Many people are aware of some of the symptoms that PMS can cause, but PMDD, a subtype of PMS that can cause symptoms of strong anxiety and depression, is something that is less well known. It can cause symptoms which can have a debilitating effect on your mental health, and this can last for the entire second half of your menstrual cycle.

If you experience PMDD or believe you may, please reach out because this condition is something which can be helped.

If you have not had a chance to listen yet you can find the PMS podcast here.

PMS and PMDD – Podcast Interview with Lisa Costa Bir

About PMDD.

Premenstrual dysphoric disorder (PMDD) is similar to premenstrual syndrome (PMS) however PMDD symptoms are more severe compared to PMS. PMDD is associated with mood swings, anxiety, depression, low motivation and even suicidal thoughts. It is also very common for PMDD sufferers to experience relationship and work issues due to their severe symptoms.

If you experience PMDD it likely indicates that there is a deep underlying hormonal imbalance occurring in your body which is causing you to experience an emotional rollercoaster. This lasts during the time period of anywhere from post ovulation (typically day 14) to the first 2-3 days of bleeding – this means it can be two weeks of the months experiencing a completely different emotional state.

PMDD may leave you with altered emotions but there are some techniques which will help to equip yourself with self-care and wellness tools to empower and soothe.

Related: Managing PMS and PMDD with Mindfulness
Related: Natural ways to treat PMS

Self-care tips for processing PMDD feelings:

1. Practice Mindfulness

Feeling governed by your emotions during PMDD time and unable to focus? Practicing mindfulness will help you to ground down into the present moment with compassion and non-judgement. Next time you are feeling overwhelmed take a moment to sit down, close your eyes and scan your body from head to toe noticing any sensations that arise. Paying attention to your body will help you to become more aware of what is happening in the present moment as well as the ability to observe the changing nature of sensations.

2. Meditation

PMDD can lead to feelings of being scattered and spacey in the mind. In meditation, focusing on the breath will help you anchor into the present moment with a sense of being more grounded and cognitively clear.

3. Gentle Yoga Practice

Gentle forms of yoga such as yin yoga works primarily on stimulating your parasympathetic nervous system (rest and digest) to allow your mind and body to slow down into a state of relaxation. Yin yoga is a form of mindfulness that holds poses for 3-7 minutes, inviting the space to find stillness within the chaotic storm that you may be feeling during this time.

4. Earthing

To ground your energy when you are feeling restless or emotional, connect to nature by going outside, take your shoes off and touch your feet on the bare earth- this is known as Earthing. Studies have shown that this technique also helps to settle the mind by activating your parasympathetic nervous system.

5. Journaling

Journaling is a healthy way to express how you are feeling during the time of PMDD, as it can be really beneficial in clearing your ruminating thoughts and feelings. Studies have shown that this technique helps to reduce stress and manage anxiety as well as depression. Journaling can help you to become more aware of how you are feeling as well as identify negative thoughts. This holds space for you to then work on a plan for resolving problems and strengthen compassionate self-talk. Set aside a few minutes a day to write down what ever feels right- you have full creative permission in your journaling practice.

6. Gratitude list

Practice gratitude when you are feeling low in mood by writing a list of 10 things that you are grateful for in your life. Studies have shown that practicing gratitude on a daily basis helps to increase psychological well being by enhancing our positive emotions. Additionally practicing gratitude helps to boost social relationships and increases social support systems for individuals. This is very beneficial for people experiencing PMDD due to their mood affecting their relationships.

7. Epsom salt bath

Do you feel tense in your body? Treat yourself to a nourishing Epsom salt bath with a couple of drops of lavender essential oil to promote relaxation and inner serenity. Bathing in Epsom salts (magnesium sulphate) is therapeutic for PMDD as it helps to stabilise your mood as well as relieve stress, depression and anxiety.

8. Talk to someone

When you are feeling low in mood, stressed or perhaps out of control with your emotions- reach out and speak to a friend, family member or health practitioner. Remember that you are not alone, hormonal imbalance is very real and your wellbeing is a priority.

The post PMDD: Processing Feelings appeared first on Alison Mitchell Naturopath.

Do you recognise that your emotions surrounding your menstrual cycle are heightened? Do you feel inner tension and find that strong emotional feelings impact your day-to-day work and personal relationships? This may indicate a deeper underlying hormonal imbalance known as premenstrual dysphoric disorder (PMDD).

PMDD is similar to premenstrual syndrome (PMS) however, PMDD symptoms are more severe compared to PMS as it includes depression, anxiety, irritability and mood swings.

Due to falling hormone levels post ovulation, PMDD symptoms usually starts 1-2 weeks prior to your period and may end 2-3 days after your period begins. For each woman this is different, it may be from as soon as ovulation occurs or may be a few days before the period.

Symptoms of PMDD:

• Feeling tense
• Feelings of anxiety
• Panic attacks
• Feelings of sadness
• Feelings of despair of even suicidal thoughts
• Irritability or anger that lasts and affects others around you
• Mood swings- you may find that you cry a lot during this time
• Lack of motivation in usual activities
• Lack of interest in relationships
• “Out of control” feelings
• Fatigue
• Sleeping difficulties
• Difficult concentrating
• Food cravings
• Binge eating
• Physical symptoms include: breast tenderness, cramps, bloating,
• headaches, joint and muscular pain (note that PMDD diagnosis must
• include the presence of mood/anxiety symptoms)
• Symptoms that interfere with work, school, activities and relationships

If you identify yourself experiencing at least five of these symptoms that begin 1-2 weeks before your period and improve within the 2-3 days after your period begins then you may be experiencing PMDD! There are many options available for managing PMDD and an effective tool for managing emotional feelings during this time is mindfulness!

So what is Mindfulness?

Mindfulness is currently a hot topic due to its many positive benefits in managing difficult emotions and situations in our lives.

Jon Kabat-Zinn, the father of Mindfulness in the western world has defined mindfulness as

“The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally”.

Jon Kabat-Zinn

Mindfulness techniques can help you to feel a sense of freedom from being reactive to thoughts, feelings and situational events- empowering you to respond rather than being controlled by your emotions.

5 Mindfulness Tips to manage emotional feelings during PMDD:

1. Awareness of breath:

The breath is a powerful tool to help you have a sense of control when you are feeling strong emotions. When feeling irritated, upset or angry with someone, take a moment to take 5 deep mindful breaths. This will help to calm down your sympathetic (fight or flight) nervous system state in order to help you to feel grounded and in a better position to respond rather than react (avoiding escalation).

2. Body Scan:

When you are feeling overwhelmed by strong feelings, take a moment to sit down, close your eyes and scan your body from head to toe noticing any sensations that arise. Paying attention to your body will help you to become more aware of what is happening in the present moment as well as the ability to observe the changing nature of sensations.

3. Awareness of thoughts and feelings:

Feeling out of control? Take a moment to observe your thoughts and feelings. Empowerment will arise as you build awareness and gain insight into the context behind your thoughts and feelings. As the observer you are allowing yourself the space to reflect, find perspective and better respond to situations rather than being reactive.

4. Practising non-judgement:

Avoid judging and criticising yourself during this time as this will only perpetuate a negative mindset. Instead become the non-judgemental observer that views and accept your feelings and emotions during this time, knowing with inner wisdom that they are impermanent and will pass.

5. Self compassion:

Mindful self-compassion is important during a time of heightened emotions; we are all part of the human condition and deserve compassion. When you are feeling overwhelmed validate your emotions and recognise your immense inner strength. Allow reflection and acknowledge that you are not defined by your emotions, they are transient and you are worthy of self-love.

Listen to the PMS and PMDD podcast here

The post Managing PMDD with Mindfulness appeared first on Alison Mitchell Naturopath.

Guts and Girl Bits Podcast Episode #44

While PMS may be common it is not ‘normal’ and can be a sign of deeper hormonal imbalances. PMS can express in different ways (there are 150 different type of signs and symptoms that can be attributed to PMS) and one of the more severe forms of this is PMDD (Premenstrual dysphoric disorder).

While up to 80% of women experience symptoms of PMS, 8% of women experience a more severe type of PMS called PMDD which usually starts occurring straight after ovulation (yep, these women often experience 14 days of severe mood symptoms such as aggression, hostility, paranoia, anxiety and depression ).

PMS is a condition that can respond so beautifully to natural treatments, so I am so very excited to share this episode with you.
I am also releasing this episode in April which is PMS awareness month. Please share this with anyone who you feel would benefit from learning how PMS and PMDD is something that should not be dismissed, and what they may be able to do to support it naturally

In this podcast episode naturopath Lisa Costa Bir shares her knowledge on how to nourish your hormones and to address the driving factors that cause PMS and we dive deep into PMDD.

The Podcast

Have a listen here or on the embedded player below:

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Get in touch with Lisa…

Lisa is a leading Naturopath in the Sutherland Shire. Lisa strives to show her clients that good health is not be simply the absence of disease but rather a state where they find mental, physical and spiritual balance in all aspects of their life.

Lisa is also a lecturer and clinical supervisor at Endeavour College of Natural Therapies where she mentors students completing degrees in Nutrition and Naturopathy and has  taught nutrition to dancers at ED5 performing Arts School.

• https://www.lisacostabirnaturopath.com
• 0404 070 142
• lisa@lisacostabirnaturopath.com

Check out previous podcasts that have featured Lisa here:

• Thyroid Health
• Ayurvedic Medicine
• How to lose weight without changing your diet (much)
• Adrenal fatigue (part 1)
• Adrenal fatigue (part 2)

Podcast Transcript

Alison Mitchell 0:08
Hi everyone, you’re listening to Guts and Girl Bits. I’m Alison Mitchell a practicing naturopath and I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is eneral and does not replace consulting with your practitioner.

