You’re weepy, bloated, irritated, eating large amounts of chocolate, your breasts hurt and your skin is breaking out. You’re probably thinking pre-menstrual syndrome (PMS) is something we all just have to live with, right? Wrong! Just because a condition is common does not mean it is normal.

The fact is that PMS may be due to hormonal imbalance, nutritional deficiencies, decreased liver detoxification and poor diet.  Identifying the reasons why you may be experiencing PMS allows for appropriate treatment and relief of the monthly discomfort that PMS can bring. That’s right, you may be able to “solve” your PMS problem.  Are you cheering yet?

First let’s talk about the particulars. PMS categories

  • Type A:  Anxiety. Characterized by symptoms such as anxiety, irritability and mood swings. This is very common and can be experienced by up to 80% of women premenstrually.
  • Type C: Cravings. Characterized by cravings for sweet and salty foods, which results in blood sugar imbalances causing fatigue, headaches and dizziness. Up to 60% of women can experience these kinds of symptoms leading up to their period.
  • Type H: Hyperhydration. Characterized by water retention, bloating, weight gain, breast tenderness and swelling.
  • Type D: Depression. Characterized by withdrawal from normal daily activities, insomnia, sadness and crying.  Much less common, as only 5% of women experience these symptoms, but these can be the most serious – special attention is strongly encouraged.

Sources of PMS

Hormonal and neurotransmitter imbalance

Although PMS is not fully understood, it has been established that it may be due to excess estrogen, low progesterone or a low estrogen/progesterone ratio. Identifying hormonal imbalances is key for proper treatment of PMS. Hormones can be evaluated through blood or saliva tests, which can be requisitioned by your ND or MD. Breast tenderness is linked to elevated estrogen levels and could be a sign of increased risk of breast cancer, so assessing hormone levels and seeking appropriate treatment is essential for breast health and breast cancer prevention.

Depression and PMS appear to be linked to a deficiency of the brain neurotransmitters serotonin and GABA (gamma-Aminobutyric acid) and omega 3 deficiency.

Liver function and environmental exposure

Often times PMS symptoms are a sign of suboptimal liver function. The liver binds excess hormones and excretes them appropriately. So if the liver is sluggish, it doesn’t do this as effectively and, therefore, we have higher hormones levels in the body. Elevated estrogen levels have also been found to decrease bile flow.

We are exposed to so many chemical estrogen-mimicking agents, which is extremely problematic as they have been linked to an increased incidence in breast cancer and hormonal imbalance. To reduce exposure, it is essential to avoid plastics, cosmetics, lotions and soaps that contain BPAs, phalalates, DDT, PCB and PCP. For a more detailed list of the most common and worst chemicals culprits that we must avoid, click here.

Dietary habits and nutritional deficiencies

Excessive estrogen levels impair B6 function in the body. In fact, those taking oral contraceptives should supplement B6, otherwise they will become deficient. Cramping and other PMS symptoms could also be due to a magnesium deficiency. It has also been identified that women with PMS symptoms have a poorer diet – they tend to consume more refined carbohydrates, sugar, dairy and sodium and also seem to be deficient in iron, manganese and zinc.

Simple changes that can make a big impact

  • Hydrate! The more water we drink, the less water we retain.  I know it sounds counter intuitive but it works, so drink up!
  • Eat a whole foods diet with minimal intake of sugar, refined carbohydrates, dairy products and saturated fats.
  • Avoid plastic water bottles and products that contain xenoestrogens.
  • Limit or restrict caffeine intake.
  • Do seasonal detoxification and ensure an adequate fibre intake to support liver function and proper excretion of hormones.
  • Identify and treat possible nutrient deficiencies, all of which can be conducted by an ND and treated through individualized dietary prescription.
  • Identify and treat hormonal imbalances. Consider having your thyroid function checked, as well as sex hormones and other hormones such as progesterone, estrogen, testosterone, DHEA and cortisol assessed.
  • Establish a regular exercise program that strives for 5 days of vigorous physical activity that has a balance of strength and endurance training.
  • Boost serotonin and omega 3 levels by increasing lean proteins and fats in your diet, such as turkey, eggs, fish, chicken, nuts and beans.
  • Botanical medicines such as angelica, licorice, black cohosh, ginkgo, St. John’s wort and chaste tree have been shown to be very helpful in the treatment of hormonal imbalance and PMS. Individual prescription of these herbs is ideal and can be accomplished with a naturopath.

I hope that by increasing your understanding of PMS, you feel empowered to make some positive and healthy changes. If you are interested in seeking treatment for these or any other health concerns I would be happy to help.

In great health & happiness,

Dr. Michelle Peris


Dr. Michelle Peris is a Naturopathic Doctor whose goal is to inspire health through educating, motivating and empowering people.  She has a family based practice out of a clinic in Oakville, Ontario.

Contact Dr. Michelle today to book your 15 minute complimentary consult.