Painful Menstruation

Painful menstruation or Dysmenorrhea is when menstrual periods are accompanied by either sharp, intermittent pain or dull, aching pain, usually located in the lower abdomen or pelvis. 50% of women experience painful menstruation to some degree and up 10% have severe, disabling pain that affects their lifes. Painful menstruation is caused by the production of prostaglandins during menstruation or just prior to menstruation. Prostaglandins cause uterine contractions, thereby causing pelvic and abdominal pain. Primary Dysmenorrhea Primary dysmenorrhea is defined as cramping pain in the lower abdomen occurring just before or during menstruation, in the absence of other diseases such as endometriosis. The problem is often under diagnosed and under treated. Women with primary dysmenorrhea have increased production of endometrial prostaglandin, resulting in increased uterine tone and stronger, more frequent uterine contractions. Secondary Dysmenorrhea Secondary dysmenorrhea is due to some physical cause and usually of later onset; painful menstrual periods caused by an another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis). Self-Care

*	Mild exercise like walking or biking. Exercise may improve blood flow and reduce pelvic pain.
*	Use a heating pad or hot water bottle over your lower abdomen for intervals of not greater than 20 minutes. Be careful not to fall asleep on the heating pad.
*	Take warm bath.
*	Gently massage your abdomen.
*	Get plenty of rest and reduce your exposure to stressful situations.
*	Follow a diet rich in complex carbohydrates, like whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine.
*	Drink a hot cup of regular tea, chamomile or mint tea.

PMS Predicts Problem Menopause

More Hot Flashes, Mood Swings Reported Later in Life for PMS Sufferers Women who suffer from premenstrual syndrome (PMS) are likely to have a harder time later in life during the transition to menopause, new research shows. In a study published in the May issue of the journal Obstetrics and Gynecology, investigators found that PMS suffers were twice as likely to experience hot flashes and mood swings as they approached “the change” as women who did not have PMS. While it may seem unfair, the link does make sense, according to Pamela Boggs the North American Menopause Society director of Education and Development. She says women with PMS tend to be especially sensitive to fluctuating hormones, and fluctuating hormones are also the cause of the symptoms associated with the time prior menopause, known as perimenopause. “We have known for some time that if a woman has bad PMS in her younger years this is a fairly good predictor of a bad perimenopause,” she said. “During this period estrogen levels are high some days and low others, and this is especially troubling for women who are sensitive.” From PMS to Hot Flashes Most women reach menopause, defined as having a year without a period, in their early 50s. Perimenopause is the period lasting a decade or so before that when menstrual bleeding become erratic and many women experience hot flashes, depression, and other well-known symptoms associated with the end of the reproductive years. In the newly reported study, researchers followed 436 women approaching perimenopause for five years, in an effort to determine if PMS was predictive of these common symptoms. All the women were between the ages of 35 and 47 when enrolled in the study, and all reported normal menstrual cycles during the preceding three months. PMS symptoms declined significantly as menstrual bleeding became less frequent, with the likelihood of having PMS decreasing by 26% among the women considered to be in early perimenopause and by 80% among women who were late in the transition period. The women with PMS at enrollment were twice as likely to report hot flashes during the study period, and slightly more than twice as likely to report having symptoms of depression. Women with PMS were also 50% more likely to report problems with sexual desire and 72% more likely to report problems sleeping. Symptoms Similar Clinicians often have a hard time distinguishing between PMS and perimenopause because many of the symptoms are similar. This study showed that a main defining characteristic of menopausal symptoms is the fact that they can occur at anytime and are not, like PMS, cyclic in nature. We concluded that changes in cycle length may, in fact, signify the transition to menopause, and that symptoms occurring frequently throughout the cycle, and not just during the premenstrual period were also predictive,” author Ellen W. Freeman, PhD, of the University of Pennsylvania Medical Center.

