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Menopause
Menopause and Premenstral Tension (PMT)
A condition characterised by nervousness, irritability, emotional instability, depression and possibly
headaches, edema and mastalgia; it occurs during the 7 to 10 days before menstruation and disappears a
few hours after onset of menstrual flow.
These terms describe a broad range of symptoms that occur cyclically which are severe enough to disturb
a womans' life patterns or cause her to seek help from a health practitioner. Most women experience some
body change cyclically during the menstruating years corresponding to the pattern of cycling hormones.
The subtle shift in mental and emotional focus as well as body response is observed and ritualised in many
cultures. Women often express a positive attitude toward the conscious observance of these patterns within
their own bodies, however when the hormonal and chemical changes result in debilitating symptoms they
may disrupt functioning in virtually all body systems.
This may include:
- Behavioral Symptoms. Personality alteration in the form of nervousness, irritability, agitation,
unreasonable temper, fatigue, depression. Violent crimes and suicide are often committed at such
a time. Symptoms that suggest clinical depression such as anxiety, palpitations, tightening in the
chest, hyperventilation are common.
- Neurological Symptoms. Headache, vertigo, syncope, paresthesias of the hands or feet,
aggravation of seizure disorders have all been recorded.
- Respiratory Symptoms. Asthma may be intensified.
- Gastro-intestinal Symptoms. Constipation, and an increase or decrease in appetite, carbohydrate
craving particularly sugar and chocolate.
- Miscellaneous. Edema, weight gain, backache, enuresis, oliguria, capillary fragility, exacerbations
of dermatologic disease, breast changes, and eye complaints
Four categories of PMT have been identified corresponding to the major symptoms patterns :
- PMT-A: Predominantly anxiety, associated with excess oestrogen, and CNS stimulation resulting in
anxiety. Excess oestrogen can be caused by deficiency in progesterone (high oestrogen/
progesterone ratio), or by inability of the body to break down oestrogen (poor liver function, or
Vitamin B deficiency resulting in same).
- PMT-H: Predominantly hyperhydration (bloating, edema), increased ACTH, water/salt saving by
kidneys.
- PMT-C: Carbohydrate craving, due to increased responsiveness to insulin.
- PMT-D: Depression, due to excess progesterone, CNS depression PMS is diagnosed on the basis of
when symptoms are present. There is (by definition) a period of time when symptoms are absent,
usually just after the onset or end of menses. PMS occurs during the proliferative or luteal phase of
the menstrual cycle when levels of oestrogen and progesterone are relatively high. Oestrogen is a
central nervous system stimulant. Progesterone is a CNS depressant. What is important in the
relationship of oestrogen to progesterone during the luteal phase.
A number of etiological factors have been identified for primary PMT:
- Oestrogen excess.
- Progesterone deficiency.
- Fluid retention. It is believed that many of the symptoms of PMS/PMT relate to a shift in the fluid
in the water compartments, intra and extracellular and intravascular with increased retention of
water and water moving into the extracellular spaces. Mediated by increased ACTH and
aldosterone.
- Hypoglycemia. The cells are more receptive to insulin in the premenstruum, causing relative
hypoglycemia resulting in carbohydrate craving.
- Decreased production of Prostaglandin E1, and the advice to use Gamma-linolenic acid, which
is found naturally in human milk and oil of evening primrose. Other nutrients encouraging the
conversion of fatty acids to Prostaglandin E1 are: Magnesium, B6, Zinc, Niacin, and Vitamin C.
- Increased production of other prostaglandins.
- Magnesium deficiency leading to decreased dopamine in the brain resulting in increase levels of
CNS stimulators (norepinephrine and serotonin).
- Increased prolactin levels causing decreased progesterone.
What can I do?
The following dietary guidelines could be suggested:
- Limit refined sugar as it increases excretion of B Vitamins, Magnesium, and Chromium, and
contributes to increased insulin secretion resulting in hypoglycemia.
- Limit salt to under 3 grams per day.
- Limit red meat because of high sodium & high fat content, to 3 oz. per day. Some evidence shows
that the hormones in red meat contribute to fibrocystic disease & menstrual cramps.
- Limit alcohol to I oz. per day. Alcohol destroys B Vitamins, Magnesium and Chromium, and may
be a potent depressant in some people.
- Limit Caffeine: it intensifies anxiety and contributes to fibrocystic disease.
- Limit dairy products. They are high in fat, interfere with magnesium absorption, & may constipate.
- Limit fats to 30% of total calories.
- Limit protein to 1 gram per kilogram of body weight.
- Avoid licorice: it stimulates the production of aldosterone.
- Minimize spinach, beet greens and other oxalates as they interfere with mineral absorption.
- Increase complex carbohydrates to 40% of diet, with whole grains, green leafy vegetables and
legumes. . They are high in fibre, B Vitamins and release sugar slowly.
- Increase potassium rich foods, which are beneficial against water retention: sunflower seeds,
dates, figs, peaches, bananas, tomatoes.
- Increase intake of natural diuretics: artichokes, asparagus, parsley, watercress.
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