Sugar and PMS

The insatiable urge to devour the ENTIRE pack of Tim Tams strikes, accompanied by persistent irritation toward, well, everything. Following a day of carb-o-loading and sweet treats, you ask yourself – what is going on?

And it soon becomes abundantly clear – you are about to have your period (well, not if you are a bloke, but as a fella, you may see such behaviour arise in the ladies in your life).

Sugar-craving (and binging) is a common symptom of pre-menstrual syndrome, alongside the pimples, bloating, sore breasts, low mood, and myriad of other signs that it is ‘that time of the month’.

Why do some women crave sugar at this time? And does sugar make symptoms worse?

First, let’s quickly look at the menstrual cycle of women.

The monthly cycle

On average, a woman will experience a 28-day cycle, comprising of 4 stages:

1. Follicular phase
2. Ovulation
3. Luteal phase
4. Menstruation

Each stage takes place thanks to the complex communication, production and action of reproductive hormones, preparing a woman’s body for pregnancy.

When levels of reproductive hormones are out of balance – which in many presents with low progesterone and excess oestrogen – the menstrual cycle can be disrupted, and/or symptoms occur.

A balancing act

With low progesterone and high oestrogen, we may experience:

• Low mood
• Bloating
• Cravings
• Swelling or water retention
• Breast tenderness
• Joint pain
• Foggy brain
• Headaches
• Insomnia
• Fatigue
• Anxiety
• Depression
• And many, many more symptoms!

There are many factors that can tip the balance between hormones. Stress is a big one, as well as toxins called xenoestrogens. Each can encourage excessive oestrogen levels.

And the balance of hormones is majorly impacted by diet quality and nutritional deficiencies. A particular area of concern is too much added refined sugar and heavily refined and processed grains.

Why? Here are a couple of thoughts.

Blood glucose, insulin and sex-hormone binding globulin
Insulin, released following food or drink to shepherd away glucose from the blood and into cells, is associated with lower levels of a hormone called sex-hormone binding globulin (SHBG).^1-3 A role of SHBG is to bind excess oestrogen leaving it relatively unavailable to bind to receptors and exert its oestrogenic effect (like symptoms listed above).

But if there isn’t much SHBG because insulin is ever present in high amounts dealing with that last sugary meal, levels of reproductive hormones like oestrogen and testosterone rise, which can lead to hormonal imbalance.

Blood glucose, cortisol and progesterone
Fluctuating blood glucose levels encourages cortisol (a stress hormone) production in an effort to maintain a stable glucose supply in the blood, mitigating the massive crashes in blood glucose following a sugar high.⁴

However, a precursor of cortisol is progesterone. When cortisol is needed, whether it be stabilising blood glucose or dealing with a stressful situation, the body will opt for more progesterone (and its precursor, pregnenolone) to be used for stress hormone production, putting aside reproductive function, like pregnancy and babies. And rightly so – the body wants the environment to be safe before a little one comes along!

Whilst the mechanisms behind hormonal imbalance and PMS are many and complex, high oestrogen and low progesterone may at least in part be due to too much of refined sugar and heavily processed foods.

Why to we crave sugar during PMS?

The craving for sweet stuff can often increase during the premenstrual phase of a woman’s cycle.⁵ This may be due to a desire for quick access energy (i.e. glucose), especially if experiencing stress (whether actual, physical or perceived).

And wanting more sugary food may be due to sugar’s mollifying effect on mood, making us momentarily happier when feeling low, anxious or irritated. Yet adequate progesterone provides feelings of calm and happiness, so balancing with oestrogen is important. In the long-run, excess refined added sugar only makes matters worse.

What we eat matters

There are plenty of wonderful things a lady can do to assist with ameliorating symptoms and rebalancing hormones, including meditation, massage, exercise, yoga, acupuncture, herbs, and supplements.

A woman’s body and menstrual cycle is beautifully complex – each person is different with unique needs and circumstances, and we encourage that you chat to your healthcare practitioner to explore what it is you require.

And as with any aspect of health, what you eat and drink matters. Diet is the basis of health, and like a house, you want to build wellness from a solid foundation. Essentially, eating mostly real, whole food will best support hormonal health. Looking at specific aspects of what we consume, here are some ideas to consider.

LIMIT

Added sugar
Often contained within heavily processed foods (but also hiding in seeimingly healthy foods, as we know), refined added sugars offer little nutrition.

