Excerpt from Eva Cwynar, M.D.'s new book, "The Fatigue Solution"
We've come a long way since the time when doctors used to debate the reality of PMS, but the short answer is that there are many reasons why PMS occurs. There are several different theories:
- Decline in progesterone levels. PMS symptoms occur during the luteal phase of a woman's cycle, which is when progesterone begins to rise (right after ovulation) and then starts to plummet about 7 days later. When you are about to get your period, your progesterone levels rapidly drop. That's what causes problems. Hormone levels normally fluctuate. If progesterone levels were measured on a scale of 1 to 10, for example, they could drop from a level of 10 to a 9.9 to a 9.8 to a 9.7 and your body would be able to adjust to the changing levels with almost no difficulty. When you're about to get your period, however, levels drop dramatically from a 10 to a 5 and perhaps even to a 1. It's that rapid change that stimulates your symptoms. And some women drop faster and lower than others, which is why their symptoms may be worse than other women's.
- Decrease in neurotransmitters serotonin and GABA activity. Serotonin is responsible for our positive emotional well-being, while GABA helps keep us calm. Reduced levels of estrogen during the luteal phase may ben linked to a drop in serotonin. Lower serotonin levels are associated with irritability, anger, and carbohydrate cravings, all of which are symptoms of PMS. It also appears that GABA receptors are less sensitive than normal, which would explain the increased sense of anxiety.
- Changes in levels of norepinephrine and epinephrine. These neurotransmitters are involved in the body's stress response. Estrogen may affect the levels of these neurotransmitters, which can influence blood pressure and heart rate as well as mood.
Other possible causes include:
- Hypoglycemia (low blood sugar)
- Mercury toxicity
- Candida overgrowth (a fungus)
- Food allergies/sensitivities
- Vitamin B6, Calcium or Magnesium deficiencies
- Inadequate protein intake - liver enzymes that convert female hormones depend on protein
- Poor liver function - the liver metabolizes one form of estrogen into other forms of estrogen
- Poor adrenal gland function
No one knows for sure what causes PMS. Some people attribute particular symptoms to increased levels of estrogen and/or progesterone; other people say the same symptom is due to decreased levels of these hormones. Studies routinely produce conflicting results. I believe that the key to eliminating or greatly reducing PMS symptoms lies in the balance between these two hormones during the menstrual cycle.
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Also, to learn more about Dr. Eva Cwynar, visit her website: www.dreva.com