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I am a New Zealand registered nurse and nutritionist (Grad Cert Sci: nutrition, Massey Univ). I am a Certified Zone Instructor, and have worked teaching Zone diet principles to hundreds of clients over the last 10 years. More recently after finding that eating Paleo food choices was the "icing on the cake" health wise, I have become a Paleo enthusiast and teacher. Follow me on twitter @juliannejtaylor

Pre Menstrual Syndrome and Menstrual Cramps, how I eliminated them completely

This is my story of how I eliminated these two sometimes debilitating female issues, I hope this will give other women some tools to eliminate them also.

I always had pain and cramps with my monthly, in high school a couple of aspirins would usually keep it at bay. In my 20’s I got increasingly annoying Pre-Menstrual Syndrome (PMS), I was grumpy and irritable, but the worst was the sore, tender lumpy breasts, like a couple of massive bruises sitting of my chest getting progressively worse over the week before my period. This was then replaced by cramps for 2 or 3 days.

In my mid 20’s I improved my diet (or so I thought) by becoming a vegetarian, also motivated by wanting to help animals and the planet. I also stopped eating fish as I was worried about the impact of overfishing.

I left New Zealand on my OE (Overseas Experience) at 26, something every good Kiwi does as a rite of passage. After 3 months in the USA I arrived in England to settle down and earn some money. My menstrual pain was getting worse and worse. It got to the point where I’d have to take Panadeine every 4 hours or I’d be doubled up and vomiting with the pain. I went back to NZ at 29, still suffering terrible cramps and still semi-vegetarian (mostly vegetarian meals and infrequent meat), the trendy diet for the ‘80s. My doctor suggested I do more exercise, so I took up running, and surprisingly this helped. Interestingly studies show female athletes report less than normal pain with their periods.

However, when I reduced the exercise the terrible pain came back. I kept suffering and swallowing pain killers. It never occurred to me there was something I could do about it. The PMS continued as well.

Approximately 30% of the female population suffer from Pre Menstrual Syndrome (PMS), and for about a third of those it is severe. About 10 percent of women have severe dysmenorrhoea (period pain).

When I was about 35 my partner picked up a copy of Dr Barry Sears “Enter the Zone”. It looked interesting, I devoured the book.  A lot of issues Sears talked about rung true with me, blood sugar problems, hunger and cravings, weight gain. He looked at food in a new light, each meal sets off a hormonal cascade starting with insulin and glucagon and then eicosanoid hormones. By controlling blood sugar and consequently hormones you control of unstable blood sugar and cravings, and achieve easy weight loss.

Sears also had a section on PMS. (My interest picked up at this point!) He says PMS appears to be linked to a genetic defect in the normal synthesis of Gamma linolenic acid (GLA). This essential fatty acid is the building block of several groups of prostaglandin hormones. Research indicates that women with severe PMS have GLA levels 80% lower than women without PMS. Some studies show women taking a GLA supplement (found in evening primrose and borage oil) get relief, however other studies found that there was no benefit. (I was in the no benefit group – tried it, didn’t work)

Sears says the problem is you can’t resolve PMS with GLA supplementation alone – it has to be combined with a diet that controls the hormone insulin. Why is controlling insulin so important? GLA is the building block of both pro-inflammatory and anti-inflammatory prostaglandin hormones. If you have high levels of insulin, an enzyme called delta -5 desaturase is activated. This is responsible for converting GLA into arachidonic acid, a fatty acid that is then converted into inflammatory prostaglandins. These hormones are connected with PMS symptoms.

Sears stated that it is essential to combine activated fatty acids (GLA) with a Zone balanced diet. This is because the Zone diet keeps blood sugar and insulin levels low and stable. The Zone diet also increases Omega 3 levels, by including lots of oily fish and taking fish oil as a supplement. The result? The same GLA goes down another pathway and gets converted into anti-inflammatory hormones called PGE1.

