Is low progesterone to blame for your PMS?

While your menstrual cycle may come and go – some months with more drama than others – there's an active sequence of hormonal events occurring behind the scenes to make it happen each month. If you suffer from PMS, ranging from weight gain to chocolate cravings to mood swings and beyond, you may want to pay close attention to your progesterone levels.

Progesterone: The anti-PMS hormone Progesterone is produced by the ovaries before menopause and in small amounts after menopause by the adrenal glands. Opposite to estrogen, progesterone is naturally higher in the second half of the menstrual cycle, when it causes thickening of the uterine wall in preparation for implantation of a fertilized egg. If no implantation occurs, progesterone levels decline, triggering the beginning of the menstrual flow.

Progesterone has many beneficial effects. It’s a natural diuretic, sleep aid, anti-anxiety compound and stimulator of metabolism (because it supports thyroid hormone). It’s also considered to be thermogenic because it raises body temperature, just like when we eat protein. Progesterone may help to build bone density, reduce blood pressure, lower LDL cholesterol, improve the appearance and texture of hair and skin, aid libido and prevent PMS. When balanced properly with estrogen, it’s protective against breast and prostate cancer. This multifunctional hormone also aids fertility and helps to balance the immune system, thereby reducing the risk of autoimmune disease. An imbalance of progesterone to estrogen is very common in women in their 30s and 40s. A deficiency in progesterone may arise from any of the following reasons:

Stress: More stress means lower progesterone, as the body steals progesterone to increase cortisol production.

Lack of ovulation: May occur with conditions such as polycystic ovary syndrome (PCOS).

Low levels of luteinizing hormone (LH): Released by the brain, LH triggers the production of progesterone.

Hypothyroidism: An underactive thyroid gland.

Excess prolactin: The hormone prolactin stimulates breast development during pregnancy and milk production during nursing. Too much prolactin can suppress progesterone production and can cause infertility and menstrual disorders. Prolactin levels can also increase with hypothyroidism and pituitary disorders.

How to get progesterone back in balance If all the above items ring true with you, you can ask your doctor to test your progesterone levels on day 19-22 of your menstrual cycle. I like to see progesterone levels between 15-35 nmol/L. If you are under that range or on the low end ask your health practitioner about one of these options.

Ease PMS and migraines with chasteberry (Vitex) Many women suffer from migraines right around the time they're due for their menstrual cycle. According to a new study, it may have a lot to do with low progesterone levels. Researchers investigated the impact of Vitex agnus-castus (also known as Chasteberry) for migraines in women with premenstrual syndrome. One hundred women with migraines and premenstrual syndrome (PMS) completed the study. The participants received 40 mg per day of Vitex for three months. The researchers found that 66 percent of the subjects reported a dramatic reduction of PMS symptoms, 26 percent reported a mild reduction and 8 percent reported no change in PMS symptoms. The investigators also discovered that, regarding migraines, 42 percent of the subjects reported a greater than 50 percent reduction in frequency of monthly attacks and 57 percent of the women reported a greater than 50 percent reduction in monthly days with headache. Vitex has been shown to increase both dopamine and progesterone, also making it an excellent choice for women who experience symptoms of depression in conjunction with PMS or irregular menstrual cycles.

Bottom line: I recommend taking 2 tablets of Chasteberry each morning before breakfast for 1-6 months.

Reach for vitamin E and evening primrose oil (EPO) While flaxseed appears to be estrogen enhancing, EPO is touted as a progesterone enhancing compound. While studies are conflicting, I've EPO improve not only PMS, but reduce breast pain that often accompanies the menstrual cycle with long term use. Researchers at the Breast Diagnostic Clinic at Mayo Clinic evaluated 85 women with cyclical breast pain and found that a daily dose of vitamin E, evening primrose oil or a combination of both alleviated cyclical breast discomfort.

Bottom line: I recommend taking 2,000 mg daily from day 12 to the first day of your menstrual cycle. For full protection consider adding 400 iu of vitamin E. According to a study in the British Journal of Obstetrics and Gynaecology, vitamin E may be helpful for alleviating menstrual cramps and decreasing blood loss during menstruation. Researchers found that pain was significantly less and of shorter duration among the women in the vitamin E group at two and four months than among the women in the placebo group. Together, they certainly make for a great anti-PMS combo.

Achieve balance with bio-identicals If your numbers are consistently low on bloodwork you may want to ask your health practitioner, or local compounding pharmacy, about 3 percent or 6 percent bio-identical progesterone cream. If you’re using this product for PMS, apply areas of thin skin (like your labia) on days 14 to 28 of your cycle when progesterone is naturally highest. For the treatment of menopause symptoms, it may be used for 25 days followed by five days off or it may be applied on a schedule that more closely matches a woman’s natural menstrual cycle.

Natasha Turner, N.D. is a naturopathic doctor, Chatelaine magazine columnist, and author of the bestselling books The Hormone Diet and The Supercharged Hormone Diet. Her newest release, The Carb Sensitivity Program, is available across Canada. She’s also the founder of the Toronto-based Clear Medicine Wellness Boutique. For more wellness advice from Natasha Turner, click here.