How Can Nutrition Help My PMDD?
PMDD is short for premenstrual dysphoric disorder, and it can be quite severe for those who experience it.
I’ve had clients describe it as “PMS on steroids”, and it really can be emotionally and physically debilitating for a week or two before the bleed, with most people finding relief as menstruation begins.
Common symptoms include anger, overwhelm, feelings of helplessness, insomnia, anxiety, panic attacks, depression and sometimes suicidal thoughts.
Dr Katharina Dalton pioneered the research into PMS and progesterone. She was the first doctor to define and treat PMS as a condition.
She used progesterone therapy (bioidentical progesterone, NOT synthetic progestins), but often used the Three Hourly Starch diet as a way of increasing a woman's progesterone, naturally.
You see, progesterone cannot bind to its receptor if there has been a drop in blood sugar. You can read more about the impact of blood sugar and hormones here.
A drop in blood sugar causes the release of adrenaline which moves glucose out of the cell, and into the blood. It is adrenaline that blocks progesterone binding to its receptor, thus blocking the biological action on the body.
Blood sugar dips occur when there's a long interval between meals and the body doesn't have the glycogen reserves to fuel. Dalton's research found that healthy women should go no longer than 5 hours between meals.
Those suffering with PMDD should go no longer than 3 hours due to the inefficiency of glucose regulation.
Dalton found that anytime blood sugars dipped, it could take up to 7 days to recover. So one drop in blood glucose can contribute to blocked progesterone receptors for several days! Is there any wonder we’re struggling with severe symptoms ahead of our period!?
This research also supports thyroid hormone being a co-factor to progesterone synthesis. Glucose is responsible for thyroid conversion in the liver, so eating a small amount of starch every few hours seems like the first step in regulating your hormonal struggles.
Low progesterone is not only a cause of PMS and PMDD, but significantly contributes to endometriosis and fertility issues, including early miscarriages.
Whilst I recommend you read Dalton's work for yourself, here are the main rules:
Divide your current starch intake into smaller meals throughout the day. If you avoid starch (this could be the main problem!), introduce it very slowly.
Always eat a starch within an hour of rising and an hour of going to bed.
Divide your big meals into small meals, eating every 3 hours (whilst awake).
Continue to prioritise your macro balance of protein, carbs and fats, incorporating fruit and vegetables with your starches.
My personal approach to this is to work on macro balance and meal frequency first using the principles I outline in the Foundations of Nutrition course, and then start to implement the three hourly starch diet, once you are confident that your nutrient balance and meal schedule is working for you.
Overtime, the liver will adapt to efficiently storing glucose (from the starch) as glycogen, supporting blood sugar management and reducing the need for adrenaline, allowing you to slowly and successfully increase that gap between your meals.
It is always sensible for me to express there is not a one size fits all approach, if you try the three hourly starch diet and it doesn’t work for you, then pull back and go back to what was working for you. There could be many reasons why certain approaches work for some over others, and quite often it takes working with a qualified practitioner to understand your unique needs.
If you’re ever stuck and want some private nutrition consulting then you can take advantage of your 10% discount code HCLUB10 for this service. Just book a free discovery call so we can discuss your options further!