The link between PMS and the adrenals
One of the most common symptoms of PMS is irritability in the week or so leading up to a period. This is generally an indication of a sharp decline in progesterone levels, a hormone that helps soothe the nervous system and decrease inflammation. There also tends to be a noticable link between levels of stress at this time and the severity of the irritability that presents.
What is important here is the link between adrenal function and level of progesterone in the body. Under increased stress, demand for the production of cortisol rises. As cortisol is ultimately produced from progesterone (see the diagram below), increased cortisol output will effectively ‘steal’ progesterone and cause its decline. In addition to increased irritability, there may also be increased levels of inflammation which present as body aches and pain. Headaches and migraines can also be common in this situation, as are increased levels of anxiety.
Treating the adrenals to reduce PMS
Chronic issues with any of the symptoms listed above, especially when coinciding with the week before menstruation, may indicate the need to treat the adrenals. Herbs and nutrients to assist in lowering the demand for cortisol can have a profound effect in liberating progesterone and greatly diminishing symptoms. These may include:
- Withania (aka Ashwaganda)
- Siberian ginseng
- Passionflower
- Zizyphus
- Vitamins B3, B5 and B6
- Magnesium
- Vitamin C
Testing to assess function
If cortisol steal is suspected, my advice is to perform a dried urine hormone analysis (D.U.T.C.H test) on day 21 of the cycle to assess both adrenal and reproductive hormone function. If the progesterone metabolite output is low, coupled with elevated cortisol, then adrenal treatment may be warranted. Typically progesterone will normalise in the next few cycles, and symptoms will diminish.
Specific progesterone support
Additional support for progesterone may be warranted, and for this I typically recommend the herb Vitex. This should be taken first thing in the morning for the 2 weeks leading up to menstruation, and then not taken for the 2 weeks that follow, then taken again until the period begins. Cycling the herb in this fashion for a few menstrual cycles can be very helpful in restoring healthy progesterone levels and avoiding a sharp drop leading up to menstruation.
For all those women (and their partners!) suffering in the days leading up to menstruation, the adrenal-progesterone connection is certainly one worth considering. Anything else to add? Please leave a comment below.
In wellness,
James Marr
