Menstruation is a natural process, yet for many, it comes with a range of symptoms that can be disruptive to daily life. These period symptoms may be common but should not be normalised as these symptoms can often point to imbalances in the body—whether hormonal, digestive, or emotional. Understanding the underlying causes of these symptoms is key to addressing them effectively.
In this post, we’ll explore 12 common period-related symptoms, their potential causes, and how herbal and dietary support can play a vital role in restoring balance.
1. Cramps (Dysmenorrhoea)
Cramps are often associated with high levels of prostaglandins, hormone-like compounds that trigger inflammation and contraction in the uterus. Excess prostaglandins, particularly prostaglandin F2α, increase uterine muscle contractions and cause pain. Elevated prostaglandins may result from high oestrogen relative to progesterone, a condition known as oestrogen dominance. This imbalance often stems from liver congestion or reduced oestrogen clearance, both of which can be exacerbated by stress, poor diet, or environmental toxins.
Potential Imbalance: Estrogen dominance, poor liver function, inflammation.
Suggested Support: Cramp bark is a highly effective remedy for easing muscle spasms and cramps. Anti-inflammatory herbs like turmeric or ginger can help, as well as liver-supporting herbs such as milk thistle. Balancing oestrogen may involve addressing gut health and reducing exposure to xenoestrogens.
2. Mood Swings and Irritability
Mood changes are common in the luteal phase (the two weeks leading up to menstruation) and are closely tied to fluctuations in oestrogen and progesterone. Lower levels of progesterone relative to oestrogen may lead to PMS-A (anxiety-predominant PMS), characterised by anxiety, irritability, and mood swings. Progesterone has calming effects on the brain, while oestrogen enhances serotonin and dopamine pathways. When oestrogen is too high or drops too quickly before menstruation, this can destabilise mood.
Potential Imbalance: Low progesterone, oestrogen fluctuations, adrenal dysfunction.
Suggested Support: Adaptogenic herbs that support the adrenal glands and balance the nervous system, such as ashwagandha, can help regulate cortisol and stabilise mood. Vitex (chaste tree) is also helpful for promoting balanced progesterone levels.
3. Bloating and Water Retention
Water retention before or during menstruation is often linked to oestrogen dominance or imbalanced aldosterone levels, a hormone that controls sodium and water balance. Oestrogen can influence aldosterone, causing the body to retain more water, which leads to bloating. Insulin resistance and blood sugar fluctuations can also contribute to fluid retention, as excess insulin affects salt retention in the kidneys.
Potential Imbalance: High oestrogen relative to progesterone, aldosterone imbalance, blood sugar dysregulation.
Suggested Support: Diuretic herbs like dandelion and nettle, as well as blood sugar balancing approaches, may help reduce bloating. Supporting oestrogen clearance with liver-supportive herbs can also mitigate water retention.
4. Fatigue
Fatigue can be associated with progesterone deficiency or adrenal dysfunction. Low progesterone levels, especially when paired with chronic stress and high cortisol, often result in fatigue. In addition, blood sugar imbalances can exacerbate fatigue if the body is struggling to maintain stable glucose levels due to insulin resistance or inconsistent eating patterns.
Potential Imbalance: Low progesterone, adrenal fatigue, blood sugar dysregulation.
Suggested Support: Adaptogens like rhodiola and maca can support adrenal health. Ensuring stable blood sugar levels with a balanced diet and considering herbs like cinnamon or barberry can also help stabilise energy.
5. Cravings, Especially for Carbohydrates and Sweets
Cravings for sugar and carbs are often associated with PMS-C (craving-predominant PMS) and can signal blood sugar imbalances or serotonin fluctuations. Low levels of serotonin, which is synthesised from tryptophan, can increase cravings as the body attempts to boost mood and energy. This is also linked to oestrogen’s role in serotonin regulation, where oestrogen fluctuations impact serotonin availability, driving cravings.
Potential Imbalance: Blood sugar dysregulation, low serotonin, estrogen fluctuations.
Suggested Support: Blood sugar-regulating herbs like gymnema or fenugreek, and serotonin-supporting approaches like a tryptophan-rich diet (e.g., seeds, poultry) can help reduce cravings. Vitamin B6 (eg. bananas, avocados, chickpeas) also supports serotonin production and can help manage PMS symptoms.
6. Breast Tenderness
Breast tenderness or swelling, especially premenstrually, is often due to high oestrogen levels relative to progesterone or prolactin sensitivity. Oestrogen promotes tissue growth, which can lead to breast discomfort when levels are too high. Additionally, high oestrogen can up-regulate prolactin, a hormone linked to breast sensitivity.
Potential Imbalance: Oestrogen dominance, prolactin sensitivity.
Suggested Support: Herbs like Vitex can help regulate oestrogen-progesterone balance. Reducing exposure to environmental oestrogens (e.g., BPA) and supporting liver health can also help decrease symptoms.
7. Heavy Bleeding (Menorrhagia)
Heavy menstrual bleeding often suggests excess oestrogen or poor uterine tone. High estrogen relative to progesterone stimulates excessive growth of the endometrial lining, leading to heavier bleeding. Poor uterine tone can also result from nutrient deficiencies, especially in vitamins A, C, and K, which are essential for capillary integrity and clotting.
Potential Imbalance: Oestrogen dominance, nutrient deficiencies, poor uterine tone.
Suggested Support: Iron-rich herbs like nettle and yellow dock support blood loss recovery, while shepherd's purse and yarrow can help reduce bleeding. Raspberry leaf tea is a delicious and effective way of increasing uterine tone and replenishing nutrients lost from bleeding.
