5 Expert Tips For Dealing With Midlife PMS

Know PMS Can Change From Your Thirties

“Perimenopause can start 12 years prior to the menopause, so it’s not uncommon to start to feel the effects of a decline in sex hormones in your 30s. There is plenty of evidence to suggest women are more prone to PMS symptoms during perimenopause due to fluctuations in hormones, most notably a reduction in oestrogen. Oestrogen is at its peak in our 20s and slowly reduces with age until we hit perimenopause, when it takes a more dramatic decline. With this comes a decline in serotonin and dopamine – our feel-good neurotransmitters. After ovulation and in the lead-up to our period, oestrogen and neurotransmitters will further decline, affecting mood, emotions and behaviour. This is why PMS moods can worsen as we age.” – Lucy Miller, nutritional therapist

Think About Your Hormonal History

“Women who have historically suffered from PMS, PMDD or post-natal depression are often predisposed to a worse menopause transition. This is likely because they are less tolerant and more sensitive to even the subtlest shift in hormones. In fact, many women end up on antidepressants when in fact it’s a hormone issue, so keep this in mind.” – Emma Bardwell, menopause nutritionist 

Keep Blood Sugar Balanced

“As we age, we become less sensitive to insulin, the hormone responsible for helping us control our blood sugar. A diet high in sugary foods and refined carbs can lead to blood sugar fluctuations, which can impact hormones and may worsen mood swings, fatigue and cravings. Imbalanced blood sugar will affect all your hormones and from a nutritional standpoint is probably the thing that affects PMS symptoms the most. Make sure you’re eating protein at every meal; don’t be afraid of foods rich in healthy fats like oily fish; and swap refined carbs for wholegrains that contain plenty of fibre, alongside plenty of beans, legumes, nuts and seeds. A mid-morning or afternoon protein smoothie can help tackle cravings, too.” – Lucy

Test For Deficiencies

“A magnesium deficiency becomes more apparent with age, often due to absorption issues in the gut, and this can lead to increased PMS symptoms such as bloating, cramping and mood swings. B vitamins can also decrease as we age due to stress, alcohol intake and our ability to absorb them in the gut. Some B vitamins – notably B6 – can help alleviate PMS symptoms. Also get your vitamin D levels checked. Age affects the formation of active vitamin D, which is vital for mental health. Insufficient vitamin D levels may contribute to mood swings associated with PMS. A comprehensive supplement like Nutri Advanced EstroLibrium will support oestrogen balance and detoxification, too.” – Lucy

Cut Back On Caffeine

“The enzymes associated with caffeine metabolism become less efficient as we age. Caffeine can also increase anxiety and irritability as well as disturb sleep, all of which may result in worse PMS symptoms. Instead, get into the habit of drinking more herbal tea. Ginger tea is anti-inflammatory and can reduce pain and bloating; chamomile tea can help with sleep and relaxation; and green tea can help you feel calmer and more relaxed.” – Lucy

Get More Sleep

“Poor quality or limited amounts of regular sleep is linked to inflammation, and hormonal imbalances can reduce the body’s ability to heal during the night, leading to heightened stress, a natural enemy of hormonal balance. As you sleep, your body detoxes and repairs and without quality rest, the body can easily slip into emergency mode, which takes its toll on hormones.” – Dr Simoné Laubscher, naturopathic nutritionist at WelleCo & founder of Rejuv Wellness

Clean Up Your Diet

“Eat organic where you can – pesticides can affect oestrogen and other hormones and worsen existing imbalances. Avoiding non-organic meat can also be a game-changer. If eating organic meat is expensive, eat less of it and eat more wild fish. The smaller the fish, the better (think sea bass or trout) as they carry fewer heavy metals.” – Simoné

Ignore Spotting Between Periods

“In your 30s and 40s, it’s common for your period to become irregular. When progesterone fluctuates, cycles can become shorter. If you used to have regular, 28-day cycles, this might become 21 days, and they tend to become heavier, too. However, spotting irregularly between periods is never normal, so always get this checked out.” – Dr Elise Dallas, GP specialising in women’s health

Cut Calories Or Carbs

“There’s a tendency among women to adopt faddy eating routines, but the right carbs are essential for making tryptophan, the precursor to serotonin, our feel-good hormone, so avoid extreme low-carb diets such as keto and Atkins. At the same time, be wary of experts who claim to offer ‘hormone balancing’ protocols that remove entire food groups without evidence to back them up. I’d go as far as saying avoid any ‘expert’ who claims they can balance hormones – this is a major red flag.” – Emma

Discount Hormone Replacement

“As we approach the menopause our cycles become anovulatory, meaning we don’t ovulate and therefore don’t produce our own natural progesterone in the second half of our cycle – this will worsen PMS symptoms. Plus, the variable levels of oestrogen and progesterone which occur as we age mean our cycles become more erratic, varying in lengthen and duration of flow. Very heavy and prolonged bleeds can also be draining, and impact energy and wellbeing. Many women live with these symptoms unnecessarily for years, when great benefit can be gained from hormone replacement. The best approach is to replace like for like, and this means bio-identical hormones. Also know it’s a myth that the hormones present in the coil (like Mirena) are adequate – this is synthetic progesterone that doesn’t work in the same way.” – Dr Fiona MacRae, hormone specialist at the Marion Gluck Clinic

Use Alcohol As A Crutch

“Many women resort to alcohol in midlife to numb symptoms, which only ends up exacerbating psychological conditions such as depression, low mood, anxiety and brain fog, which interfere with a woman’s ability to function in life – professionally, personally and socially. And if you are feeling fatigued and lacking in energy, this impairs your likelihood of exercising, eating well and taking care of yourself – it’s a vicious cycle.” – Emma

Turn To Processed Food

“A poor diet, which triggers inflammation, is a key trigger for worsening PMS symptoms later in life. Reduce packaged, ultra-processed foods, and include plenty of healthy fats in your diet, like olive oil, oily fish, avocado, nuts and seeds. A good-quality omega-3 supplement is also a good idea. Also be sure to include plenty of fibre in your diet to bolster your gut microbiota – improving the health of your gut bacteria is a simple yet effective way to support your mental and reproductive health.” – Emma

Forget To Exercise

“Engaging in regular aerobic exercise has been shown to alleviate PMS symptoms, reduce fatigue and mitigate symptoms of depression. Brisk walking, running and cycling will all elevate the heart rate and enhance lung function, so make these a priority. It’s essential to make regular exercise a habit, not something you do solely during symptomatic periods. Exercise is also a form of self-care, which is something we must prioritise in midlife. In fact, to effectively mitigate the effects of midlife PMS on wellbeing, women should prioritise self-care as a cornerstone strategy. Therapy or counselling to address mood-related symptoms can also be immensely beneficial.” – Elise

Suffer In Silence

“I see countless women who feel ashamed of their symptoms and avoid discussing them for fear of being judged. At the same time, the depression women feel because of shifts in hormones is very real and can be serious. Don’t suffer in silence – check out the work of Nick Panay, a consultant gynaecologist who specialises in the menopause and hormone-related issues, as well as NAPS (the National Association for Premenstrual Syndrome).” – Emma

For more from the experts or to book a consultation, visit LucyMillerNutrition.com, EmmaBardwell.com, TheLondonGeneralPractice.com, MarionGluckClinic.com & Rejuv.co.uk