For decades the medical community has assumed that symptoms of PMS (premenstrual syndrome) are related to the hormone shifts associated with the menstrual cycle. Why one woman suffered mood swings, headaches, cramping and cravings, while others did not, was thought to be caused by variations in hormone levels and possibly genetics.
Recently, that theory has been turned upside down by emerging research. Studies that compared women with and without PMS symptoms found no difference in hormone levels between groups. Instead, they found big variations between blood sugar metabolism during the period of time leading up to the menstrual cycle.
What is Actually Behind PMS?
Turns out that PMS is not about wild hormone fluctuations but is instead about wild increases in energy requirements by a specific part of the brain. Brain cells use an unproportionate amount of sugar (glucose) to generate energy. The brain uses approximately 20% of the carbs that we consume but only accounts for about 7% of the body’s mass. This increased drive for sugar within the brain is a foundational reason that women experience PMS. So, why would we crave sugar and often foods that contain sugar and fat when we are nearing menstruation?
Turns out that the cerebellum, the area of the brain that controls primitive emotions, metabolizes much more glucose in women that experience significant PMS symptoms around the premenstrual phase of the month. When the cerebellum does not get the sugar it demands prior to menstruation, it becomes dysfunctional leading to irritability, anger, mood swings and poor mood. In fact, in people that experience bipolar disorder (both men and women) the cerebellum behaves similarly. Turns out that the cerebellum is now thought to be involved in many psychological disorders.
Cravings occur as a result of the cerebellum requiring more energy and we are wired to go to the fastest source of energy to satisfy this need. Junk food and sweets are metabolized quickly, proving a fast source of fuel for the active cerebellum.
The Danger in Perpetuating PMS Cravings
As easy as it may be to grab the nearest cookie or chocolate bar, unfortunately, this perpetuates the blood sugar imbalance that propels PMS and many other dangerous conditions. Blood sugar imbalance is linked to countless inflammatory conditions such as depression, anxiety, cardiovascular disease, diabetes, autoimmunity and even Alzheimer’s disease. So, the quick fix for PMS symptoms can lead to a landslide of unintended health consequences.
The PMS and Blood Sugar Relationship
When we eat carbohydrates, the digestive process breaks them into smaller units of glucose which are then absorbed into intestinal cells and spit out into the blood stream. In the moment, our blood sugar goes up which stimulates the release of the hormone insulin from the pancreas. This hormone must attach to receptors on each cell’s surface, communicating that glucose needs to enter the cell to be metabolized and turned into energy.
For many reasons, this process may not be working efficiently which can lead to glucose remaining in the bloodstream instead of moving into the cells. High levels of glucose in the blood, aka high blood sugar, causes inflammation and tissue damage. If that wasn’t bad enough, this situation also means that your cells aren’t getting their much-needed energy source because glucose isn’t making it into the cells. This leaves you with low energy and high blood sugar: a recipe for disaster.
Fixing Imbalanced Blood Sugar
In conventional healthcare, blood sugar is assessed with two typical methods; fasting glucose and HbA1c. Fasting glucose checks your blood sugar levels after 12 hours without food and HbA1c looks at the ratio of your red blood cells that are attached to glucose which provides a 3-month average reading of your blood sugar.
In our practice, we often see relatively normal fasting glucose and HbA1c ln lab panels, but upon deeper investigation we find that our patients are spiking and dipping all day long. This causes their average blood sugar (HbA1c) to look normal but the highs and lows that our patients are experiencing throughout the day can cause everything from anxiety and low energy to chronic pain and tissue damage.
If women are unknowingly living with a blood sugar rollercoaster, things only get worse around their menstrual cycle. The increased need for energy within the cerebellum which causes the majority of unwanted PMS symptoms often leads to poor food choices and a rollercoaster of blood sugar highs and lows. The trick to alleviating PMS symptoms is balancing blood sugar consistently.
