Premenstrual Syndrome/Tension (PMS/PMT) and Natural Progesterone

What is PMS?

PMS is a term which means Pre Menstrual Syndrome (PMS), sometimes referred to as Pre Menstrual Tension (PMT). It refers to a constellation of symptoms that, when combined, form the basis of this diagnostic term. It’s a medical term used to describe associated mental and physical problems that occur usually during the second half of the menstrual cycle, although PMS has been observed in many women throughout their cycle.

The main clue in diagnosing PMS is not so much the nature, but the cyclic timing of these symptoms. Symptoms appear around Day 12-14 right through to your period. Some women can display PMS symptoms unabated, even after their period has passed, though a majority will find relief after menstruation commences.

Typical PMS symptoms can include some or all of the following (there are many others, see Estrogen Dominance Symptoms List often associated with menopausal symptoms):

• irritability
• migraine / headaches
• loss of libido
• fatigue
• mood swings
• bloating / fluid retention
• depression
• backache
• lumpy and/or sore breasts
• weight gain

Many women displaying symptoms of PMS are displaying symptoms of estrogen dominance brought about by a lack of progesterone production. Emotional mood swings and irregular bleeding are commonly associated with anovulatory cycles (where no ovulation takes place). If no ovulation occurs during that month, PMS symptoms are usually more severe as there is no progesterone to oppose the estrogen build up (see diagram below).

PMS controversy

There appears to be a general misinterpretation of what these symptoms represent. Doctors believe PMS is caused by estrogen deficiency basing it on the fact estrogen levels drop slightly after ovulation, as it should to make way for progesterone (pro-gestation). For this reason PMS is often treated with estrogen replacement therapy and/or the oral Contraceptive Pill, and viewed as an estrogen deficient condition.

Doctors are assuming that your progesterone levels will surge during the last two weeks of a your cycle. But if you fail to ovulate that month, or produce sufficient levels of progesterone to balance the estrogen, then you will, in fact, be progesterone deficient (thus the term estrogen dominant). That’s where PMS kicks in. And you may fail to ovulate … even at a very tender age. You’d be surprised how many women of all ages fail to ovulate every month.

This might explain why many women respond beautifully to progesterone supplementation. Certainly, it reinforces the theory that maybe, just maybe PMS is an estrogen dominance disease consequent to inadequate progesterone levels. Women report an easing of symptoms with the flow of their period, when estrogen and progesterone levels are close to zero. PMS subsides only to gradually build again next month.

How is progesterone used to treat PMS?

The treatment approach to PMS is to address estrogen dominance before it sets in. Estrogen dominance occurs mostly in industrialized countries and commonly occurs in the following situations:

• When women are on estrogen replacement therapy.
• Premenopause when early follicle depletion results in the lack of ovulation and thus a lack of progesterone well before the onset of menopause.
• Exposure to xenoestrogens which is the cause of early follicle depletion. Xenoestrogens are foreign substances found outside the body in the air and food that have an estrogen effect on the body.
• Birth control pills with an excessive estrogen component.
• Women who have had a hysterectomy (or tubal ligation) leading to dysfunction of the ovaries.
• Post menopause, especially in women who are overweight or suffering insulin resistence.

Unopposed estrogen in our bodies results in all sorts of hormone-related health problems such as PMS, endometriosis, uterine fibroids, infertility, weight gain, increased blood clotting, thyroid dysfunction, even cancer, in both men and women.

In theory and in practice, the best way to treat PMS with progesterone is to work from day 12 if your have a 28 day cycle, or day 14 if your have a 30/32 day cycle. If you build up your progesterone levels from day 12, increasing gradually prior to your period, you will take control of your PMS very, very quickly.

Some women find it necessary to commence progesterone earlier than day 12 purely to overcome the build-up of tension and associated symptoms.

Women usually find that within 3 months of progesterone supplementation their life is back on track.