PMS as a predictor of menopause symptoms

Could troublesome periods be a sign of things to come?

Emma Thornton

20 February 2017

PMS and the menopause 

If you have troublesome periods or PMS, is this likely to be a sign of things to come in terms of your experience of the menopause? Quite possibly. However, don’t panic just yet – it’s also pretty likely that if you’re able to tackle 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. Now, let me explain.

So, it might not be so much the specific 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 Ross 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

A common example is 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 actually very likely that the hormone oestrogen is at the root of the problem – oestrogen dominance to be specific. That is, too much oestrogen throughout the typical monthly cycle, which means when oestrogen levels eventually drops off in order to give you your period, the drop is 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, that are those more at risk of having a more unpleasant menopause experience. If a woman of child-bearing age has a surplus of oestrogen, as she reaches the menopause oestrogen fluctuations are much more frequent – so this means that more substantial crashes in oestrogen (as they arise from a higher start point) are a common occurrence. So, it’s a bit like having a constant stream of episodes similar to those of PMS – just more severe (hot flushes and a host of additional symptoms are added to the mix) plus they’re more unpredictable and irregular – yes, this sounds about right. 

What does the research say?

Back in 2004, a pivotal study finally 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, it was found that women suffering from PMS at the start of the study were indeed more likely to suffer from hot flushes, low mood, sleep problems and decreased libido as they approached the menopause [1]. 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. 

So, how can you help yourself and keep these under control?

Firstly, some general advice is to try and tackle the problem whilst you’re still young. If you can keep on top of your hormones early on then you’re much more likely to have plainer sailing later on in life.

Now, let’s talk specifics. My number one rule is to always pay attention to your monthly symptoms. Too many of us are guilty of suffering in silence and not really considering what actually might be going wrong. If you regularly suffer from heavy, painful periods plus sore breasts, water retention and mood swings then oestrogen dominance must 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. 

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, it’s definitely worth taking all of these factors into account too.

Next up, blood sugar regulation. 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 carbohydrates and by having a source of protein with each meal – your sex hormones will definitely thank you for it! 

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 need fat!). I don’t 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. Also, be sure to include plenty of fresh fruits and vegetables rich in vitamins and minerals such as magnesium and B vitamins as these can help with aches, pains and your energy levels. Finally, watch what you’re drinking. Make sure you’re drinking plenty of water and cut back on caffeine and alcohol as much as possible – these are stimulants which could be exacerbating common menopausal or PMS symptoms such as anxiety or hot flushes. 

Last but not least, you might want to consider trying a herbal remedy, 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.

These lifestyle factors are especially important as unfortunately treatment options are often limited for menopausal women and those suffering from PMS. 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 to HRT – although it may be effective at relieving some of the symptoms of the menopause, when you eventually come off the medication, you risk experiencing a menopause all over again! Your oestrogen levels still drop (albeit from an artificial high from the meds) and symptoms can soon reappear.

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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