Hi, everyone, welcome to Guts and girl bits. Today I’m joined with Lisa Costa Bir – naturopath extraordinaire. She is known as the thyroid queen in many circles, but in this episode, we’re going to be talking about PMS, particularly PMS in the way that it affects mood and mental function as well. Thank you so much for joining us.

Lisa Costa Bir 0:53
Thanks for having me back again.

Alison Mitchell 0:56
If you didn’t catch it in previous episodes, Lisa came on and talked about thyroid health and Adrenal Exhaustion as well. So those were some really good episodes if you wanted to jump back on and have a listen to those. But PMS, it’s an interesting topic. Do you see a lot of that in clinic?

Lisa Costa Bir 1:13
I do. I see loads of it, I think is something that a lot of women suffer with, but just think that it’s normal.

Alison Mitchell 1:22
Yeah, they just have to put up with it.

Lisa Costa Bir 1:24
Hmm, yeah.

Alison Mitchell 1:25
And it’s something that you’ve had a bit of in your own personal journey.

Lisa Costa Bir 1:28
Oh I’m the PMS queen. So anyone that’s ever lived with me, my Mum, Dad, partners can definitely attest to the fact that I have made them suffer with my PMS, but I’ve I found that using naturopathic strategies in particular looking at thyroid and serotonin to be instrumental in helping me manage my own PMS. So I’m very passionate about helping other women because It is definitely something that can get better. And so women don’t have to dread their luteal phase. And for some women, it is literally from the point that they ovulate day, say that’s your day 14 that they suffer for two weeks out of every month. And you know, that’s half half the month.

Alison Mitchell 2:19
So they don’t had to dread that

Lisa Costa Bir 2:24
They don’t, and neither do their families.

Alison Mitchell 2:29
So the phases of a cycle. So there’s the two the two main phases, then you’ve got your follicular phase, the first half, and say average person wins the 28 day cycle that’s between days and then the second half is you luteal phase which is after ovulation. That’s also generally 14 days, but everyone’s so different. 28 days is just like a number that’s been put out there. Like I mean, the cycle could be 26 to 35 days and just be totally comfortable for you. It really just depends on you know how It’s affecting you if you’re getting any symptoms as well.

Lisa Costa Bir 3:02
Yeah, that’s really good to clarify because I have had patients say to me, I don’t have a 28 days cycle, you know, 30 days a day stressing out because it is 30 days, but that’s, that’s completely normal to me.

Alison Mitchell 3:14
Yeah, yeah, that’s it. The 28 days is a number that’s been brought by pill companies. Yeah. Okay. So Pms is typically it’s in that in that luteal phase.

Lisa Costa Bir 3:26
Exactly. You know, if you’re, if you’ve got mood issues, or breast tendonitis, or you know, backache or anything like that, and it’s day 13 that’s not really it’s not classified as pms.

Alison Mitchell 3:39
No, that would be ovulation symptoms or something else. Yeah. Okay. All right. So what are the main symptoms of PMS, and are the different types of symptoms you can get?

Lisa Costa Bir 3:48
So I think there’s over 150 different signs and symptoms associated with it. So there’s loads of them and every woman’s presentation is a little bit different, but generally Send them out more common things on slack mood or anxiety or irritability, bloating, pain dysmenorrhea. So, like back pain or cramping, breast tenderness, fluid retention, cravings, we could go on and on.

Alison Mitchell 4:18
So many Yeah. And because it is so many symptoms, it has been broken down into categories as well. So we’ve got PMS, a PMS anxiety, which is where you’ve got your typical sort of anxiety symptoms and, and more worrying and feeling like you want to be more introverted, and then PMS C which is why you’ve got your food cravings. And then you tend to get that what’s called hyper hydration in that period as well where you get more breast engorgement, fluid retention and bloating. And there is PMS D, which is like more mild experience of depression and then PMDD Which is what we’re going to be talking a bit more about in this session today to talk about that. Sure.

Lisa Costa Bir 5:05
So that relates to premenstrual dysmorphic disorder or more severe ball of pms. About 6% of women experienced premenstrual dysmorphic disorder. So just a heightened mood symptoms much flatter in terms of the mood more melancholy or more irritable, more sensitive, more paranoid, completely different to how that patient maybe is in follicular phase and so they notice a difference but they don’t really understand why am I having this heightened mood responses just, it can really impact their relationships can impact their jobs. I’ve had a patient that just kept cycling through job after job after job because she was very aggressive and at conflict with all her colleagues, but only in the luteal phase. They found it very difficult to deal with and she recognized I’ve got a problem but I don’t know. I don’t know what happens to me every every month i turn into this raging, another person that I don’t recognize and I don’t know how to stop it. So it can be very distressing to for an individual where they know this isn’t my normal self, but I can’t seem to stop myself from being like this.

Alison Mitchell 6:16
Yeah, it’s like they’ve got this little person comes out takes control, little devil. Yeah.

Lisa Costa Bir 6:23
So, you know the sleep may also be affected sluggishness not wanting to be interacting with others tools that can be that social isolation and are very sensitive.

Alison Mitchell 6:37
which I think that it is fairly normal and then stage before you get periods to be a bit more introverted, but when it’s actually affecting your quality of life and you know, your ability to interact with people in that it’s completely different.

Lisa Costa Bir 6:51
And especially if it’s happening, you know, 10 days before you actually get your period and it’s gone on for that amount of time for a lot of people. If it happens one or two days before they have the blade. It’s not so much of an issue, but 10-14 days that’s a really long time, isn’t it to suffer?

Alison Mitchell 7:10
Do you think that there are other things that influence a woman’s susceptibility to experiencing PMS?

Lisa Costa Bir 7:15
Absolutely. I have no doubt that if a woman has experienced stress, it comes up again and again and again. But where a woman is juggling a lot. In the weeks prior to menstruation, I often find that pms is far worse. And I see this all the time I see myself, but I see it with students, for example, but during semester time students that patients of mine during the semester time because they’re juggling quite a lot in terms of their workload, maybe they’re working and all the rest of it and they’re putting that pressure on themselves. menstruation, or PMS is more profound. And then over the holidays or Christmas and someone if they’re quite relaxed, they get their period. They come like oh, who knew it was coming? Just because they’ve been getting more sleep. They’re, they’re more relaxed. So I feel like that poor stress adaption definitely causes the female hormones to go a little bit out of whack. Yeah. Which makes sense, right?

Alison Mitchell 8:16
Yeah. So if you’re at a stage in your life where you’re more stress, so be that, you know, going through HSC as a young person, or dealing with toddlers ors teenagers, yeah. Oh, yeah, flee. Yeah.

Lisa Costa Bir 8:31
And I think that’s because we’re, we’re juggling a lot. Apart from cortisol, the stress hormones, it’s probably depleting nutrients like magnesium and B vitamins, which is so important for hormone balance. We won’t be getting enough sleep this multiple factors. Yeah, sure. Okay.

Alison Mitchell 8:50
So what’s actually what’s actually happening in the body when people are going through PMS?

Lisa Costa Bir 8:56
I think there’s lots of things happening differently. We’re seeing sensitivity with hormones with oestrogen and progesterone. If we’re thinking about what happens in that luteal phase, when most women are getting that exacerbation, we’re seeing fluctuations with oestrogen and progesterone. So that definitely impacts mood cravings and bloating and all that sort of stuff. But we’re also seeing dysregulation with neurotransmitters, such as serotonin and GABA and serotonin is the one that’s really studied in most detail, and we see that the dropping with estrogen, estrogen is neuro active so it it actually is involved in serotonin pathways. There’s some studies show that with the decline in oestrogen that occurs in that luteal phase, we also see fluctuations and really a drop in serotonin and that’s a big driver of the mood disturbance. Definitely have cravings and things like that. Yeah, for sure. And so in building upon that in conventional medicine, they’ve they’ve really understand that and that’s why antidepressants are actually the number one medication used to manage premenstrual dysmorphic disorder. Because they understand that serotonin has up to large, has a large part to play.

Alison Mitchell 10:19
I mean, I understand why that is used by when naturopaths and our naturopathic philosophy, – Tolle causum – cause is to treat the cause. And when you’re just addressing the serotonin directly, it’s not really getting to the underlying cause. I mean, everything has its place. But for us, we’ve got a very different treatment approach. No, definitely. Yeah. So, so obviously, like we know that using anti-depressants is going to be working on the neurotransmitters. So for PMS, pmdd. That’s going to be quite indicated for that but other forms of PMS often the oral contraceptive pill is recommended. And for my understanding one of those reasons is because it’s actually basically phasing out our own hormones and inhibiting ovulation. So you know, natural cycle, we’ve got estrogen coming up high high until ovulation, and then that will actually drop down. And then progesterone, which is released from the corpus luteum, which is the shell of our oocyte, that’s going to be then gradually taking that, that whole place there. So the relationship between the oestrogenand progesterone should be a fairly smooth inverse. But what can happen is that if we are stressed or other hormonal factors are at play, like you said your thyroid function, then that ovulation is not going to be strong enough that corpus luteum is basically going to be a little bit sloppy, instead of these nice source of progesterone. And so then, the dropping of that means that estrogen and the progesterone tend to wobble a little bit in relationship to each other. And then the pill basically stops ovulation from happening. It just supplies synthetic hormones. So theoretically, you’re getting these synthetic hormones in replacement, so you don’t get the symptoms as a result of the other hormonal fluctuations.

