PMS Getting Worse in Your 40s? Here Is What Is Changing

The short answer: In your late 30s and 40s you ovulate less regularly. You make Progest after you ovulate, so fewer ovulations means less Progest. Your Estros can still run high or swing from month to month. That gap between the two is what makes your PMS worse. Low nutrients, a slow liver or bowel, stress and poor sleep make the gap wider. You can test for each of these and work on them.

What changes in your body in your 40s

The years before menopause are called perimenopause. For most women they start somewhere in the 40s and can last several years.

During this time your ovaries do not release an egg every month. When you skip ovulation, you skip the Progest that follows it. Progest is the hormone that calms your nervous system, helps you sleep and balances the effect of Estros on your breasts and uterine lining.

Your Estros does not drop at the same pace. In many months it stays normal or runs higher than before. You end up with more Estros relative to Progest than you had in your 20s and 30s. This is often called Estros dominance, and I cover it in more detail in my article on balancing Estros dominance naturally.

Signs this is what is happening to you

You are likely dealing with low Progest and relative Estros excess if you notice several of these in the week or two before your period:

• Your breasts are swollen and tender.
• You are more irritable, anxious or tearful than you used to be.
• You sleep poorly or wake at night in the days before your period.
• You bloat and gain a few pounds of water.
• Your periods are heavier, or your cycle is shorter than it was.
• You get headaches or migraines around your period.
• You crave sugar and carbohydrates.

If your symptoms used to last two days and now last ten, that is a sign your hormone balance has shifted.

Why it is not just "getting older"

Age starts the change, but it does not decide how bad your symptoms get. I look at three things: deficiency, toxicity and your terrain.

Deficiency

Your body needs raw materials to make and balance hormones. The ones I check most often are:

• Magnesium. You lose more under stress, and low magnesium is linked to cramps, poor sleep and mood changes before your period.
• Vitamin B6 and zinc. Both support Progest and neurotransmitter balance.
• Protein. If you do not eat enough protein, your blood sugar swings and your cravings and mood get worse.
• Iron. Heavier periods drain your iron stores, which leaves you tired and foggy on top of your PMS.

Toxicity

Your liver breaks down used Estros and sends it to your bowel to leave your body. If your liver is overloaded, or you do not have a bowel movement every day, that Estros gets reabsorbed and goes back into circulation. Certain gut bacteria make this worse. This is why I look at your gut as part of your hormone picture.

You also take in compounds that act like Estros in your body. Plastics, synthetic fragrance, some pesticides and some personal care products all add to the load your liver has to clear.

Your terrain: stress, sleep and thyroid

When you are under constant stress, your body puts its resources into stress hormones. Long-term stress can also disrupt ovulation, which leaves you with even less Progest.

Poor sleep raises your stress hormones and makes your blood sugar harder to control. Your sleep and your hormones affect each other in both directions.

Your thyroid matters too. A slow thyroid can make your periods heavier and your PMS worse. If you are tired, cold, gaining weight or losing hair along with worse PMS, read about thyroid support and get a full thyroid panel, not just TSH.

Test first, then act

I do not guess with hormones. Two women with the same symptoms can have very different causes. Testing tells you which one you are dealing with.

These are the labs I find most useful for worsening PMS:

• Cycle-timed hormone testing. Testing Estros and Progest in the second half of your cycle, about a week after ovulation, shows whether you are ovulating and how much Progest you make. A saliva or dried urine test can also show how well you break down Estros.
• A full thyroid panel. TSH, free T4, free T3, reverse T3 and thyroid antibodies.
• Ferritin and a full iron panel, especially if your periods are heavy.
• Vitamin D.
• Fasting glucose and insulin to see how your blood sugar is behaving.

You can order these through my lab page.

Track your symptoms by cycle day for two or three months before or alongside testing. Write down your sleep, mood, bloating, breast tenderness and flow. This pattern tells you and your practitioner a great deal.

See your medical provider promptly if you have very heavy bleeding, bleeding between periods or after sex, periods closer than three weeks apart, or mood changes that are severe or frightening. These need to be checked for other causes.

What you can start doing now

These steps support your hormone balance while you wait for your results:

1. Eat protein at every meal, including breakfast. This keeps your blood sugar steady and reduces cravings before your period.
2. Have a bowel movement every day. Eat more fiber from vegetables, seeds and legumes, and drink enough water. If you are not going daily, start here.
3. Eat cruciferous vegetables such as broccoli, cabbage, kale and Brussels sprouts most days. They support your liver's clearance of Estros.
4. Cut down your exposure. Store food and water in glass or stainless steel, not plastic. Switch to fragrance-free personal care and cleaning products.
5. Keep alcohol to a minimum. It disrupts your sleep and adds to your liver's workload.
6. Protect your sleep. Go to bed at the same time every night and keep your room dark and cool, especially in the week before your period.
7. Lower your stress load where you can. A daily walk, slow breathing or time outside all help bring your stress hormones down.

If you take any medication or hormone therapy, do not stop or change it on your own. Make any changes only with your prescribing practitioner's supervision.

How I work with worsening PMS

My approach is to test first, find whether deficiency, toxicity or stress is driving your symptoms, and then build a program in the correct order. Support your bowel and liver before you push hormone balance, so your body can clear what it breaks down. I use nutrition, herbs and non-toxic homeopathic hormone support. You can read how that works in Non-toxic Homeopathic Hormone Balancing, and see my programs for how we work together.

Not sure where to start?

Take the free quiz. It takes a few minutes and shows you which area to look at first: thyroid, gut, hormones, energy, skin or sleep and stress.

If you would rather talk it through, book a free 15-minute call. We will go over your symptoms and the labs that make sense for you.