PMS in teens - is the oral contraceptive really the only choice?

More and more I’m hearing that teens who present with PMS, painful periods that include symptoms such as fatigue, irritability, mood swings, depression, abdominal bloating, breast tenderness, acne are increasingly offered the oral contraceptive pill - FULL STOP.  End of story.

While the exact causes of these premenstrual conditions is not straightforward, it is hypothesised that there are 3 areas involved:

  • A sensitivity to the natural hormonal fluctuations during the 2nd part of the menstrual cycle (luteal phase)

  • Abnormal activity in the “happy” neuro-hormone serotonin pathway

  • Deviations  in a “normal” progesterone response  and the “anti- anxiety”  neurotransmitter GABA 

All or just one may play a role to these array of symptoms…..

A pharmacologic approach is so brutal - basically shut off the hormones! Out comes the prescription pad and one or all of the following are offered: selective serotonin reuptake inhibitors (SSRIs), oral contraceptive pills (OCPs), gonadotropin-releasing hormone (GnRH) agonists, and non-contraceptive oestrogen formulations.

These medications may offer some relief - may… but they always ALWAYS ALWAYS also come with a price - depression being the most significant one for teens.

The are far more delicate ways to manipulate and support these 3 pathways than polypharmacy:

  1. Palmitoylethanolamide (PEA) an endocannabinoid isolated from soybeans, peanuts, and egg yolks has been shown to relieve pain and menstrual cramp - especially when dosed in the luteal phase

  2. Consumption of a higher wholegrain carbohydrate diet  combined with good quality proteins in the late luteal phase has been shown to improve mood-related symptoms of PMS - how does this work?

    • The protein element provides good levels of the essential amino acid tryptophan.  An essential amino acid is one of eight, that cannot be made in the human body and must be supplied by the diet. Tryptophan (in the right environment) can cross the blood brain barrier and convert into serotonin - the feel god neurotransmitter.

    • To enter the brain, tryptophan must be transported across the blood-brain barrier by a carrier protein (like a little shuttle bus). Scientists have found meals rich in  wholegrain carbohydrates promotes a moderate increase in insulin production (not too high not too low) allowing  tryptophan to cross the blood-brain barrier and  increasing serotonin levels in the brain.

  3. Assessing nutrigenomics and the young woman’s natural ability to make sufficient levels of progesterone, serotonin, dopamine and serotonin and tailor a plan accordingly…. Of course I recommend LifecodeGx Hormone Panel.

I vote for helping our young women understand their bodies and cycles, not just switch them off, medicate and suppress!

In health,

T x

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