The Hidden Cause of Your PMS and How to Fix It Fast
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Coming up on this episode of The Doctor's Pharmacy. And here's something most people don't know. It's not just your ovaries that produce estrogen. Your belly fat is also an estrogen producing factory, right? So all those belly fat cells in there aren't just holding up your pants. They're actually spewing out hormones.

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Are you ready to prioritize wellness? Maybe you want to make more informed choices on the latest health trends or simply understand the science. I'm Dr. Mark Hyman. I'm a wellness expert and I want to welcome you to my podcast, Health Hacks. In every episode, I'll provide guidance on how to live a longer, healthier life.

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Welcome to the doctor's pharmacy and another edition of Health Bytes. I'm Dr. Mark Hyman. Now, a common assumption is that the symptoms of PMS are an inevitable part of being a woman and require medical intervention with sometimes serious medications to correct them.

Now, to think that 75% of women have a design flaw that requires medical treatment just to live a normal life is just absurd. PMS is not a normal consequence of being female.

If you're one of the many women who do suffer from PMS, you don't have to suffer from PMS every month. Enduring mood swings, breast tenderness, fluid retention, migraines, bloating, or heavy painful periods. While medications may sometimes be helpful, they can have pretty significant side effects

And the good news is you can balance your hormones without them and without their potential side effects. Many young women are becoming increasingly aware of the potential harms of birth control, not because their conventional gynecologist is explaining it to them, but through their own personal experience.

They're on a journey to educate themselves and they want a more nuanced, personalized approach to hormonal health. So today we're going to discuss what you can do to support your menstrual cycle through your diet and a comprehensive functional medicine approach to get rid of PMS for good and feel great all month long. The key to solving this type of problem is getting to the root cause of the symptoms. Now I hear this story all too often, but the good news is that there are simple solutions that don't involve taking medication.

We know what causes hormonal imbalances. Sugar, caffeine, alcohol, stress, a lack of exercise, and environmental toxins all contribute to hormonal imbalance and worsening of PMS. Even changes to your gut microbiome can affect your hormonal health. So what would conventional medicine docs do for PMS? Well, they give you NSAIDs or things like ibuprofen.

birth control. They might give you Serifem or Prozac, in other words, but they don't get to the root cause of symptoms and they inhibit your natural cycle, your infradian rhythm. And the birth control pill often has significant side effects with long-term use, including mood and gut issues, dysbiosis, taking the pill depletes folate, vitamin B2, B6, B12, vitamin C and E, magnesium, zinc, selenium, all important, by the way, for fertility.

There's also an association between hormonal birth control and depression. In fact, a nationwide prospective cohort study of over a million young women in Denmark reported an increased risk for antidepressant use in women prescribed hormonal contraceptives. And the results were published in JAMA Psychiatry. And their risk was highest in the adolescents who were aged 15 to 19 years old. So we don't want to be giving these teenagers antidepressants and the pill and just medicating the side effects of medication. It's crazy.

So you have to look for what are the real underlying causes of PMS. Well, it's hormonal imbalance. And there are a lot of causes for hormonal imbalance. So it's important to understand what they are and how to deal with them.

The main problem is something called estrogen dominance, which means that your estrogen levels are too high and your progesterone levels are too low. Now, this may be an absolute increase, in other words, a very high estrogen and low progesterone, or it may be a relative dominance of estrogen over progesterone.

And unfortunately, this is not something well-recognized by traditional medicine. And you can measure this, right? The fluctuations in estrogen in relation to progesterone can cause all sorts of problems, including neurotransmitter signaling and lots more, because estrogen in part regulates serotonin levels in the brain, and that can contribute to PMS symptoms, things like mood swings, depression, irritability. And an absolute or relative excess of estrogen in relation to progesterone drives most of the symptoms of PMS significantly.

And menstrual problems like fluid retention, breast tenderness, migraines, mood swings, heavy bleeding, cramps, all that is really related to this excess estrogen and inadequate progesterone as women get through their later cycles in life. Poor diet is certainly a big factor. And when you clean up the diet, a lot of hormonal stuff just gets sorted out.

And then there's a lot of, unfortunately, hormones in conventional meat and dairy products. So I encourage you to eat regenerative, organic products, and particularly dairy might not be your best friend if you're having a lot of female hormone issues. I'd encourage people to just quit dairy as an experiment to see what happens. There are also environmental toxins that play a big role in hormonal health. And unfortunately, a lot of these petrochemical toxins

are also endocrine disruptors. They act as hormonally active compounds in the body, even at low doses. And in fact, there's a word for them called xenoestrogens. Xeno means foreign, and obviously estrogen means estrogen. So foreign estrogens, and they come from pesticides, plastics, many personal care products, skincare products.