8. Spotting Between Periods
Spotting between periods is often a sign of hormonal imbalances. One of the key hormones involved is progesterone, which plays a crucial role in maintaining the uterine lining during the luteal phase (the second half of the menstrual cycle). Low progesterone levels in this phase can lead to spotting. Additionally, when oestrogen levels are high relative to progesterone (oestrogen dominance), the endometrial lining may become excessively thickened, making it more prone to breaking down irregularly, which can cause spotting.
Hypothyroidism (low thyroid function) can also disrupt menstrual cycles, causing abnormal bleeding or spotting due to its effect on overall hormone regulation. Uterine polyps, fibroids, cysts, or infections can also contribute to spotting by causing structural or inflammatory changes in the uterus.
Potential Imbalance: Low progesterone, oestrogen dominance, hypothyroidism, structural abnormalities, infections
Support: Herbal remedies like Vitex can help balance progesterone levels, while liver-supportive herbs like milk thistle can aid in the proper metabolism of oestrogen. If thyroid dysfunction is a concern, remedies like ashwagandha and selenium can support thyroid health.
9. Constipation and Diarrhoea
Constipation and diarrhoea around menstruation are often linked to hormonal fluctuations and their effects on the digestive system. During the luteal phase, progesterone levels rise, and this hormone has a relaxing effect on smooth muscle, which can slow digestion, often leading to constipation. Conversely, higher levels of prostaglandins during menstruation stimulate both uterine and bowel contractions, which can sometimes result in diarrhoea and cramping. Additionally, oestrogen influences gut motility and microbiota, which can affect digestion differently depending on the balance of hormones and individual gut health. These hormonal shifts can make bowel movements more erratic, causing either constipation or diarrhoea in some individuals.
Potential Imbalance: Progesterone imbalance, prostaglandin imbalance, oestrogen imbalance
Support: Anti-inflammatory herbs like ginger can reduce cramping. Fibre-rich foods, hydration, and digestive-supporting herbs like fennel can ease constipation, while chamomile can help soothe the gut.
10. Headaches
Headaches around menstruation are typically associated with oestrogen fluctuations, particularly a sharp drop in oestrogen before menstruation. This is similar to migraines triggered by other hormonal shifts, such as those experienced during menopause or while on certain birth control methods. Magnesium levels also tend to drop during menstruation, and low magnesium is linked to an increased risk of headaches and migraines. Dehydration and blood sugar imbalances can also exacerbate hormonal headaches, especially if diet or stress isn't well managed.
Potential Imbalance: Oestrogen fluctuations, magnesium deficiency, dehydration, blood sugar imbalances
Support: Phytoestrogenic remedies such as red clover, black cohosh, and flax seed can help balance large oestrogen fluctuations. Magnesium supplementation and anti-inflammatory herbs such as feverfew or ginger may also help alleviate menstrual headaches.
11. Irregular Cycles
Irregular menstrual cycles can stem from a variety of causes, including hormonal imbalances, lifestyle factors, and stress. One common condition that disrupts cycle regularity is PCOS (Polycystic Ovary Syndrome), which is often characterised by elevated levels of androgens, insulin resistance, and irregular ovulation. Thyroid dysfunction, whether hypothyroidism (low thyroid function) or hyperthyroidism (overactive thyroid), can also cause irregular cycles due to thyroid hormones' integral role in both metabolism and the regulation of reproductive hormones. Additionally, chronic stress and elevated cortisol levels can interfere with the hypothalamic-pituitary-ovarian (HPO) axis, which is responsible for regulating the menstrual cycle. When cortisol levels remain high, this can suppress the proper functioning of the HPO axis, leading to irregular or absent periods.
Potential Imbalance: PCOS, thyroid dysfunction, chronic stress, HPO-axis dysfunction
Support: Adaptogenic herbs like ashwagandha and rhodiola can help manage stress and support adrenal health, while Vitex and white peony may assist in regulating the hypothalamic-pituitary-ovarian (HPO) axis. Improving thyroid health with herbs such as iodine-rich bladderwrack or selenium-rich foods like Brazil nuts can help manage thyroid-related cycle irregularities.
12. Mid-Cycle Pain (Ovulation Pain or Mittelschmerz)
Mid-cycle pain, also known as mittelschmerz, occurs around ovulation and is typically felt as cramping or discomfort on one side of the lower abdomen. This pain arises as the ovary releases an egg, and the rupture of the follicle can cause localised pain, which is generally mild but may become more intense if inflammation is present. Additionally, elevated levels of prostaglandins, the hormone-like substances involved in egg release, can heighten pain sensitivity and contribute to increased discomfort during this phase of the menstrual cycle. Prostaglandins also play a role in uterine contractions, and their influence on surrounding tissues can make mid-cycle pain more pronounced in some individuals.
Potential Imbalance: Inflammation, prostaglandin imbalance
Support: Anti-inflammatory foods rich in omega-3 fatty acids (eg. fatty fish, flax seeds, chia seeds, walnuts) and anti-inflammatory herbs such as turmeric or ginger can help reduce ovulatory pain.
Addressing Root Causes for Lasting Relief
To address these symptoms effectively, it's essential to consider root causes such as chronic stress, nutrient deficiencies, digestive health, blood sugar imbalances, and hormone metabolism. Integrative approaches like supporting adrenal and thyroid health, improving liver detoxification, and stabilising blood sugar can be crucial in rebalancing hormones and reducing these symptoms.
If you're ready to explore how to support your body and hormones more effectively, reach out to me for 1:1 support tailored to your unique needs.
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