Lisa Costa Bir 12:18
And I think the big thing there is that was your own supply, you do get those fluctuations because the hormones are changing, you know, every day really, in particular, if you experiencing profound stresses or something like that, they’re they’ve got a wobbly pattern, but where you’re taking the pill, you’re getting that same amount. If it’s a monophasic pill, you’re getting that same amount every day. So, you know, you’re getting that stability, which, you know, is not necessarily what your body would normally be doing.

Alison Mitchell 12:51
We’re not creatures that are monophasic. There are biphasic pills, but I think that you know, there’s a lot of people out there Any sort of information like Lara Briden and other people who talk about how ovulation is actually key to a woman’s general health and well being in terms of our mental health and our general inflammation load and our immune health and our digestive health and musculoskeletal health and cognitive function, you know, we need to ovulate for that to happen. So even though it is an option, it’s not something that like Personally, I think, is that great. Yeah, no, I think I think there’s places for it but in PMS naturopathic stuff can be like, very good. Yeah. As we’ll talk about, Mm hmm.

So then what happens then when you’re on the pill, and you still getting PMS?

Lisa Costa Bir 13:44
So if that’s really unfortunate, if you’re on the pill and you’re still getting PMS, it pretty much means that you’re on the wrong pill for you. So with patients like that, I would say, you know, sometimes patients want to take the pill for contraceptive, for contraception. That’s fine, or because they got endometriosis or something like that. Yeah. So we just need to change the pill, and maybe choose one that has the strength that’s more appropriate for that individual. Or we’re looking at other we were looking at herbal options I use Saffron a lot in my clinic, which actually works on that serotonin pathway. So if the period has just occurred because of those changes in serotonin, that’s, I think that’s really useful to us.

Alison Mitchell 14:34
Yeah, so there’s always going to be times when women do want to be on the pill, and that’s fine, if that’s what they want to do. So that we know that we’ve got some options to treat it on top of that. And I know you love your Saffron,

Lisa Costa Bir 14:44
I love Saffron it’s changed my life and so many of my patients,

Alison Mitchell 14:49
yes, yeah. Yes. I’ve had similar experiences with my patients too. And we’ll talk about that when we talk about our herbs bit. Yeah. But before Herbs lets get into diet. Hmm. So there’s just a general protocol that you generally recommend for people preparedness isn’t there?

Lisa Costa Bir 15:09
Yeah, I mean look in my clinic pretty much everyone gets very similar diet anyway. whole food diets are very nutrient dense. Lots of fruit and veggies. I think the recommendations for two fruits and five veggies is a little bit ridiculous. I’m aiming for much higher and I think the latest research anyway coming out on cardiovascular health is suggesting 10. So I’m not getting my patients to measure or anything like that, but try to get as much variety as possible. And you know, your two fruits and veggies should really just be in your entree breakfast, trying to spread them out throughout the day and have as many as possible. The more fruits and veggies we have, the more nutrients we’re getting, which is going to be beneficial for PMS and reducing inflammation and oxidative stress. Adequate protein is also really, really important and the big thing to me is adequate carbohydrates, which is where I find all of my patients actually falling down. They not eating enough of the right carbohydrates. Yeah. Particularly in that week before they get their period because they’re feeling maybe bloated or they’ve got a bit of a distorted feeling about how they look and because of those changes that are occurring with the low oestrogen and serotonin, which affect our perception of ourselves. So our relation with the higher estrogen and steroid hormones, women might pass the window and think, oh, look at me. I’m fantastic. And in the luteal phase, literally a week later, walking past that same window and just thinking oh my god, look at me I look terrible or whatever. And literally, not much has changed except for changing the hormones and neurotransmitters as a result of what’s happening.

Alison Mitchell 16:53
It’s fascinating, isn’t it? Yeah, really does change the way you view yourself. Like I always like put the When I’m describing it to my patients I say, oestrogen is like your go getter friend. She’s like you’ve got this girl you just honestly just chill out. Definitely, yeah, if you’ve got high oestrogen, you tend to be a bit more vivacious and have more body confidence, but then when that drops down the lack of that support, so yeah, that’s, that’s interesting.

Lisa Costa Bir 17:22
It’s really interesting. So, you know, a lot of people, a lot of women, because they’re feeling a bit more retained more fluid or whatever, they reduce their carbohydrate intake, but really in the luteal phase, that’s when you probably need to be upping your carbohydrate. If you are someone that suffers from low fat flat mood and that lack of motivator it’s particularly in that week before they get their period because they’re feeling maybe bloated or they’ve got a bit of a distorted feeling about how they look and because of those changes that are occurring with the location and serotonin which affect her perception. ourselves. So our relation with the higher estrogen and storage of hormones, women might pass their window and think oh, look at me. I’m fantastic. And in the luteal phase, literally a week later we’ll pass that same window and just thinking oh my god, look at me I look terrible or whatever and literally not much has changed except for changing the hormones and neurotransmitters as a result of what’s happening to us and they really does change the way you view yourself. I always like put when I’m describing it to my patients I say oestrogen is like your go getter friend. She’s like you’ve got this girl you look great. Yeah, and progesterone is like just just chill out and take a rest Yeah, if you’ve got high oestrogen tend to be a bit more vivacious and have more body confidence, but then when that drops down, the lack of that support. So yeah, that’s, that’s interesting.

It’s really interesting. So You know a lot of people, a lot of women, because they’re feeling a bit more retained more fluid or whatever, they reduce their carbohydrate intake. But really in the luteal phase, that’s when you probably need to be upping your carbohydrate if you are someone that suffers from more of that flat mood and that lack of motivation, because carbohydrate intake actually increases serotonin. So that lowered serotonin is driving a lot of those mood symptoms. So that you know, the last thing we want to do is restrict the carbohydrate, the more the serotonin even more. So I find actually increasing carbohydrate intake in the luteal phase is actually really important. And that insatiable hunger that a lot of women experience with payments in that week before is also there’s a lot of research suggesting that due to low serotonin as well, yeah, that’s so interesting.

Alison Mitchell 19:55
So the sorts of carbohydrates you’d be suggesting for people to increase more often Not like you know your hot chips and cereal.

Lisa Costa Bir 20:03
Quite the opposite of course. So lots of fruit. I’m big on fruit, potatoes, maybe not the white potatoes, but we get so many beautiful, different colored potatoes to bake those, etc. Rice, I’m a huge fan of good quality breads so sourdoughs for example, all of those really lovely carbohydrates that are quite nutritious, quite grounding, which is what a lot of people actually need in that week before they’re be a bit kind of Space Cadet ish. Yeah, and that’s also because of that lowered estrogen issues really, really important for cognition. And as it drops in that luteal phase, a lot of women feel a bit spacey and you know ‘where are my keys oh i cant remember and where this…’ and so ensuring that you’ve got adequate carbohydrates is actually really good. Yeah, I think I read a study. This has to do with pair of unicorns but when a student drops in that perimenopausal period serotonin drops by 50% so the same would be probably true of that pms in that luteal phase with oestrogen dropping. serotonin drops substantially if you think about it. Yeah, perspective.

Alison Mitchell 21:22
Yeah, that’s so interesting. Okay, what about things like nutrients?

Lisa Costa Bir 21:29
So yeah, this I love a good B vitamin. I’m on a good B complex. I love magnesium, too. But the one a lot of people don’t know about, which I found to be really, really useful is calcium. So calcium levels dropped dramatically in the week before menstruation and there’s some good research showing that a thousand milligrams, so quite a large amount actually helps with a lot of the mood symptoms. So irritability, anxiety, flat mood. etc, which is quite good, isn’t it?

Alison Mitchell 22:02
Yeah, that’s really good. But yeah, everyone’s all about the magnesium they are which I mean, we need. Yeah, we need a lot. We need a lot more than that too we need the calcium. Yeah. Because they work hand in hand.

Lisa Costa Bir 22:14
Yes, please. So using maybe a product that has both of them would be the best. Yes. Okay.

Alison Mitchell 22:22
You want to talk about herbs?

Lisa Costa Bir 22:25
Okay. If you insist.

Alison Mitchell 22:29
Okay. Shall we start with Saffron?

Lisa Costa Bir 22:32
Okay. I love Saffron. I just think it’s so so useful. And the research shows that you know, it’s on par there with a lot of antidepressants too. So and you know, it can be taken with some antidepressants as well. So it’s quite, it’s quite a useful one. It is very expensive, but really, really worth it. You don’t use it much. Now you’re not using a lot at all. Use if it’s just plain old PMS, maybe 10 mls a week, and if it is premenstrual dysmorphic disorder, up to 15, and maybe even combine it with St. John’s Wort if they’re not on the pill. Yeah. And I find that so useful and I’ve had patients that have come and see me for premenstrual dysphoric disorder that pretty much spend all their luteal phase on the couch can’t work can’t look after their children like some people who have very, very severe symptoms, and they have just had such great results and not have not experienced any of that. And that’s within a cycle. The research does show saffron from being useful premenstrual dysmorphic disorder, the best results we’re seen in s.. were taking it for about four months. But in my clinical experience, I see people noticing a difference with by that next cycle. I find that was very, very quickly. We didn’t feed him.

