PMS and Period Pain
Diet can make a difference.
Author: Julianne Taylor – 23 October 2009
Approximately 30% of the female population suffer from Pre Menstrual Syndrome (PMS), and for about a third of those it is severe. About 10 percent of women have severe dysmenorrhoea (period pain).
PMS appears to be linked to a genetic defect in the normal synthesis of Gamma Linolenic Acid (GLA). This essential fatty acid is the building block of several groups of prostaglandin hormones. Research indicates that women with severe PMS have GLA levels 80% lower than women without PMS. Some studies show women taking a GLA supplement (found in evening primrose and borage oil) get relief, however other studies found that there was no benefit.
Dr Barry Sears (author of The Zone Diet) says the problem is you can’t resolve PMS with GLA supplementation alone – it has to be combined with a diet that controls the hormone insulin. Why is controlling insulin so important? GLA is the building block of both pro-inflammatory prostaglandin hormones and anti-inflammatory hormones. If you have high levels of insulin, an enzyme called delta -5 desaturase is activated. This is responsible for converting GLA into arachidonic acid, a fatty acid that is then converted into inflammatory prostaglandins. These hormones are connected with PMS symptoms.
Sears stated that it is essential to combine activated fatty acids (GLA) with a Zone balanced diet. This is because the Zone diet keeps blood sugar and insulin levels low and stable. The Zone diet also increases Omega 3 levels, by including lots of oily fish and taking fish oil as a supplement. The result? The same GLA goes down another pathway and gets converted into anti-inflammatory hormones called PGE1.
Sears stated “That’s what I’ve done with hundreds of PMS patients, and it WORKS: these patients report significant reduction, if not eradication of PMS within 30 – 60 days”
In 1996 I read Dr Sears’ first book “Enter the Zone”. At the time I suffered PMS, mainly mood swings and breast tenderness. What caught my eye was the section in his book on reproductive disorders and his successes with PMS.
What was I waiting for? It was worth a shot. I immediately changed my diet to eating Zone balanced meals. The next cycle – nothing, not the tiniest bit of breast tenderness, not a single black cloud. After 20 years of putting up with monthly discomfort – I’d finally found the answer. After some 13 years now on the Zone diet, I’ve found that also cutting out grains and diary and taking Omega 3, give me consistent PMS free periods.
What about period pain: dysmenorrhoea?
Dysmenorrhoea is characterised by severe uterine pain during menstruation. Primary dysmenorrhoea is not caused by any underlying medical issue such as endometriosis or fibroids.
One cause of dysmenorrhoea is thought to be an overproduction of pro-inflammatory eicosanoid (prostaglandin) hormones that cause pain and vascular constriction. There is also a lack of anti-inflammatory and vaso-dilating eicosanoid hormones. In fact elevated levels of inflammatory prostaglandins have been measured in the menstrual fluid of women with severe dysmenorrhoea.
Fatty acids are the building blocks of these prostaglandin hormones – Omega 6 fats and arachidonic acid are the building blocks of the inflammatory, pain causing and vaso-constricting hormones, and Omega 3 fats are the building blocks of anti-inflammatory hormones. If your diet has an imbalance of too high levels Omega 6 and too low levels of Omega 3 you have lots of building blocks of hormones causing the pain and blood vessel constriction, and a lack of building blocks of anti-inflammatory prostaglandins.
Several studies have shown that taking omega-3 fatty acids can reverse the symptoms of dysmenorrhoea, by decreasing the amount of omega-6 FA in cell membranes and replacing it with Omega 3. High levels of omega 3 in cell membranes ensure the building blocks of anti-inflammatory hormones are available in abundance.
In addition to PMS I also suffered severe incapacitating menstrual pain, which resulted in nausea and vomiting. Only catching it in time with painkillers would keep it at bay. Interesting to me was that my period pain had become increasingly worse during my years as a vegetarian. I ate virtually no food with any decent amount of omega 3 and my body must have become increasingly deficient. Along with implementing the Zone diet I started taking 2000mg EPA+DHA (6 purified fish oil capsules a day). Within a month the pain reduced to tolerable levels, although I still needed pain relief. Not only that, but joint inflammation (knees and neck) decreased by about 80% as well.
More recently I have experimented with removing grains, legumes and dairy from my diet (Paleo diet) as grains and legumes in particular are linked with joint inflammation. Not only has the joint inflammation practically disappeared, but the menstrual pain has reduced to almost nil.
I recently came across this testimonial from a woman following the Paleolithic diet, she found both PMS and dysmenorrhoea disappeared after following this programme for only a week.
As well as taking omega 3, certain other supplements appear to help.
Zinc: in one study 1 to 3 x 30mg doses were given daily for one to four days prior to onset of menses, and prevented virtually all menstrual cramping.
Magnesium: Double-blind studies have found magnesium supplementation to be effective for treating primary dysmenorrhoea. It has vaso-dilatory and muscle relaxant effects, as well as inhibiting the synthesis of prostaglandin F2 alpha (a pro-inflammatory hormone).
Exercise: Regular high intensity exercise will reduce painful periods. Female athletes report less than normal pain with their periods.
My recommendations for both PMS and period pain:
- Take Omega 3 – use a high quality fish oil supplement. 2000mg EPA+DHA per day.
- Eat a zone balanced, reduced carbohydrate diet. Focus on getting your carbs from fibrous colourful vegetables and fruit – they increase polyphenols and antioxidants which are anti-inflammatory. They also increase the alkalinity of your diet which helps you retain calcium. Higher calcium levels are linked with less PMS.
- Cut out or minimise oils that contain Omega 6, as these can convert to inflammatory prostaglandins. Use oils that are high in monounsaturated fat (Omega 9) such as olive oil, nuts and avocado.
- Minimise arachidonic acid – this fat is the building block of inflammatory prostaglandins and is found in fatty red meat and egg yolks.
- Take a good quality vitamin, mineral and antioxidant supplement with iron. This will ensure that dietary deficiencies are reversed.
- Try going grain, legume and dairy free, you might find this gives further benefits, especially if you suffer any other problems, such as gut issues, indigestion, acne, headaches, eczema, tiredness or auto-immune problems.
- Make sure your vitamin D levels are at the top of the ideal range. Calcium and vitamin D are linked with a significantly reduced PMS risk. Vitamin D is crucial for calcium absorption, if you are deficient you only absorb about 10% of the calcium from your diet. Get sunlight on your arms and legs for 10 minutes a day (off peak) in the summer. In winter it pays to supplement with 2000iu per day.
- Do regular high intensity exercise, it elevates mood and reduces menstrual pain.