Sears stated “That’s what I’ve done with hundreds of PMS patients, and it WORKS: these patients report significant reduction, if not eradication of PMS within 30 – 60 days”

What was I waiting for? It was worth a shot. I immediately changed my diet to eating Zone balanced meals. The next cycle I was stunned at the result – nothing, not the tiniest bit of breast tenderness, not a single black cloud. After 20 years of putting up with monthly discomfort – I’d finally found the answer to PMS. Unfortunately the cramps did not abate.

What about period pain: dysmenorrhoea? Dysmenorrhoea is characterised by severe uterine pain during menstruation. Primary dysmenorrhoea is not caused by any underlying medical issue such as endometriosis or fibroids.

One cause of dysmenorrhoea is thought to be an overproduction of pro-inflammatory eicosanoid (prostaglandin) hormones that cause pain and vascular constriction. There is also a lack of anti-inflammatory and vaso-dilating eicosanoid hormones.  In fact elevated levels of inflammatory prostaglandins have been measured in the menstrual fluid of women with severe dysmenorrhoea.

Fatty acids are the building blocks of these prostaglandin hormones – Omega 6 fats and arachidonic acid are the building blocks of the inflammatory, pain causing and vaso-constricting hormones, and Omega 3 fats are the building blocks of anti-inflammatory hormones. If your diet has an imbalance of too high levels Omega 6 and too low levels of Omega 3 you have lots of building blocks of hormones causing the pain and blood vessel constriction, and a lack of building blocks of anti-inflammatory prostaglandins.

Several studies have shown that taking omega-3 fatty acids can reverse the symptoms of dysmenorrhoea, by decreasing the amount of omega-6 FA in cell membranes and replacing it with Omega 3. High levels of omega 3 in cell membranes ensure the building blocks of anti-inflammatory hormones are available in abundance.

Interesting to me was that my period pain had become increasingly worse during my years as a vegetarian. I ate virtually no food with any decent amount of omega 3 and my body must have become increasingly deficient. After learning about Omega 3, I started supplementing my diet with 2000mg EPA+DHA (6 purified fish oil capsules a day). Within a month the pain reduced to tolerable levels, although I still needed pain relief. Not only that, but joint inflammation (knees and neck) decreased by about 80% as well. Again this was a revelation to me. Even though I had started eating fish again and restricted my intake of omega 6 – it was not enough. Only taking the additional daily supplement of omega 3 was effective. I continued to eat along Zone diet guidelines for the next 12 years, the menstrual cramps continued but were never severe as long as I took the omega 3. The PMS came back from time to time, and I couldn’t figure out why.

About 18 months ago I was introduced to the Paleo diet though CrossFit Auckland (where I started working as a nutrition coach). After reading both Robb Wolf and Loren Cordain’s work, I was convinced that Paleo food choices were worth trying. This article was particularly convincing, Cereal Grains: Humanity’s Double-Edged Sword, as was this interesting testimonial on relief of PMS and cramps on the paleo diet. http://www.thepaleodiet.com/success_stories/#menstrual

I removed grains, legumes and dairy from my diet (Paleo diet). The menstrual cramps became almost non existent as did the PMS. It’s now been 16 months 100% PMS free, and since adding magnesium to my supplements 100% menstrual cramp free. This was the missing link, when I cut these foods out completely, I got complete relief. While the Zone diet reduced these foods considerably and fixed my blood sugar and weight issues, it was not the full picture. Food quality matters, a point Robb Wolf has noted again and again when I wrote to him of my experience. The Zone: Better with Paleo Foods

Even a gynecologist I spoke to found this almost unbelievable. However, I regularly find clients have similar results to me.

Just a note here – Sears noted that GLA (evening primrose oil) helps some people, my experience of it has always been negative. I feel worse when I supplement, and it tends to increase PMS symptoms and inflammation. It is a very individual requirement. I recommend first following trying out diet and supplements below and only try GLA after a couple of months if you are not getting as much relief as you hoped for.

