Is PMS a predictor of menopause?

Could troublesome periods be a sign of things to come?

Qualified Nutritionist (BSc, MSc, RNutr)
Ask Emma

20 February 2017

If you’ve had a tricky time of things in terms of troublesome periods or PMS, throughout your child-bearing years, could this be a sign of things to come as you approach menopause? Quite possibly. However, don’t panic just yet! It’s also pretty likely that if you’re able to tackle any hormonal issues as they crop up earlier on in life, you could stop them spiralling out of control by the time you reach middle age. So, let me explain.

Now, it might not be so much the symptoms of PMS that can predict the experience you will have during the menopause, but more likely, what’s causing the symptoms in the first place. And for many; this is all down to hormone imbalance.

Understanding your period and hormone imbalance 

Women's health advisor Emma Thornton explains how hormone imbalances can come about, how they could be contributing towards monthly symptoms and what can be done to help. 

Watch the video

If you find that you are suffering from very ‘typical’ PMS symptoms including heavy, painful periods, sore breasts, water retention, mood swings and so on, it’s likely that the hormone oestrogen could be at the root of the problem - and this is what we call oestrogen dominance.

Too much oestrogen relative to progesterone throughout the typical monthly cycle can mean that when oestrogen levels eventually drop off to give you your period, the 'drop' is much more substantial. It seems that this more drastic drop off, or fluctuation, is what’s likely to be giving rise to many of these nasty symptoms!

Unfortunately, it’s likely that it’s these groups of women, suffering from these sorts of symptoms, who are more at risk of having a more unpleasant menopause experience later on. We know that oestrogen fluctuations are likely part of menopause anyway, so if you are suffering from oestrogen dominance already, then the symptoms can become heightened! 

Many women report that they experience a constant stream of what could be described as PMS symptoms but often more severe and unpredictable -hot flushes and a whole host of additional symptoms are often added to the mix.

What does the research say?

Back in 2004, a research study gave us some scientific evidence in order to back this theory up. The study obtained data from 436 middle-aged women and, after adjusting for confounding factors including age, race and the incidence of depression, (meaning these weren’t having an influence) it was included that women suffering from hot flushes, low mood, sleep problems and decreased libido as they approached the menopause1. Interestingly, it was also concluded that fluctuations in oestrogen were positively associated with many of these symptoms.

So, it’s more than likely this is where the connection lies and fluctuating hormones are an important factor. 

How can you help yourself and keep these under control?

Firstly, some general advice from me is to try and tackle any hormonal issues as soon as possible, nipping them in the bud before they get out of control. If you can keep on top of your hormones early on then you’re much more likely to experience plainer sailing later on in life!

Now, let’s talk specifics. 

1- Start paying attention to your monthly symptoms

Too many of us are guilty of suffering in silence and not really considering what actually might be going on with our hormones amongst the monthly turmoil. If you regularly suffer from heavy, painful periods plus sore breasts, water retention and mood swings then oestrogen dominance and potentially using Agnus castus to help control your symptoms should be considered.

On the other hand, light, infrequent periods, low mood and lack of confidence may suggest oestrogen is low. These issues shouldn’t be ignored and if you are able to identify them, you can attempt to tackle them accordingly.

It’s important to also understand that our endocrine system is very much in sync. This means that as we approach menopause it’s common for our thyroid to go a little offline too. Symptoms of underactive thyroid can include fatigue, joint aches, sleep, weight gain and poor hair... many of which are common menopausal symptoms too! Too avoid a double whammy; it can be really useful to support your thyroid in the lead up to middle age too. Look out for any tell-tale symptoms and consider using a kelp supplement to support your metabolism.

2 - Balance your blood sugar

 Now, it seems that the hormone insulin can have a big impact on your sex hormones too. Aim to keep you blood sugar levels steady by avoiding refined, white sources of carbohydrates and being conscious of including a source of protein with each meal – your menstrual cycle will definitely thank you for it! 

3 - And don’t diss fats

Now, there are many other aspects of your diet that could also be having an impact on both symptoms of PMS and the menopause. We’ve touched on sugar and refined carbs, but fats are important too. And by that, I mean having the right kinds and in the right amounts (yes, you actually need fat!). I don’t generally advocate a low-fat diet; you need healthy fats as they have a number of important roles – including helping to make your hormones! So, make sure you include healthy fats and a source of protein in every meal – it’s all about having a balanced plate. 

4 - Next, let’s address stress

Stress can affect nearly every inch of your body and particularly the rest of your endocrine systems. If your stress response is all fired up (high levels of the hormones adrenaline and cortisol to be specific) other hormones can become affected; including your sex hormones. Stress isn’t always clear cut though: did you know that too little or too much exercise, smoking, dehydration, constipation and insomnia are all forms of stress on the body?

So, take some time out to relax and do things your enjoy. Nourish your body with nutrients that will help support your nervous system such as magnesium or some B vitamins and add some relaxation techniques to your ‘to-do’ list a little more often!

5 - Finally: helpful herbs instead of meaningless med?

Last but not least, you might want to consider helping to manage some of your symptoms with the help from some herbal remedies, especially if you suspect you have a hormone imbalance.  Agnus castus is a licensed herbal remedy used to help relieve symptoms of PMS including painful periods, sore breasts, bloating and irritability. For common symptoms associated with periods more generally, head to our period pages for more information.

Managing your lifestyle and using herbs can be really important steps in managing your symptoms, especially important as treatment options are often limited for women nowadays. For younger women, anti-depressants or the contraceptive pill are often the go-to options. Sure, although these options can be effective, they can have their own sets of side effects and may not necessarily be treating the root cause of the problem! As a result, problems can return when you come off the meds. 

The same applies later in life when it comes to HRT – although it may be effective at relieving some of the symptoms of the menopause, when you eventually come off the medication your oestrogen levels will drastically drop off and you you risk experiencing a menopause all over again as nasty withdrawal symptoms crop up!

So, if you suspect that any medication you are on isn't quite working for you - this is definitely worth discussing with your doctor.

So, by managing your period troubles early on, it seems likely you could set yourself up for a smoother transition into menopause – sounds good to me!

1. Freeman. E.W. et al. Premenstrual syndrome as a predictor of menopausal symptoms. Obstet Gynecol, 2004, 103(5), 960-966

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A traditional herbal remedy used to relieve the symptoms of PMS
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