News

When was the last time you sat down at the table to eat with your family? Decades ago, this was practice that happened once, twice, or sometimes even three times a day. But these days, between fast food and microwave meals, many people are missing out on this once-common practice. New research shows, however, that eating together as a family—or even as a couple or with friends—can have numerous tangible and intangible benefits.

More than half of Americans feel they eat fewer family dinners now than when they were growing up, according to recent polls But most Americans—92 percent—look forward to the family dinners they do have.

Why are we spending less time eating together when we enjoy it so much? Between work, school, and extracurricular activities, families find it harder to sit down for dinner. And some families even schedule a sit-down dinner! The typical full-time American employee clocks 47 hours work a week, more than many other countries where family dining is emphasized. Nearly one in five Americans spends 60 or more hours per week at work. When work hours increase, leisurely family dinners become inconvenient.

Kids who eat dinner with their parents at least twice a week are less likely to be overweight. Those who eat with family five or more days per week do better in school, have better relationships with their parents, and are less likely to have drug or alcohol problems. Although scientists don’t yet know the benefits to childless couples who eat dinner together, researchers at Ohio State University are studying the area.

Eating together also has benefits that are harder to measure. Cody C. Delistraty, writing for The Atlantic, noted how continuing family dinners after his mother’s death helped him and his father cope with the loss and stay connected. For many people, eating together is a great way to create space and unwind after a long workday.;

Getting in the habit of regular family meals can be difficult for many families who are juggling lots of obligations. But even a couple of dinners a week can make a significant difference. If you feel your family could benefit from more regular meals together, begin by setting aside one day each week for a family meal, then increase to two or three days each week.

You don’t have to be a gourmet chef to eat well with your family. Start with simple, healthful recipes like marinated tofu or a simple pasta dish. Have family members pitch in to make a side salad or warm dinner rolls. Eat slowly, chew thoroughly, and enjoy the conversation. If you’re short on time, even dining together on takeout can reap many of the same benefits for your family.

If you’d like to eat well and increase your family’s bond, make the commitment to eat together more often. You may have to be creative, give it a try! Memories and connectedness will last a lifetime.

With all the liking, tweeting, and pinning going on these days, it’s a wonder we get anything accomplished outside of our virtual lives. The pace of the world around us seems to be exponentially increasing, while our minds and bodies are often left craving simpler times.

I hear at least once a day that there are not enough hours in a day to make the necessary lifestyle changes for optimal health. Many of my patients are sleeping very little, eating on the go, forgoing physical activity, and laugh when I ask about their libido. "What sex life?" they often respond. Why is it that we are so pressed to find the time we need to take care of ourselves? The answer may be found in a recent New York Times article questioning our culture’s obsession with productivity.

Our bedrooms used to be used for the primary purpose of resting. Now, because of our mobile devices and society’s obsession with productivity, we are often left feeling guilty or lazy for finding solace in our beds. For better or for worse, we are now able to accomplish tasks anywhere, anytime. With so many options of where to direct our attention these days, it can be tough to prioritize our time. I often prescribe one or all of the following lifestyle suggestions as a starting point for my patients:

You are how you eat

When we grab our meals to go or eat while responding to emails, our bodies are unable to properly digest the food we take in. We, physiologically, are designed to digest food while sitting down, in a quiet environment, taking our time, and chewing thoroughly. Going against our physiological needs, because we don’t have time, can lead to an array of symptoms from gas, feeling bloated, and heartburn, to migraine headaches and acne. By taking our time with meals and adequately digesting our food, we are our setting ourselves up for success by minimizing distracting symptoms and optimizing our long-term health.

Move your body

Studies show that physical activity is very effective at reducing fatigue, improving alertness, and combating stress. Something as simple as taking a fifteen-minute break, away from the task at hand, to take a brisk walk is all that is required to boost your overall efficiency and creativity.

Leave your phone, computer, and other devices at the door

Just as you are in the habit of removing your shoes at the door, create a new habit of leaving your electronic devices at the door when coming home for the evening. You will be amazed at how much time you have once your ability to check your emails and social networking sites is not within an arms reach.

Turn down the lights

Minimizing screen time and dimming the lights in the evening allows our body to produce adequate melatonin, a hormone that helps us fall asleep. Sleep is essential to our body's ability to repair and detoxify. A good night's sleep is not a luxury, but a necessity and should be at the top of everyone’s "To Do" list.

I will leave you with a quote from my son’s favorite bedtime story:

"It is true that I am slow, quiet, and boring. I am lackadaisical, I dawdle and I dillydally. I am also unflappable, languid, stoic, impassive, sluggish, lethargic, placid, calm, mellow, laid-back and, well, slothful! I am relaxed and tranquil, and I like to live in peace. But I am not lazy." From Eric Carle’s "Slowly, Slowly, Slowly," said the Sloth.

In Part 1 of this 5-part series, we introduced the Myers–Briggs Personality Indicator and its first pair of characteristics, Introversion and Extroversion. Part 2 covered the second pair, Intuition and Sensation; Part 3 the third pair, Thinking and Feeling; and Part 4 the fourth pair, Perception and Judgement. Remember that everyone, to varying degrees, has both of the characteristics described in each of the pairs of attributes. Here in Part 5 we provide some shorthand tips for interpreting and applying this remarkable tool to everyday life.