Whilst a little is okay, don’t make it a mainstay of the diet for reasons discussed above. In addition, the liver plays a critical role in eliminating excess hormones from the body, and as we are aware too much sweet stuff – particularly fructose – can lead to fatty liver and comprise liver function.

Heavily processed and refined foods
Especially grains, but also trans-fats, which can encourage inflammation and menstrual pain. If eating grains, choose whole versions that are packed in with fibre, and fats should come from whole food or minimally processed sources like avocado, flaxseed or extra virgin olive oil.

Alcohol and caffeine
Whilst a little of each is okay for many, you may wish to trial how you feel without and see if you feel better for it. Otherwise, consume with care and in moderation, as each impact the balance of reproductive hormones, can stress the body, and burden the liver.

ENJOY

Fantastic fibre
Fibre is delivered in real whole foods like vegetables, fruit, nuts, seeds and legumes. Fibre is important to help eliminate excess hormones through bodily excretion, and plays a dual role in helping good gut bugs of the intestinal microbiome to thrive, encouraging hormone metabolism and normalising oestrogen levels.

Fabulous healthy fats
Whole foods containing omega-3 fatty acids, like sardines and walnuts, can help lower inflammation. Low-grade chronic inflammation is linked with symptoms of PMS.⁶

Flaxseeds have the added benefit, being not only a source of omega-3 fatty acids, but also fibre and lignans that may help in reducing negative effects of when certain forms of oestrogen are in excess.⁷

Lovely leafy greens
These are packed with phytonutrients that help many aspects of health. They, along with nuts and seeds, are great sources of magnesium and vitamin B6, seen to assist in alleviating premenstrual symptoms via a variety of mechanisms including sugar metabolism and mood.

Brilliant brassica
Cruciferous vegetables such as radish, broccoli, cauliflower, kale, and brussel sprouts contain a phytonutrient called indole-3-carbinol, which promotes methylation of oestrogen metabolites, rebalancing hormone levels.⁸

Powerful protein
Ensure you start the day including protein, such as free-range eggs, beans, nuts, or full-fat plain yoghurt, to support liver function and its metabolism of oestrogen, as well as stabilising blood sugar levels throughout a day, encouraging more sustained energy, better food choices, improved sleep and health overall.

Finally, remember to not be too hard on yourself! Understand that the body is complex and changes you make will take time to have a noticeable, positive impact. Focus on managing stress, reducing intake of foods that encourage a stressful state, consuming mostly real whole food, and being kind to yourself.

By Angela Johnson (BHSc Nut. Med.)

References:

1. Daka, B Rosen, T Jansson, PA Råstam, L Larsson, CA Lindblad U 2012, ‘Inverse association between serum insulin and sex hormone-binding globulin in a population survey in Sweden,’ Endocrine Connections, vol. 2 no. 1, pp. 18-22,
2. Strain, G Zumoff, B Rosner, W & Pi-Sunyer, X 1997, ‘The relationship between serum levels of insulin and sex hormone-binding globulin in men: the effect of weight loss’, vol. 79, no. 4, pp. 1173-1176.
3. Wallace, IR, McKinley, MC, Bell, PM, & Hunter, SJ 2013, ‘Sex hormone binding globulin and insulin resistance’, Clinical Endocrinology, vol. 78, no. 3, pp. 321-329.
4. Trickey R 2003, Women, Hormones and the Menstrual Cycle, Allen & Unwin, Crows Nest N.S.W.
5. Rossignol, AM & Bonnlander, H 1991, ‘Prevalence and severity of the premenstrual syndrome. Effects of foods and beverages that are sweet or high in sugar content’, Journal of Reproductive Medicine, vol. 36, no. 2, pp. 131–136.
6. Puder, JJ, Blum, CA, Mueller, B, De Geyter, C, Dye, L, & Keller, U 2006, ‘Menstrual cycle symptoms are associated with changes in low-grade inflammation’, European Journal Of Clinical Investigation, vol. 36, no. 1, pp. 58-64.
7. Brooks, JD, Ward, WE, Lewis, JE, Hilditch, J, Nickell, L, Wong, E, & Thompson, LU 2004, ‘Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy’, The American Journal Of Clinical Nutrition, vol. 79, no. 2, pp. 318-325.
8. Linus Pauling Institute 2008, Indole-3-Carbinol, viewed 3 Jan 2017, <http://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/indole-3-carbinol>.