My recommendations for both PMS and period pain (note I am not a Doctor – if you need to consult a medical specialist first):

  • Paleo diet, I.e.  grain, legume and dairy free. This will control food quality, reducing gut irritant foods.
  • Take Omega 3 – use a high quality fish oil supplement. 2000 – 3000mg EPA+DHA per day.
  • Try eating a zone balanced, reduced carbohydrate diet. Focus on getting your carbs from fibrous colourful vegetables and fruit – they increase polyphenols and antioxidants which are anti-inflammatory. They also increase the alkalinity of your diet which helps you retain calcium. Higher calcium levels are linked with less PMS
  • Magnesium: Double-blind studies have found magnesium supplementation to be effective for treating primary dysmenorrhoea. It has vaso-dilatory and muscle relaxant effects, as well as inhibiting the synthesis of prostaglandin F2 alpha (a pro-inflammatory hormone).
  • Zinc: in one study 1 to 3 x 30mg doses were given daily for one to four days prior to onset of menses, and prevented virtually all menstrual cramping
  • Vitamin E, mixed tocopherols, 200iu per day, is shown to reduce cramps and bleeding.
  • Cut out or minimise oils that contain Omega 6, as these can convert to inflammatory prostaglandins. Use oils that are high in monounsaturated fat (Omega 9) such as olive oil, nuts, especially macadamia and avocado.
  • Minimise arachidonic acid – this fat is the building block of inflammatory prostaglandins and is found in fatty red grain fed meat and egg yolks from grain fed chickens. Eat grass fed meat.
  • Make sure your vitamin D levels are at the top of the ideal range. Calcium and vitamin D are linked with a significantly reduced PMS risk. Vitamin D is crucial for calcium absorption, if you are deficient you only absorb about 10% of the calcium from your diet. Get sunlight on your arms and legs for 10 minutes a day (off peak) in the summer. In winter it pays to supplement with 2000iu per day. See article on Vitamin D for more information.
  • Do regular high intensity exercise, it elevates mood and reduces menstrual pain. Female athletes report less than normal pain with their periods.
  • Take a good quality vitamin, mineral and antioxidant supplement with iron. This will ensure that dietary deficiencies are reversed.

See Zone online shop for the following products:

OmegaRx and Omega Science high concentrate Omega 3 fish oil capsules.

Thompson’s Kelp – low levels of iodine are linked with Polycystic breast and endometriosis.

Vitamin D 1000iu tabs. (You may need up to 5000iu per day to get ideal blood levels)

Thompsons Vitamin E 200iu

Zone Micronutrient – a high quality vitamin, mineral and antioxidant supplement.

EicoRx: Omega 3 concentrate plus GLA, and toasted sesame oil extract to ensure GLA is converted to anti-inflammatory hormones.

Maryland Medical Centre article on menstrual pain: http://www.umm.edu/altmed/articles/menstrual-pain-000052.htm

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18 Responses to “Pre Menstrual Syndrome and Menstrual Cramps, how I eliminated them completely”

  1. Barbara #

    Wow, so this is why! I’ve slipped off just about everything recently but this post is great for motivating me to getting back on the straight and narrow!! 😉

    Thanks Julianne, I really enjoy reading your posts!

    October 26, 2010 at 10:32 am Reply
  2. I know this is an old post, but I have recently started on my paleo journey (3 weeks) and have just got my monthly’s. I have had a slight pain but nothing on my usual stay in bed and spend the next 4 days grumpy and in pain. This makes me even more motivated to continue on my journey and it’s great to read up on these issues through your blog. Thanking you!

    December 7, 2011 at 10:30 pm Reply
    • That’s fantastic – let us know how you go as time goes on.

      December 8, 2011 at 2:45 am Reply
  3. Nina K. #

    Hiya,

    made exactly the same experience with primrose oil. I switched to a low carb diet, eliminated almost all grains, eat some legume, but not very often and drink matcha on my “special” days, no pms no cramps no mirgraine! Healthy nutrition rulezzz 🙂

    December 15, 2011 at 11:51 am Reply
  4. jens #

    Hoping you will find this: Does ‘no dairy’ also mean “no organic, grass fed, no antibiotic” dairy like real yogurt, and real buttermilk?