Tips For Hormonal Balance

PMS is a direct result of hormone imbalance and can be greatly reduced by adding natural progesterone in the body. Bioidentical Progesterone Cream reduces the following PMS symptoms  

*	Irritability
*	Mood Swings
*	Insomnia
*	Migraines/Headaches
*	Bloating
*	Weight Gain
*	Breast Swelling or Tenderness
*	Fatigue
*	Backaches
*	Depression
*	Anger
*	Lack of Self Esteem
*	Craving for Sweets / Chocolate
*	Confusion Disorientation
*	Poor Judgment / Decisions
*	Swings in Energy Levels

  Furthermore, every system in the body can be affected by PMS: Immune, Digestive, Circulatory, Nervous, Endocrine and Dermatology (Skin) Systems. Victims of PMS may experience any combination of the above symptoms, in varying degrees of severity, from mild to overwhelming! Progesterone is made in the ovaries. Progesterone production begins just prior to ovulation and increases rapidly until it reaches an average production of about 20mg per day. If an egg is not fertilized, progesterone production falls, triggering the menses. Progesterone is necessary throughout gestation for the survival of the fertilized egg, the resulting embryo, and the fetus. During pregnancy the placenta produces 300mg to 400mg of progesterone per day. Progesterone has many other functions, among them protecting against fibrocysts, helping the body use fat for energy, and helping normalize blood clotting and blood sugar levels. Today, many health professionals claim that the symptoms associated with PMS and menopause are due not so much to estrogen, but to a deficiency of progesterone and an overabundance of estrogen. It is believed that progesterone balances estrogen and that an overproduction of estrogen can lead to health problems. Too much estrogen is known asestrogen dominance. Bioidentical progesterone is progesterone. It is derived from a natural source and then converted to progesterone. Bioidentical progesterone has the same molecular configuration as the progesterone produced by the body and can be used to supplement the progesterone produced by the body and to balance oestrogen and progesterone levels. Bioidentical progesterone has no side effects. The standard dose is 20mg daily.  

Premenstrual Syndrome

The Cause Of PMS Premenstrual emotional and physical changes occur in nearly 80% of menstruating women. The symptoms vary from woman to woman and from cycle to cycle. Their intensity ranges from mild to incapacitating. About 20% to 40% of women who have PMS experience symptoms that make life difficult. 2.5% to 5% experience Premenstrual Dysphoric Disorder (PMDD) a severe form PMS. There is no definitive diagnostic test for PMS. A combination of physiological, genetic, nutritional, and behavioral factors are all involved. Although tests may be used to rule out other conditions in women who experience severe symptoms, emotional and physical changes that are in sync with a woman’s menstrual cycle are usually a tell tale sign. The most important indication of PMS is the cyclic nature of the symptoms. There is usually a symptom-free time period 1 week after menstruation ends however, at least 25% of patients don’t have a symptom-free time period. These women should be evaluated for other medical conditions. The physical, emotional, and psychological changes that occur in PMS coincide with hormonal changes due to the menstrual cycle. They usually occur in response to the declining levels of progesterone just prior to menstruation. Under ideal circumstances, prior to the use of petrochemicals & herbicides & pesticides, our bodies probably stabilized these changes without discomfort. As food sources became contaminated we lost the ability to balance our hormones during PMS. Why? Xenosteroids from our food delivery system actually increase estrogen in our bodies without changing the progesterone levels. This causes a hormonal imbalance. In fact, PMS symptoms may be the bodies innate intelligence telling a women to correct this imbalance. Why? All hormone dependent cancers have been traced to estrogens not progesterone. Our hormonal imbalance and PMS has steadily increased since the use of petrochemicals. What can we do? Remove petrochemicals and metabolize the estrogen stored in the fat cells which, is where the body retains estrogen, and you remove the overall intensity of this man made syndrome. Stop eating conventionally farmed foods. Although they may be more affordable, there is plenty of information that shows organic practices and foods are inherently more vital to our bodies. You may not see the benefits immediately, but your body has been accumulating these exogenous substances since you were born. Women are also finding symptomatic relief and a return to good health by utilizing a natural, plant derived, bioidentical progesterone which restores normal hormonal balance. With a strong committment to diet even the natural progesterone will not be needed. Depression-related symptoms are prevalent in women who suffer PMS. Studies indicate that there may be an underlying psychological condition that causes or contributes to PMS. Approximately 60% of women with major affective disorder (e.g., depression) also have PMS, and more than 30% of women who suffer chronic depression experience their first depressive episode during a time of significant hormonal change (e.g., premenstrual). In one study, between 57% and 100% of women who suffered PMS were found to have had at least one prior major depressive episode, compared to 0% to 20% of women without PMS. However, PMS encompasses more than depression, and by focusing too much on this aspect, other important physiological factors may be overlooked. Conventional treatment consists of hormone therapy prescribed for the most benign of symptoms including skin eruption, water retention and bloating to the very debilitating cramps, rage and irritability that can last for hours or days. Women now have alternatives to conventional therapy and can decide if synthetic hormone replacement is the safest and friendliest way to approach these debilitating problems. Jacques Rossouw, Director of the WHI(Women’s Health Initiative) stated, “There’s no real safe time for taking hormones.” The “pill” prescribed for birth control is used to confuse and alter the physiology of the body to think it is eternally pregnant. This type of PMS control is under intense debate since the WHI, (Womens Health Initiative) found out that hormone manipulation with artificial agents are causing increased breast and uterine cancers, blood clots and strokes. What You Can Do To Reduced Premenstrual Symptoms without having to take birth control. Reducing premenstrual symptoms focuses on relieving symptoms and involves exercise, dietary changes, and supplements. Exercise has a profound effect on hormones including those involved in the menstrual cycle. Women who exercise experience less anger, depression and other symptoms. Exercise also reduces stress, which elevates PMS symptoms. Women, especially those who experience PMS, are encouraged to exercise 20-45 minutes a day or 3 times a week if daily is not possible. Stress reduction can help reduce PMS symptoms. Physical trainers and physical therapists can help women incorporate exercise and movement into their lives. A counselor or therapist can provide advice on reducing stress as well. Don’t allow yourself or others to think your a basket case just because you’re taking control of your PMS. Just So You Know What Common Premenstrual Symptoms Include: Mood-related (“affective”) symptoms