I mean, these petrochemical products acts as a toxic foreign estrogen-like molecule that drives hormonal imbalances in most female cancers like breast, uterine, ovarian cancer. So toxins are a big factor and you have to reduce your exposures. A lot of nutritional deficiencies also affect hormone function, particularly magnesium, vitamin D, and also iron. What else should we be doing for

PMS or premenstrual syndrome, how do we get you back in balance and so you don't have to suffer and be really struggling your whole life? Because I just don't think that is something that women should accept. It makes me actually quite angry that the conventional medicine system doesn't really take this seriously or just tries to medicate it instead of dealing with it from the root cause.

So the first thing is food. Food is medicine. It's information. It controls every function of your body and mind, including your hormones. And it connects us to almost everything that matters in our lives. So you have to know that what you put in your fork is the most important thing you do every day for your health. So the first step to do with your diet is to cut down inflammation because inflammation will mess up your hormones. So first, get rid of the junk, right? Then get rid of the junk and then add in the good stuff. So take out the bad stuff, add in the good stuff.

What's the bad stuff? Well, our current diet is really high in sugar and starch, and that drives insulin resistance, and that leads to belly or visceral fat.

And here's something most people don't know. It's not just your ovaries that produce estrogen. Your belly fat is also an estrogen-producing factory, right? So all those belly fat cells in there aren't just holding up your pants. They're actually spewing out hormones. And there's something called aromatase also that increases estrogen production that's found in fat tissue. So, you know, having more estrogen production

is not necessarily a good thing, especially when it comes from your visceral fat. So what are the things you should eat and not eat to eliminate PMS symptoms, right? Eat real food, right? Real food. You know what that is, right? My joke is if God made it, eat it. If man made it, leave it. Did God make an avocado? Yeah. Did God make Doritos or a Twinkie? No, right? Just don't eat that. So also you want to reduce fast absorbing carbohydrates, right? Any flour products, sugar,

quickly absorb sugars like flour, instant oats, white rice, potatoes, or not all potatoes, like the small fingerling potatoes may be okay, but the big starchy potatoes we all eat are a problem. And they can spike insulin. And that leads to insulin resistance and inflammation. And that can cause

PMS can cause PCOS. It can increase the risk for all chronic diseases. Also, you want to really limit caffeine or get rid of it entirely for a while to see how it affects your hormones. And for sure, alcohol. Alcohol, it will screw up your estrogen and make you estrogen toxic ultimately. These really make hormone imbalances worse.

Also, I would encourage you to do a full dairy elimination for eight weeks. It's often a huge factor in PMS and many menstrual and hormonal issues. Next, I want you to avoid ultra-processed foods, right? Starch, empty carbs, grains, sugar,

Sugar-sweetened beverages, energy drinks, teas, coffee, you know. I mean, think about it. Any coffee or frozen blended drink from Starbucks, Dunkin' Donuts with flavor, it means tons of added sugar or glucose syrup. And lots of women drink these and they start their day with these drinks

not realizing it's a sugar bomb, like a vanilla latte, mocha frappuccino, even a matcha have tons of added sugar. I mean, a grande mocha frappuccino has almost 13 teaspoons of sugar. I mean, you never put 13 teaspoons of sugar in your coffee in the morning, but if you're going to Starbucks for your morning fix, you're literally killing yourself.

Also, avoid some of these, quote, healthy nut milks or oat milks. They're often blended starch, sugar, and water. So be careful. Oat milk really spikes your blood sugar. Sometimes there's also additional sugar from the flavoring too, like vanilla or chocolate, whatever, hazelnut. Just stay away from all that stuff. Drink black coffee. Put a little almond milk in it.

Ask for the unsweetened almond or coconut milk, although usually you don't have that. Also, I want you to avoid processed food, packaged food, all kinds of food with, quote, health claims on the label, you know, plant-based, vegan, keto, gluten-free, whatever. It doesn't mean it's healthy. And my rule is that if it has a health claim on the label, I guarantee you it's bad for you. So just don't eat. It's a way of getting food marketers to kind of get you engaged, but it's often hiding something bad underneath.

