What Happens during the Menstrual Cycle?

A typical menstrual cycle can last between 21-35 days, with an average of 28 days. During the first part of the cycle, the level of estrogen is increasing causing the lining of the uterus to thicken. An egg in the ovary is also growing at this time. On day 14 (depending on your cycle), a surge of hormones causes the mature egg to be released from the ovary and into the fallopian tube, this is called ovulation. At this point the egg can either be fertilized by sperm or it will degenerate. If the woman is not pregnant she will experience a drop in hormones and the lining of the uterus will be shed, this is called menstruation. If you experience irregular periods or excessive bleeding, these may be early indications that your hormones are out of balance. With a little investigation, these problems can be identified and corrected.

What is Pre-Menstrual Syndrome (PMS)?

Many women experience pain, bloating, breast discomfort, cramping, depression, bowel changes and irritability before and/or during their period. The pain and cramping is caused by uterine contractions. The uterus is a muscle which can contract and relax. Often times the uterus is contracting harder to help slough the old uterine tissue off. The good news is that there are many things you can do to make your period more manageable!

What can I do to alleviate PMS?

Follow diet and lifestyle recommendations (below) to prevent PMS. A hot water bottle is often enough to reduce the even severe cramps. If the hot water bottle is not quite enough, rub olive oil or castor oil on your tummy, place a towel over the oil and then a heating pad over the area. If these simple suggestions aren't enough to lessen your PMS, then you may want to consider supplemental help. (see below) Perimenopause (the time before Menopause) may often look like severe PMS combined with menstrual irregularities. Use the same treatments for Perimenopause as you use to prevent/treat PMS. Additional Period Advice: make sure to avoid chlorine bleached tampons, pads and panty liners because these products contain dioxin and hydrocarbon residues. An example of non-chlorinated sanitary products is Seventh Generation.

Menopause

Menopause is defined as not having a menstrual cycle for at least 12 months. Menopause is the natural shutting down of the female reproductive cycle. This happens (on average) between the ages of 45-55. Menopause is a normal process and is not a disease or a disorder that always requires medical intervention. The transition itself may be hard for some women but it should not cause much physical distress. Menopausal symptoms may be lessened or prevented by eating a healthy diet, staying hydrated, and having a consistent exercise program. When necessary, other interventions such as supplements, hormone balancing botanicals, hydrotherapy and massage may be employed to help ease the physical transition. It is also important to pay careful attention to preventing osteoporosis and heart disease (as menopause increases the likelihood of getting either of these conditions).

Many health care professionals believe that it is simply the withdrawl of estrogen that causes menopausal symptoms. We (N.D.'s) believe that menopausal symptoms can be an indication of hormonal changes as well as strain on the adrenal glands. The adrenal glands control our "fight or flight" response. After many years of stress, the adrenal glands have become fatigued and have trouble responding appropriately. Many menopausal symptoms overlap with the symptoms of adrenal fatigue. Dr. Bowen uses herbs that address both adrenal fatigue and hormone changes.

Diet/Lifestyle recommendations for PMS or Menopause

Diet

• Reduce: Total fat, saturated fat, refined grains and flours, sugar and salt, use only modest amounts of low-fat hormone-free dairy (Do not eat/drink any animal products with hormones in them ~ these hormones may complicate your body's natural hormones).
• Increase: organic fruit and vegetables, beans and soy (unless personal or family history of estrogen sensitive cancer), whole grains, nuts and seeds, olive or canola oil, cold-water fish (tuna, salmon, mackerel, herring, halibut, sardines) and filtered water. Eating lots of fiber-rich foods will help the liver to process your hormones (especially useful for avoiding PMS).

Lifestyle

• Exercise: Exercise is a must to prevent PMS because it helps to increase circulation and decrease pelvic congestion. Menopausal women who have consistent exercise programs have been found to have less severe Menopausal symptoms such as hot flashes than their sedentary counterparts.
• Self-nourishment/Stress Reduction: Yoga, meditation, counseling, pilates, go to or go back to school, travel. If you haven't already, identify what you are passionate about and embrace it. It is never too late to discover what inspires you and makes you happy.

Dr. Bowen's Top Picks for Hormone Balancing Supplements

Flaxseeds/Flaxseed Oil: I love to use flax seeds as a great source of both Omega-3 Fatty acids and also fiber. Grind them as needed and add them to food or protein shakes. The oil is helpful for balancing hormones, reducing systemic inflammation and alleviating constipation. Store in the refrigerator to prevent oils from going rancid.

Vitex Agnus-Castus: This herb is also known as Chaste tree berry. it can be used in any situation that involves imbalance in female hormones. My favorite herb by far for treating either PMS or Menopause.

Evening Primrose Oil: May be helpful for alleiviating hot flashes. May also be helpful for reducing breast pain/tenderness (either PMS or Menopause).

Vitamin B-6 (Pyridoxine): Plays an important role in the making of serotonin. Birth control pills deplete Vitamin B-6. B-6 deficiency may cause depression, irritability, and insomnia. Any of these symptoms may be present with either PMS or Menopause.

Women's Phase I: This product is used for prevention or treatment of PMS and menstrual cycle irregularities. It contains Vitamin E, Vitamin B-6, Calcium, Iodine, Magnesium, Chromium, Borage Seed Oil, Wild Yam, Dandelion root, Dong Quai (Angelica), Passionflower, St. John's Wort, Vitex and Ginkgo Biloba.

Women's Phase II: This product is used to help ease menopausal symptoms such as hot flashes, mood changes and vaginal atrophy. The formula includes the following herbs: Dong Quai (Angelica), Licorice root, Burdock, Wild Yam and Motherwort. This product addresses adrenal fatigue and helps balance hormones.

Resources
The Clinician's Handbook of Natural Medicine, Michael Murray, ND and Joseph Pizzorno, ND., Herb Joiner-Bey, ND, pp. 423-428. Churchill Livingstone. 2002.
Women's Encyclopedia of Natural Medicine, Tori Hudson, N.D. Keats Publishing. 1999. pp 135-180.