Alison Mitchell 23:57
Yep, I would say that. my clinical experiences similar like that often, I’m combining it with other herbal nervines. But it’s usually fairly quick in terms of its action. And, and the interesting thing about the way that it works within the three months is because then that is suggesting that it is actually impacting on the hormonal level as well. Because then that’s like your, like your longer stage of your oocyte formation and recruitment.

Lisa Costa Bir 24:24
Interesting, interesting.

Alison Mitchell 24:26
So I guess that’ll probably be something to keep your eye on.

Lisa Costa Bir 24:29
Definitely. There are some like for me, I will only use it generally in the luteal phase too. So, you know, for my patients, I tend to put it in the big 500 ml bottle because it gets kind of tricky to have to take two different types of herbal formula, but it can just be taken in the luteal phase rather thanthroughout the cycle.

Alison Mitchell 24:53
saves money too. And because it is it’s such a… With the way that it’s harvested, it’s like this one little stand in a flower that has to be picked out by hand all these little tweezers and then the whole plant and it How much does it take to actually like make a tincture? So I guess environmentally It is better to use it less when when you can. Okay? I’m, I’m also a big fan of as you said St Johns wort, so particularly for when you’re feeling really irritable and sensitive to everything going on around you. And you know that when when you just can’t stand the slightest noise and you can stand the slight tough and you’re like “stop touching me”.

Lisa Costa Bir 25:40
or like stop chewing in front of me i can hear you crunching their apples.

Alison Mitchell 25:44
St John’s what is known as an antidepressant but it has so much more than that. Like traditionally it’s called a thymoleptic which means mood balancer. And like when you look at the traditional approach on it, it’s not Not just for people who are depressed. It’s also for just general people, irritability, irritable or anxious as well. But there is a caution obviously because it increases the CYP450 pathway through the liver of the drug metabolism. Yeah. So if you’re on the pill you can take stJohn’s wort sorry

Lisa Costa Bir 26:20
Unless Can you take the remotiv, that one’s okay.

Alison Mitchell 26:23
Yeah, yeah, they can, because that one’s a field of St Johns wort. And John’s while there doesn’t seem to have the hypercin or hyperforin or whichever constituent is being shown to be responsible for that pathway.

Lisa Costa Bir 26:37
Yeah, yep. So that one’s All right.

Alison Mitchell 26:39
Yeah. So that’s the Flordis one. Yeah. I also love dandelion leaf, when people tend to be their own foodie feeling as well. And dandelion works on the liver, and like a naturopathic approach as well as that, you know, you got to get your hormone clearance happening. Through your liver, you got to be detoxing. So while dandelion leaf is typically more of a diuretic compared to the dandelion root, it’s still have a little bit of an affinity for that. That detoxing action.

Lisa Costa Bir 27:14
I guess I love all the adaptogens for PMS too, Withania, rhodiola licorice, due to the fact that stress tends to make the PMS worse I find that they’re really really helpful. And before I started using Saffron, that’s pretty much what I used to use and get good results but it’s definitely elevated to another level. The other herb I find really, really useful is Chamomile actually for PMS This is a mild antidepressant which has been studied in PMS and shown to assist with mood, but it’s also fantastic as an antispasmodic. So quite good for that cramping that some women experienced too. is also a mild bitter. So it’s hitting a number of levels. Yes, yes. I like chamomile

Alison Mitchell 28:07
It’s nice. It’s anti inflammatory. It’s also mildly anti-andronergic,

so a few research papers showing its helpful in PCOS So I always put it in my PCOS formula, especially if there’s tension stress and gut issues. Yeah, lovely. It’s amazing. Yeah.

Lisa Costa Bir 28:11
oh i didn’t know that

Alison Mitchell 28:29
Okay, what about Vitex?

Lisa Costa Bir 28:31
Oh, you know what, I haven’t thought of Vitex at all, but I just thought of Vitex.

Alison Mitchell 28:37
Also known as Chaste Tree

Lisa Costa Bir 28:38
Yeah. So if there are issues with prolactin, then I’m always thinking about Vitex. Yes. And definitely there is that shorter luteal phase. Thinking about Vitex there too and as being very well studied for pms and so many women find it useful. I guess my only caution, I guess for listeners is that I find as lecturers we have I don’t know if you see this too, a lot of students just tend to go ‘oh female reproductive complaint- vitex’. Yeah. So I think we need to be really clear about how Vitex works and why we are prescribing it, not just using it for all female reproductive complaints. It is dopaminergic. So it actually decreases, it lowers prolactin via that mechanism, and high prolactin can cause a lot of issues. So it’s, it’s useful from that perspective. It is definitely not something I would use in isolation for a lot of the patients I see. And I mean, I’ve taken it myself and actually aggravated because I had other issues that were causing my PMS. So I think We always need to be very holistic and well rounded in our dispensive Herbs. Yeah, does that make sense?

Alison Mitchell 30:09
it does make sense. And I actually see a lot of people have self described Vitex because you know, it’s in the health food shop says on there. Yeah. And even has it on the label. Yeah. But there have been studies on it as Yeah. As as you said, like our understanding of it has developed. Sure. So it doesn’t, it’s not actually a progestogenic it’s a prolactin lowering herb. So the pathways are different. Yeah. How when we learnt it previously so it can’t be extrapolated to all PMS, basically.

Lisa Costa Bir 30:37
So we feel it’s so good that you pointed it out, because we said there’s more than 150 different signs and symptoms associated with periods. So Vitex is definitely not going to fix all 150 is such an individual thing.

Alison Mitchell 30:49
But I guess if you try it, maybe if you can afford a consult, then you’re essentially you’re investing your time and your health by self experimenting so you could experiment and you might find that it’s okay. And if you do find that you aggravate them stop, and then you know, you need to look at other aspects, you know, in other areas and, you know, eventually it will revert. And I actually aggravated on it too. So it’s interesting that we both did, because it took me about two months to go back to normal afterwards.

Okay. All right. Another herb i love it Vervain. So my students will know that I love vervain. It’s a bitter, it’s cooling. And it’s really good for reducing tension and irritability. So if you’re, you know, you’re a workaholic and you wound up and you’re tight and everything’s in your neck and your shoulders, then vervain is really good for you. So when you were a bit more, like angry and patient, that’s a personality. That’s me essentially. Yeah, that’s everyone. I think. Well, not really.

I always like to put that in mixes for PMS if they’ve got that sort of personality going on, which is you know, when when you’re a mom, I think in particular you’re working Mum. Yeah.

Lisa Costa Bir 32:11
Yeah, juggling.

Alison Mitchell 32:12
Like, will you just do the thing that I asked you to do. Yeah, yeah, that’s my kids at least. Not my patients.

Lisa Costa Bir 32:18
not your patients,

Alison Mitchell 32:19
no not my patients i’m talking about my kids.

Lisa Costa Bir 32:24
It’s challenging. I mean, I think a lot of women who express the same thing with what I saw yesterday two small children, and so put down and hard on herself because she’s losing patience and frustrated with her children. But when we look at what’s really going on, and she’s because she’s got one of those watches and her youngest ones, five months old, and she’s she’s getting five max five hours sleep a night. Breastfeeding having to look after the three year old tooth fairy. He’s at that stage of life where he’s trying to assert his independence. It’s full on, isn’t it?

Alison Mitchell 33:08
Yeah, yeah. Well you’ve been through that.

Lisa Costa Bir 33:12
Well, only one.

Alison Mitchell 33:13
but it changes desn’t it there’s all Yeah there’s always different…

Lisa Costa Bir 33:16
Eight’s a breeze to anyone who’s got children young guards. eight is so good. She’s so she’s just a little pal. We go out for dinner together. I think they become independent. Yeah. And so I still, you know, shout at her in the morning to put shoes on and everything but it’s so much easier. Yeah.

Alison Mitchell 33:38
But it’s it’s a common thing. Like I see a lot of patients say, I feel like I’m more snappy at my children. Like I’m more irritable with them and losing patience with my kids. You know, whether it’s sleep deprivation or just poor stress response or PMS. You know, it’s a common driver for people to start, like acting on their health

Lisa Costa Bir 33:57
Definitely. Yeah, yeah. So I think you You know it, the body’s telling us that something isn’t quite working. And we need a bit of extra support, because you can’t give up your children. Some, but I thanked my patient yesterday, there’s actually we try to work out how she can get more sleep and it doesn’t appear that it can happen. She hasn’t got any family to help her. So you know, it is it is what it is there were things that we can’t change. So we’re just going to work with that. And sometimes that just means the herbs and nutrients just to support that adaption to stress because, as I said to her yesterday, you know, maybe 100 years ago in the past 30 other women living in the household, helping breastfeed and wake up at night and it was a little bit different. So even though we’re modern women, maybe we have a little bit harder in some respects.

Alison Mitchell 34:57
Yeah, I mean, we do we do have a harder and But then we’ve also got a lot more built burdens on yourself physically without like hormonal disruptors. So yeah, that’s a whole other podcast. Yeah.

Lisa Costa Bir 35:10
So you know, women one to one, I’ve PMS and why they’re experiencing these symptoms. I think it’s kind of normal considering the juggling that a lot of women have to do.

Alison Mitchell 35:26
Yeah, it’s just our way of our body saying, you’re too much

Lisa Costa Bir 35:31
just chill out a little bit. Yeah. So often women need to do less and prioritize. What’s what can you know? Is the house gonna miss Themis? He will Oh, because it you clean it up it will be messy again tomorrow, or does it really matter if those clothes don’t get folded? For a month? What? Yeah, but you know what I mean? It’s it’s better just to get a bit more sleep.

