Is it PMS or Perimenopause?


Symptoms of perimenopause and PMS look and feel very similar. You may just have PMS, or you may just be in perimenopause. Or more commonly, depending on your age, you could have both. How can you tell?

Maybe its PMS….

If you a part of the 85% of women that have PMS, you don’t need a PMS definition, as it’s something that plagues you every month without fail. There are approximately 150 symptoms of PMS, both physical and emotional.  As many as 10-20%  of women experience life altering symptoms that cast a dark cloud over their head and cause them to change their lives in order to accommodate the time of the month that they will be in the PMS zone.

I can certainly identify with this. When I was in my fertile years, I had HORRIFIC PMS. I would’ve done almost anything to get relief. When I finally realized that the misery I experienced every month was indeed a bad case of PMS, I set upon finding relief. I didn’t know then that PMS requires a comprehensive whole-life approach; and that taking Advil, oral contraceptives and even natural supplements was not enough to get to the root cause of my problems. 

Thankfully, after in-depth study of nutrition, health coaching, functional lab testing and especially natural hormone balance, I was able to alleviate about 80% of my PMS symptoms in the last few years that I had my period.

Some common PMS symptoms are:

 - Irritability, depression, fatigue

 - Anger, sadness, guilt

 - Food cravings, water retention, headaches

  - One of the less common PMS symptoms is aversion to noise. Yup…I totally had that one too!

PMS cannot be pinned down to one cause. It is a complex problem that can produce cyclical misery for those who suffer.

Some of the current research on PMS correlates it with:

 A diet low in fiber and protein and high in sugar and refined carbs

 Fluctuating blood sugar and insulin levels

 Vitamin B6 deficiency 

 Imbalanced ratio of calcium to magnesium

 Low progesterone levels

 Low adrenal output of DHEA and cortisol necessary for stress control

 A neuroendocrine problem of low endorphin levels

 Less receptors for progesterone

Is it Perimenopause?

Perimenopause and PMS can coincide.  Perimenopause is a long stage in a woman’s life when her body is actually preparing for menopause and unresolved PMS problems can make a woman’s transition out of her fertile years a difficult one. For most women, perimenopause begins around age 40 and can last as little as a few years and as much as 12 years. But here’s the clincher…you can be starting perimenopause and still have PMS. Not a really happy place to be.

Women in their perimenopause transition may feel:

 moody

 depressed 

 fatigued

 irritable 

And they may be experiencing:

 cravings for sweets 

 difficulty sleeping at night

 Hot flashes

 Mid-section weight gain

Sounds a little like PMS, huh?

In perimenopause, your periods may get:

 heavier

 lighter

 further apart

 closer together 

As you age and your reproductive system is changing, it’s completely natural for your periods to change and is not a reason to run to the doctor to get checked out, although you shouldn’t ignore periods that come more often than every 21 days. There are various reasons why you could have a shorter than normal cycle so you do need to see a doctor if you are getting your period more than once a month to rule out any serious conditions.

On the other hand, if you are in your 40’s and 50’s, and your periods are coming every 40 days, then 35 days, then 60 days, or something like that, well…welcome to the epitome of perimenopause. It’s completely normal, if not a little unnerving.

Understanding Progesterone

Progesterone is the first hormone to drop off in perimenopausal women and   it functions as a mellowing, soothing hormone.  In the childbearing years, when women are having regular periods, they produce progesterone every month during ovulation. When ovulation becomes erratic, progesterone production falls off a cliff. Less progesterone can manifest as anxiety in women.

Diagnosing PMS vs Perimenopause

If you have the above listed symptoms and are wondering if you are in perimenopause, here’s the deal:If your periods are occurring regularly, it’s PMS. If your periods are becoming erratic, its perimenopause. 

Either way, both PMS and a symptomatic perimenopause is correlated with a hormone imbalance. 

Covering up your symptoms with Advil, sleep aids, anti-anxiety medications and more might make your health worse in the long run. Too much Advil can irritate the lining of the stomach, overwork your liver and harm your intestinal gut barrier. 

If you are a woman in her 20’s or 30’s and have PMS or if you are a woman in your 40’s or 50’s and have problematic perimenopause symptoms, this time of your life presents you with great opportunity.  It’s a wake-up call to give your body the love and attention it deserves, and here’s how you can start:

PMS or Problematic Perimenopause: The Solution is the Same 

1. Get a comprehensive hormone profile- This test should be done either via saliva or dried urine. It can be done via blood, but then you won’t be able to test your diurnal cortisol pattern, and knowing those numbers are crucial in arriving at a plan to alleviate some of your PMS/Perimenopause symptoms. This hormone profile will also let you know your ratio of estrogen to progesterone. Not enough progesterone in relation to estrogen can cause tender breasts, irritability, anxiety, and has been correlated with fibroids and endometriosis. Many doctors won’t test your hormones unless your infertile and trying to conceive. That’s ridiculous! Every woman should be able to get a hormone test if she suffers from PMS or is experiencing difficulty in perimenopause. You can actually order your own salivary hormone profile from an organization called 

2. Seek Support-Don’t suffer in secret. Let others know that you need help. Men will never know what it’s like to have PMS, so you need to gently explain that you need help or space or both. Also, working with a trusted mentor, someone who has been there can really help smooth out the bumps in your unique female journey. If you would like to know how I can help you, contact me here

3. Get Moving-Aim for 20-30 minutes per day, but don’t force yourself to exercise if you feel completely drained. Knowing when to rest is just as important.

4. Manage your blood sugar, because all-over-the-map blood sugar can cause crazy cravings. Don’t consume carbohydrates by themselves. Have fat, fiber and protein at every meal and snack. For instance, if you’re craving some chips, have organic corn chips with some guacamole. A combo like that will help balance your blood sugar. If you eat just the chips alone, it will raise blood sugar more quickly than if you’d combined it with the guacamole. 

5. Understand the different physical and emotional phases of your menstrual cycle. Know when it’s ok to push yourself and when to give yourself a break. You can find out more about that here.

6. Take an active B vitamin complex-Vitamin B6 is called the “woman’s vitamin” and can be helpful at alleviating some PMS and perimenopausal symptoms. Make sure you take it as part of an entire B complex as they work synergistically with each other. I like Active B Complex from Integrative Therapeutics. 

7. Try a magnesium supplement as this may aid in quelling cramps and lessening anxiety.

8. Consider chaste tree (also called Vitex)- This herb is the standard of care in Germany for women who suffer from PMS. If you are pregnant or lactating though, pass on this as there is not enough data to safely recommend it in those situationsFrom my own PMS experience, my work with clients ranging in age from 18-60, and just listening to other women speak, I feel as though we’re in the midst of a hormonal-PMS’ing-perimenopausal revolution. Women are finally realizing that its totally ok to admit that they have PMS or perimenopause challenges and are seeking help for them.

Whether you are in your 20’s and 30’s and suffering with PMS, or you are in your 40’s and 50’s and trekking through perimenopause, I want you to know that it doesn’t have to be hormone hell.I won’t be the health coach who tells you that you can knock out PMS completely is a complex problem that does not have a failsafe “cure”….but I will tell you this:You CAN absolutely improve your hormonal issues, be happier and enjoy life more. And when you stop to think about how much time this occupies spread out over your fertile years, it really does pay emotional and physical dividends to deal with the issue of PMS and/or perimenopause problems as soon as possible.

With the right lifestyle changes, stress management, correction of nutrient deficiencies and well-deserved self-care, you can sail above the rising sea of PMS and perimenopausal problems.



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