*	Depression
*	Sadness
*	Anxiety
*	Anger
*	Irritability
*	Frequent and severe mood swings.

  Mental process (“cognitive”) symptoms

*	Decreased concentration
*	Indecision.

  Pain and associated discomfort

*	Headache
*	Breast tenderness
*	Joint and muscle pain

  Nervous system symptoms

*	Insomnia (sleeplessness)
*	Hypersomnia (sleeping for abnormally long periods of time)
*	Anorexia
*	Food cravings
*	Fatigue
*	Lethargy
*	Agitation
*	A change in sex drive
*	Clumsiness
*	Dizziness or vertigo
*	Paresthesia (prickling or tingling sensation)

  Gastrointestinal symptoms

*	Nausea
*	Diarrhea
*	Palpitations (rapid fluttering of the heart)
*	Sweating.

  Fluid and electrolyte symptoms

*	Bloating
*	Weight gain
*	Oliguria (reduced urination)

  Skin symptoms

*	Acne
*	Oily skin
*	Greasy or dry hair

 

Premenstrual Migraines

Blame it on hormones: Approximately 70 percent of all women who get migraines can predict the onset of a headache around their menstrual cycle, says Merle Diamond, MD, associate director of the Diamond Headache Clinic in Chicago. For some, it’s the hardest headache to treat because it’s longer and more severe than the headaches they get at other times of the month. Menstrual migraines are brought on by changing levels of estrogen–usually falling–that happens twice a month: with ovulation and with the menstrual cycle. While estrogen doesn’t cause a migraine, it’s one of the most powerful triggers for women, says Dr. Diamond. That may help explain why women are three times more likely to get migraine headaches than men. As women reach their 30s and 40s, their headaches tend to get more frequent and more severe, in part because of stress, says Dr. Diamond (a migraineur herself). Another reason: Hormonal fluctuations increase as women approach menopause. Keeping a diary of your menstrual cycle helps because you can predict when you’re most at risk–typically the days immediately before and after the menstrual cycle–and use medications before the headache hits. There is some good news. With the end of menopause, migraines stop or become significantly less frequent for 65 to 70 percent of women. HRT ads misled women about the benefits, risks of HRT By JENNIFER WALKER-JOURNEY BEASLEY ALLEN LEGAL NEWS Date: December 12, 2009 12:00 AM Connie Barton bought into the message. It seemed to be everywhere – television, magazines, even her doctor was telling her that those nasty symptoms of menopause could be squashed by just taking a once-daily pill. Not only did the miraculous Hormone Replacement Therapy (HRT) help with hot flashes, vaginal dryness and mood swings, it also helped counter serious health problems associated with estrogen loss – osteoporosis, heart disease, colon cancer, Alzheimer’s disease, tooth loss and blindness. It seemed almost too good to be true. Drug makers like Wyeth published articles in medical journals and hired respectable figures like Lauren Hutton to act as spokeswomen in their ads. “There’s nothing more important than protecting your health,” Hutton said in one commercial. “Believe me, the time to protect your future is now.” Five years after starting hormone therapy, Barton learned the hard way that HRT was not protecting her future. In fact, it was hurting it. What Wyeth failed to tell doctors and consumers was that evidence was beginning to mount against HRT, information the drug company kept hidden in an effort to protect its billion-dollar empire. But in 2002, in the midst of the Women’s Health Initiative (WHI), a massive study on the causes of mortality and morbidity in menopausal and post-menopausal women, researchers noticed a shocking trend. Data showed that women who took HRT were at much greater risk of developing breast cancer. The hormones also increased a woman’s risk of other health conditions including heart attack, stroke, blood clots and dementia. The study into hormone therapy was immediately stopped. But it was too late for thousands of women like Barton, who were now fighting life-threatening illnesses. Barton took Wyeth to court and in October was awarded $75 million in punitive damages and $3.75 million on compensatory damages. But the victims’ fight is far from over. Wyeth faces more than 10,000 other product liability suits from women harmed by HRT, and more and more victims are filing suit every day. Sources: Beasley Allen New York Times Relieving PMS by Ellen Hale