Alison Mitchell 35:57
Yeah, you got to prioritize Just sort of like, delegate what doesn’t give you joy? As much as you can. Yeah, there is that if you if you find that like maybe your work gives you a little bit more joy, you could do an extra hour at work, get that income and then pay someone to do an hour of cleaning

Lisa Costa Bir 36:14
Yeah, I’m big on that. So I’m not a rich woman, but I do have a cleaner – hundred dollars he’s only coming once a month now. So that really equates to $25 a week, which for me is a massive Game Changer because I hate I hate cleaning the shower. I hate changing the linen and all that sort of stuff. So he’s well worth the money. You know, so I think it is about choosing. I’m gonna I would prefer to have him come in and do that for me and not go out for dinner. Yeah, you know, I’d rather put the money there. Yes, he’s helping my mental health

Alison Mitchell 36:48
If that’s important for you, then you find money from somewhere else. Or maybe you would rather do an extra couple of hours at clinic

Lisa Costa Bir 36:57
Yeah, definitely. Definitely. Yeah. Yeah, for sure. Yeah, they do what gives you joy? Hmm. Which is not which is not cleaning the bathroom.

Alison Mitchell 37:06
Yeah, I actually don’t mind cleaning but that’s kind of like a relaxed.. Okay, I like cleaning some some aspects I like doing my main stress relief is gardening,

Lisa Costa Bir 37:18
gardening some really good. And it’s funny that that you mentioned gardening because gardens have actually been found to be happier individual so they’ve actually found that there’s certain bacterias and microbes in the soil, which release serotonin and gardeners actually get those microbes on the skin. So it’s it’s all done that way they inhale them, which is really interesting. gardening is a recommendation for individuals with PMS in that it’s gonna work on multiple ways. They’re the soil and the microbiome, but also I find that when you’re out in the garden, you can’t it’s kind of like a forced meditation because you’re quite present when you’re there especially if you’ve got birds and trees and things like that. Can’t help engaging with all that and just slowing down naturally. So, a lot of the time release, sympathetic nervous activation, which disrupts the hormones, but when you’re gardening out in nature, we actually find that green spaces lots of research to show that it lowers/ regulates cortisol reduces anxiety. very beneficial I would say, yeah.

Alison Mitchell 38:27
And you’re literally earthing while you’re doing it now which would be reducing inflammation in the body?

Lisa Costa Bir 38:32
Yeah, yeah. And so I think there’s even studies on trees to secreting certain substances which are immune modulating too. Very clever outset the basis of naturopathic principle if you know nature is medicine.

Alison Mitchell 38:46
So the further we get away from nature, the more our body tells us that something goes wrong, and PMS is one of those ways that it’s telling us that, particularly for us, ladies,

Lisa Costa Bir 38:56
yeah, so common recommendation for me. We’ve talked a bit about the Herbs I’m really big on lifestyle things too. And often, people, women that have PMS are often doing a lot of things. And so we’re actually getting them to slow down and do less. So it might be just taking your shoes off at work and your socks and earthing, or going going out for a quick break to where there’s some green, some grass, sitting down there and taking the shoes and socks off. And it’s incredible, just that simple. tasks can just help you feel so much calmer and grounded.

Alison Mitchell 39:34
It’s simple but powerful. Yeah. And then just doing fun things.

Lisa Costa Bir 39:41
Yes, definitely. Yeah. Isn’t life too short not to be having fun?

Alison Mitchell 39:48
Definitely, if you can say the humor in life and it’s just going to be a more enjoyable ride for you.

Lisa Costa Bir 39:53
Absolutely. So it’s a predictor of well being, you know, people that are more optimistic and can see the good in things that I mean, life’s not all about roses and chocolates, but being able to understand that there are ups and downs and things. Sometimes things happen to us that they are always not nice or pleasant, but they’re always contributing to our growth and development as a person. We can see the PMS or other disease as that, I think it can be really helpful.

Alison Mitchell 40:28
Yeah, you know, you actually learn from it as opposed to just sort of having to dread it and not appreciating it.

Lisa Costa Bir 40:35
So, going back to fun, I often ask patients, what do you do for fun, what makes you laugh? And more importantly, how often do you do it? Sometimes people aren’t laughing at all and it’s very fun. It’s fun.

Alison Mitchell 41:02
Like I said, I like gardening. and i like video games, get my PlayStation going…

Lisa Costa Bir 41:07
yeah. So, you know, I think they say children laugh 200 times a day. And when you earn children you would know with two, they fight they can be in hysterics if you say pharma poo or something like that they are literally rolling around tears flowing far is just hahaha so funny. Whereas adults tend to be way more reserved and might not laugh once throughout the day, which is

Alison Mitchell 41:36
well I’m very childish in my mind. And I’m lecturing, I’m talking about this a solo ad called potassium phosphate, which we refer to as P.P. And every time I say I go pee pee I just start laughing too much. I’m obviosuly too childish

Lisa Costa Bir 41:52
you I think it’s a lovely thing to find that amusing. So when we know I’m really big on it, Finding the laughter because there’s so much to it in terms of depth what it does to our body. It helps modulate the immune system when you’re laughing You can’t be in a fight or flight sympathetic dominant state. And we’ve the research shows that again and again, that it’s that sort of state that drives penis and other disease states. So the more that we are relaxed and laughing, the better our life is, and this less disease for us, essentially. It’s actually like simple medicine. It’s really yeah,

Alison Mitchell 42:33
so get outside get dirty. And start laughing

Lisa Costa Bir 42:36
that laughing Yeah, and that could be you know, watching Funniest Home videos means on Instagram, I love Brown cardigan, hysterical. Yeah, anything. It doesn’t have to cost anything.

Alison Mitchell 42:50
Yeah, that’s it. Tim has this thing that you look through all the time. And I love going over here every shoulder elements always this collection of memes and fails and that sort of thing like gym fails I love watching those.

Lisa Costa Bir 43:05
You laughing at other peoples misfortunes?

Alison Mitchell 43:12
Yes. I’m having fun. I’m sure okay, at the end of the day, okay, probably, you know, you talked about how gardening is really important when it comes to like the microbes in the earthing and the mindfulness as well, but like I just wanted to sort of expand on that and talk about gut health a little bit too, and how we actually make so much serotonin in our gut and our gut bacteria does that too. So that’s another area that you need to look out. Definitely, huh yeah. So that would be just you know, assessing do you actually have enough of the good bacteria are you breaking it down properly, are you eating inflammatory foods and then like if you got leaky gut you can work on that, or if you’ve got maybe an overgrowth of some unfriendly bacteria or you’ve got so you’ve got dysbiosis, SIBO or something going on there. It’d be important to address that and deal with a mentor that either you’re just ticking that off, getting that sorted, because that could be another driver. Absolutely. Yeah. Yeah. And speaking of other drivers, you was talking about thyroid before. Yeah.

Lisa Costa Bir 44:15
so I found for me personally, an underlying thyroid issues a sluggish thyroid was a really big driver of pms. So getting that under control and increasing t3 and thyroid function, I’ve noticed a significant difference in pms severity. Huge, so important. So I guess sometimes PMS is still PMS, but there’s other conditions underlying it, too.

Alison Mitchell 44:48
Yeah. And everything is so interconnected, interwoven, nothing exists in a vacuum. So in the body anyway. Yeah.

Lisa Costa Bir 44:56
So dysfunction in one area will always affect everything else.

Alison Mitchell 45:02
Goes to show how, you know you do need to look at everything holistically. Yeah. Is there anything else you wanted to go through for how to be happy in PMS?

Lisa Costa Bir 45:14
Well, I think is something that doesn’t happen overnight. I think we all just need to be, we need to be patient and if you’ve had a pms for a certain amount of time, it does take a few months to get on top of it. But really, I think using knew what’s going on, but definitely move stuff. Using Saffron, B’s and magnesium and applying from the lifestyle things that we talked about – fun. Making sure you’ve got enough carbohydrates omplex carbohydrates in the diet, adequate nutrients full stop, i think you should notice a change very, very quickly. Yeah.

Alison Mitchell 45:53
Awesome, thank you.

Lisa Costa Bir 45:55
Pleasure

Alison Mitchell 45:56
Thanks, everyone, for listening. I’ll talk to you next time. Bye.

Lisa Costa Bir 46:00
Bye bye

Transcribed by https://otter.ai

The post PMS and PMDD appeared first on Alison Mitchell Naturopath.

Almost every woman has experienced menstrual cramps at some stage of their life, and if you have then you know they are definitely not an enjoyable experience.  They can range from a slight ‘twinge’ or feeling of mild discomfort that you can put up with, to such a degree of pain that despite pain killers and medications you are still curled up in the foetal position, maybe passing out from the pain and also experiencing all sorts of stomach complaints to go along with it.  Some conditions some as uterine fibroids, endometriosis and adenomyosis can cause severe period pain and erratic bleeding, however it is common to get period pain without it being caused by other conditions.  The technical term for period pain is dysmenorrhoea.

Quite often women are told that period pain is “normal”.  Well that’s not quite true – it’s certainly common, but normal implies that it’s okay to be in that much pain, and it isn’t.

I used to experience period pain along the lines of the above description – not the nice, go about your day one (I wish) but the ‘I think my insides are about to explode’ sort of period pain.  Over the course of my naturopathic studies I experimented on myself with different treatments and tricks to reduce this pain, until with more experience and knowledge I have been able to reduce the pain each month to a ‘niggle’.  My personal experience in this makes period problems and women’s health issues one of my favourite things to treat.

