Study Investigates the Relationship Between PMS and Sleep

By Dr. Sharon Gurm

A recent study published Dec 19, 2012 in PLoS ONE investigated the pattern of circadian rhythm (sleep-wake) and melatonin levels in women who experience a particular type of PMS known as premenstrual dysphoric disorder (PMDD).  Women with PMDD experience mood deterioration in the second half of their menstrual cycle, characterized by depressed mood, tension, affective lability, and irritability.

Researchers measured melatonin levels in two groups of women over the course of a monthly cycle – one group consisted of those who experience PMDD and the other a control group without PMDD. They found lower melatonin levels throughout the month and more frequent reporting of sleep disturbances in the women with PMDD compared to the control group. Melatonin levels were lowest during the luteal phase and correlated with worsening of the 4 core mood symptoms listed above.

Although the study involved a small sample size, the findings are interesting and suggest there is a relationship between lower melatonin levels, quality of sleep and PMDD. Future studies should look at the relationship between daytime levels of cortisol and nocturnal levels of melatonin in women who experience PMS.

Conventional treatments for PMS or PMDD typically involve hormone therapy in the form of oral contraceptives and sometimes anti-depressants, only in hope of managing the symptoms but not resolving the problem on any permanent or restorative level. Based on the results of this study – from a clinical perspective – it would be logical that treatment of PMDD should involve balancing the circadian rhythm by evaluating a woman’s daytime cortisol levels (the hormone that opposes melatonin levels). Altered daytime cortisol levels inevitably lead to disruption in melatonin production, resulting in sleep disturbances and/or non-restorative sleep (i.e. not feeling ‘rested’ when one wakes) and are usually characterized by varying levels of daytime fatigue.

There are natural solutions to restoring balance to the circadian rhythm. Diet, lifestyle and nutritional deficiencies are often at the root of the problem. A complete evaluation involving salivary hormone testing (assessing cortisol and other adrenal hormones), nutritional testing and a thorough health-symptom-lifestyle evaluation will help guide the individualized treatment needed to permanently correct for the hormone imbalance.

Contrary to common belief, PMS in any form is not ‘normal’ or ‘healthy’. It occurs because there is an imbalance in your body. But the good news is that you need not suffer. With the right approach, you can get rid of PMS naturally – and for good!

For more information, call (604) 949-0077.

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