Kelowna Naturopathic Clinic

JEKYLL & HYDE OR JUST HORMONES GONE A WRY

Throughout the medieval ages, women's menstrual disorders were considered either irrelevant and not to be discussed or the result of sinful actions and punishment by evil spirits. This is obviously incorrect and tells a lot about the crazy minds of the "medical" personnel of that time. Today although we take pride in our higher level of medical knowledge, there is still much that is poorly understood about the complexity of the female menstrual cycle and biological clock.

A frequent scenario goes something like this. A woman in her early 30's attends a doctor's office with a complaint of breast tenderness, mood swings and bloating that occurs several days before her cycle. She has had this problem in many cases for years but has never sought any medical advice for it. She now wants help.

What this woman is describing is a combination of premenstrual syndrome and fibrocystic breast disease. Premenstrual syndrome (PMS) is a recurrent condition of women, characterized by a variety of symptoms that come on 7-14 days before menstruation. This syndrome affects about 1/3 of women between the ages of 30 and 40. Symptoms can include anxiety, irritability, mood swings, increased appetite, fatigue, depression, crying, insomnia, fluid retention, abdominal bloating, breast tenderness, back ache and headache. Some women will only get a few of these symptoms and others will experience all of them to some extent.

Fibrocystic breast disease (FBD) is a recurrent, typically premenstrual, breast swelling, pain and tenderness disorder. Characteristically both breasts are affected, with multiple cysts of varying sizes giving each breast a nodular consistency. The size of the cysts typically fluctuates. This condition is very common, affecting 20-40% of premenopausal women. It is usually a component of the premenstrual syndrome.

The cause of FBD and PMS are apparently due to an increased estrogen to progesterone ratio, also called estrogen dominance. In other words, the ovaries are producing more estrogen than progesterone or the body is more sensitive to the estrogen produced. In some cases, there are normal amounts of estrogen but inadequate levels of progesterone.

Since the liver is the primary site for estrogen clearance, any factor that interferes with proper liver function may lead to estrogen excess.

There is evidence of an association between low thyroid function and FBD and PMS. Some women are iodine deficient and others may have hypothyroidism.

Various dietary and nutritional disruptions have also produced PMS/FBD signs and symptoms. In particular, there is strong evidence supporting an association between caffeine consumption and these disorders. Coffee, tea, cola, chocolate and cocoa are the main culprits. Vitamin E, A, B6, iodine, magnesium, zinc, and essential fatty acids such as evening primrose oil and flax oil all have shown to benefit most cases of PMS/FBD. Many women also respond to a lower carbohydrate containing diet with particular attention to the reduction of refined grains and sugars e.g. pasta, bread, potatoes, and junk food.

Since each woman is unique, treatment needs to be individualized. A general program might look like this:

1. The diet should be primarily low in processed carbohydrates, high in complex carbohydrates, with large amounts of dietary fibre. Adequate protein is a must. This may come from animal or vegetarian sources e.g. soy, lentils, millet, beans, nuts and seeds, corn, brown rice, fish, chicken and turkey. All caffeine containing foods should be eliminated. Estrogens from drugs and contaminated food should be avoided. Organic, non-hormone fed meat must be sought if to be used.

2. The following supplements can be used: Calcium & Magnesium, B complex, B6, Vitamin E, Beta-Carotene, Iodine, Zinc, Flax seed or Evening Primrose Oil.

3. Liver and Colon supporting remedies are often useful in this treatment. They can include milk thistle, dandelion root, artichoke, acidophilus, and psyllium seed powder.

4. Progesterone cream rubbed into the ski 1-2 times daily for 14-21 days of the month is often very beneficial for both PMS and FBD. Wild yam cream is not the same and contains no progesterone but other hormone like substances. The use of progesterone must be prescribed by a licensed naturopathic or medical physician.

5. Stress management and relaxation techniques are always valuable in getting through the month. Find some time to do things for yourself and yourself only. A positive mental state only enhances this physiologic treatment.

6. Symptoms such as depression, insomnia, and extreme mood disruption may require natural or synthetic anti-depressants and/or sedatives. These symptoms often resolve themselves when the hormonal imbalance is remedied.

Virtually all cases of PMS and FBD are either extremely manageable or curable. Occasionally more drastic measures such as cyst aspiration and/or drug use are necessary. Treatment will only get better as the female monthly cycle is better understood.