You need not be able to make complete sense of this acronym jumble to receive some benefit from the insights of Carl Jung and Myers and Briggs. The most important point is to realize that some of your more intransigent characteristics may simply be part of you—they’re innate, almost like the color of your eyes or your unique fingerprint—and that rather than trying to change or alter them, it’s best to accept them. Then, should they cause trouble for you, you’ll know you can learn about the opposing characteristic, and try to cultivate those qualities in yourself. They are there already, you just need to find them and nurture them. This can help you to become more accepting of others as well as yourself, and this usually leads to better and more peaceful relationships.

Fundamentally, it’s a big help to understand and recognize introversion and extroversion in yourself and others. Simply knowing that extroverts get energy from being with people, that introverts need time alone to recharge their batteries, and that extroverts outnumber introverts in this world, can be quite valuable.

As important as the I/E pair is, you don’t even need it to recognize the main types of people in the world. Interestingly, just four combinations of the S/N, J/P, and T/F pairs determine all the main personality types. In extreme shorthand:

• SP: practical, adventurous, spontaneous
• SJ: practical, conservative, formal
• NF: romantic, artistic, creative
• NT: intellectual, inquiring, innovative

Remember, everyone has each of these eight tendencies to varying degrees. You can think of them as existing on a range from zero to one hundred, with more people falling into the middle 40–60 range than the extreme 80 or 90 range for any given trait. MBTI is a useful guide to understanding yourself and others, but needs to be interpreted and applied flexibly, not rigidly. Now, which MBTI characteristic is that?

Sometimes it’s easy to forget that the simplest things can make a big difference, and that not all health comes down to chemicals and hormones. Here at PMS Comfort, we talk a lot about the impact of do-it-yourself natural remedies for PMS and PMDD. Diet, lifestyle, attitude, nutrition, herbal medicine—they can all make a difference. And we realize that many of our readers are weighing decisions about whether to take birth control for PMS or antidepressants for PMDD, so we pay a great deal of attention to drugs for PMDD and PMS, too.

So it was refreshing to read about new research into gratitude power, and how it can help you be healthier. Of course, Oprah has talked about the power of gratitude: there’s even a “Power of Gratitude” page at Oprah.com, and you can buy a Gratitude Power Workbook that says it will help you transform your fear.

Robert Emmons of the University of California at Davis, the author of a book on gratitude power, as well as the foremost researcher in this promising field, recently received a large grant to further study this topic. His research to date includes the remarkable finding that simply writing down five things for which you’re grateful, on a daily basis, can help speed recovery from heart attacks and other diseases.

Given the way PMS, PMDD, depression and other mood conditions can make everything look dark and bleak, this simple exercise seems like a win-win. There’s no downside to taking a couple minutes out of your day to examine what you have to be grateful for: certainly, most of us spend at least that much time every day in our minds, going over things that seem to be working against us.

We think these simple gratitude power exercises are worth a try for anyone, and especially women who are hoping to squeeze more life and living into each month.

Many women don’t suspect that their feelings of exhaustion, tiredness, fatigue, and just plain feeling “blah” might be related to their hormones and their period. They may not notice that these symptoms recur most months at about the same time each month. But what seems like a random pattern of feeling good one day and feeling thoroughly “beat” the next may actually be a regular, monthly occurrence of PMS, or possibly it’s more severe cousin, PMDD.

Many of the symptoms of PMS and PMDD are accompanied by malaise and feeling tired and out of it. PMDD especially can cause women to feel sad and depressed, and who doesn’t feel fatigued when they’re depressed? Plus, when it’s hard to get out of bed because it feels like your body won’t obey you, that’s depressing. Women with severe PMS experience a host of symptoms—any one of which could make it necessary to spend the day in bed with a hot water bottle or the shades drawn: headaches, migraines, cramps, bloating, crying spells, irritability, withdrawing from social contact, anxiety, and confusion. The list goes on, but the point is, how could you have these symptoms and not be exhausted?

Of course, feeling tired and wiped out isn’t necessarily the result of other symptoms. Sometimes, it’s the only PMS or PMDD symptom.

If you’ve read this far, and your fatigue isn’t premenstrual—maybe you’re not even a reproductive-aged woman—you are probably wondering what else might be making you tired. So, a list of some of the most common reasons for fatigue follows. But remember: feeling tired can be caused by something as simple as the common cold or as serious as cancer, not to mention that often it is a result of lack of sleep. If your fatigue persists or worsens, and especially if you have other unexplained symptoms, see your doctor to have your symptoms medically evaluated.

The most common causes of fatigue we’ve seen:

• Poor or improper diet
• Food allergy
• Hypoglycemia or low blood sugar
• Lack of exercise
• Depression, anxiety, & stress
• Nutritional deficiency

You can learn more about each of these subjects by following the links to the related articles. Keep checking back, as we are going to explore each of these topics, and how they relate to fatigue and depression, more in coming blog posts.

We’ve discussed birth control hormone drugs for PMS & PMDD before. Birth control pills like Yaz® and Yasmin® allegedly cause dangerous side effects; and all birth control hormones, from Nuvaring® to Depo-Provera® to the pill, cause side effects that many women simply can’t tolerate. Now there is new evidence from the prestigious New England Journal of Medicine that these birth control methods—pills, patches, and rings—don’t prevent pregnancy nearly as well as long-acting reversible contraception methods such as IUDs, implants and injections, including Depo-Provera®.

