Female hormone imbalances including PMS are the most common things that I see in my practice. Conventional medical solutions for PMS and hormonal imbalances are very poor for most part, consist of birth control pills and/or antidepressants to help alleviate symptoms and only causing more problems in the long run. One of the key things that needs to be addressed is the underlying cause, and if ignored over time, the body continues to break down causing more symptoms to occur. So from a functional medicine perspective it is our goal to address the underlying cause of the stressors that are driving the body to go out of balance.
As the female body is stressed one of the main things that occurs is the hormone progesterone gets converted into a stress hormone called cortisol. When this happens it causes the progesterone to estrogen ratio to go out of balance, this is also referred to as estrogen dominance. The body naturally should have about 25 times more progesterone to estrogen which can be assessed via a salivary lab test.
If you look at the female cycle essentially it can be broken down into two phases. The first phase is referred to as the follicular phase, in this phase the hormone estrogen predominates and helps to thicken the endometrial lining so an egg can be implanted. Once estrogen levels drop between day 12 and 13 this signals ovulation where a corresponding rise in progesterone occurs. The rise of progesterone is a hallmark of the luteal phase and in plays a role as a pro-gestational hormone that helps the egg grow.
With many patients that have PMS, many are not getting enough progesterone in the second half of the cycle. This lack of progesterone causes symptoms just before bleeding such as breast tenderness cramping headaches etc. The solution is to not just give progesterone alone, because if the underlying stressors are not addressed the progesterone will just be used to fuel the stress response.
How we address the underlying cause of the problem is to reduce the prominent stressors the person is dealing with. Stress causes the body to convert progesterone into cortisol, getting the predominant stressors under control prevents the body from burning itself up. So doing simple things such as addressing blood sugar handling issues helps regulate cortisol. Addressing infections such as parasitic, bacterial and fungal infections can help address the underlying cause and put cortisol back in the balance.
The adrenal glands are primarily responsible for producing cortisol at the same time producing a good portion of the woman’s sex hormones. So to address PMS is vitally important that the adrenals are supported so they can function optimally to provide hormonal balance. The female hormones never spontaneously go out of balance by themselves so to produce a lasting change we need to address lifestyle, diet, and female hormone support all the same time. The solution comes from doing the right things, in the right combination, at the right time.