The Answer to PMS
The answer to PMS is regulating blood sugar, but not just during the few days before your cycle begins, it needs to be balanced all month. When we begin our work with patients, we require that they monitor their blood sugar for some time. We use this data to find patterns in their diets that lead to stable or unstable blood sugar and then we make adjustments, so their glucose levels stabilize. More often than not this means increasing fat intake.
Fat is the alternative fueling option for your cells. When glucose is not readily available, your body will make ketone bodies from fat and deliver them to your cells so they can be broken down to generate energy. Fat has many benefits. Healthy fats slow digestion, balance blood sugar, calm overactive brain activity, provide building bloods for proper hormone function and cool inflammation.
What is the Right Amount of Fat?
The amount and type of fat that each person needs to balance blood sugar varies from person to person. In fact, we find that each patient is so individual that no two blood-sugar balancing diets are the same. We utilize the expertise of a trained nutritionist to analyze each patients’ results so a balancing and healing diet can be designed for each patient’s needs.
The incredible results are that patients experience improved mood, energy, sleep and focus as their body regulates blood sugar. When inflammation levels drop alongside blood sugar fluctuations, we see pain, cravings, headaches and many other symptoms dissipate. While the research linking PMS symptoms to blood sugar imbalance may be novel, it aligns with the experiences our patients are having in our clinic each and every day.
Four More Tips for Regulating Blood Sugar and Ending PMS for Good
Balancing blood sugar is foundational to long-term health. Aside from finding the right diet and eating the right amount of fat, these are our most helpful tips to boost blood sugar metabolism and help your body and mind glide through your menstrual cycle without the pain and agony associated with PMS symptoms:
Move Your Body
Exercise has countless benefits that protect the body and brain against disease and aging. However, exercise is especially helpful for regulating blood sugar and therefore reducing the blood sugar swings associated with PMS. Exercise increase blood sugar metabolism, moving sugar our of the blood and into the cells more efficiently. This means fewer highs and lows and more consistent energy metabolism. This improves your cell’s ability to take up and use glucose
Get Great Sleep
Getting great sleep and enough of it is directly linked to blood sugar balance. In fact, regularly sleeping less than 7 hours per night increases the risk of insulin resistance and poor glucose control. This may not be surprising if you think about the last time that you had a poor night of sleep. Most likely, your cravings for sugar and caffeine increased as your body struggled to maintain energy throughout the day.
One reason this occurs is because the hormones that stimulate hunger increase after insufficient sleep while. Those with imbalanced blood sugar are more likely to experience inadequate sleep quality and those with poor sleep quality have a higher risk of blood sugar imbalance. If blood sugar or insulin levels are high, sleep is likely being affected. In fact, high blood sugar and poor-quality sleep both lead to diminished function within body and brain.
Boost Fiber Intake
While organizations like the American Heart Association recommend consuming 25-30 grams of fiber per day, we often find that our patients do better with closer to 40-50 grams per day. Fiber is effective for balancing blood sugar because it slows digestion and the demand for glucose metabolism while feeding healthy microbes in the gut. Both of these functions lead to better blood sugar control. It’s also critical to eat a variety of fibers such as insoluble fiber from nuts and vegetables and soluble fiber from foods like flax, chia and psyllium husk. Your microbiome will get an extra boost by increasing prebiotic fibers like inulin and oligofructose.
Although chronic stress has become normalized in our culture, it is not a normal state for the body. Chronic stress leads to increased levels of the stress hormone cortisol which is linked to insulin resistance, poor mood and decreased blood sugar control. Improving stress response with deep breathing, meditation, mindfulness and time in nature can boost your body’s ability to balance blood sugar and therefore calm symptoms of PMS.
If you suffer from symptoms of PMS, you will benefit from balancing your blood sugar all month long. In addition, increasing your body’s natural glucose metabolism with exercise, sleep, stress reduction and increased fiber and fat will lead to better overall health and reduced PMS symptoms. If you don’t know where to start, finding a well-trained functional medicine professional that can help you identify the specific foods that cause your blood sugar to spike or dip is critical for creating the right blood-sugar-balancing-diet.