If you are researching birth control methods, you are probably weighing a handful of concerns: convenience, effectiveness, and risk of side effects. If you are researching PMDD medication or treatments for PMS, you want a drug that will address your symptoms but without bad side effects.

What this new study tells us is that for convenience and effectiveness, and to some degree for risk of side effects, there is little reason to even consider birth control hormone pills, patches, and rings.  Women using these methods were more than 20 times more likely to become pregnant—that’s 2000%! Women using IUDs, implants, or injections had far more success preventing pregnancy, regardless of their age. The risk of contraception failure doubled for women under the age of 21. The long-lasting methods require much less of what doctors call “compliance” – remembering to take medications, remembering to get drug refills, and so forth.

Some women don’t tolerate hormonal treatments, whether for birth control, PMS or PMDD, or another health issue, so it is good news that IUDs and other long acting methods were found to be vastly superior, and had few or no side effects. Long-lasting hormonal treatment like Depo-Provera® was as effective as IUDs and implants in this study.

Of course, an IUD or other long acting non-hormonal birth control method will not prevent or treat PMDD or PMS. Depo-Provera has not been widely studied for PMDD and PMS. Because it does interfere with your body’s natural hormone self-regulation, it might work, though it could cause similar problems to other hormonal treatments.

Every woman has to make these difficult decisions related to her own health care for herself, whether it is how to treat PMDD or PMS or how to prevent unwanted pregnancy. Of course, doctors and health care practitioners have the information and expertise to help you make an informed decision, and for many women it will be important to include family members in these choices. But studies such as this one make the decision about the best birth control with the least chance of side effects very much easier.

Most women who experience PMS & PMDD symptoms are familiar with PMS food cravings—the kind that ruin many a well-intentioned diet and exercise plan. There is another type of PMS weight gain that results from PMS bloating, but since that is water weight it generally comes off soon after the cycle completes. That’s a very small consolation, though, if you need to fit into a certain outfit on a certain day on which you happen to feel swollen and bloated, not to mention if you are simply tired of getting a bloated, blah feeling for days or weeks every month.

The real culprit in PMS weight gain is those uncontrollable food cravings. PMS cravings can feel downright overwhelming and impossible to control. Never mind that nearly every woman intuitively realizes that the foods she craves before her period: salt, sweet, fat, and starch, usually, are the very foods that can make premenstrual mood, cramps, and bloating worse, while they’re also packing on the inches and the pounds.

We have a couple of suggestions for this PMS weight gain problem. First, focus on what you eat the rest of the month, when you don’t have to battle cravings. By the time the chips are calling to you from the grocery aisle, it may be too hard to resist. If you start eating right from day one, it will actually help reduce premenstrual cravings and overeating. Second, take a good multivitamin with adequate calcium and magnesium (meaning, not a one a day vitamin—those never have enough calcium and magnesium.) You’d be surprised how boosting your nutrition level over the course of a few months can help control cravings: it could be that the vitamins and minerals are what your body and your brain is actually hungering for. Third, drink plenty of water and steer clear of addictive sweet and salty foods. This will help control bloating, and help prevent the cycle of food craving. Finally, try not to beat yourself up about food and weight.

Having PMS or PMDD is bad enough without berating yourself for cravings that are beyond your control. We’re not suggesting you plow through a pint of premium ice cream every day for a week before your period, but you can try to take it easy on yourself; remind yourself that you’re doing the best you can; and remember that you didn’t choose for your hormones to be topsy-turvy. Then, the next chance you get, start over, and get back on your plan. This is the best way to succeed at weight loss and beating those PMS food cravings.

If you suffer from the debilitating symptoms of PMDD, also known as premenstrual dysphoric disorder, it may surprise you to learn that up until now, it has been at the margins—or, more accurately, in the appendix—of mainstream psychological thinking in the U.S. That’s because the formal guide to the diagnosis of mental illness, the DSM-IV, listed PMDD at the back of the book, in its appendix, where conditions that the psychiatric profession wasn’t sure about were listed. Now, PMDD appears to be poised to join other recognized illnesses and conditions in the main section of the upcoming new DSM-V.

If you’ve been diagnosed with PMDD, or wondered if you have PMDD, you might be a little disconcerted to learn that it is considered a mental illness – but for any condition to be treated by medical doctors with psychiatric medications like Prozac® or Sarafem® (Fluoxetine®) and other SSRIs, it has to be listed in the DSM and is then called a mental illness.

The downside of this, of course, is that there is a social stigma associated with the word “mental illness.” Many people don’t realize that by itself, it is just a label that doesn’t really mean anything, and that millions of people have depression and other “mental” illnesses that we now understand are physical ailments like any other – they just happen to affect the brain, instead of joints or kidneys or other structures.

One potential upside to PMDD’s promotion to the main section of the DSM-V, up from the appendix, is an increased recognition of premenstrual dysphoric disorder, with more attention to research and investigation on possible causes and cures likely to follow.

An interesting side note: with an increasing recognition of PMDD, there will be a tendency for general practitioners to make this diagnosis, even though gynecologists and psychiatrists are probably more familiar with the condition, its diagnostic criteria, and how to manage it. PMDD can’t be diagnosed in your typical 5-15 minute doctor’s visit.

