Everything you need to know about premenstrual syndrome

Premenstrual syndrome is characterised by a set of symptoms that can occur 1, 2, or 3 days before your period — or even a good ten days before, during the second phase of the menstrual cycle known as the luteal phase, which begins after ovulation.

In some women, premenstrual syndrome is very mild; in others it is severe or even debilitating. If your menstrual cycle is regular and your period returns every month, it is a syndrome that can genuinely affect your quality of life!

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In some women, symptoms are so severe and persistent that it is no longer a case of premenstrual syndrome but premenstrual dysphoric disorder (PMDD). The difference lies in the intensity of the symptoms, and in the fact that psychiatric symptoms are in the foreground — such as depressive mood or particularly intense anxiety[3] — as though it were a cyclical depression.

To diagnose PMDD, the DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders, a reference work) requires the presence of at least five of the following symptoms in a woman, with at least one affecting mood during the week before the onset of menstruation.

It is estimated that this syndrome affects around 75% of women of reproductive age, or even more, which is far from negligible! As for PMDD, it is estimated that 3 to 8% of women of reproductive age meet the diagnostic criteria, but in reality the incidence of this syndrome may be higher, with potentially 13 to 18% of women of reproductive age experiencing symptoms severe enough to considerably disrupt their daily lives [5].

In order to explain premenstrual syndrome, it is helpful to briefly revisit the hormones involved in the menstrual cycle.

The menstrual cycle is divided into two phases: the follicular phase (from the first day of your period to ovulation), and the luteal phase (from ovulation to the day before your next period).

To summarise, in theory the follicular phase is dominated by oestrogen secretion, whilst the luteal phase is dominated by progesterone secretion.

Premenstrual syndrome can occur when progesterone does not dominate during the luteal phase. This can take two different forms: either progesterone is secreted in sufficient quantities but oestrogen is secreted in excessive amounts; or progesterone is secreted in too small a quantity, in which case oestrogen effectively dominates over progesterone.

Premenstrual syndrome is therefore caused by a hormonal imbalance between oestrogen and progesterone (oestrogen> progesterone) [6].

Furthermore, it would appear that chronic inflammation plays a role in premenstrual syndrome, as it can block progesterone receptors and stimulate oestrogen receptors.

Nevertheless, this syndrome remains poorly understood and other mechanisms are likely involved in the onset of symptoms.

There is no treatment or medication that specifically treats premenstrual syndrome as such.

However, it is common practice to prescribe the pill to relieve symptoms. The pill puts the ovaries on pause: they no longer produce oestrogen, ovulation is not triggered, and there is no egg to produce progesterone. Your sex hormones are at a low, and PMS can, in effect, no longer exist. Except that when you stop the pill, PMS often resurfaces. And if you are trying for a baby, a women's fertility food supplement can sometimes help by influencing ovulation and the cycle. 

Another option offered by medicine is progesterone cream, which can help compensate for a deficiency in natural progesterone.

Finally, to address emotional and neurological symptoms, doctors may also prescribe antidepressants.

It is entirely possible to naturally regulate your hormones and experience a more peaceful cycle. The key often lies in rebalancing oestrogen and progesterone hormones and reducing inflammation.

Fancy a latte? Our food supplement premenstrual syndrome Pink Balance, a delicious red berry powder for hormonal balance, containing maca and shatavari to help rebalance hormones and ease PMS. Bonus: it's naturally rich in B vitamins! 

PMS may be common, but it is not inevitable. That said, let us not forget our inherent cyclical nature as women: the hormonal variations of the menstrual cycle necessarily involve variations in energy levels. It is therefore normal to experience a slight dip during the luteal phase and around your period. Welcoming and accepting this time that lends itself to introspection, by slowing our pace, can help us feel more in tune with our cyclical nature and reduce premenstrual syndrome[9].

*Be careful not to self-supplement — food supplements are not without risk, can interfere with other supplements, foods, and medications, and may not be suited to your personal situation, not to mention the importance of choosing them carefully and adjusting dosages accordingly. It is therefore preferable to seek guidance from a healthcare practitioner specialising in nutrition (such as a naturopath or nutritional therapist).