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You want foods that really balance your blood sugar. You want to focus on fiber-rich, low-glycemic, non-starchy veggies, low-glycemic fruits. And fiber is really important because it helps balance out your hormones. It helps build a healthy microbiome. It helps prevent the reabsorption of estrogen that can cause estrogen toxicity. So you want to eat the rainbow. Aim for about eight to 10 servings of colorful veggies daily for all their health benefits. Make sure you sort of eat every day

Something from the cruciferous vegetable family, like that's the broccoli family, broccoli, cauliflower, kale, college cabbage.

Brussels sprouts, arugula, bok choy, they're all important because they actually support estrogen detoxification. And they help balance the estrogen and progesterone because they contain amazing phytochemicals such as glucosinolates or indole-3-carbinol, diindylmethane. All of these are big medical words, but they're essentially molecules that are in the broccoli family that help induce the expression of certain enzymes called CYP450 enzymes that enhance

the metabolism of estrogen in the right way to produce beneficial estrogen metabolites, including, for example, they're called 2-hydroxyestrone. And they reduce the formation of a toxic estrogen metabolite called 16-hydroxyestrone. This is associated with heavy periods, with breast tenderness, breast cancer, and DNA damage. So there's different ways your estrogen can be metabolized in your body to the good or bad metabolites. And

And the bottom line is if you eat more broccoli, you'll be shifting towards the good metabolites. So that's the take home. Okay.

But the science is there, it's quite fascinating. And I do measure in my practice the estrogen metabolites and I can see what's happening with women's metabolites and whether they need more B vitamins or more support for glutathione or more of these chemicals from food, these phytochemicals like indole-3-carbinol or diandromethane. You also want to focus on slow absorbing and burning carbs, sweet potatoes, yams, lentils, some whole grains are fine like quinoa, non-starchy veggies, protein.

To avoid the blood sugar spikes, those are really important. Then you eat protein first as opposed to starch first. Eat about four to six ounces of protein per meal, roughly the size of your palm. Make sure you use high quality sources, grass-fed meats, pasture-raised eggs, poultry. I recommend Force of Nature. I love it. I don't have any financial relationship, but they have great regenerative sources of chicken and meat and bison and venison, elk, so forth.

You actually need protein, by the way, to make hormones. So they're part of the building blocks. You need good fats to make hormones as well. Make sure your diet's really nutrient-dense. You want a lot of bioavailable micronutrients like iron, magnesium, B vitamins, and so forth. Nuts and seeds are great for hormones. I love all...

bunch of science on how they regulate hormonal health, but things like flax seeds are my favorite. Almonds, chia seeds, hemp seeds, pumpkin seeds, sesame seeds, sunflower seeds, all these are rich in fiber. They're full of good fats. They have micronutrients like calcium, magnesium, zinc, iron, B6, phosphorus, which are all important for a healthy menstrual cycle and hormone balance, right? Your body is just a big biochemical machine and you have to put in all the right ingredients to make the right things work. And what the

The problem is, is most of our diet is depleted. Most of us are nutritionally deficient at some level or other. Most of us have unhealthy microbiomes. Most of us are exposed to toxins. Most of us eat too much sugar. Most of us drink too much coffee. Most of us drink too much alcohol. Most of us don't exercise enough. No wonder we're having all these problems, right? So we really need to get our act together if we want to reset. And it doesn't take that long. One or two cycles of doing this for women really helps reset the whole system.

One of the cool things you can do is use flax seeds, ground flax seeds, about two to four tablespoons. It's great for your hormones. It's great for beneficial compounds that are helpful in regulating your hormones like lignans. And also it's great for bowel movements, right? So they really balance the hormones and they block the negative effects of some of the excess xenoestrogens. So if you're exposed to environmental toxic estrogens, you can actually reduce your exposure to them by having these flax seeds.

Also you wanna increase the anti-inflammatory fats in your diet, the omega-3s, EPA, DHA, and my favorite sources obviously are sardines, herring,

Mackerel, anchovies, you can use small wild caught salmon. Sometimes there's omega-3 enriched eggs. There's plant-based sources like walnuts, chia, and hemp, but they're not really moving the body into the EPA and DHA. Only about 10% is converted. So you want to get also the preformed EPA and DHA from fish or from supplements.

Now, if you're a vegetarian or vegan, it's really important to supplement with omega-3 fats. It really will help your hormonal health. Also, increase monounsaturated fats. These are avocados, olive oils, extra virgin olive oil, macadamia nuts, seeds, really important. Saturated fat may not be bad for most people. You just have to watch your cholesterol and see what happens. But grass-fed butter, ghee, coconut oil, actually saturated fat is the building block for your

Hormones, right? Your hormones are made out of fat. Also, you want to decrease the inflammatory fats, right? Trans fat, hydrogenated fat, margarine, even a lot of the vegan butters. They're actually not recognized as safe to eat anymore by the FDA, but they're still lurking on the grocery store shelves. So be religious about never eating them.

