Question:

I have struggled with horrible PMS for years, only to have it lifted at menses. I feel guilty about not being able to keep my raging hormones out of my personal life.

Answer:
Hormone fluctuations definitely play on our emotions because when estrogen levels decrease – serotonin levels decrease as well. Serotonin helps us feel good mentally and emotionally.

Physiological Process:
It’s important to understand the physiological process of PMS. The female hormone estrogen starts to rise after menstruation and peaks around mid-cycle (ovulation). It then rapidly drops only to slowly rise and then fall again in the time before menstruation. Estrogen hold fluid and with increasing estrogen comes fluid retention: many women report weight gains of five pounds premenstrually. Estrogen has a central neurologic effect: it can contribute to increase brain activity and even seizures. Estrogen can also contribute to retention of salt and a drop in blood sugar. PMS patients and migraineurs benefit from both salt and sugar restriction and a mild diuretic.

The physical, emotional and psychological changes that occur in PMS coincide with hormonal changes of the menstrual cycle. PMS may be a response to declining levels of estrogen and progesterone that occur just prior to menstruation. The exact role of the various hormones is not clear. Some neurochemicals (chemicals that help make up the nervous system) also have been implicated. Hormones and neurochemicals may interact to produce PMS. Read more on PMS and the Causes on the WomensHealthChannel.

This fluctuation in the hormones affects our bodies – thus, affecting mood and how we function and act. It will be a challenge to try to be nice and polite while we are feeling blue, irritable, depressed, etc. from the fluctuation in estrogen. It will take God’s power, some medical treatment, changes in stress and nutrition and supportive people in our lives to help us get through this phase.

In the related article below on menopause I cover some of the steps women can take to help themselves deal with estrogen deficiency: Preparing for Menopause.

Emotional and mental wellness: When you are experiencing the symptoms of hormone loss, you will feel blue. This increases emotional fragility and a sense of low self-esteem. Deficiency in hormones and lack of sleep cause irritability, confusion and sadness, angry outbursts, tears and relational problems.

While estrogen therapy may be recommended to help elevate mood, women should also incorporate natural methods of elevating mood such as lowering stress and increasing recreational and exercise programs. I encourage women to consider a new venture, career or learning a useful pursuit such as photography, writing or computer technology. I knew someone who finished her MSW when she was 55! Start participating in meaningful recreational and social activities. Begin hiking, biking, bird-watching, participating in a book club, or enjoying Christian ministry or new hobby.

Spiritual wellness: This will provide power and perspective during painful times of PMS. As a Christian. you can be certain that the Lord cares about you and understands your suffering. He will be your companion through this valley. Take more time to read Scripture, the Psalms and pray. This will help alleviate depression and anxiety caused by menopause. Memorizing Scripture can change your attitude about life.

When the writer of Psalm 42:5 felt depressed, he talked to himself and told himself biblical truth about life, the future and God: "Why are you downcast o my soul? Why so disturbed within me? For I will yet praise Him, my Savior and my Lord."

Challenge your thinking and renew your mind according to the truth of Scripture in order to get God's perspective on your life and experience a greater sense of wellness all-around.

Why not write out some goals to help you better manage the symptoms you are dealing with and consult with your physician about medical interventions? Plan to get more rest and relaxation during this time. Don't plan any stressful events when you know this time of the month is coming. Determine to take better care of yourself.

Finally, trust in the promises of God. Isaiah 58:11 says, "The Lord will guide you always; he will satisfy your needs in a sun-scorched land and will strengthen your frame. You will be like a well-watered garden, like a spring whose waters never fail."

Here are some recommendations from the WomensHealthChannel on treating PMS:
"Exercise
Exercise has a profound effect on hormones, including those involved in the menstrual cycle. Women who exercise experience less anger and depression. Exercise also reduces stress, which worsens PMS symptoms. Women, especially those who experience PMS, are encouraged to exercise regularly, 20-45 minutes, 3 times a week.

Nutrition
It is not clear how dietary changes affect PMS. Some studies show that drinking tea and increasing carbohydrates during the weeks preceding menstruation is helpful. Carbohydrates increase the level of the neurotransmitter serotonin (the low level of serotonin has been linked to PMS-related depression). Some nutritionists recommend vitamins, especially vitamin B6.

Reducing or eliminating alcohol, caffeine, refined sugar, salt, dairy products, and animal fats may also be beneficial. A professional nutritionist or dietician can advise women on dietary changes that may relieve symptoms.

Stress reduction
Stress reduction can help reduce PMS symptoms. Physical trainers and physical therapists can help women incorporate exercise and movement into their lives. A counselor or therapist can provide advice on reducing stress as well."

I also hope that you will be encouraged and know that God loves you and understands your pain and suffering. He is also the God of grace who can give you strength to keep going despite this obstacle in your life. May He help you find ways to better manage PMS in the future. And please know that He does not condemn you for this – but wants to help you. Take care.

©copyright 2007 by Lynette J. Hoy, NCC, LCPC