The Menopause Self Help Book
by Susan M. Lark, M.D., The Wild Rose Scientific Herbal by Terry Willard, Ph.D., Menopausal Years The Wise Woman Way by Susun S. Weed
are drawn heavily upon for this segment. All references are provided here.
PREMENSTRUAL
SYMDROME (PMS)
In spite of clinical evidence of physiological changes as the underlying
disturbance, most medical textbooks, researchers and physicians have attributed
PMS symptoms to psychological causes. Though psychological factors may
intensify the patient's suffering, they do not cause the
syndrome.30
PMS, which has been attributed to an increase in the estrogen-progesterone
ratio, involves a wide variety of symptoms such as water
retention, sore breasts, digestive
distress, decreased libido/sexual frigidity,
and emotional uproar. The symptoms are different
for every woman, but all usually disappear with the onset of menstruation.
For most women, the nature of premenstrual symptoms is likely to change
with the onset of menopause. Then it's also common to feel sore
all over or have difficulties with normal sexual relations. Herbs,
when used wisely, can be a much gentler way than drugs to deal with the
symptoms of PMS;31 however, it is possible that some women
will need estrogen supplementation.30
Fluctuation in hormone levels: Dr. Elizabeth Lee Vliet has studied
the connection between moods and fluctuation of hormone levels and has
found that "approximately 80-85% of these women in their mid-thirties
and early forties who described 'worsening PMS' had below-normal estrogen
levels at these points during their menstrual cycle."
Dr. Vliet found also that "prematurely low estradiol levels were even
more likely to be present in women who had experienced a surgical procedure
that affected blood flow to the ovaries, such as tubal ligation or hysterectomy
(even when the ovaries were left in place)." To restore their estrogen
levels to more normal levels these women were offered low-dose estrogen
supplementation rather than antidepressants, as is commonly practised
by many physicians. Dr. Vliet has been "astonished at the results". In
spite of this, she cautions that "estrogen should not be used by women
at high risk of breast or uterine cancer, fibroid tumors of the uterus,
liver or gall bladder disease, or depression."
EFAs-Essential fatty acids (linoleic
and linolenic acids) such as flaxseeds and pumpkin seeds promote 'good'
prostaglandins I and III which reduce inflammation, boost immune function,
decrease menstrual cramps, and decrease risk of heart disease by regulating
blood pressure and platelet stickiness. All of these factors help reduce
PMS symptoms. Essential fatty acids are particularly important to menopausal
women because the deficiency of these oils is responsible in part for
drying of the skin, hair, vaginal tissues and other mucous membranes that
occurs with menopause.16
In some studies, breast tenderness and other PMS symptoms such as irritability,
depression and bloating improved significantly in women taking evening
primrose oil (EPO), an omega-6 EFA, as compared with those taking a placebo.
However, not all studies have shown this, so this application remains
a subject for debate.23
Some 70% of PMS patients have some atopic factor as an underlying cause
(eczema, arthritic-related disease), and EFAs have been found very useful
for many in the treatment of these symptoms.33 An increasing
amount of research indicates that people who suffer from atopic eczema
have a defect in the function of a crucial enzyme that GLA (gamma-linolenic acid) helps to metabolize.23
Oral dietary supplement forms of GLA have not only proved effective in
improving atopic eczema in various studies but have also been shown to
be significantly superior to a placebo in relieving itching and reducing
the need for steroid medications. Not all trials have reported such positive
results, but topical EPO formulations for treating atopic eczema are officially
approved and commonly used in England.23
Vitamin E has been found to be of
benefit for symptoms of PMS.16 Results from studies regarding
claims that vitamin E can lower cholesterol and other blood lipids are
mixed; however, one recent double-blind, placebo-controlled study found
that 500 IU of vitamin E daily can elevate the ‘good’ cholesterol HDL
by about 14%. This form of cholesterol helps transport the dangerous forms
of cholesterol out of the body.12 Several other studies indicate
that vitamin E can help protect against potentially life-threatening blood
clots.12
A double blind, placebo-controlled study examined whether vitamin E reduces
symptoms of PMS. It confirmed earlier research reports and concluded that
"all major categories of PMS symptoms are improved with supplementation
of 400 IU of vitamin E daily."12
CAUTIONS regarding vitamin E include:
Persons who are taking anticoagulant drugs
should be followed closely by their physicians especially when taking
vitamin E supplements. This includes those with vitamin K deficiency.
Vitamin E has not been found to interfere with coagulation factors
in normal individuals.12 Note that vitamin E over 100
IU is contraindicated for women with diabetes, those taking digitalis,
and anyone experiencing vision disturbances.31
Vitamin E may also elevate blood pressure
and has been anecdotally reported in persons with preexisting hypertension
or predisposition to hypertension. It may also be dangerous in high
doses in persons suffering from rheumatic disease. This adverse
effect has not been reliably observed in normal individuals.12
Do not take vitamin E at the same time that
you take a separate inorganic iron supplement or the contraceptive
pill, both of which may interfere with vitamin E activity. On the
other hand, the form of iron such as ferrous fumarate used in multiple
vitamins is thought to be compatible with vitamin E. Discontinue
vitamin E if any signs of toxicity such as fatigue, nausea, muscle
weakness, stomach upset, or skin disorders occur.12
Dietary Changes for PMS: Dr.
Elizabeth Lee Vliet advises the following for relief of PMS:
Avoid simple sugars; reduce salt, cut out alcohol, caffeine, nicotine
and chocolate, especially just before your period
Increase intake of complex carbohydrates to 60 percent of total daily
caloric intake (have a low-fat, low-sugar, high-fiber bran muffin instead
of a brownie)
Decrease intake of protein to about 20 percent of total daily calories
and concentrate on the low-fat protein sources such as fish, chicken,
low-fat cheese
Proper spacing of meals. Reduce long intervals between meals; practice
more frequent eating with smaller portions
Add vitamins B6 (don't exceed 100 mg per day), B complex, vitamin
C