Chapter 1

PMS ... A Treatable Problem

There are those who feel that premenstrual syndrome, commonly referred to as PMS, is not physically real but rather a symptom that is psychosomatic ("all in the mind").

We absolutely disagree with that misbelief.

What is PMS?
Premenstrual Syndrome is a hormonal disorder characterized by widely varying physical and emotional symptoms. It usually occurs before the menstrual period but can occur anytime during the cycle. The symptoms of PMS usually improve once the menstrual period begins, followed by a relatively symptom-free period of time after menses.

PMS isn't just another name for menstrual cramps or simple premenstrual tension. By analyzing the body as a whole, you can get a clearer understanding of what the actual causes of the PMS are. In our practice, we usually obtain a full history and physical examination as well as a blood and hair analysis during the first visit. By the conclusion of the second visit where we usually test for allergies, candidiasis, and assess thyroid & hormonal imbalances, most patients know the causes of their PMS and other related problems. They also learn the type of treatments to be utilized to help them get well.

An important point to remember is that PMS usually isn't any one particular disorder. As a syndrome or a characteristic collection of symptoms, it represents several problems interrelating in such a way as to cause different symptoms in different women depending upon their specific hormonal/nutritional imbalances, and the status of their immune system.

In fact, many of the symptoms commonly described as PMS are similar to those commonly associated with Candida albicans (yeast) infections, hypoglycemia, allergies, low thyroid as well as other conditions described in this booklet. Is it any wonder that even some highly skilled doctors find the diagnosis and treatment of specific symptoms difficult and often frustrating? It has been my experience that no long-term relief can be attained by merely treating symptoms or masking them with drugs. It is my opinion that the entire PMS disorder spectrum has to be treated as a whole with each of the contributing components addressed. Only in treating the entire system can the physician help the patient on a long term basis.

What are the symptoms of PMS?
While more than 150 symptoms have been associated with PMS, Table I lists some of most common ones, and Table 2 lists some of the conditions that PMS can aggravate. Please keep in mind that although an individual may exhibit some or many of these symptoms, it is not conclusive evidence that they are suffering from PMS. In order to make that determination, a differential diagnosis is required by a trained physician.

How many women have PMS?
It is estimated that over 50% of all women who menstruate experience PMS. At least 30% of these women's PMS symptoms are severe enough to seriously disrupt both their personal and professional lives.

Possible Signs, Symptoms and Conditions
Commonly Related to PMSThese symptoms, like others mentioned in this book, require the expertise of a physician to diagnose their exact cause. It should be emphasized that many illnesses and disease conditions have identical symptoms.
        Abdominal bloating                Fluid retention
        Acne                              Food "binges"
        Allergies                         Forgetfulness
        Anxiety                           Frequcnt colds
        Asthma                            Headachcs
        Asthma/bronchitis                 Hostility
        Backaches                         Hot flashes
        Boils and sties                   Increased appetite
        Bowel disorders                   Irritability
        Breast tenderness                 Loneliness/sadness
          and/or swelling                 Low self-esteem
        Brittle fingernails               Mental confusion
        Cervical problems                 Migraine
        Clumsiness                        Muscle spasms
        Cold sores                        Painful menses
        Craving sweets/                   Panic attacks
          chocolates                      Poor concentration
        Craving salt                      Recurrent urinary
        Crying for no reason                 tract infections
        Cystitis                          Seizures
        Depression                        Shortness of breath
        Dizziness                         Sinus problems
        Endometriosis                     Swelling of joints
        Excessive sweating                Tension
        Eye problems                      Vaginal discharge
        Fainting                          Weight gain
        Fibrocystic breast

How can I find out if I have PMS?
Because the symptoms of PMS are so individual and variable, it cannot be diagnosed solely through laboratory tests. You are the best person to start a preliminary diagnosis. Then, with the help of an understanding physician, a clinical diagnosis can be made based on your report of signs and symptoms.

The best way to determine if you are suffering from PMS is to keep a daily record of exactly what your symptoms are, and when they occur, for a minimum of three consecutive menstrual cycles. We can then determine from that record if your symptoms are indeed related to your menstrual cycles, or if they have their origin elsewhere (see the Daily Symptom record in Appendix A).

What causes or contributes to PMS?
Although the exact causes of PMS have not been determined, many doctors feel PMS can be aggravated by those conditions included in Table 2.