Also, you want to reduce your intake of vegetable oils, these refined, highly processed oils. You know, if they're cold-pressed, if they're organic, if they have high oleic levels, they may be okay. We need some, but the amount we're eating is just a pharmacologic dose. Sunflower, corn oil, canola oil, safflower oil, not so great.

Also stay away from processed meats stay away from like hot dogs stay away from weird processed cheeses I mean you should be there anyway, but Kraft singles and can't call it cheese because it's not more than 51% cheese That's just a bunch of chemicals obviously reduce your exposure to pesticides and and hormones and antibiotics that are stored in in in in some of these foods and you can use the clean 15 and Dirty dozen guide from the environmental working group to guide you on which are the least contaminated and

or the most contaminated foods, fruits and vegetables. So it's not always possible, but try to eat grass-fed and organic when possible. Fill it to your water. Also, support your gut. Really important to support your gut. Probiotic-rich foods are key. Things like sauerkraut, kimchi, miso, natto, which may taste weird, but it's actually really good for you.

And prebiotic foods also like asparagus, artichokes, jicama, and juice from artichokes, all great for your gut health. Don't eat within three hours of bedtime. Don't fast for too long. Actually can be problematic for women. And start your day with a nutrient-dense diet.

Food, right? Protein, fat, and fiber. Think protein, fat, and fiber. Not the typical breakfast. We have cereal, muffins, bagels, you know, sugared coffees. I mean, French toast, pancakes. I mean, the American breakfast is the worst. And you do not want to start your day with that. You want protein and fat and fiber for breakfast.

So you can have eggs, spinach, peppers, olives, maybe some feta cheese from sheep, an omelet with avocado, protein shake. And you also need potentially some supplements. A number of supplements have been shown to really help ease PMS symptoms because they improve metabolic health, hormonal metabolism. And here's the superstars.

Magnesium, glycinate, about 400 to 600 a day. Calcium is sometimes helpful. It's calcium citrate, about 600 a day. Vitamin B6, really important for estrogen metabolism, 50 to 100 milligrams a day. And folate, especially preformed folate,

form called methylfolate, about 800 micrograms a day. Vitamin B12 in the form of methylcobalamin, about 1,000 micrograms a day. And evening primrose oil, that works really well. Take 500 milligram capsules, one or two twice a day. Take fish oil, omega-3s, EPA, DHA, about 1,000 milligrams, one or two a day. Taurine, also really important for hormone metabolism. It's an amino acid, about 500 milligrams a day. Helps liver detox. And a good multivitamin. All these things work together.

And the good news is there's also a lot of herbs and phytochemicals that can really help

including chaseberry. Also vitex is known as vitex, but chaseberry fruit extract is very good for regulating menstrual cycles and helping with PMS. Milk thistle, dandelion root also is great. Certain isoflavones from soy, red clover, kudzu root help improve estrogen detoxification because they boost some of the metabolism enzymes that you need to properly regulate estrogen. And they can be taken as supplements or in the diet.

Also keeping your gut healthy, I do recommend probiotics to help normalize estrogen and hormone metabolism. Maybe five to 10 or even more billion organisms a day in a probiotic supplement. So you wanna make sure you really attend to your diet, your lifestyle, your sleep,

stress level, your microbiome, optimizing nutrition, taking the right herbal support, maybe a little progesterone that can help balance your hormones. And really we can help reduce this whole phenomena of estrogen dominance that's leading to so much of the suffering that women have around their periods, including PMS, heavy bleeding, clots and mood changes and migraines and you name it. Now remember, women are not defective.

PMS is not a natural condition of being female. You can thrive and be healthy by paying attention to a few natural laws of biology and don't need drugs to survive. You just have to learn how to balance your hormones with some simple changes in your diet, lifestyle, and supplements.

Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at DrMarkHyman. And we'll see you next time on The Doctor's Pharmacy.

I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more. And now you can have access to all of this information by signing up for my free MarksPix newsletter at drhyman.com forward slash MarksPix. I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey and I hope they'll help you too. Again, that's drhyman.com forward slash MarksPix. Thank you again and we'll see you next time on The Doctor's Pharmacist.

This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions, and neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional.

This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center in Lenox, Massachusetts. Just go to ultrawellnesscenter.com. If you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.