Below are a few simple techniques that you can try both throughout the month and during your period to make things a bit more comfortable for you.

1.  Acupressure Points

Acupressure uses the same meridians and points as acupuncture, however instead of using needles you are using your fingers and thumb to apply pressure.  You can do this at any time, and is a fantastic way to self treat.  It is always a good idea to consult an acupuncturist initially, as they can teach you what points may be more specific for yourself.  Below are some examples of common points that are used to reduce period pain.

Spleen 4

Acupressure Point – Spleen 4 / Grandfather Grandson Point / Gongsun

Also known as the Grandfather-Grandson point, this is located on the inner foot and helps to harmonise the abdominal area as well as reduce stress.  To find the point,  run your finger along the inside of the first metatarsal bone about an inch, until you find a slight depression.  Sit on the ground with the soles of your feet touching each other, so that you can hold the points of both feet at the same time.  Hold for 2 minutes.

Spleen 6

Acupressure Point – Spleen 6 / Sanyinjiao / Three Yin Intersection

To locate this point place one hand with your little finger in line with the base of your ankle bone, on the inside of your leg. Just above your index finger, along the edge of the bone, you’ll find a point that is quite tender to touch, particularly if you’re suffering from painful periods (you may also feel a very slight indent here).  Hold this point until you feel a reduction in your period pain.  It can take five to ten minutes for some women.  Repeat as necessary throughout the day for best results.

Liver 3

Acupressure Point – Liver 3 / Taichong / Great Rushing

This point helps to move stagnation of the body and blood, making it a good point for a wide variety of conditions – especially period pain.  It can often be a tender point to press, and most women with period pain will have stagnation along their liver meridian.  You can locate this point on the line between the first and second toe, about 3 finger widths from the edge.  You will know that you’re on the point when you find a slight indentation here, and it will be somewhat sensitive.  It is easiest to use you index finger for this point.  Start by massaging the point lightly, then hold it more firmly for another few minutes, breathing deeply all the while.  This is a very detoxifying point.

According to Adrian Low, Acupuncturist at Health Dimensions another helpful technique for reducing any form of lower abdominal pain is to massage the line running along the middle of the inner forearm (from wrist to elbow) in small circles with your thumb. It works best when performed on the side opposite to which your abdominal pain is on (e.g. if the cramping is on your left, massage your right arm).

2.  Exercise

One of the last things you’d probably want to do during your period is exercise, but exercise can help to improve blood flow and to produce endorphins which reduce pain.  A moderate paced walk during your period can be of benefit, as can yoga (see below).

The best way that exercise helps period pain, however, is when it is done consistently during the rest of the month.  This aids circulation, endorphin production and exercise is also able to reduce stress hormones.  Oestrogen dominance is a common cause of period pain, and keeping a healthy body fat percentage can help to minimise the effects of this – exercise of course is of benefit for this.

3.  Heat

If the muscles in your pelvic area are tight, it can worsen period pain.  Applying heat helps these muscles to relax, softening the uterus and the muscles and ligaments attaching to this area, which reduces pain (yay!)  Some research has also found that the application of heat also helps to reduce the pain chemicals sent to the brain.  Heat application is one of the simplest ways to reduce period pain, and if you’ve got a heat pack or hot water bottle at home it can be set up in no time at all.

You can use a wheat bag, a hot water bottle, or you can even find stick on heat patches which are great if you need to use it while out and about.

4.  Essential oils

There are several essential oils which can help to reduce period pain by relaxing the muscles and balancing hormones.

A 2012 study on Korean high school girls found that massaging the abdomen daily with a blend of clary sage, marjoram, cinnamon, ginger, and geranium in a base of almond oil was more effective pain relief than acetominophen (paracetomol).

A 2012 Japan study showed that massaging the abdomen with cream containing a blend of essential oils blended with lavender, clary sage, and marjoram in a 2:1:1 ratio (this was diluted in an unscented cream at 3% concentration) throughout the cycle was able to reduce period pain within one month.

Certain essential oils such as Clary Sage and Sweet Marjoram can be applied directly to the abdomen during a period, with a hot facewash applied ontop of that to enhance it’s absorption.  Clary Sage is calming, relaxing and soothing to the female reproductive system, and Sweet Marjoram has pain relieving properties.

It is always advisable to consult a practitioner trained in the use of essential oils, who can prepare you an individualised formula.

5.  Physical Therapy and Stretches

Often by relieving tightness in the ligaments and muscles of the pelvis, thighs and lower back you can reduce the severity of period pain.

According to Osteopath Steven Takchi,  “The hip flexors anatomically lie close to the female reproductive system.  Due to sitting all day, the hip flexor is activated and this can contribute to tissue tightness, potentially putting more pressure on those organs.  A tight psoas and pelvic floor can also contribute to period pain tightening the fascia in that area, and a rigid and tight pelvis can contribute to period pain because of altered biomechanics which can cause restriction to the pelvic splenic nerve (this nerve comes from the sacrum to supply that whole area).  These areas are often tight due to sitting all day.”

Consulting a physical therapist such as an osteopath to address structural imbalances or muscle tightness can help to reduce period pain.  In the mean time, you can stretch your hip flexors at home.  You can find several videos online to do this, such as this video.

6.  Yoga

Yoga is another great way to reduce menstrual cramps.  Not only will it provide many of the same benefits as your standard stretches, but it will also help with relaxation, and to promote healthy energy flow along your meridians.

Below are some poses that may be particularly helpful during your period.  Rather than describe these poses, I have compiled some links to articles by yoga instructors, which illustrate them more clearly with pictures.

Pasasana: Noose Pose

This helps to stretch out the hips, which can often get sore during periods.  While the Noose Pose has your feet positioned close together, you can widen your feet in a variety called a Half Bound Squat, if needed.

http://www.active.com/yoga/articles/4-yoga-poses-to-ease-menstrual-cramps?page=2&stop_mobi=yes

Ustrasana: Camel Pose

This will provide a relieving stretch along the front of the body.  Practised regularly, this can help to promote good posture and strengthen the back.

http://www.fitsugar.com/photo-gallery/30192496/Camel/

Supta Baddha Konasana: Supine Butterfly pose

You may instinctively been doing this pose already.  It is a relaxing pose which helps to open the hips and rests the lower back.

http://www.myyogaonline.com/poses/restorative/reclining-bound-angle-pose-supta-baddha-konasana

Virasana: Child’s Pose

This pose helps to lengthen the spine, and relaxes the abdomen and nervous system.  Great for when things are all getting ‘a bit too much.’

 https://freedomgenesis.com/childs-pose/

http://www.myyogaonline.com/poses/restorative/child-pose-balasana

Note:  It is generally recommended to avoid poses called ‘inversions’ during your period, which are essentially any pose akin to a handstand.  The theory behind this is that is can promote retrograde flow, which is the movement of endometrial blood and cells into the pelvic cavity.  This is thought by some to contribute towards endometriosis.  This notion is debateable, and some health practitioners believe that a healthy immune system can ‘mop up’ this endometrial tissue when it travels beyond it’s home, therefore making the culprit an imbalanced immune system, rather than a yoga position.

 7.  Spices

Some of the herbs I commonly prescribe for period pain are readily available as culinary herbs – in particular ginger and turmeric.  These herbs both have pain relieving properties, so when taken regularly throughout the month they can help to reduce inflammation, making your period less painful.  Ginger is also great at reducing nausea, so extra can be taken during your period for added benefit.

Ginger is lovely in stirfries, marinades, sauces etc.  However when you’re wanting to take it during your period you will need a larger dose than you would normally have in meals.  To reduce pain and nausea, grate some ginger into a cup of boiling water (you could add some lemon and/or honey for taste) and sip on this, a couple of cups a day.

Turmeric is a spice that has been used in abundance in Indian foods and Ayurvedic medicine.  Nowaday it has a huge amount of evidence supporting it’s anti-inflammatory effects.  The spice is best utilised by the body when prepared in the traditional methods (that is, cooked with oils) so including turmeric into your cooking throughout the month can help to reduce inflammatory chemicals building up, therefore reducing pain.  High strength preparations are available in tablet form, and these may be helpful to take during your period as an alternative to common pain killers (thankfully Turmeric is safe on the digestive system).

8. Calcium rich foods

There is some research on the use of calcium to reduce period pain, it is likely that it is helpful because among other things, we know that it is important for muscle tone and along with magnesium, supports healthy contraction and relaxation of muscles.  Throughout the month aim to eat a wide variety of foods rich in calcium which include beans, seaweeds, nuts and seeds e.g. almonds and sesame seeds, dark green leafy vegetables (such as spinach and kale), as well as dairy (if you are intolerant to dairy, avoid it as this can worsen period pain as it can increase inflammation).

9.  Epsom salt baths

Epsom salt is the common name for Magnesium sulphate.  As you may know, Magnesium is an important mineral for your health, and it is most commonly known for it’s muscle and nerve relaxing properties.  Women who experience complaints such as period pain and PMS are often low in magnesium (most people are!) so addressing this deficiency can be of benefit throughout the month with food and supplementation, and for acute period pain have an Epsom salt bath to absorb the magnesium through your skin.  Simply add 2 cups of Epsom salts to a warm bath and soak in it for at least 15 minutes.  Try adding some essential oils for an added benefit.    Your cramps will reduce, and you should feel relaxed from the lovely bath.   Ahhh.