               Many of the related conditions that aggravate PMS
               (such as hidden food or environmental allergies,low
               thyroid or yeast infections) can also bring on other
               health imbalances by weakening the immune system.

What can be done about PMS?
Because the practice of Naturopathic medicine is an art as well as a science, it is important that we work together to find the treatment that works best for you, your particular symptoms and personal lifestyle.

Depending on your individual symptoms and their severity, you may be advised to consider dietary modification, therapeutic natural medicines, physical and physio-therapies, exercise, stress reduction and the use of natural progesterone.

Natural medicines are available at our clinic to help PMS sufferers accomplish the therapies outlined by the physician. These therapies are based upon a woman's individual needs as ascertained through blood and hair analysis, thyroid studies, and other Naturopathic Medicine diagnostic procedures and our clinical experience.

In some PMS cases we may prescribe natural progesterone to supplement the patient's own production of progesterone. Widely prescribed in England since 1948, progesterone is one of the two primary female hormones.

Natural progesterone is derived from natural plant sources and is non-toxic.

           *********************** NOTE *************************
           Although the names sound similar, don't make the
           mistake of confusing natural progesterone with
           progestagens (synthetic progesterone derivatives).
           Used in oral contraceptives or prescribed individually,
           progestagens (under various proprietary names such as
           Amen� or Provera� also known generically as
           medroxyprogesterone) probably will not relieve PMS
           symptoms.  They can actually lower the amount of
           (natural) progesterone in the blood, thus intensifying
           PMS.  Furthermore, PMS (if left untreated) can develop
           into menopausal symptoms such as hot flashes and
           excessive sweating (see Chapter 5).

                               TABLE 2:
                   Some Major Aggravators of PMS

       (These conditions, like others mentioned in this book,
       require the expertise of a physician to diagnose their
       exact cause.  It should be emphasized that many illnesses
       and disease conditions have identical symptoms.)

                * Chronic yeast infections(Candidiasis)
                * Debilitated immune system
                * Excess prolactin (a pituitary hormone)
                * Excessive emotional or physical stresses
                * Food allergies and/or chemical sensitivities
                * Hypoglycemia (low blood sugar)
                * "Junk food" diet
                * Long-term use of antibiotics
                   and/or steroids (such as prednisone).
                * Low thyroid function
                * Low adrenal gland function
                * Low exposure to sunlight
                * Obesity
                * Poor absorption, digestion and elimination
                * Progesterone deficiency
                * Relative estrogen surplus in
                        relation to progesterone
                * Underactive (sluggish) liver function.
                * Vitamin, mineral and enzyme
                        deficiencies or imbalances
                * Toxin buildup in liver and bowels
                * Amino acid deficiencies or imbalances

We firmly agree with Dr. W.C. Douglass, M.D. who states: "It is shocking to know that there are many doctors who are confused about progesterone. These doctors erringly believe 'progesterone' is found in birth control pills. It simply isn't! Instead, birth control pills and other synthetic hormones contain possible cancer-causing agents called progestagens which the drug companies pass off to many doctors as being the same as progesterone. Natural progesterone, not progestagen, offers protection from the disagreeable side effects of estrogens. Progestagens actually increase the problems caused by estrogens. That is why progesterone is so effective in relieving the pain and suffering of PMS and menopause." [1].

What is Endometriosis and how does it react to Estrogen?
Endometriosis is the presence of endometrial (uterine lining) tissue in abnormal locations such as in the uterus wall or the bladder wall. Endometrial cells, normally found only in the lining of the uterus, are exquisitely sensitive to estrogen stimulation. It is this tissue of the human body that has now been shown most commonly to turn cancerous when overdosed with estrogen. Endometriosis is extremely difficult to control, and may cause hemorrhaging and severe pain. Like fibroids, mild or moderate endometriosis usually clears up when menopause takes place. But supplemental estrogens make endometriosis worse. Some authorities, such as Somers Sturgis, maintain that a history of endometriosis should be a contraindication to ERT (Estrogen Replacement Therapy). Many physicians prescribe estrogen even before asking their patients if they have any such history. [2] There are better ways to naturally help this condition.

***An Important Note About Endometriosis***
If you suffer from ENDOMETRIOSIS, you will be relieved to know that this condition can be helped by natural progesterone, thyroid, as well as other natural medicines as indicated by your doctor.

------------ SOME FACTS ABOUT ESTROGEN ---------------
Did you know that...