Another evolving factor to keep an eye on: it is now recognized at the highest levels of research and medicine that SSRIs—selective serotonin reuptake inhibitors, like Prozac®, Sarafem® and Zoloft®—don’t work for depression through helping with serotonin levels in the brain. In fact, they don’t work any differently than placebo, a fact that is causing tremendous reverberations in the world of mental health.

This may not be true for PMDD: since it hasn’t been studied, we don’t know if SSRIs work differently in PMDD than they do in depression. But this is unlikely, since the use of Fluoxetine® for PMDD grew out of the similarities between depression and what used to be called late luteal phase disorder. So as the whole paradigm of serotonin deficiency begins to crumble, the treatment of PMDD may change too—perhaps just in time for the DSM-VI.

Antidepressants like Sarafem®, Prozac®, and Zoloft® are the most commonly prescribed medications for PMDD and PMS. In fact, if you’ve talked to a doctor or done a little internet research about PMDD and PMS, there’s a good chance you’re already familiar with the use of the selective serotonin reuptake inhibitor (SSRI) class of drugs for the treatment of PMDD and severe PMS.

We discussed previously how Sarafem® was brought to market for PMS only after the patent on Prozac was about to expire, and that before Sarafem®, PMDD was not a household word. And, of course, like all medications, antidepressant side effects are a real concern.

Recently an even more important question has come to the forefront, accentuated by the recent New York Times Magazine article by Siddhartha Mukherjee which discussed, among other things, the research of the Ph.D. psychologist Irving Kirsch, who conducted groundbreaking research showing that SSRI antidepressants do not work much better than placebo (sugar pill.) Kirsch also found that the drug companies and the FDA suppressed negative studies of SSRI antidepressants, and this resulted in a skewed and overly optimistic estimate of their effects. At this point, the the research on SSRIs adds up to one unavoidable conclusion: most of the prescriptions for Prozac®, Zoloft®, and similar drugs are of questionable utility, because these drugs don’t work significantly better than placebo for mild and moderate depression. SSRIs do work well for serious, major depression.

This brings us to the important question of whether SSRI antidepressants for PMDD and PMS are a good idea. Do they work? Are they better than placebo? How can we tell which woman really needs antidepressants for PMDD, and who doesn’t? Is the risk of side effects worth the risk of trying a medication that may be no better than sugar pill?

The answer to the first question is yes – antidepressants work for PMDD. The tricky part is that it is now a clear scientific fact that for mild and moderate depression, antidepressants aren’t superior to placebo, so it is unlikely that they are better than placebo for severe PMS and PMDD.  But the real crux of the issue is the third question: how does anyone know if antidepressants are the right choice?

There is no way to determine this answer based on blood tests or a doctor’s exam. This important decision must be based on the severity of the symptoms, as determined by both the prescribing health care practitioner, and the patient. Do the symptoms resemble those of major depressive disorder? Are they truly debilitating and oppressive so that they are major impediment to functioning in the world, living life, and fulfilling one’s role and responsibilities?

There are certainly cases of major depression that meet these criteria, and they often respond to the SSRI antidepressants. Similarly, we can expect that when PMDD symptoms are so severe that they might as well be major depressive disorder for days to weeks out of the month, SSRIs are appropriate.

However, as we referenced earlier, SSRI antidepressants have side effects, and many women prefer to avoid them. When PMS and even PMDD symptoms fall short of the kind of interference with living that major depression causes, there are a wealth of excellent alternatives that have few side effects; are effective, and more effective than placebo; and that in some cases have been shown to be as effective as antidepressants.

Women and doctors should consider diet and stress management, as well as other lifestyle factors, as effective PMS & PMDD therapies. Proven remedies like Vitex agnus-castus, or Chasteberry; calcium; magnesium; and vitamin B6 as first line natural PMDD treatments that can be used before, or even instead of, antidepressants. Other supplements and herbs such as B-complex vitamins; the herbs Dong Quai and Black Cohosh; and the problems of food allergy and hypoglycemia are all worth adding to the list of natural PMDD alternatives.

A new study just came out in the Archives of Internal Medicine using vitamin D to treat painful menstrual cramps (dysmenorrhea.) What is really interesting about the study is that instead of giving women daily vitamin D, the researchers instead gave a single large dose—300,000 IU!—and found it worked remarkably well to control cramps.

300,000 IU of vitamin D is a very large dose, one you could only get from a doctor. But vitamin D turns out to be a whole lot less toxic than doctors had always supposed, so that taking a substantial daily dose—as high as 2000 IU per day—is unlikely to have any dangers or side effects; it could help cure menstrual cramps; and, according to the latest research, would probably reduce your risk of cancer and chronic pain, and would also help improve your immune system.

Vitamin D has many effects in the body. It is actually more like a hormone than a vitamin, and so it is not surprising how many different body systems, and symptoms, it helps and affects.

One of the important functions of vitamin D has to calcium metabolism, which is why it is sometimes thought of as “the bone vitamin.” Because calcium and magnesium work together to control muscle contractions in the body, we recommend a combination of vitamin D, calcium, and magnesium, taken consistently to control cramps. We have other suggestions too. While this massive dose of vitamin D for menstrual cramps may work, we think a balanced daily approach is best.

We’ve already discussed how to be supportive when your significant other’s PMS symptoms are at a peak. However, in some relationships, ongoing PMS and PMDD symptoms can cause a severe strain on both partners, and can undermine the very foundation of a marriage or relationship. In cases like this, it’s not enough to simply have better coping skills, or to be more supportive.  

