OVERVIEW

Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms which are related to the menstrual cycle. The condition affects most women of child-bearing age, most commonly in the two weeks prior to menstrual flow.

Most women experience some premenstrual symptoms, while approximately a third of women experience distress as a result of a number of symptoms. Between five and ten per cent of women are thought to suffer with premenstrual dysphoric disorder (PMDD) – an extreme and incapacitating version of PMS. Some women find that their hormones severely impact on their quality of life, affecting social and personal relationships at home and at work.

Causes

Research suggests that women with PMS have a defect in the ability to make the fatty acid gamma-linolenic acid (GLA) and that this can affect the production of hormone-like substances called prostaglandins that regulate organ functions related to the principal symptoms of PMS.

NUTRIENTS

Fatty acids

Omega-3s EPA and DHA found in oily fish tend to be low in our diets, yet they are vital for hormonal health.

Omega fatty acids play a vital role in the healthy functioning of every living cell; forming the building blocks in the brain, they are essential for normal physiological function in humans.

EPA and GLA have several health-giving properties; as well as nourishing phospholipid cell membranes, these highly unsaturated fatty acids act as powerful free radical-scavenging antioxidants. Virgin evening primrose oil is rich in GLA and botanical antioxidant triterpenes, which protect against the oxidative cell damage caused by free radicals together EPA and GLA, triterpenes provide a natural boost to the immune system, which is often depressed whilst women are menstruating.

Important metabolites of EPA and GLA (eicosanoids such as prostaglandins and leukotrienes) regulate several important bodily functions including inflammation, pain, blood clotting and fluid balance. The synergistic properties of EPA and GLA help with several symptoms of pre-menstrual syndrome (PMS), including:

• Breast pain and tenderness
• Emotional mood swings
• Irritability
• Poor concentration – the ‘scatter-brain’ tendencies which affect some women
• Muscle tenderness and cramps
• Menstrual pain
• Bloating
• Tiredness and lack of energy
• Low immune system

Several studies have reported favourable outcomes with EPA and GLA supplements (Brush et al, 1994; Deutch et al, 2000). In one double-blind placebo-controlled trial, menstrual pain (dysmenorrhoea) was inversely associated with omega-3 fish oil intake (Harel et al, 1996)  The study found that omega-3 fatty acids from fish oil substantially decrease menstrual cramps, which are believed to be prostaglandin-mediated. By providing the omega-3 EPA without DHA (another omega-3 fatty acid) thereby maximising the EPA:DHA ratio, our supplements maximise the production of EPA metabolites.

Supplementation with pure EPA may also be beneficial in helping to balance the brain chemicals serotonin and dopamine, which are affected by the pre-menstrual fall in the sex hormones oestrogen and progesterone prior to bleeding. These chemicals are responsible for the changes in mood, particularly affecting those with premenstrual dysphoric disorder (PMDD) – the most extreme form of PMS.

The antidepressant properties of EPA are well documented as are EPA’s ability to regulate the actions of cortisol – the stress hormone closely linked to PMDD 

As well as ensuring that you consume the right amounts and types of fat daily, it is helpful to make some lifestyle changes in order to reduce symptoms during menstruation. Ensure that you minimise stress, which can trigger biochemical changes including the over-production of cortisol. Exercise is also thought to play a part in the severity of PMS symptoms – both in terms of its ability to lower stress and ease menstrual cramps. Other important dietary factors to consider are limiting the foods that can aggravate various symptoms, including sugar, caffeine, alcohol and salty foods – all of which can encourage fluid retention. Of course, it is also important to ensure that you drink enough water, which is crucial for many biological processes to function properly.

WE RECOMMEND

Women with symptoms of PMS or PMDD should take 1-2 grams of pure EPA daily, depending on the severity of the symptoms. The dose should be split into two, morning and evening, best taken with food for optimum absorption.With its high EPA content we recommend Pharmepa RESTORE at 2 capsules daily, because it’s suitable for counteracting omega-3 deficiencies and restoring a healthy omega-6 to omega-3 ratio. For those individuals with a sub-optimal AA:EPA ratio and low omega-3 index, high dose EPA is not only beneficial for increasing omega-3 levels and raising the omega-3 index, but is particularly effective in restoring the AA:EPA ratio, with favourable outcomes on long-term health. Once an optimal AA:EPA ratio and omega-3 index is achieved, switching to Pharmepa MAINTAIN can provide the key ingredients for the long-term maintenance of healthy omega-3 and omega-6 levels.

For vegetarians, our Echiomega supplement provides a more effective solution than flaxseed oil, with higher conversion to the important long-chain fatty acid EPA.