    Thank you.

    April 20, 2012 at 2:17 pm Reply
  5. acm #

    I’ve sort of found the opposite — I was previously pretty symptom-free (maybe an Advil every few months), already taking Omega-3’s, etc., but since switching to paleo I’m getting a serious uptick in “perimenopausal” symptoms: more cramping and nausea before and during my period, more discomfort midcycle, and more temperature disregulation. If the other health benefits I’ve found weren’t so convincing, this would have been enough to drive me off the diet already. Have added more vitamin E after doing some research, but still no luck. Has anybody found this sort of problem and/or have any advice to offer? I’m not sure I can live this way… 🙁

    June 12, 2012 at 4:47 am Reply
    • I’ve heard an occasional report of women finding things worse on paleo. It would be useful to look at what has changed – perhaps in terms of protein carb fat. I regularly see women who increase protein and fat and decrease carbs and don’t do well in many ways. They feel worse, their sleep gets worse, they get hungry and dont lose weight if that is their goal.

      I find this often applies to women who tend towards a pear shape and are either not overweight – or only a little.

      Is that the case with you? If it is – add in more carbs – like root vegetables, fruit, and possibly rice. Some people are also fine with non gluten grains and legumes as long as they are prepared properly. Keep protein to about a palm size at meals – no need to have a lot – 3 – 4 oz is fine for women. Some do better with an increase in good fats like olive or coconut oil.

      June 12, 2012 at 7:43 am Reply
      • acm #

        I wonder a bit if my system was relying on some things I ate a lot of just by chance — I’m thinking of milk, for example, which I used to drink a lot. If nothing else, it could well have been a source of additional estrogen that was helping mitigate my perimenopausal symptoms. May try some of that before adding in grains, as I really like the fact that my appetite (and probably thus blood sugar) is much more steady these days, with no hunger pangs or mufin cravings. I do sort of miss my decades of morning Cheerios, but it’s more nostalgia than craving…

        I’m not really concerned with weight — that is, my ideal would probably be lower than where I am, but my current weight is sustainable without fighting myself, which is key, and is perfectly pleasant and healthy. I’m pretty sure I’m keeping up calorically, but it could well be that my system is taking longer to adjust (enzymes, gut flora, whatever) to the sudden change from starches to fats and proteins, and that I’m just not extracting everything I need. I’m not really going low carb (am eating quite a bit of fruit, paleo muffins, honey on my ground nut “cereal,” etc.) but it could be the balance of things.

        Dunno, may give it another month and then try adding back some milk to see if that equalizes things a bit. Definitely don’t want to rush into hot flashes unnecessarily!!

        June 13, 2012 at 1:41 am Reply
        • Not sure how you are doing now – but thought I’d suggest watching the amount of nuts – nut cereal etc, you may be consuming very large amounts of omega 6 – which is pro-inflammatory

          July 24, 2012 at 2:53 pm Reply
          • Camilla #

            Dear Julianne, thank you a lot for your reply.

            I just have had my menstruation and it is still very painfull … and I still need too pills to stay alive with the pain! 😉
            But my legs and abdomen are swelling only just a little (since I am meeting animal proteins) and taking omega3 and B-complex vitamins… and this is very good!

            I noticed that cereals make me feel too hungry and nervous, except brown organic rice. I am getting also some eggs and low-mercury fishes.

            I wonder if I should interrupt with soy-milk and butter, that I assume regularly, and with sesame-cream (tahin) wich I eat a lot! My god I hope thay don’t have omega6…

            I don’t eat legumes except sometimes lentils and chickpea which I tolerate well.

            I must say my general energy is growing. And for information my general blood exames are good and I have no evidence of problems with my ginecologic system (but I had chlamydia for years, just cured last month with the help of an important and very good doctor).

            I think I could eat some white meat if this would help… but to be honest, what scares me is that when I was young I had two kind of fibroid (leg and arm) and I believe vegan diet interrupted this tenedecy of me to produce (benign) tumours (but I also ate a lot of sugar and candies!)