So, for partners and spouses who want to help their wife or girlfriend get relief from premenstrual misery, here are our suggestions:

First, read our previous post. You don’t want to say in the middle of a premenstrual episode “Our problem is your PMS”—you’re going to need to be more sensitive, and supportive, than that. This is not to say that it’s OK to feel like a punching bag, but it’s also not OK to dismiss the real suffering your partner is experiencing.

Second, the best approach to PMS and PMDD symptoms is a holistic one. This means it has to address diet, physical activity level, stress, hormones, and (especially) nutrition. Of course, nagging about diet and exercise is not going to help matters. But understanding that skipping breakfasts, and that a pizza-beer-junk food diet and sedentary lifestyle are big contributors to the problem is a crucial first step—especially if you take the lead in helping your partner make the transition to a healthier lifestyle. And remember, don’t make this about her losing weight or take up a “blame the victim” mentality. You’ll both be healthier when you both live well, and it will help you and your relationship.

What does that healthier lifestyle entail? Here’s our guidance for a healthier, hormone-balancing diet. A healthy diet is an essential part of natural PMS relief, and it’s so much easier when both of you eat well. Physical activity is another crucial component of a healthy lifestyle, and this can mean anything from walking to joining a gym. The important thing is to spend more time being active, and less time sitting.

Stress is a little bit harder to get a handle on, because it can come from so many areas in life, and solutions can range from simple to very complex. Some people get a handle on their stress by making incredibly simple decisions: to not sweat the small stuff; to address a destructive friendship or work relationship; or even by eating right and being more active. For many others, stress comes from old patterns that need to be addressed with professional help, whether in individual or couples counseling. Many people swear by meditation or yoga as a way to relieve daily stress. Whatever the path you choose, stress relief is an important component of premenstrual symptom relief.

These basics can make a big difference, and sometimes all the difference. More often, though, they’re the foundation that allows specific PMS and PMDD remedies to work. For many women, and many relationships, more is needed to help balance hormones and mood chemistry fluctuations that cause premenstrual symptoms. Many women choose to take medications for their symptoms: hormonal birth control and antidepressants are doctors presribe for severe PMS and PMDD. Many women, though, prefer natural remedies. Herbs and nutrients can work very well for PMS symptoms, especially when they are used in the proper combinations.

PMS and PMDD don’t need to jeopardize relationships, if you and your partner are willing to make some changes to your communication and your approach to health.

PMS Comfort has so much practical information for women on what to do about PMS, PMDD, and premenstrual symptoms in general. We even have an article on whether men get PMS. (Spoiler alert—they don’t. It’s pre-menstrual syndrome. When men get moody and achey, it’s not because of their hormonal cycle: men don’t have one.)

What PMS Comfort has not had, up till now, is any pointers for the men and women who suffer along with their spouses or significant others as a result of PMS symptoms. If your partner, wife, or girlfriend has PMS, or irritability or anxiety or mood swings related to her period, what is the right way to deal with it? How do you and your relationship survive the challenge of PMS? PMS doesn’t need to ruin relationships, but there is a right way and a wrong way for a concerned partner to respond when PMS symptoms start to make things difficult.

Here are our suggestions on what to do, and what not to do, so that you don’t make the PMS situation worse.

First, don’t be dismissive: even if you think certain behaviors or emotions are caused by PMS, saying so can make it sound like you’re minimizing them. This is because whatever your significant other is experiencing at the moment, she’s not feeling “PMS” – she’s feeling anxious, or overwhelmed, or crampy, or sad, or angry, or any number of things. PMS is not a feeling, and it’s best if you try to understand what she’s feeling, and relate to it as a feeling, not as a medical condition.

Second—to clarify #1 above—this means you don’t say “you must be getting your period”, or “is it that time of the month” or “you’re just PMSing.” All of these are dismissive and somewhat belittling.

Third: enough about what not to do. What is the right way to respond? First, try to be understanding, patient, and supportive. While this may seem challenging, and a bit too vague, the important thing is compassion: your partner doesn’t like how she feels, and probably doesn’t like making you go through it with her. But if you respond by lashing out, or blaming, it can make things worse. Try to avoid over-reacting.

Fourth: some women want to be consoled when they’re upset, some want to be left alone. Your partner or wife may want to be consoled one time, and left alone the next. Remember, the storm of hormones, mood chemicals, and emotions and sensations of PMS and PMDD can be confusing and changeable. So, if she asks you to leave her alone, and then gets upset that you weren’t more compassionate, you may feel like you’re being placed in an impossible situation where everything you do is wrong. However, PMS can make emotions change like the wind. It’s not your fault, and it’s not her fault either. The best you can do is try not to make the situation worse, and try to communicate clearly with your partner, and ask her to communicate clearly with you.

Fifth: make “I” statements. In other words, even though your wife or girlfriend may blame you when she’s in the throes of PMS misery, don’t respond by blaming her. Instead, make “I” statements that express how you feel.

Coming in part two: what to do when PMS or PMDD is threatening your relationship.

We’ve said before that the most popular home remedy for premenstrual misery is a hot water bottle. We’d like to amend that statement, because so many women we know go straight for one thing to soothe that PMS feeling—chocolate! Whether you are a milk chocolate or a dark chocolate kind of gal, and whether you like it plain or with almonds or rice crisps—maybe you prefer to drink your cocoa—most women seem to intuitively know that chocolate can hit the spot in those few days before your period.

