Premenstrual Syndrome

What Causes Premenstrual Syndrome?

In order to deal properly with premenstrual syndrome we need to understand and — if possible — remove the underlying causes and risk factors.  We need to ask: "What else is going on inside the body that might allow premenstrual syndrome to develop?"

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Accurate diagnosis of the factors behind premenstrual syndrome consists of three steps:

Step 1: List the Possible Causative Factors

Identify all disease conditions, lifestyle choices and environmental risk factors that can lead to premenstrual syndrome.  Here are five possibilities:
  • Low Melatonin
  • Magnesium Need
  • Manganese Need
  • Copper Toxicity
  • Low Progesterone

Step 2: Build a Symptom Checklist

Identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
having had a small bowel resection
reduced progesterone level
current birth control pill use
joint pain/swelling/stiffness
being postmenopausal
being easily irritated
refined sugar consumption
moderate alcohol consumption
breast soreness during cycle
elevated MCH
painful menstrual cramps
disturbed sleep
... and more than 50 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of premenstrual syndrome:
Cause Probability Status
Copper Toxicity 96% Confirm
Magnesium Need 19% Unlikely
Manganese Need 0% Ruled out
Low Progesterone 0% Ruled out
Low Melatonin 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate being premenopausal or being perimenopausal, The Analyst™ will ask further questions including this one:
Do you suffer from Premenstrual Syndrome (PMS)?
Possible responses:
→ No / don't know
→ Minor
→ Moderate
→ Serious
→ Severe
Based on your response to this question, which may indicate PMS, The Analyst™ will consider possibilities such as:
Copper Toxicity

Estrogen results in increased copper absorption.  Copper is closely related to estrogen metabolism, so an imbalance can cause many female health problems such as premenstrual syndrome.  Taking extra zinc and vitamin B6 before the menstrual period can reduce copper levels and thus the symptoms of PMS.

Low Melatonin Level

Melatonin can exhibit strong effects on the reproductive system, and the activity of the female hormones estrogen and progesterone is closely tied with its regulation of the sleep-wake cycle.  Abnormal biological rhythms and sleep-wake cycle disturbances are often a primary feature of periodic depression, another common characteristic of PMS.  Melatonin imbalances have been specifically linked to PMS.

A study reported finding that women with PMS had an earlier decline in melatonin secretion, resulting in a shorter overall secretion time.  "The data demonstrate that women with premenstrual syndrome have chronobiological abnormalities of melatonin secretion... The fact that these patients respond to treatments that affect circadian physiology, such as sleep deprivation and phototherapy, suggests that circadian abnormalities may contribute to the pathogenesis of premenstrual syndrome." [Arch Gen Psychiatr 1990;47(12): pp.1139-46]

Magnesium Requirement

Magnesium deficiency is strongly implicated as a causative factor in PMS.  Red Blood Cell magnesium levels in PMS patients have been shown to be significantly lower than in normal subjects.  The deficiency is characterized by a generalized hyperesthesia syndrome (with generalized aches and pains), and a lower premenstrual pain threshold.  One clinical trial of magnesium in PMS showed a reduction of nervousness in 89%, mastalgia in 96%, and weight gain in 95%.

Manganese Requirement

In a double blind study of women with normal menstrual cycles, lower dietary manganese (1.0mg versus 5.6mg) was found to increase mood and pain symptoms during the premenstrual phase.  [Am J ObstetGynecol.  1993 May; 168(5): pp.1417-23]

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