            So, I am going to continue with your scheme-diet, I think I have no choice.
            Thank you again!
            Camilla

            July 24, 2012 at 8:13 pm
          • acm #

            Oh! I had no idea — I thought nuts were suggested as part of paleo because of the Omega-3’s, but now I see that they also have plenty of Omega-6’s. Hmmm, will need to more consciously work more Omega 3’s into my diet, I guess.

            I did take your previous suggestion and start adding a few servings per week of yams or potatoes, and that seems to have calmed my whole system down too, so thanks for that. I think this is going to work out, but obviously there’s room for a bit more tweaking! 🙂

            July 25, 2012 at 1:03 am
  6. Camilla #

    Hi Julianne, I am writing from Italy so excuse my bad English.
    This is a very very interesting post.
    I have always had menstrual cramps for almost 20years and even if I changed my body, my emotions and so on… the cramps are still there. I learned how to manage them with the diet and the gym, but it’s still a painful experience that makes me intoxivate with lots of pills.

    I tried to take off gluten, and i noticed I feel really better. But I have problems with all the animal proteins, as i have been vegan until last month. A neutopathic problem convinced me to introduce vitamins B and fish oil and fish, and i admit i really feel better. The nervous system has repaired quickly and mesntrual pain has reduced!

    I feel more energy and concentration. The only problem is that eating fish has given me immediately mucos, nasal discharge and some acne, which with the vegan diet wasn’t present. But all the rest opf problems conected to nervous system are almost totally healed.

    I must admit I have had always problems with white carbs and sugars, so maybe with insulin levels, and eating fish and fresh vegetables, makes feel really good.

    I do feel all you wrote in this post is the answer to my problems, so I reduces all carbs, at least some brown rice and gluten-free pasta. For the rest I take fruits in the morning, and fresh vegetables during the day. But I canot eat fish every day at every lunch and dinner, and i dont want eat meat, i really cant do that also for spiritual motivation.

    May you think I can have a similar paleo diet (I also have read the book!) by eating only fish and no meat?
    Please note that I also have some mercury intoxication.

    I am taking the Omega 3 (and reduced the omega6!), magnesium, zinc and vitamin D, and also a B-complex (except b12 that immediately makes my skin a disaster! … the same effect with the yeast )

    Thank you again if you have any suggestion… I hope this second menstruation that is arriving, will go better… as I really ate a lot of fish and cut off all the gluten.

    Take care!

    Camilla

    July 20, 2012 at 7:19 am Reply
    • Eating fish for protein and not meat is fine. Maybe you could eat eggs as well?

      If you have mercury – stick to fish that is low in mercury, the smaller fish are better, tuna and large predatory fish are worse.

      Let me know how your next cycle goes.

      regards
      julianne

      July 20, 2012 at 8:48 am Reply
  7. Steve #

    Several statements about omega 3 and 6 are over generalized in this article. Gamma Linoleic Acid, GLA, is in evening primrose oil, is an omega 6 not an omega 3, and yet helps many to lower the types of prostaglandins that cause period cramps.

    Not all omega 6s are bad.

    December 9, 2014 at 12:51 am Reply
    • You are right – not all omega 6 are bad, nor is it bad to eat oils containing omega 6 – we need a certain amount for prostaglandins / eicosanoid hormones. The problem it the imbalance – too much omega 6 and too little omega 3. Omega 6 makes primarily pro-inflammatory hormones, however it also makes some anti-inflammatory hormones and as you say GLA. In my experience GLA is tricky – if I take it – I get overload and feel worse – yet others feel better.

      December 9, 2014 at 10:12 pm Reply
  8. ieda #

    do you take all the supplement together? because im afraid there will be side effect if i take too much supplement

    June 20, 2015 at 8:40 pm Reply
    • I’d suggest take the omega 3 (or more oily fish) with meals and the magnesium before bed as it also helps sleep and see how you go with those first.

      June 23, 2015 at 4:36 pm Reply

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