Premenstrual Syndrome PMS A

Premenstrual Syndrome PMS A (Anxiety): Overview

Many Holistic doctors categorize PMS into four types – A, C, D and H – which were originally identified by Dr. Guy Abraham, M.D. 'Type A' or 'PMS-A' ("Anxiety") is the most common symptom category and is related most strongly to an estrogen excess and progesterone deficiency in the luteal phase.

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Causes and Development

The causes of estrogen-progesterone imbalance include inadequate neurotransmitter synthesis, low serotonin, adrenal fatigue and cortisol dysregulation.

Estrogens appear to affect mood by suppressing MAO-A while enhancing MAO-B, resulting in increased levels of epinephrine, norepinephrine and serotonin (all normally deactivated by MAO-A) and decreased levels of dopamine and phenylethylamine (both normally metabolized by MAO-B).  The effects of these changes on mood and behavior are well documented:

  • Epinephrine triggers anxiety
  • Norepinephrine can create hostility and irritability
  • Serotonin, at high levels, can cause nervous tension, drowsiness, palpitations, water retention and inability to concentrate and perform
  • Dopamine is believed to counteract these three amines by inducing a feeling of relaxation and increasing mental alertness.

It is of interest to note that a decreased dopamine level in the hypothalamus is also believed to be central to the hormonal imbalances found in polycystic ovarian disease.

Signs and Symptoms

Symptoms of PMS-A include:

  • Nervous tension
  • Weepiness
  • Anxiety
  • Mood swings
  • Irritability
  • Periods start suddenly and are heavy with clots

Symptom ratings correspond to the raised serum estrogen levels, and serum estrogen to progesterone ratios give the best correlation.  There is no significant correlation of symptoms with the decreased progesterone levels.

Treatment and Prevention

Eating plenty of cruciferous vegetables (such as broccoli, cabbage, cauliflower and brussels sprouts) will help your body to metabolize the excess estrogen.  Other supplements that could help relieve symptoms include:

  • Vitamin E supplements
  • Ginger
  • Chaste tree
  • Milk Thistle B Complex (taken every day)
  • Vitamin B6 (taken during the last 14 days of each cycle)
  • Calcium (1,500mg daily) and Magnesium (1,000mg daily)
  • Chlorophyll
  • Dandelion
  • Chamomile

References and Further Information

See also:

Premenstrual Syndrome (PMS)
PMS-A (Anxiety)
PMS-C (Craving)
PMS-D (Depression)
PMS-H (Headache)

Signs, symptoms & indicators of Premenstrual Syndrome PMS A (Anxiety):

Symptoms - Reproductive - Female Cycle

Conditions that suggest Premenstrual Syndrome PMS A (Anxiety):


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Vitamin B6 (Pyridoxine)

In one study, women received 50mg per day of vitamin B6 or a placebo for 3 months.  Symptoms amongst these women included depression, irritability, tiredness, headache, breast tenderness and swollen abdomen/hands.  At this dose depression, irritability and tiredness were the only symptoms to respond and they were reduced by 50%. [Gynecol Obstet Invest 1997;43(2): 120-124]

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