Of course, we usually think that chocolate hits not only the spot, but also the hips, so it has a reputation as junk food. But there has been more and more research showing that chocolate is good for you: now a new study getting plenty of attention shows that people who eat chocolate weigh less than people who don’t! We did a doubletake when we saw that: we thought most people eating chocolate in the form of low quality candy that’s full of unhealthy sugars and fats. But, it turns out, people who eat more chocolate have a lower Body Mass Index (BMI.)

As is often the case with research, it’s hard to know exactly what this means. Maybe people who are naturally thin eat more chocolate, for some reason. Or maybe, when they’re talking to researchers about what they eat, heavier people don’t admit to eating chocolate while thinner people do.

Right now, all we can say is there appears to be an association, or correlation, between eating chocolate and lower BMI. But that is not all that chocolate seems to be able to do: evidence is mounting that chocolate prevents heart disease and stroke, and may even help keep blood pressure in line. No researchers are saying that eating chocolate helps PMS or PMDD, though plenty of women would be happy to be subjects in that study!

Chocolate is rich in plant antioxidants and powerful chemicals called plant polyphenols that prevent damage to the heart, the blood vessels, and to all the cells of the body. Plant-based antioxidants like those in chocolate, green tea, broccoli, and blueberries are receiving more and more attention (while less is going to vitamin C and vitamin E pills.) We have suggestions on how to incorporate more of these nutritional powerhouses in your diet—but a moderate amount of chocolate and tea doesn’t hurt, and it might just help your figure, too.

Once again, dietary supplements are in the news, and as usual the journalists charged with covering this story aren’t necessarily asking the right questions. On March 18th, 2012, Dateline NBC featured an investigation by Chris Hansen into one particular supplement laboratory and one particular weight loss product.  While the message most people will take home from the story (as indicated by the headline of the story itself) will be that the safety of dietary supplements, including herbal remedies and nutritional supplements, is in question, Chris Hansen stated at the beginning of the broadcast that “the majority of dietary supplement manufacturers and laboratories are responsible and produce safe supplements.”

I chose the formulas for the PMS Comfort products myself, and have seen the positive effects they’ve had in the lives of women with PMDD and PMS. I have inspected the plant where these products are manufactured – and so has the United States Food and Drug Administration. In fact, every lab that meets current FDA standards has had to invest millions of dollars in testing equipment, and has to submit every product they produce to a rigorous manufacturing and testing protocol to make the process, and the product, is safe and secure.

Nearly every dietary supplement produced in the United States is manufactured in a plant with stringent safety and cleanliness standards. It’s unfortunate that millions of consumers might conclude that the shabby practices revealed in the investigation are representative of the industry as a whole.

Women with premenstrual dysphoric disorder, premenstrual syndrome, and other premenstrual problems like breast tenderness or migraines need to know that there are safe, reliable alternatives to pharmaceutical drugs. Many women simply cannot tolerate hormonal birth control or antidepressants for PMS and PMDD—those are the two main drug solutions available—and many more prefer to avoid synthetic medications, and are looking for natural, alternative remedies in order to live a healthier, more holistic lifestyle.

By providing high quality, Good Manufacturing Practices (GMP)-approved herbal and nutritional supplements, we are doing our part to both help women, and to help restore the reputation of alternative medicine. We wish that there were no stories about wayward labs and marketers to even be told—but that if they have to be told, it is reported responsibly, so that an accurate picture of the overall dietary supplement business, and alternative remedies in general, is given.

We read with interest a recent study that showed that what has been called frigidity or female sexual dysfunction turns out to be mostly about relationship issues. That’s right, women’s sexual satisfaction is based to a large degree on the health, comfort, and mutuality of their romantic relationship. In other words, there’s no such thing as a female sexual frigidity, only emotionally and sexually unsatisfying relationships. Now, who do you think is surprised by this information? Not most women, that’s for sure! The idea that sex, sexual satisfaction, orgasm, sexual climax, or whatever term you want to apply is, for women, built on a foundation of a good relationship is so basic, and so elementary, that we are tempted—gasp!—to think that this news would only come as a surprise to men, and specifically the male medical professionals who likely coined the terms frigidity and female sexual dysfunction.

Snarkiness aside, it just makes sense that a woman can really relax and enjoy sex if she doesn’t feel like her partner is really 100% there for her. Your partner doesn’t show you tenderness and respect? It’s hard to leave that outside the bedroom. Your husband (or wife) doesn’t do his (or her) fair share around the house? That will probably make it hard to relax and enjoy intimacy. Does your boyfriend (or girlfriend) show more interest in playing poker or video games than he (or she) does in you? It’s hard to want to please someone, and be pleased by someone, who really seems so disinterested and “not present.”

We know that PMS and PMDD can do a real number on libido and sex drive, and that PMS gets blamed for a lot of sexual problems. And, like anything else that affects your health, it’s hard to feel sexy if you feel lousy. But, it’s not just PMS or PMDD that mess with sexual desire: all of the dynamics that put stress on a relationship: fidelity, finances, friendships, getting along, and feeling like you’re in it together, can make it hard for a woman to fully enjoy sex and reach orgasm when things aren’t going well.

