Is it their hormones…is it teenagehood….is it their brain development?

What is up with your teen and their mood?

Let’s start with the breakdown of what PMS really is…and what it isn’t!

Premenstrual Syndrome (PMS) describes a group of symptoms that occur cyclically and improve shortly after menstruation starts.

Menstruators are often aware their period is coming from emotional and physical changes that occur in the second half of the menstrual cycle, so after ovulation and before the onset of menstruation. If these become extreme or impeding activities of daily living we often discuss it as a few subtypes: 

PMS-A (anxiety): more sensitive than usual (especially to perceived rejection or criticism), feeling on edge or irritable, feelings of overwhelm

PMS-D (depression): low mood with lethargy, forgetfulness, and confusion.

PMS-H (water retention):abdominal bloating, weight gain of over 3 pounds, Breast tenderness/swelling

PMS-C(cravings): increase carbohydrate cravings, general increase in appetite, fatigue, headaches.

PMDD: this is PMS-D but much more debilitating – right after ovulation until first day of menses there is extreme depression and even as extreme as thoughts of suicide. 

This is different from depression or anxiety that someone already has that can be worsened during the luteal phase – a person experiencing PMDD often feels great the other 2 weeks of the month, and then as soon as they ovulate depressive symptoms appear and are relieved as soon as menstruation starts.

A few things to point out:

It’s normal to feel a bit more tired and hungry the week before and during your period – shedding the uterine lining is metabolically taxing and it’s normal for your hunger levels to ebb and flow throughout your cycle. 

If you aren’t sure whether it’s PMS or not, the first step is to start tracking your menstrual cycle and see if your mood complaints match up with that pattern.

Otherwise if mood is a struggle and it doesn’t seem to be related, then potentially you are struggling with another mood issue such as anxiety or depression. Also, for most teens it’s just that you need support with emotional regulation – teens aren’t intentionally ‘blowing up’ over everything. Their current brain development process makes this more challenging (more on this and supporting teen brain development in my next article!)

Let’s circle back to supporting hormones and your teen’s mood. 

Can we test for this and how can we support them?

First and foremost I want to address a myth: PMS is not a dysregulation of hormones – it’s a stress response to our hormones changing – which they are supposed to do. Some menstruators experience that shift more intensely than others, which means testing your hormones does not help up determine if you have PMS or not NOR does it direct how we support. However some bloodwork may be ran to rule out other conditions that could be impacting your period health.

Oftentimes when there is anxiety or depression already, those symptoms can feel worse during the luteal phase of a menstruators cycle. Supporting your mental health overall will support your PMS. The best current research for therapies to support anxiety and depression are: (these should be used under the direction of a healthcare practitioner) St. John’s wort, saffron, lavender, GABA, theanine,Vit D, fish oil,  plus correcting any nutritional deficiencies, like iron or B12. 

But for PMS specifically the data we have that can support is:

Vitamin D – getting your Vitamin D levels tested and then properly dosed to get you into optimal range improves the PMS experience.

Calcium – calcium supplementation at the correct dosing shows benefit in reducing PMS symptoms

Remember this does not constitute medical advice and adding in any supplements or medications should always be discussed with your HCP.

But to really support a healthy cycle means supporting a healthy body overall – our period is a vital sign, just like blood pressure and heart rate! The best ways to support a healthy cycle:

1. Eat enough – and eat mostly whole foods – what does this mean? Fruits, veggies, whole grains, and enough protein – mensturater bodies are very sensitive to low calorie diets and they make all symptoms worse. There is data that shows menstruators who eat whole foods with fruits and vegetables and adequate protein have less period problems.
2. Sleep – getting enough sleep helps our body regulate all of its cyclical nature. Being in the rhythm of our sleep-wake cycles sets the stage for our other cycles!
3. Movement – our bodies are designed for movement. The more sedentary we are the worse symptoms we may experience – but also movement that you enjoy! Is it walking with a friend or dancing in your kitchen, weightlifting, boxing, cycling…find a movement practice that you enjoy and this will immensely help your mood and your period health.

What if I am on birth control? Will this affect my mood? How can I best support myself?

Some people who use hormonal birth control will experience more depression. In 2016 JAMA released a study that showed women using hormonal birth control are significantly more likely to be diagnosed with depression. The risk was greatest for teens using progestin-only methods. So being aware and prepared for that potential outcome is important and can be supported with the same options as above. 

Another important point to make here is that people on OCP (oral contraceptive pill) don’t experience PMS! Since the OCP stops ovulation and the cycling of hormones – it’s not possible to have actual PMS while on the pill. However each person’s experience is important – so track what’s going on to understand and discuss with your period literate healthcare practitioner. And if mood is an issue while on the OCP then definitely check in with your doctor!

Also the OCP does cause some micronutrient deficiencies such as B vitamins, selenium and magnesium, so discussing proper supplementation with your HCP can help mitigate this. Deficiencies in B vitamins is also linked to worsened experiences of anxiety and depression.

To learn more, book a virtual Teen Wellness Discovery Session using the link below.

Meet Dr. Erin TeWinkel – the Teen Wellness Warrior!

Dr. TeWinkel is on a mission to improve teen health and build it’s foundations so they can own their health for the rest of their life.

When a teen is supported in their health early on, the stage for success can really be set.

Teens and their families are often given limited choices to deal with their health concerns. Whether it be hormonal struggles, acne, painful periods, anxiety and depression, dieting and healthy weight management or sexual health – all of these can be addressed with a tailored plan to each teen.

With a strong clinical focus on gut and brain health optimization, Dr. TeWinkel has created the Teen Resliency Method to ensure our teens are strong, resilient and HAPPY.

She is here to empower and support teens and their families throughout the many ups and downs of adolescence. Teens have an immense unharnessed potential – she is here to ensure that potential shines.

Erin is a graduate of the Canadian College of Naturopathic Medicine and the University of Guelph. She was born and raised a farm girl – but fell in love with the city. She now lives here with her growing family and is usually found putting her epic skills as a fort engineer or LEGO Masterbuilder to use.

Follow Dr. TeWinkel on Instagram @drtewinkel and book a Teen Wellness Discovery Session here