Dr. de Castro
Painful Periods...Read this!
Period pain. Seems to be synonymous with being a women, or person with a uterus
But what if I told you that there's a normal level of discomfort...and then there is something beyond that.
Something a lot of women feel and think is NORMAL...when it isn't.
That thing is call PMDD, different than PMS but a sister to it in a way. Let's dive in to what they both are, why they happen and how we can deal with them.

Now little story time, I believe I've had PMDD most of my life, but I've never been fully diagnosed with it. Since I now have a combination of fibroids, endometriosis and PCOS, it's hard to pick apart where my symptoms are coming from, since they all overlap so much. But growing up, from my first period at about 10, they were heavy, crampy and MISERABLE
First, let's talk PMS, or Premenstrual Syndrome. This is a syndrome (or collection of symptoms) that describes the psychological, emotional and physical symptoms that may occur during your luteal phase, or the phase right before your actual period. This can be anywhere from a day before your bleeding starts to the 2 weeks prior. Most women have some level of these symptoms, with varying levels of intensity.
PMS symptoms can include:
Low mood
anxiety
mood swings
irritability
bloating
fatigue
headaches
breast pain/tenderness
brain fog
decreased libidio
Cramping
Low back pain
Pelvic pain
Headaches/migraines
Now WHY does this happen? We think its due to the fluctuation of estrogen and progesterone that naturally happens during your cycle. We don't know EXACTLY what causes PMS but the thought is that there is increased sensitivity to progesterone, or some interaction between our sex hormones and some neurotransmitters like serotonin and GABA.
That being said, women who have had a hysterectomy, ablation, are on an IUD or similar circumstances where the ovaries are still functioning, you can still get PMS withOUT having a period follow it. Certain birth controls and medication with progesterone can also cause similar symptoms.
Now diagnosis is...subjective. It's typically based on reports of symptoms, looking for timing and repetition of these issues. You can go a little further and basically induce temporary menopause to see if that stops the symptoms...buuuuuut that's a bit extreme in most cases.
How do we manage this?
The western medicine approach is typically to hand you some birth control pills or put in an IUD. But a word of caution, there are risks with birth control that don't get discussed in many cases, so make sure you are INFORMED before making that decision. Other medications like Danazole for breast pain and Spironolactone for bloating may be recommended, but again, make sure you fully understand ANY medication you're taking.
Now let's talk NATURAL management
Diet changes may be beneficial, especially if you are leaning estrogen dominant which can make PMS symptoms worse (getting your hormones tested can help figure this out). Lowering sugar, refined carbs, and caffeine may help with symptoms. Also looking at increasing fibre rich foods, healthy fats and of course...your veggies!
Stress is another large component of PMS symptoms. Managing stress by increasing time in nature, breath work, meditating and making time for the things you enjoy are key

Daily movement can help manage hormones staying in balance (within reason. Crazy, extreme forms of anything can have negative effects too). Going for a daily walk, adding a yoga practice once a week and lifting weight 2 or 3 days a week can make a MASSIVE improvement in your health and PMS symptoms.
Some supplements and remedies that can help PMS include
Magnesium - great for cramps and may help with sleep
Fiber - this helps keep your bowels moving, which helps detox extra estrogen from your body. Aim for at LEAST 25g/day
Supplements containing things like broccoli seed extract, DIM, B Vitamins and other nutrients can help support. Be sure to discuss with your provider before starting anything new
Turmeric - helps with inflammation
Now every woman is different. Every case is different, there are some general guidelines to help educate yourself. And if you have severe forms of this, to the point that it impacts your life severely, then we need to look at the PMDD diagnosis or Premenstrual Dysphoric Disorder. This is like taking PMS and turning the dial to 29384729835792. You can work with the same recommendations above, but finding a holistic provider like a naturopath or functional medicine practitioner may be the way to go.
Hope some of this information helps you make informed decisions about your health, advocate for yourself, and live your most blissful life!
In joy and happiness,
Dr. Samantha de Castro DC, BKin
DISCLAIMER: This information is intended to be educational, NOT medical advice. Always communicate with your health care professional about your health when making changes.
Dr. Samantha De Castro is a licensed chiropractor and doctor of chiropractic, but she is not YOUR chiropractor. She can not diagnose you. This does not replace being seen by your own health care provider. This information should not be used too self-diagnose or self-treat. This is informational ONLY and we do not accept responsibility for any outcomes.