Mitigating the Premenstrual Syndrome (PMS) Symptoms - Runners Edge Physio
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Mitigating the Premenstrual Syndrome (PMS) Symptoms

Mitigating the Premenstrual Syndrome (PMS) Symptoms – Part 1

Natalie Snyder, PT, DPT, OCS, CSCS Female Athlete Specialist

July 22, 2021

Dear Ladies!

What does being a female athlete mean to me? Two things: Athlete. And Female. What sets an athlete apart from non-athletes?

A lot of things actually! Simply put, and tell me if you agree:

  1. We have high standards for our own strength, performance, and progression to become the best athlete we can be.
  2. We are dedicated to make each physical activity, workout, training, and nutrition a part of our schedule and lifestyle.
  3. We thrive seeing our own journey toward a goal we set: whether it’s for a race, an accomplishment, a change in our body composition with muscle definition, or learning to improve our overall health and lifestyle.

What sets a female from a male?

A lot of things, too! Simply put, and tell me you feel this too:

  1. We have less testosterone to allow us grow muscle strength and size. Instead, we have female hormones – primarily estrogen and progesterone.
  2. We go through that time of the month (TOTM) which is associated with poorly understood changes of how estrogen and progesterone affects our cognition, mood, energy, and ability to make strength and performance gains.
  3. We liX less weights than men, generally speaking when looking at the total weight. In fact, we are just as trainable and as strong as men, speaking when looking at the ratio of our own and men’s body weight: lean mass in kg to weight liXed.

So, we have those TOTM and PMS days that we want to blame on when we are feeling more irritable, weak, tired, moody, bloated, crampy, and feeling unsocial. This affects 3 out of 4 women, so you’re not alone. Some people may say “Oh don’t worry about it,” or some people may say “Wait, what did I do to upset you?” As desperate as you may feel to not let this affect your relationships with people around you, there are ways you can mitigate these symptoms you’re experiencing right before you get your period. It’s all physiology and endocrine-driven!

As your body is going under inflammation for shedding the uterine lining, your body is also experiencing negative inflammatory responses including cramping, bloating, irritability, lethargy, and fluid shiX by the estrogen levels. These symptoms can be mitigated by the combination of

rest and recovery with nutrient support aspect to counter estrogen upon competing for the receptor sites.

  1. Brain: depression, anxiety, brain fog, irritability, mood changes occur because of the estrogen hormone crossing the blood-brain barrier and hypersensitize our serotonin levels among the brain cells.
  2. Fluid Balance: bloating and temporary weight gain, not because we’re retaining or losing water, but because we are shiXing fluid out of blood and into other spaces. Don’t use diuretic or caffeine pill to shed off the bloating. Progesterone competes with aldosterone receptors, and it retains more fluid as the body kicks sodium in other spaces, and water follows.
  3. Inflammation: because of the rise of estrogen-progesterone levels to allow the uterine lining to shed.

Ways to mitigate the symptoms for 5-7 days BEFORE your first day of next cycle or period:

  1. Dial down your training intensity to 50%. Focus on techniques, drills, and form.
  2. Sleep, and give yourself adequate rest. Your body is already working harder.
  3. Increase your carbohydrate intake at breakfast and before/aXer a workout session, as the uprise of estrogen is sparing your glycogen storage in your muscles preventing your muscles from using it for energy.
  4. Increase your protein intake right aXer a workout session to cease the catabolic response of muscle exercising and maintain the protein synthesis.
  5. Combine the following every night for 5-7 days before you have your period:
Magnesium150-250 mgTied to inflammation to dampen the effects, also tied to muscle contraction in the neuromuscular aspect.
Zinc45 mgTied to our immune system, we use zinc for fighting a cold, infection, or to build uterine lining tissue.
Omega-3 FaLy Acids1 gOvercoming the prostaglandin E2 inflammation factor that comes with influx of estrogen affecting different receptor sites. Polyunsaturated fatty acids in the form of Omega-3s attaches to the same receptor sites to downgrade inflammation.
Baby Aspirin80 mgNot everyone needs or can tolerate baby aspirin or other non-steroidals. From fertility literature, they are recommended to help mitigate some of the inflammation by affecting the COX inhibitors, the receptor sites of inflammation.

With those mitigation approach above for the next 3 or 4 cycles, everything will flat-lines and bottom out the hormone fluctuations in a good way by bringing everything down, moderating the stress, bleeding less, bloating and cramping less, and feeling the PMS symptoms less.

Then you will know EXACTLY how to train smarter, not harder! And you’ll feel better, feel more recovered, feel more energized, yet still listen to your body as our body is not meant to be on high-throttle drive 24/7. ☺

Female Athlete photo in honor of Lydia Jacoby winning Gold at Olympics Tokyo in July 2021.

Mitigating the Peri-Menopause Symptoms – Part 2

Natalie Snyder, PT, DPT, OCS, CSCS

Female Athlete Specialist

July 22, 2021

Let me ask you, ladies…

Are you in your early-40’s or approaching 50’s?
Did you notice that your body is starting to change, energy levels are fluctuating, feeling more
stressed, respond to training less, and recover differently?
Do you feel like you’re not able to push your training intensity as well as you used to?
Are you afraid of losing your muscle mass?
Don’t PAUSE right now. Because right now is the time to PLAY! Just a little differently because
women change so much more throughout their life than a man does, because of the hormones.