10.  Good fats

By increasing your consumption of ‘good’ fats, you can help to reduce inflammation, thereby reducing period pain.  Eating wild-caught fish and opting for grass-fed over grain-fed meats regularly throughout the month is a great way to help to boost your omega-3 levels.  It’s also a good idea to avoid the types of fats which increase inflammation, such as processed vegetable oils, deep-fried products and margarine, and avoid meats from grain-fed animals.  It is possible to supplement with a omega-3 supplement such as fish oil, however it is important to ensure you are getting a good quality product – see your practitioner for more info on this.    To read more about fats, click here.

The post 10 ways to ease period pain appeared first on Alison Mitchell Naturopath.

Ladies, this one is for you.

Certain types of pads and tampons contain chemicals that may worsen period pain, cause allergic reactions and irritation, lead to pelvic inflammatory conditions and even fertility problems.  They have a huge impact on our environment, as some of their ingredients never break down.  In this article I will look at what these synthetic products are doing to our body, and discuss some of the alternatives that are available to us.

Tampons – Is this the most important item to choose organic?

Chances are, if you’re interested in your health and wellbeing you have decided to ‘go organic’ – you shop for organic fruits and vegetables, you limit your use of house hold chemicals, you might also use organic body products.  But for women, an often overlooked source of chemicals is through our sanitary items – pads and tampons.

Most conventional pads and tampons use a variety or blend of rayon (wood pulp), viscose (synthetic product) and cotton.  Some tampons are also coated in polypropylene (a crude oil derived plastic) to make them ‘slippery’ as well as to bind and contain the synthetic fibres together (pure cotton tampons are much stronger so will not disintegrate).   Cotton is actually quite a ‘dirty’ crop – it is the most heavily sprayed crop in the world (26% of the world’s pesticides are used on cotton!) so cotton products contain a whole host of pesticides.  These cotton products are then bleached with chlorine, which as a result leaves a by-product called dioxin.  Most sanitary products also have added chemicals to absorb odour or create fragrance, however these are also derived from crude oil products.

This may in fact be one of the most important items with which to choose organic, as our ‘lady bits’ are actually extremely capable of absorbing chemicals.  This is not good news for the health conscious, and to make matters worse these chemicals can actually increase period pain!

The pesticides from cotton, the polypropylene that coats and exists within the tampon and the dioxin from bleach combine to create a hectic combination of chemicals that increase inflammation in our ‘lady parts’ and can also lead to other health problems such as endometriosis and infertility.  These chemicals are also commonly responsible for causing irritation and allergic reactions down there, so going organic can result in a much pleasanter time of the month.

Consider this rough equation:

• A woman with a regular cycle will have 11-13 periods a year.  Assuming she has a standard menarche from 13, and enters menopause at 51, that’s 456 periods.
• Take out about 42 periods for an average of 3 children (9 months pregnancy, approx 5 months of no periods during breastfeeding) to reach 414 periods.
• The average women has a period for 3-7 days (so let’s say 5), and can use anywhere from 3-6 tampons or pads a day (so let’s say 5).  That’s 25 pads and/or tampons a period.
• 25 pads/tampons a period x 414 periods = 10,350 pads/liners in a lifetime (oh and don’t forget the thousands of liners we’re probably going to use as well!)

That’s a lot of pads and tampons, and cumulatively, a lot of exposure to chemicals that you don’t want down there!

Photo by Karl Wiggers on Unsplash

GOING ORGANIC

Nowadays, many people are making efforts to reduce their exposure to chemicals – for good reason.  Good quality research papers have shown that many pesticides in our food can disrupt hormones, nervous system health and our immune system, and in addition can lead to several cancers and conditions such as chronic fatigue syndrome.

Going on from this, we can extrapolate from the knowledge that eating chemicals is bad for us, so therefore applying chemicals to our skin is bad as well.  (Cue an abundance of body creams and lotions with ‘organic’ labels, and another booming industry fraught with misinformation that misleads consumers (organic body products are not regulated in the same way that organic foods are, and many products labelled as organic may still contain harmful chemicals) – regardless of whether it is labelled as organic we should still diligently check ingredients of products we choose, and buy from reputable companies/suppliers).  Using (actual) organic body care products is another good move; in fact it may be even more important than using organic food as our digestive system, when working properly has a lot of acids and enzymes (e.g. in our saliva and stomach) that help to break down and eliminate chemicals.  Our skin is an amazing organ, and it has a great capacity to absorb anything that we apply to it, particularly when it is rubbed on in an oily based i.e. a cream.  This comes in very handy when we want to apply therapeutic creams, however not so good when the creams contain nasties.

The mucous epithelial membranes that exist within regions such as the rectum, nose, lungs and vagina have an even greater absorptive ability than the skin, which is why pessaries and suppositories have such a fast and effective action.  In addition to this the blood supply from the vagina goes directly into the pelvic plexus (the same veins the ovaries normally empty into), so when certain hormones and chemicals are applied to the vaginal mucous membranes they are directed towards the uterus before they are assimilated into the rest of the blood stream(1).

Pads and tampons are a major source of chemicals, due to the excessive spraying of cotton crops.  Tampons that contain other fibres, such as rayon, can leave trace amounts of fibre and chemicals on the vaginal wall after removal – this is an issue for not only chemical exposure, but greater risk for toxic shock syndrome.  According to Dr. Philip Tierno, a Clinical Professor of Microbiology and Pathology at NYU Medical Centre, 100 percent cotton tampons “consistently test under detectable levels for TSS toxins.”(2)  This is because non-cotton products have a structure that is more likely to shed fibres.  In the attempt to bind these fibres together tampons are coated in a type of plastic coating called polypropylene.

Check out this video to see the different tampon types hold their fibres together.  These polypropylene chemicals do not break down or decompose.  Remembering how many tampons are used in a life time this could accumulate, potentially contributing to health concerns, but it the immediate sense it can also cause irritation of the sensitive vaginal area.  Vulvovaginitis is a problem that many women experience and if it is worsened by sanitary items, it can make that time of the month a very uncomfortable time.

I have experienced in both myself and my patients a significant reduction in period pain with the use of organic sanitary items.  While there is limited research on this matter, I theorise the pain reduction to be due to a few reasons:

• By avoiding the polypropylene there is less of a topical irritation, creating less inflammatory chemicals in the area.
• Insertion and removal of tampons cause micro-tears in the vaginal wall, in which tampon residue can remain.  Synthetic tampons have a greater likelihood of leaving residue and the nature of their fibres can be more irritating.
• The removal of chemicals which can mimic oestrogen can both reduce prostraglandin production as well as reduce the exacerbation of conditions such as endometriosis, pelvic inflammatory syndrome and fibroids.

WHAT ARE OUR OPTIONS?

Organic pads and tampons

There are several brands that use organic products, and organic cotton tampons.  While they are usually a little pricier than conventional brands, I personally consider it to be worth it.

Organ(y)c, TOM Organic and Natracare are good options.  TOM Organic is an Australia based company, and also offers ‘subscription’ service, a novel idea considering this is something we use on a regular monthly basis (ooh and they’re pretty!).  Other less widely available brands include Seventh Generation.

Reusable pads.

Reusable pads usually consist of organic cotton and come in a variety of shapes and colours.  They are clipped onto the bottom of the panties and when used, need to be soaked overnight then washed as per normal.  This is considered to be more environmentally friendly than disposable pads and tampons, and many women consider this to be more comfortable as well – they feel like normal underwear and are silent (no plastic crinkling sound).  While the need to wash these pads may turn some women off, the environmental benefits are good and these are a viable option for those who do not wish to use an insertable product.

Wemoon is an Australian based company that offers a variety of reusable pads.  Lunapads also offer products online in a variety of fun colours, and also stock liners.

Menstrual cups.

Menstrual cups are bell shaped silicon or latex cups that are inserted into the vagina to collect menstrual flow.  This is a concept that has been around for a long time, however it is not commonly used or known about these days, perhaps due to a perceived ‘ick factor’?

According to the Diva Cup website, once you have tried menstrual cups you realise that most concerns are unwarranted – i.e. a typical flow is only 30mL per day, therefore removing the cup really isn’t going to be like a scene from a horror movie, and menstrual blood only smells once exposed to oxygen, so using the cup isn’t going to create more of an odour (in theory it will be less so!).  They can take a few cycles to get the hang of, to ensure they are positioned correctly.

Menstrual cups do have an impressive list of benefits – they are good for the environment, they can be kept in for 12 hours, reduce period pain (see above) and save money in the long term (while they cost about $60 to buy outright, they can save you up to $150 a year compared to buying disposables).

A good brand is the Diva Cup, which is approved by TGA in Australia.  Other brands include JuJu, Lunette, The Keeper (made from rubber) and The Moon Cup (made from silicon).

EDIT 3/10/17: I wanted to share my personal experience with a menstrual cup. Not long after writing this article I invested in a Diva Cup, and I can share with you that it has made my time of the month much easier, as having to change the cup only once in the morning and night means I can essentially forget about my period while I am out and about. I also have not had to buy any tampons, and only bought about 2 packets of pads (excluding maternity pads for post-partum) in the 4 years since getting the cup. I used to experience a lot of period pain, and when starting to use this I did notice there was some discomfort on the days I was worse, so I chose to use a pad on those days, however as time has gone on I now don’t have any period pain (I think due to improving my chemical exposure, using herbs, exercise, yoga and having a baby) so I can use the cup for my whole period. I used to have to wear a liner with it during the night and on day one of my period, but not at the moment. I found that it took a few cycles to get practiced enough to insert it confidently, having to learn the right angle to put it in and how to hold it so I could twist it into position, but now I can do it easily. I have on occasion had to change it whilst away from home but it is easy enough to do, I just tidy it up with some toilet paper and give it a good clean when I get home. I did read some reviews that the cup stains, but I haven’t found that to be the case, and this is 3+ years later. I also have been fine to exercise with it in, as long as it is inserted correctly to begin with. So essentially, I would definitely recommend getting a menstrual cup!

