Where the menstrual cycle brings us
An excess of ‘androgens’ — male hormones — such as testosterone in the second half of your cycle can lead to oilier skin and random pimples, says Dr Nicholas Lowe, a consultant dermatologist. “Some women also find that being on a low estrogen Pill can cause breakouts,” he says.
“If you’ve also got thinning or excess hair or weight that won’t shift (see below) you might be one of the 30% of women with some form of polycystic ovarian syndrome, caused by an excess of male hormones,” says gynaecologist Dr Gabrielle Downey.
“Switching to a Pill such as Yaz or Yasmin may help regulate excess testosterone that could be causing the oiliness,” says Dr Lowe. If it’s mild and hits only in the second half of your cycle, you can pre-emptive strike by applying a product that contains acne-fighting salicylic acid such as Dr Nick Lowe Oil Control Day Cream €22.49 (from Boots) the week before your period.
“Zinc is a key nutrient for skin and 30mg taken last thing at night could help breakouts,” says Dr Marilyn Glenville, author of The Natural Health Bible for Women (Duncan Baird €24.50). Up your zinc quota by adding wheat germ to your breakfast smoothie or pumpkin seeds to your salad.
“Low sex drive is more likely a relationship or body image problem than a hormonal one,” says Dr Downey. Low testosterone could be one hormonal culprit but this occurs as women get older (think menopause) so it’s an unlikely cause if you are under 38, she says. But the most likely cause, says Dr Claudia Welch author of Balance Your Hormones, Balance Your Life (Lifelong €17.04) is ongoing stress which causes the body to re-prioritise the production of desire-dampening stress hormones such as cortisol over estrogen and oxytocin that make you feel warm, fuzzy and like getting down.
Spend time with a friend who’s got kids.
“When women spend time with other women and their children, their levels of the hormone oxytocin rise which gives rise to greater feelings of connection and bonding,” says Dr Welch. “It’s a great stress release and indirect way of rediscovering your sex drive.”
If that sounds like hell — or you have children and it’s clearly not working — new Fembido (£24.95 / €29.40 for 60 tablets at chemistdirect.co.uk) contains Damiana Leaf which clinical trials have shown increases sexual desire and could make orgasm better by affecting circulation where it counts.
About a quarter of women suffer with Pre-Menstrual Syndrome (PMS) — bloating, breast tenderness and moodiness — from rising progesterone in the second half of the cycle (cruelly, it gets worse in our mid-30s). This is normal. But for 5-10% of women, severe, irrational mood swings signal pre-menstrual dysphoric disorder (PMDD) or extreme PMS.
“The most distressing symptoms of PMDD are mood-related,” says Dr Nick Panay, a consultant gynaecologist. “Women become a Jekyll and Hyde character in the two weeks before their period and can even get violent. Most get misdiagnosed with a psychiatric disorder.”
Keep a cycle diary, writing down key words about how you feel on each day for two to three months to help your GP confirm a diagnosis, suggests Dr Panay. You can keep a daily online symptoms diary at pms.org.uk and print it for your doc.
“If it’s cyclical, doctors might prescribe anti-depressants in the second half of the cycle only, or medication to stop the cycle,” says Dr Panay.
If your pre-period moodiness is mild, Dr Downey says treatments such as cognitive behavioural therapy may help identify triggers and patterns.
Turn into a Malteser-inhaling machine pre-period? Although food cravings are not directly associated with hormones, your cycle may still be to blame. “In the second half of the cycle many women experience a rise in insulin resistance,” says Dr Panay. “This can lead to increased blood sugar spikes and cravings for simple carbs such as chocolate and cakes”. It’s worsened by living or working under stress that raises adrenaline making cravings worse.
Try and avoid excess caffeine or alcohol – sticking to a cup or glass a day — in the two weeks before your period as these cause ‘rebound hypoglycaemia’ (quick drops in blood sugar) and more cravings, says Dr Panay. Just half an hour of cardiovascular exercise releases enkephalins and endorphins that help blood sugar balance (even if it’s the last thing you fancy). Taking 200mg a day of chromium and adding a pinch of cinnamon to your breakfast cereal or smoothie are also proven to help chronic sugar-seeking, says Dr Glenville.
