PMS-A is the most common PMS symptom category and is related most strongly to an estrogen excess and progesterone deficiency in the luteal phase. Symptom ratings correspond to the raised serum estrogen levels, and serum estrogen to progesterone ratios give the best correlation. There is no significant correlation of symptoms with the decreased progesterone levels.
Estrogens appear to affect mood by suppressing type A-monoamine oxidase (MAO) while enhancing type B-MAO. These enzymes are involved in the oxidation of biogenic amines – norepinephrine, epinephrine, dopamine, and serotonin – which have significant effects on mood and behavior. The net effect of estrogen on these MAOs is to increase the levels of epinephrine, norepinephrine and serotonin (all normally deactivated by MAO-A) and decrease the levels of dopamine and phenylethylamine (both normally metabolized by MAO-B).
The effects of these changes on mood and behavior are well documented: epinephrine triggers anxiety; norepinephrine, hostility and irritability; serotonin, at high levels, nervous tension, drowsiness, palpitations, water retention and inability to concentrate and perform. Dopamine is believed to counteract these three amines by inducing a feeling of relaxation and increasing mental alertness. It is of interest to note that a decreased dopamine level in the hypothalamus is also believed to be central to the hormonal imbalances found in polycystic ovarian disease.
Estrogens also affect mood by competing for pyridoxal-5-phosphate binding sites, stimulating hepatic tryptophan pyrolase (shunting away from serotonin synthesis), and decreasing glucose tolerance.
Signs, symptoms & indicators of Premenstrual Syndrome PMS A (Anxiety)
Anxiety related to menstrual cycle
Irritability related to cycle
Mood swings during menstrual cycle
Conditions that suggest Premenstrual Syndrome PMS A (Anxiety)
Being/being post menopausal
Risk factors for Premenstrual Syndrome PMS A (Anxiety)
Yeast / Candida
Some researchers suggest systemic candida overgrowth may trigger PMS symptoms by activating an autoimmune response to sex hormones such as estrogen. The normal rise and decline of estrogen in the female monthly cycle could help explain the periodic flare-ups and subsequent quieting of candida symptoms, which can be similar to those of PMS. For women experiencing PMS discomfort who also have a high Candida / Yeast score, treating the candida may improve PMS symptoms.
Recommendations for Premenstrual Syndrome PMS A (Anxiety)
Theanine (L-Theanine)
Theanine (100-200mg daily) can induce a state of relaxation and have a continuous mood-elevating effect.
Vitamin B6 (Pyridoxine)
In one study, women received 50mg per day of vitamin B6 or a placebo for 3 months. Symptoms amongst these women included depression, irritability, tiredness, headache, breast tenderness and swollen abdomen/hands. At this dose depression, irritability and tiredness were the only symptoms to respond and they were reduced by 50%. [Gynecol Obstet Invest 1997;43(2): 120-124]
Key
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Premenstrual Syndrome
PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.
Estrogen
One of the female sex hormones produced by the ovaries.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
MAO
Abbreviation for a breakdown enzyme monoamine oxidase. A MAO inhibitor blocks the action of monoamine oxidase, thus raising the levels of the monoamine neurotransmitters such as norepinephrine, epinephrine, dopamine, and serotonin - which have significant effects on mood and behavior. Epinephrine, norepinephrine and serotonin are normally deactivated by MAO-A while dopamine and phenylethylamine are normally metabolized by MAO-B.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Noradrenaline
(Norepinephrine): A catecholamine hormone secreted from the adrenal medulla and post-ganglionic adrenergic fibers in response to hypotension or emotional stress.
Dopamine
A neurohormone; precursor to norepinephrine which acts as a stimulant to the nervous system.
Serotonin
A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Hypothalamus
An important supervisory center in the brain regulating many body functions. Despite its importance in maintaining homeostasis, the hypothalamus in humans accounts for only 1/300 of total brain weight, and is about the size of an almond.
Tryptophan
Essential amino acid. Natural relaxant and sleep aid due to its precursor role in serotonin (a neurotransmitter) synthesis. Along with tyrosine, it is used in the treatment of addictions.
Glucose
A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.
Candidiasis
Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.
Autoimmune Disease
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Yeast
A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.