Absorbent Underwear

Companies such as Modibodi and THINX offer underwear that has absorbent section where a pad would be. They can be worn as a back up for menstrual cups or tampons, or on their own for those with a moderate-light flow. You can choose the type of absorbency that’s right for you – the range goes from 2.5ml absorbency (1/2 tampon) to 10-20mL (2 tampons).

They are reusable, so great for the environment, and save money for you over time. For athletes who don’t like wearing pads, tampons and cups during exercise, this is a great option.

Other options (that I haven’t research too extensively…)

• Reusable tampons (hard to find, most I’ve seen appear to be knitted, could that could be your next craft project?)
• Sea sponges (think re-usable tampons from the sea)
• Free bleeding (you were just going to wash those clothes anyway, I guess?)

Have you tried some of the less conventional options?  Or have you noticed a change from using organic pads and tampons?  Let me know your thoughts.

Works Cited

1. Touitou, Elka and Brian, W Barry. Enhancement in drug delivery. Boca Raton, Taylor & Francis Group : CRC Press, 2007.

2. Women Beware: Most Feminine Hygiene Products Contain Toxic Ingredients. Mercola.com. [Online] 22 May 2013. [Cited: 6 November 2013.] http://articles.mercola.com/sites/articles/archive/2013/05/22/feminine-hygiene-products.aspx.

The post Choosing the right products for that time of the month. appeared first on Alison Mitchell Naturopath.

PMS stands for Pass My Shotgun, Pardon My Sobbing, Perpetual Munching Spree, Pimples May Surface…

PMS jokes are everywhere, as it is probably the most common female hormonal disorder. Many women accept monthly changes to their mood, appetite, energy and sleep patterns as an annoying but inescapable part of life, and yet PMS is a treatable condition. In Australia, it is estimated that up to 75% of women experience PMS at some time in their lives, with 18% of women suffering the more severe form – premenstrual dysphoric disorder (PMDD). PMS and PMDD are often poorly recognised, let alone diagnosed or treated.¹ These conditions can have a severely detrimental effect women’s lives, but PMS can be easily and effectively treated with diet, exercise and Natural Medicines.

What causes Premenstrual Syndrome?

As you would expect, most of this havoc is due to hormonal imbalance, however very commonly it is existing nutritional deficiencies, as well as diet, stress and exercise combined, that really tips you over the edge.

Studies have shown that women who experience PMS have excessive amounts of oestrogen which causes relatively lower levels of progesterone compared to women who don’t². Not everyone is the same of course, and some women may have low progesterone but not necessarily excess oestrogen.

The psychological symptoms

Progesterone has a metabolite called allopregnanolone, which acts in the Central Nervous System  by interacting with the sedating GABA A receptors to positively affect mood and behaviour, whilst improving stress response and cognitive function.³

When progesterone and its metabolites are low, less of the calming effect from the GABA receptors are experienced so you can experience all sorts of mood imbalances such as irritability, anxiety or depression. On top of this, oestrogen has excitatory effects in the CNS by acting on the glutamate system, so women with excess oestrogen often feel wound up and irritable. ⁴

The physical symptoms

A common complaint with PMS is fluid retention. High prolactin (another reproductive hormone) is associated with cyclic breast tenderness and fluid retention. Prolactin naturally elevates during the second half of your cycle and may be further increased by stress, low blood sugar and high oestrogen. Aldosterone (a hormone produced by the adrenal glands) also contributes to symptoms of fluid retention, contributing to weight gain and bloating. Stress is the key driver of high aldosterone. Interestingly, stress may also reduce your sensitivity to progesterone.⁵ Another relatively common symptom accompanying this time is latent virus activation e.g. getting cold sores at that time of the month.

What can we do about it?

The specific treatment varies on the woman as everyone experiences PMS differently. The core focus is to use nutritional supplements and herbal medicine which can help to balance hormones, support stress levels and reduce unpleasant symptoms. In clinic I use high strength herbal medicines which includes use both liquid and tablet forms, all of which are stringently tested for quality, safety and the strength of the active parts. Working towards a healthy eating (diet) and balancing lifestyle factors (e.g. reducing stress) is important as well.

One of the main herbs Naturopaths use for treating PMS is Vitex (Vitex agnus castus, also known as Chaste tree). It is best taken first thing in the morning for two or three months to see results. Various studies have demonstrated that Vitex supplementation significantly improves the spectrum of premenstrual symptoms over a period of three months. One study showed that symptoms of irritability, breast fullness and bloating were improved by 50%,⁶ whilst another found that 93% of 1634 participants reported an improvement or complete remission of symptoms monitored, including depression, anxiety, food cravings and fluid retention.⁷ Furthermore, by normalising the luteal phase, Vitex has been shown to improve fertility in women with luteal phase defect.⁸ In a study on infertile women with pathologically low progesterone levels, a dose of 36 mg of dried fruit daily improved fertility rates by approximately 15% within three months.⁹

Peony (Paeonia lactiflora) and Dong quai (Angelica sinensis) are also great hormonal regulators specific for PMS and menstrual irregularities.¹⁰

To support mood and stress levels there are herbs that calm the nervous system and balance GABA levels such as Passionflower (Passiflora incarnata), herbs to support adrenal gland function such as Rehmannia (Rehmannia glutinosa) and Licorice (Glycyrrhiza glabra); and adaptogens – herbs that help you ‘adapt’ to stress such as Siberian ginseng (Eleutherococcus senticosus) and Withania (Withania somnifera).

To further support your nervous system it’s important to ensure you don’t have nutritional deficiencies that will leave your nervous system frazzled. For example, B vitamins and magnesium are crucial for combating stress and so many people are deficient these days. Your body uses more of these when you’re stressed so if you lead a stressful, busy lifestyle at times then you most likely need top up with some supplements to get you back on track.

As well as having a diet that is high in protein, fibre and good fats (these are all crucial!), there are key nutrients that are needed for blood sugar regulation, such as chromium and magnesium, to improve carbohydrate metabolism and blood sugar control.

Vitamin B6 – for production of neurotransmitters, essential fatty acid metabolism, oestrogen metabolism, and progesterone support.

Magnesium – to reduce cramps, to support mood, for blood sugar control, to reduce aldosterone, and support energy production. Intracellular (but not plasma) magnesium levels have been found to be lower in women with PMS, so women who are deficient in magnesium are more likely to suffer from PMS.

Calcium – this is also important for nervous system support, and to regulate the control of muscular contraction and relaxation. Interestingly, symptoms of calcium deficiency are similar to many PMS symptoms and in some women PMS may be due to underlying calcium dysregulation which may be driven by vitamin D deficiency.

Chromium – essential for blood sugar level control, insulin production and pancreatic health. Chromium deficiency can lead to more sugar cravings and blood sugar fluctuations.

Omega fatty acids – Omega 3 is important for healthy prostaglandin levels, and a deficiency of Omega 3 can cause a variety of symptoms such as menstrual and premenstrual cramps, depression, irritability, dry/rough skin, acne and cravings for oily and fried foods.

If you’re someone who really suffers in the lead up to your period each month, it’s certainly worth getting some professional advice from a naturopath about the key elements of treatment for you. It’s something that many women seem to think they just have to endure and put up with, without looking into ways they could reduce their symptoms. If you’re one of those people – now you know there are things you can do, so why not give naturopathy treatment a try?

READY TO DISCUSS YOUR HEALTH NEEDS?

CONTACT ME TO MAKE AN APPOINTMENT

1. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 2003; 28(3): 1-23.
2. Wang M et al. Relationship between symptom severity and steroid variation in women with premenstrual syndrome: study on serum pregnenolone, pregnenolone sulfate, 5a-pragnane-3,20-dione and 3a-hydroxy-5a-pregnan-20-one. J Clin Endocrinol Metab 1996; 81: 1076-1082.
3. Monteleone P et al. Allopregnanolone concentrations and premenstrual syndrome. Eur J Endocrinol 2000; 142: 269-273.
4. Backstrom I et al. Pathogenesis in the menstrual cycle-linked CNS disorders. Ann N Y Acad Sci 2003; 1007: 42-53.
5. Kumar S, Mansel RE, Scanlon MF, Hughes LE, Edwards CA, Woodhead JS, Newcombe RG. Altered responses of prolactin, luteinizing hormone and follicle stimulating hormone secretion to thyrotrophin releasing hormone/gonadotrophin releasing hormone stimulation in cyclical mastalgia. Br J Surg 1984; 71(11):870-3.
6. Loch EG et al. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens Health Gend 2000;9(3):315-20.
7. Berger et al. Efficacy of Vitex agnus castus L. extract Ze440 in patients with premenstrual syndrome. Arch Gynecol Obstet 2000; 264 (3): 150-3.
8. Wuttke W et al. Chaste tree (Vitex agnus-castus)- pharmacology and clinical indications. Phytomedicine 2003; 10(4): 348-57.
9. Bone K. Clinical Guide to blending liquid herbs. Churchhill Livingstone 2003, p 145.
10. Sakamoto S et al. Pharmacotherapeutic effects of kuei-chih-fu-ling-wan on human uterine myomas. Am J Chin Med 1992; 20 (3-4): 313-7.

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