*Since September 1977, drug companies are required to give doctors and pharmacists brochures with warnings that estrogens increase the risk of cancer. They must also advise doctors that estrogen not be prescribed for nervousness, depression or for "restoring youthfulness" during menopause because it is ineffective for those purposes! [3]

*Premarin� generically means conjugated estrogens from pregnant- mares-urine. This form of estrogen comes from the urine of pregnant horses. Premarin a can intensify allergies to horses and other animals.

*There are millions of women in this country using Premarin� and other estrogens not fully realizing the possible devastating implications of using these synthetic drugs.
Dr. Katharina Dalton, M.D., one of the world's foremost authorities on natural progesterone, has found that premenstrual symptoms such as painful menses, hot flashes and bloating result from a relative estrogen surplus and progesterone deficiency.

*Scientist and hormone researcher Dr. Ray Peat, Ph.D. states: "The symptoms of menopause result mainly from a progesterone deficiency relative to the estrogens." [4]

In 1979, menopausal flushing was found to be associated with an elevation of the pituitary hormone "LH" (Luteinizing Hormone). A lack in progesterone is known to cause a rise in LH.

Many studies have established a clear
link between long term estrogen usage
and cancer of the uterus and breast.

*Estrogen use causes an increased rate of heart attacks. It causes a magnesium deficiency as well as a decreased level of folic acid, vitamin B6 and zinc which promotes clotting and abnormal fat accumulation, anemia and PMS. [5]

*Estrogens probably do not prevent osteoporosis ("brittle bones") or help calcium supplementation in laying down new bone. Chronic estrogen use may even hamper the process. "Estrogen doesn't restore bone mass to a degree demonstrable by roentgenography (x-rays) and may aggravate bone loss by stimulating the release of growth hormone." [6]

*A person who has had a hysterectomy can still have some PMS symptoms or menopausal symptoms such as hot flashes.

After a woman has a hysterectomy and/or her breast(s) removed (in many cases due to years of estrogen use) her specialist usually prescribes an estrogen suppressing drug such as Danazol� because excess estrogen use can cause cancer"!

* Estrogens (Premarin�, birth control pills), sulfa drugs (such as Bactrim� or Septra�), prednisone, and cigarettes can all lower thyroid function.

*Chronic estrogen use over a period of years can possibly cause degenerative diseases, including cancer, to manifest up to 20 years after taking such carcinogens. Because of the length of time between taking the estrogen and onset of diseases, many physicians and patients do not suspect estrogen and synthetic progesterone derivatives as a possible primary cause of cancer or other degenerative diseases.

Estrogens had been used in the beef and poultry industry to help fatten the livestock so that they will weigh more and therefore be worth more at market. Estrogens (i.e. Premarin� can cause women to swell up and also put on weight. This weight gain will probably not respond to dieting.)

Most synthetic prescription drugs are derived from coal tar (or petrochemicals) and, when used over a long period of time, may cause harmful side effects. It is very important for the patient to know why a drug is being given and what the adverse side effects may be. We recommend that our patients get a copy of the "Physician's Desk Reference" (PDR), available at any bookstore, along with a medical dictionary. Then read the facts before taking any prescription drug. A pharmacist may be very helpful in describing the side effects and drug characteristics among strong synthetic chemical prescription drugs.

According to Dr. Robert Mendelsohn, M.D., studies have established a clear link between estrogen treatment and endometrial (uterine) cancer. He states that "the risk of cancer is of great concern to a woman who undergoes natural menopause but not, of course, to one experiencing post-hysterectomy menopause, because her uterus is no longer intact. Of concern to her, however, is the possibility of increased risk of cancer of the breast."

"A number of scientific studies have associated the use of estrogen therapy with an increased incidence of cancer of the breast. No responsible authority has yet been willing to state positively that estrogens cause cancer of the breast, nor has any responsible authority been able to prove that they don't."

"Given the possibility that estrogens may be causing breast cancer, you would suppose that doctors would stop prescribing them until the question is resolved. Instead they continue to observe the ridiculous and deadly principle that drugs are innocent until proven guilty beyond a shadow of a doubt." [7]

As you can clearly tell from the facts presented above, PMS NEED NOT BE DEBILITATING! It is not one of the hopeless or "incurable" diseases. Without a doubt, PMS is not only uncomfortable, it can be leading factor in disturbing a normal way of life. The answer for thousands of our patients is in prevention.



Next Chapter 2 : CANDIDASIS . . . The Yeast Infection