Cramps aren’t the only problem women suffer in their monthly cycles. For many, premenstrual syndrome (PMS) can be just as bothersome. PMS occurs in the last 7 to 10 days of the menstrual cycle–called the luteal phase. The time at which these symptoms occur is very important because it’s what allows doctors to track their cyclic nature and make a diagnosis. While premenstrual syndrome remains a mysterious malady, there is growing recognition that it is a true physical syndrome, and there are a number of new treatments to help lessen its symptoms. The American College of Obstetrics and Gynecology (ACOG) says from 20 to 40 percent of all women suffer some symptoms of PMS, which it defines as “a recurring cycle of symptoms that are so severe as to affect lifestyle or work.” ACOG estimates that 5 percent of women have severely disabling PMS. The variety of symptoms and combinations of symptoms are usually divided into four major groups, according to Lisa Rarick, M.D., medical officer in FDA’s division of metabolism and endocrine drug products. Breast tenderness, swelling, weight gain, and bloating comprise one group of symptoms. A second group includes emotional changes such as depression, forgetfulness, crying, insomnia, and confusion. A third group involves headaches, food cravings (especially sweets), increased appetite, fatigue, and dizziness. The fourth group includes anxiety, nervous tension, mood swings, and irritability. For the most part, PMS is alleviated by treating its symptoms. For example, for those who suffer from symptoms of water retention, diuretics may help. They are a component of many OTC medications for PMS. In 1988, FDA tentatively proposed that three OTC diuretics could be used in menstrual drug products (including those that treat PMS): caffeine, ammonium chloride, and pamabrom. It is believed that caffeine may help relieve bloating and water retention because it acts as a mild diuretic, and that it also may help relieve the fatigue many women complain of in the premenstrual period. On the other hand, excessive amounts of caffeine may aggravate anxiety and tension, and some doctors think it may be associated with increased breast tenderness. Some over-the-counter medications for PMS combine several ingredients. One product, for example, contains pyrilamine maleate (an antihistamine approved for OTC use but not specifically for PMS), pamabrom and acetaminophen. Women should read the labels of OTC products and check with their doctors for advice on the best treatments for the specific PMS symptoms they have. Some doctors believe women may be able to help themselves through the discomfort of PMS without pills by exercising, eliminating or cutting down on smoking, and changing their diets. “I recommend eating small frequent meals because a lot of food causes blood sugar to swing up and down, and that may effect premenstrual problems,” says M. Yusoff Dawood, M.D., director of the Division of Reproductive Endocrinology at the University of Texas Medical School in Houston. To stem water retention, many doctors recommend reducing salt intake, and to reduce headaches, avoiding liquor. No scientific studies have proven that exercise can reduce PMS, but there is much anecdotal and indirect evidence that it does, doctors say. “The idea is that exercise raises levels of beta endorphins, [which] have a positive effect on mood and behavior,” says Michelle Warren, M.D., co-director of the Division of Reproductive Endocrinology at St. Luke’s-Roosevelt Hospital in New York City. Moreover, she believes exercise may reduce water retention. Vitamin B6, known as pyridoxine, is recommended by some doctors to relieve PMS, but studies on its effectiveness have been inconclusive, according to Dawood. Use of extreme doses of it have been associated with neurological problems. For those whose PMS is unrelieved by most common treatments, more help is available. While not approved for these uses by FDA, some doctors prescribe birth control pills and use of progesterone suppositories (during the premenstrual phase) for PMS. Oral contraceptives prevent ovulation and therefore prevent the luteal phase from occurring. Although progesterone suppositories have proven no more successful than a placebo in controlled studies, because they seem to help some women, Warren believes they are worthwhile. Prescription painkillers, diuretics, tranquilizers, and antidepressants are also prescribed by physicians in severe cases.

