Last month I discussed PMS, which is caused by a mismatch between your estrogen and progesterone. During the first half of your cycle, estrogen stimulates the growth of the uterine lining and wall, as well as your breast tissue. During the second half of your cycle, after ovulation, your ovaries produce enough progesterone to offset the effects of estrogen. This prevents continued growth of your uterine lining and wall and breast tissue so that when your period begins, you have normal flow and no cramping and no breast tenderness and emotional dysregulation the week before. This also helps prevent increased risk for endometriosis, fibroids, fibrocystic breast disease, and breast and uterine cancers.

 

But, if you have PMS, your ovaries produce less progesterone than estrogen during the second half of your cycle, causing PMS symptoms and increasing the above risks. This imbalance, called Estrogen Dominance, is the root cause of PMS. Because you are low in progesterone, the ideal treatment is progesterone—completely bioidentical to your own progesterone, and which is an extract from yams.

 

A recent article states “combined estrogen and progestin oral contraceptives, as well as progestin-only preparations (oral contraceptives, implants or injections) are widely used for contraception, but they are also indicated in menorrhagia, endometriosis, acne and hirsutism, fibroid uterus and premenstrual syndrome. However, they have been associated with high rates of cardiovascular events, venous thromboembolic disease, ischemic strokes and breast cancer.” Progestins (non-bioidentical forms of synthetically altered progesterone) are also known to cause emotional dysregulation. Most of the conditions for which oral contraceptives are used, other than birth control, can more safely be treated with bioidentical progesterone.

 

Most patients who come to St. Pete Health & Wellness with women’s health issues have seen another doctor first and been treated with birth control pills (BCP)—because that, unfortunately, is the standard of care. They come because they are not happy with that treatment choice, or it isn’t working adequately, or it is causing other problematic symptoms. They state they have not been offered bioidentical progesterone and have not been informed of the associated risks and side effects. If you want birth control pills as your form of birth control and are informed of the alternative forms and the risks, that is one thing. But if you have PMS, you can now see that bioidentical progesterone is not only the safest treatment, but also helps reduce the risk for multiple other women’s health issues.

 

Topical progesterone may be sufficient to treat some of your PMS symptoms, but for more severe symptoms—especially emotional dysregulation—oral progesterone can be much more effective. If your emotional dysregulation is the most severe of your symptoms and starts at ovulation and lasts through the beginning of your period, you may have Premenstrual Dysphoric Disorder (PMDD), which is not the same as PMS as it has a different cause. You do not want progesterone as it will make PMDD worse.

 

If you have PMS, you don’t need to. If you have PMS, you are at risk for other women’s health issues. If you have PMS, you don’t need to take the risks associated with BCPs unless you also want this form of birth control. Call St. Petersburg Health & Wellness to safely stop your PMS symptoms and prevent future health issues.