Leslie Carol Botha: First we find out that synthetic hormones are linked to breast cancer and mortality AND then we find out that PMS – premenstrual syndrome is linked nutrient deficiency. And how many years have women been subjected to the “Take Two Valium and Go Home Honey, Syndrome?” Now young mothers are encouraged to go on Xanax to be better mommies. Is anyone else furious?
Micronutrients and the Premenstrual Syndrome: The Case for Calcium
Journal of the American College of Nutrition
Susan Thys-Jacobs, MD,
Clinical Director, Metabolic Bone Center, St. Luke’s-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York
Presented at the Micronutrients and Women’s Health Symposium, American College of Nutrition Annual Meeting on Advances in Clinical Nutrition, Washington, D.C., October 1st 1999.
Key teaching points:
• Calcium, magnesium, 1,25 dihydroxyvitamin D and other minerals are dynamically related to the menstrual cycle.
• Alterations in calcium homeostasis (hypocalcemia and hypercalcemia) have long been associated with many affective disturbances.
• PMS shares many of the features of depression, anxiety and the dysphoric states.
• Cyclical changes in calcium metabolism during the menstrual cycle may help explain some of the features of PMS.
• Recent evidence has demonstrated the efficacy of calcium in the treatment of PMS.
Premenstrual syndrome afflicts millions of premenopausal women and has been described as one of the most common disorders in women. Research over the past few years suggests that a variety of nutrients may have an important role in the phase related mood and behavioral disturbances of the premenstrual syndrome. There is scientific evidence, at least for a few of these micronutrients, specifically calcium and vitamin D, supporting cyclic fluctuations during the menstrual cycle that may help explain some features of PMS. Ovarian hormones influence calcium, magnesium and vitamin D metabolism. Estrogen regulates calcium metabolism, intestinal calcium absorption and parathyroid gene expression and secretion, triggering fluctuations across the menstrual cycle. Alterations in calcium homeostasis (hypocalcemia and hypercalcemia) have long been associated with many affective disturbances. PMS shares many features of depression, anxiety and the dysphoric states. The similarity between the symptoms of PMS and hypocalcemia is remarkable. Clinical trials in women with PMS have found that calcium supplementation effectively alleviates the majority of mood and somatic symptoms. Evidence to date indicates that women with luteal phase symptomatology have an underlying calcium dysregulation with a secondary hyperparathyroidism and vitamin D deficiency. This strongly suggests that PMS represents the clinical manifestation of a calcium deficiency state that is unmasked following the rise of ovarian steroid hormone concentrations during the menstrual cycle.
Introduction and Background
Nearly 60 years ago, Frank described the premenstrual tension syndrome . Premenstrual syndrome (PMS) is widely recognized as a recurrent, cyclical disorder related to the hormonal variations in the menstrual cycle, disrupting the emotional and physical well being of millions of women during their reproductive lives. The syndrome is characterized by a complex group of signs and symptoms that occur during the luteal phase of the menstrual cycle, remitting soon after the onset of menses. Many women experience mild symptoms, and as many as 30% to 50% suffer from troublesome symptoms. Surveys indicate that approximately 5% of North American women consider their symptoms to be severe enough to have a substantially negative impact on their health and social well being. Symptoms vary among different individuals and may include depression, irritability, mood swings, bloating, breast tenderness and abdominal discomfort (Table 1). Because of the number and diversity of symptoms, innumerable theories and mechanisms have been proposed to elucidate this syndrome with an array of therapeutic approaches offered [2,3]. The majority of these approaches have proved disappointing and scientifically unfounded. Current strategies now advocate the selective serotonin reuptake inhibitors, oral contraceptives, nonsteroidal anti-inflammatory agents and the gonadotropin releasing agonists in the management of women suffering with PMS.
Research over the past few years suggests that a variety of nutrients may have an important role in the phase related mood and behavioral disturbances of the premenstrual syndrome. In addition, there is scientific evidence, at least for a few of these micronutrients, supporting their cyclic fluctuations during the estrous and menstrual cycles. This review will summarize what is known pertaining to the physiology of the premenstrual syndrome, the efficacy of specific micronutrients in PMS and hypothesize as to why calcium may be the leading mineral of concern.
Page is no longer active – please see the abstract at http://www.ncbi.nlm.nih.gov/pubmed/10763903
2011 Study abstract here: http://scholarworks.umass.edu/open_access_dissertations/433/