How does natural progesterone cream help PMS?

Progesterone balances estrogen’s effects. Estrogen is a very powerful, stimulatory hormone that has multiple effects upon the body. These effects are listed in table below:

ESTROGEN EFFECTS	PROGESTERONE EFFECTS
Builds up uterine lining (proliferation)	Maintains uterine lining (secretory)
Stimulates breast tissue	Protects against fibrocysts
Increases body fat	Helps use fat for energy
Salt and fluid retention	Diuretic
Depression, headache/migraine	Anti-depressant
Interferes with thyroid hormone	Facilitates thyroid hormone action
Increases blood clotting	Normalizes blood clotting
Decreases libido	Restores libido
Impairs blood sugar control	Regulates blood sugar levels
Increases risk of endometrial cancer	Protects from endometrial cancer
Increases risk of breast cancer	Probable prevention of breast cancer
Slightly restrains bone loss	Stimulates bone building
Reduces vascular tone	Propagates growth of embryo
	Precursor of corticosteroid production

During the times of fluctuating hormone levels which are associated with PMS the effects of estrogen are not sufficiently offset by the tempering action of progesterone. This results in what is known as ‘estrogen dominance’. In the menopausal woman the signs and symptoms of estrogen dominance may include hot flashes (flushes), sleep disturbances, poor bladder control, dryness of the vagina, mood swings and irritability. Some women also report weight gain, lack of energy, malaise, forgetfulness, cloudy thoughts, anxiety or panic attacks, sore bones and general aches and pains. Not everyone will experience all of these symptoms; however, even one or two can be difficult to cope with if not addressed adequately. Correcting any imbalance between the hormones estrogen and progesterone, especially the lack of progesterone, will usually rid an individual of many of these symptoms within a few months. In the younger woman (pre- or peri-menopausal) estrogen dominant symptoms present as PMS, often with menstrual changes. The symptoms arise due to an under-production of progesterone rather than an excess of estrogen production. Irregular or shorter intervals between periods, spotting, irregular bleeding and heavy bleeding are all indicators of hormonal imbalance especially in the peri-menopausal woman. The long-held belief that these symptoms and feelings are due to estrogen deficiency is rapidly being replaced by the understanding that progesterone plays an active role in preventing these changes from occurring. If there is a menstrual blood flow (regular or irregular) then there is plenty of estrogen being produced by the ovaries. It is estrogen that stimulates growth of the uterine lining. It is progesterone that holds the uterine lining together. If there is a deficiency of progesterone then the uterine lining breaks down; hence irregular and heavy bleeds result. The younger woman suffering from PMS is likewise experiencing the symptoms of estrogen dominance. Often PMS women exhibiting symptoms are treated with the Pill to “stabilize” the hormones. The Pill overrides the natural hormone production of women and in the case of the peri-menopause adds estrogen but fails to address the progesterone deficiency because the Pill doesn’t contain natural progesterone. Often women treated with the Pill find their symptoms worsen rather than improve. This is due to the added estrogen of the Pill not being balanced by natural progesterone and “estrogen dominant” symptoms are exacerbated. The progestin in the Pill does not do what natural progesterone does in terms of balancing the effects of estrogen and therefore the Pill usually aggravates symptoms in an already estrogen dominant woman. In estrogen dominant women experiencing PMS the first line of treatment should always be bio identical progesterone cream supplementation. Giving the Pill is giving the wrong hormone. A woman still getting a bleed (regular or irregular) is producing sufficient estrogen. It is the progesterone that is in deficiency and not estrogens. The medical profession has for decades been convinced by the pharmaceutical industry that women are estrogen – only entities and that progesterone is a nebulous hormone. The truth is that progesterone is produced by the body in quantities a thousand-fold greater than estrogens. Progesterone is a pivotal hormone for the propagation of life and for the production of other hormones, including estrogens, glucocorticoids and corticosteroids. Without progesterone there would be no menstrual cycle or reproduction. Progesterone has its own distinct and active role to play in the body including keeping the stimulatory effects of estrogen under control.