“Having a handful of almonds as a snack can keep cravings at bay because their essential fatty acids keep you satiated for longer,” she says.
If you’re mainlining sleep pre-period, blame hormonal overdrive as rising progester- one has an anaesthetic affect, relaxing muscle activity, says Dr Downey. Constipation before your period is also thanks to progesterone’s relaxing effects on the bowel, she explains.
“Progesterone dampens intestinal muscle contractions that keep you regular so women can become bloated and constipated before periods.”
A multivitamin high in B vitamins and magnesium taken all month can help your body replace the energy stores used up by the hormonal upheaval that takes place in the second half of your cycle, says Dr Glenville.
For constipation, Dr Glenville suggests soaking a tablespoon of whole linseeds or flaxseeds overnight. “They become a jelly like mass that you can swallow first thing in the morning to keep your bowels moving in a healthy way,” she says. “You can continue this daily for the two weeks before your period.”
“If your hair is looking thinner in the light or its receding at the temples or on the scalp, this male pattern thinning could be the result of excess testosterone levels,” says Steven Franks, Professor of Reproductive Endocrinology at Imperial College London.
“Women with PCOS are more likely to have this kind of hair loss.” If you have excess hair on the chin, sideburns, lower back, tummy, chest or nipples, you could have PCOS. Low iron stores and underactive thyroid can result hair loss.
As soon as you notice a “male pattern” of hair thinning see your doctor, says Prof Franks. “Early treatment is important as it can slow or halt the condition causing the hair loss but it can’t replace hair that is already lost,” he says.
Talk to your GP about a referral to a specialist PCOS clinic or endocrinologist who can provide treatment for the symptoms you’re most concerned about, including prescribing laser hair removal for excessive hair growth. Ask your doctor for blood tests to check your thyroid hormone and ‘ferritin’ or iron stores, Dr Glenville says, adding: “Eat plenty of good quality protein such as eggs, lentils and lean meats for healthy hair.”
Tummy bloat is one thing and if it’s really associated with your period will be alleviated when you start your bleed. But according to Dr Downey, many people — including GPs — don’t know that excess weight around the tummy is a symptom of PCOS.
“People with PCOS don’t handle carbohydrates well,” she says. “They might be eating what they have always eaten but find they are suddenly gaining weight for no reason.”
“Lifestyle is key in helping women cope with the symptoms of PCOS,” says Dr Downey. Exercise she explains, is essential to helping the body handle carbohydrates and burn off excess calories, as is a diet low in carbohydrates and high in vegetables and quality protein.
“By getting the Body Mass Index under 30 or shifting about 10% of excess weight, patients see other symptoms of PCOS improve such as hair loss and pimples,” says Dr Downey.
If lifestyle doesn’t work, a specialist may be able to prescribe medication such as Orlistat (for obesity) or Metformin (used to treat diabetes) for cravings and excess weight associated with PCOS. Talk to your doctor.
Up to 70% of us will experience breast pain, tenderness and even benign lumps at some point. For most, this will relate to normal hormonal changes taking place in the fortnight before your period. “The breast glands get swollen and retain fluid as your body prepares itself for a possible pregnancy,” says Dr Downey. As progesterone also encourages the body to retain fluid, if your diet is high in salt or caffeine, tenderness and soreness may get worse as breasts retain water.
Get any lumps that remain after your period checked by your doctor immediately, says Dr Downey.
“Breast pain and tenderness can also be helped pre-period by wearing an extra supportive underwire bra and by avoiding salt pre-period to lessen any fluid build up in the breasts,”
For monthly breast tender- ness and pain, Evening prim- rose oil or starflower oil is proven to alleviate symptoms, but you need to take it for around three months to see a difference, says Dr Panay.
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