We think the current views of sex and sexuality, of women’s orgasm and sexual satisfaction, including the ideas of frigidity and female sexual dysfunction, deserve some serious reconsideration in light of this new information. After all, is anyone really surprised that what happens outside the bedroom matters inside the bedroom?

There is a kind of standard set of recommendations for natural relief of PMS and PMDD that seems to get published the web over and over by different authors, in thousands of articles that claim to give you the essential tips for relieving and treating PMS. As experts in the natural relief of PMS and PMDD symptoms, we think some of these recommendations are probably helpful: in fact, you’ll find much more detailed, informative, and nuanced versions of them in our many articles on natural PMS relief.

But one common recommendation you’ll find widely distributed on in articles and discussion boards on the web is for the dietary supplement, evening primrose oil for PMS. (evening primrose oil is also sometimes known as EPO.) Unfortunately, evening primrose has been studied for PMS, and every study has shown that it doesn’t work any better than placebo, or sugar pill.

There are natural treatments that have been proven to work for PMS: Vitex agnus-castus, the minerals calcium and magnesium, and vitamin B6 all work better than placebo. Some studies have shown they work as well as, or better than, prescription and over-the-counter medications for PMS and PMDD, which is why all of them are included in our PMS Comfort products. We include some other herbs and nutrients that are supportive of women’s health and a healthy, symptom-free menstrual cycle, including some herbs that we know from clinical practice help aid hormonal balance. But we do not use evening primrose oil in our natural remedies for PMS because there simply isn’t the science to show it’s effective—and there is science to show it’s ineffective.

If you're the investigative type, you can check out this information on evening primrose oil for PMS, by two Italian researchers, for yourself.

What about those other common recommendations that are often packaged along with the suggestion of EPO? They’re often presented in one single article, as if every woman’s PMS or PMDD was alike, and as if each woman’s individual symptoms didn’t deserve special consideration. We’ve organized our website differently, so that you can look up your specific symptom and what to do about it. Do you have menstrual cramps, or PMS cramps? Do you wonder if your symptoms might mean you have PMDD? .  Do you have PMS anxiety and tension?  Looking for a diet for PMS and a nutritional approach to PMDD?  Are you just generally interested in natural PMS remedies?

But unless there’s a new big study coming up, we won’t be suggesting you take EPO for PMS. Researchers have moved on, and are looking into chastetree berry and stress reduction as the most likely scientific, natural ways to treat PMS and PMDD.

It’s sad but true: women often have their self-confidence and self-esteem shot down—often by men—and don’t realize they have the right to stand up for themselves, and that they are not, in fact, crazy, stupid, incompetent, irrational or oversensitive. Men (and occasionally women) have often used PMS as an pretense to make these kind of accusations, but that is just one example of a way that women's power and confidence gets chipped away.

In fact, there is even a name for this kind of subterfuge: “gaslighting.” The word comes from a 1944 movie, Gaslight, that starred Ingrid Bergmann and Charles Boyer. (A note to film buffs: this was Bergman’s first Oscar for Best Actress, and it was Angela Lansbury’s screen debut, for which she was nominated for an Oscar. It was also nominated for best picture.) In it, Boyer's character tries to get his wife, played by Bergman, committed to an insane asylum so he can get his hands on her valuable jewelry. He constantly turns down the gas lights in their house, and then tells Bergman, when she says she can’t see, that she’s imagining things – that the house is perfectly well lit. The term “gaslighting” came to mean a man undermining a woman’s self-confidence—indeed, her version of reality—under false pretenses and usually with some ulterior motive for personal gain and power.

We were reminded of this by an excellent post, addressed to women from a man, declaring “You Are Not Crazy.”  The point is, gaslighting is more than just a movie. It’s not something that died with black and white pictures and old-time film stars, but continues today, and is something with which many women are all too familiar.

We don't think girls and women should have their personal power sabotaged, which is one reason we focus on empowering women through education. We hope to be part of a solution that helps women build up solid self-confidence and self-esteem that can’t be undermined by gaslighters.

We keep talking about how PMS and PMDD are real, physical, genetic, biochemical, hormonal conditions, and not, as some would have you believe, simply “in your imagination” or a “neurosis.” We’re happy to report that the evidence—scientific evidence—keeps rolling in that the supports our position.

We have to keep revisiting this, and hammering the topic home, because sometimes it seems as if the only people who understand PMS (and this goes for PMDD too) are the women who suffer from it, and occasionally an understanding husband or partner who is truly supportive. All too often doctors, health care practitioners, family and friends seem to think PMS is an imaginary affliction that women dream up because…well, apparently, just because. But let's get real for a second: no woman would actually wish for a bloated, achey feeling several days out of the month; for difficulty concentrating and brain fog; for fatigue and mood swings; and all the other PMS symptoms that are no walk in the park, despite what the PMS doubters think.

Now, the good news: the “PMS is imaginary” school of thought took a major hit last year when research was published showing that among identical twins, there is a strong genetic component to premenstrual syndrome. When a strong genetic component is proven it suggests a biochemical or physical basis for a condition, rather than a purely psychological or emotional one. As always in the world of science, more studies are needed to confirm the findings, but this study of 176 sets of girl twins clearly showed that the tendency to PMS is an inherited trait.

The results of this study made us curious: has any other researcher looked into this question? Twin studies are among the most reliable studies for a wide variety of medical conditions and personality characteristics because they make it clear what is being affected by genetics, and what is a result of environment and psychology.

