imbalances. Nutritional intervention may help female athletes better cope with PMS by returning the athlete to a state of balance. One nutritional theory holds that premenstrual syndrome result from a deficiency in vitamin B6 (pyridoxine). Their theory is based on vitamin B6‘s role as cofactor for several enzymes and its association with low levels of the neurotransmitter serotonin, which is well associated with depression.

Another nutritional theory involves the mineral magnesium, which is involved in the synthesis of dopamine, a deficiency of which is known to cause many mood and behavior disorders.  Magnesium supplementation has reportedly been successful in relieving mood fluctuations.
Vitamin E has also been implicated in PMS, through its interaction with prostaglandin synthesis.

Nutritionists generally advise PMS patients to limit their consumption of refined carbohydrates, increase their protein and legume intake, replace saturated fats with plant oils such as olive, evening primrose and black currant oil.  They also advise their patients to avoid caffeine and alcohol.

Throughout the centuries, women have depended upon herbs to reduce the symptoms associated with menstruation.  Natural phytoestrogens can alleviate the symptoms of PMS and dysmenorrhea. Herbs such as black cohosh, chaste berry, alfalfa, soy (genistein), Siberian Ginseng and licorice have demonstrated that there is a non-toxic alternative to hormone replacement therapy for the management of menopausal and PMS symptoms.  The Athlete’s Diet recommends these herbs in conjunction with omega-3 fatty acids, flax seed and evening primrose oil  as a preventive measure. The use of these compounds can also enhance the health and performance of female athletes.

Menopause begins with a gradual decrease in the production of estrogen and progesterone. In order to minimize the harmful effects that estrogen cessation causes, women are treated with pharmaceutical hormones during menopause. Estrogen replacement therapy is administered in pill form or by way of a patch. Estrogen replacement therapy, although useful in retarding osteoporosis can predispose women to breast cancer. Therefore, The Athlete’s Diet instead recommends the use of botanical compounds, healthy oils and intense exercise to delay and slow the development of osteoporosis. Several molecules found in plants (phytomolecules) influence calcium metabolism and effect bone density. Phytomolecules include the  estrogen-like substance, genistein. Genistein is a phytoestrogen and isoflavonoid found in soybeans. Genistein produces a weak, stimulating effect on osteoblasts. Osteoblasts are the cells that form new bone to replace the lost or resorbed bone. The effect of the botanical compound genistein is similar to the effect of the pharmaceutical steroid hormone estradiol.

The Athlete’s Diet reiterates its belief that exercise, built into everyday living patterns is the best method to preserve a woman’s skeleton. Female athletes who  prepare their bodies with exercise, resistance training and proper nutrition before they enter menopause are healthier than those who don’t.

Female athletes who live in the mountainous regions of the world maintain higher levels of bone mass. The increased density of their bones is due to their physically active life.  Their work consists of climbing hills and carrying heavy loads. These stresses placed on a body during exercise stimulates bone growth and retards bone loss.

More in this category: « Osteoporosis Aging & Fat »