As it turns out, a 1993 study looked at this same question of PMS in twins and found that, lo and behold, there is a strong genetic influence on PMS. This study came from Australia; the one mentioned above came from Canada. We weren’t surprised by this: it seems the United States has a prejudice against PMS—many people don’t take it seriously, and assume that only PMDD, the most severe type of PMS, is “real.” There are studies showing this genetic component for PMDD as well: a 2007 study showed that a variation in an estrogen receptor gene is associated with PMDD.

Of course, these studies don’t mean that genetics is the one and only cause of PMS and PMDD: the genes involved could cause a woman to have higher than usual requirements for vitamin B6, calcium, or magnesium, or some other nutrient, or to be more susceptible to the effects of caffeine or stress.

If you’re a scientific type, here’s how to look up the two PMS studies themselves (you can go directly to pubmed or try google scholar):

 

October 2011, The heritability of premenstrual syndrome. Lead author: Jahanfar S, in the Journal Twin Research and Human Genetics

April 1993, The premenstrual syndrome: a twin study. Lead Author: Condon JT, in the British Journal of Psychiatry.

Caffeine is bad for PMS and PMDD, because it increases stress and anxiety levels. The science on caffeine is confusing, though, because caffeine appears to help with concentration and depression. How can something that makes anxiety worse help with depression and concentration? We have no idea. Anxiety and depression are nearly inseparable—it’s hard to have one without the other. And anxiety tends to interfere with concentration too.

In any case, we’ll stick to our guns, if you’re concerned about PMS and PMDD symptoms, avoid caffeine. You can learn more about how to determine if caffeine affects your symptoms in our food allergy test article.

However, we want to call your attention to yet another confusing bit of research: it turns out that drinking 200 milligrams of caffeine in a day—the amount in 1-2 cups of coffee, or one little red energy drink, or about four cups of tea—will change your estrogen level. The funny thing is, the study, which will be published this week in the American Journal of Clinical Nutrition, shows that the effect of caffeine on estrogen varies depending on your ethnicity.

In white women, caffeine lowered estrogen, whereas in Asian women it raised it. The effect also appears to depend on the source of the caffeine: green tea and caffeinated soda raised estrogen no matter the race of the woman consuming it.

All of this leads us to wonder if perhaps Asian women consume more green tea, and if coffee has some quality that might lower estrogen—a quality that tea and soda, obviously, are missing.

We should point out that this study only looked into women of reproductive age, not menopausal or post-menopausal women. We’d say this qualifies as a very preliminary study: you can’t really draw any health conclusions from it. Unfortunately, many medical research studies leave one with a similarly unsettled feeling, since so often they raise more questions than they answer. On the other hand, over time, research is quite good at revealing truths in health and medicine, as long as that research is conducted and interpreted fairly.

With all the confusion out there about what to eat—should I go raw? How much protein do I need? What about low carb?—it’s reassuring to know that the simple, native way Greek peasants ate as recently as 50 years ago is one of the healthiest and best-proven diets ever studied.

It’s also comforting to know that, of course, the Mediterranean Diet was not based on any fad, or what movie stars ate, but that instead it is the diet that was consumed for centuries in that region of the world. What’s more, there is simply no other diet that has been so well researched for its ability to prevent heart disease, cancer, Alzheimer’s, and other chronic diseases that plague the developed world.

In fact, you’re probably already familiar with many of the healthy diet principles that have entered our understanding of good-for-you food as a result of research into the Mediterranean Diet.

    Olive oil? Check—a staple of the Med Diet. Everything we know about the benefits of olive oil come thanks to what we’ve learned about how this diet rich in plant foods and unsaturated fat prevents disease.

    Moderate wine consumption? Check—although the research on this seems to waffle between a study indicating benefit this month, followed by a study next month that says alcohol is bad for you, there is clear evidence of some benefit to drinking wine, particularly red wine. If you’ve ever heard of the French Paradox, then you’re familiar with a key Mediterranean Diet concept. That’s right: the original scientific article on the benefits of the Med Diet confirmed for the whole world the value of red wine.

    Whole grains? You guessed it—another traditional Med Diet staple that has now been promoted by food manufacturers, cereal companies, and medical societies throughout the U.S. As you might imagine, Greek peasants ate rough brown bread full of fiber and all the nutrients from the whole grain.

    Plant-based diet? Long before this became a buzzword for sustainability, and championed by the raw vegan camp, Greek peasants were eating a diet based on plants. One reason for this is that it’s simply less expensive, and what their countryside could easily provide. The original Med Diet studies were done on the island of Crete, and islands tend not to be able to support a lot of grazing animals to be slaughtered for meat.

    The perils of excess saturated fat and cholesterol? Although this subject has become a little controversial in natural medicine circles, partially because the proponents of statin cholesterol-lowering drugs have pushed them as a panacea for seemingly all that ails us, Mediterranean Diet research was the first salvo in the war against cholesterol, and the first place where researchers really understood that a diet high in saturated fat and cholesterol led to more heart disease.

So yes, you probably already knew more about the Mediterranean Diet than you may have realized. We’ve taken these healthy diet principles and translated them into a healthy eating plan for PMS and PMDD: The PMS Balance Diet, plus our guidance on what not to eat, make it simple to integrate the healthiest diet in the world into your life.