There are few ways that you can do to make small changes in your lifestyle for the greatest bang
for your buck and your health longevity.

Peri-menopause begins commonly around the 5 years before menopause starts, and you can
tell by how your body is responding differently and is changing regardless that you have not
changed one bit of your training and nutrition. You may feel fatigued, gain belly fat, lose muscle
mass, and feeling temperature fluctuations. Let me show you the timeline of what’s happening
when we go from normal menstrual cycle to peri-menopause to post-menopause.

During normal menstrual cycle, the time of the month is predictable, and I have already gone
through how to train with and around your monthly calendar. During peri-menopause, this
graph is pretty much showing us what’s happening in our body. It’s unpredictable and
incomprehensible, just like how we feel about our body reacting after training or plainly out of
the blue.

In the early timeframe, in your 40’s when you feel what you’re doing in your 30’s isn’t working
for you. You’re not training, or overtraining and not adapting, not recovering well, feeling more
tired, having more brain fog, but still have your periods. The dysregulation is due to the
hormonal ratios are changing, downregulating of the testosterone and less estrogen stimulus.

You’re not crazy, it’s just physiology. When you begin to feel that this is just about to start for
you, then start putting steps into place to prepare your body and make most of your physical
activity as you enter menopause. Enter menopause stronger than ever and set up for success.

Adjust your Focus.
Changing your lifestyle should focus on working more strength, power, and aerobic. Plus
putting in a little bit MORE recovery time between high intensity interval training or heavy
training days. In addition, your training regimen also responds to your diet. Your body uses
what you put in, just like gas for your car to keep it running. You’d want a good gas for a highspeed
mustang, right?

Protein Intake.
If you’re in mid-to-late 40s, training through peri-menopause, you will want to increase your
focus on protein to fill up the amino acid pool. Especially Leucine, an essential amino acid that
helps with brain cognition, muscle protein synthesis, and to reduce body fat accumulation.

Aim for 30-40 grams of protein per meal, especially right after a workout. That will stimulate
the best muscular growth and protein synthesis while reducing the catabolic state with elevated
cortisol.

Fuel-Up.
Increase complex carbohydrates with sources are coming primarily from fruits and vegetables,
or high-fiber unprocessed sources such as wild rice, bean-based pasta, or cauliflower crust.

The last thing is for you to avoid carbs at all costs because that will turn you into low energy
availability (LEA), thus increasing more cortisol, fat storage, fatigue, poor recovery, poor training
adaptations, brain fog, or having uncontrolled cravings at the end of the day. I would
recommend start in the morning with a good oatmeal and protein breakfast with some sugar
intake (from fruits or a pump to sweeten your coffee) to bring the natural morning cortisol
levels down. Then focus on complex carbohydrates such as beans, sweet potatoes, squash, etc.
for other meals.

If you are in LEA state, then your hormones will shift and down-regulate our appetite hormones
as luteinizing hormone (LH) is tightly bound to ghrelin (hunger hormone) and leptin (satiety
hormone). If the LH is surging all over the place, then your appetite hormone will end up all
over the place too.

Your thirst sensation will also be muted, so pay close attention to your hydration and water
intake (coffee or alcohol are supplementation, doesn’t count for the total hydration intake).

We are fueling for what we are doing. Get that protein in to be able to carry our body
composition change from lean mass, bone, body fat, and maintaining it in the optimal balance.

In summary, meal timing should be 4-5 times a day, not skipping breakfast, and fuel up before
AND after a workout session, preferably within 30 minutes.

Track it.
So, where do we start? Are you still tracking? That’s where we start. When you notice that
your periods are becoming more and more irregular. Start tracking your mood and how you’re
responding to training over the course of 6-8 weeks to see any patterning. Make note of any
symptoms you’re having, such as hot flashes, heat intolerance, putting on belly fat, or feeling
unusually tired.

Lift Heavy Shit.
Interventions starts with putting in more high-intensity and aerobic work to help with blood
sugar control. This helps the body to tap into using more of the body fat at rest and
downregulating the signal for putting on more adipose tissue. Include lifting heavier (Lift Heavy
Shit – LHS) by blocking in time and 2-3 weeks of lifting heavy weights and high anaerobic
intensity stuff.

Increase your focus on technique and core strength in the gym, focus on the heavy weightlifting
at the gym or with weights at home, then you include up-tempo, steady state, and endurance
for the cardiovascular standpoint. You can learn to rotate your training to specific blocks of
anaerobic, heavy, and recovery.

Recover.
As much as you would think that resting is going to make the belly fat accumulate more, lose
the chance to uptake your training, or miss your chance to make strength progression, it is
actually the opposite.

Our body and physiology need to learn how to adapt from a sudden increase in stress from
exercise while already trying to adapt into the new state of menopause with hormonal drop-off.
So, the more we stress our bodies with high-intensity activity and heavy lifting, we also need to
balance it with the other extreme.

During normal menstruating cycle, the General Adaptive Stress Model (GAS Model) states:

  • If we have 3 weeks of stressors and 1 week to resist or compensating to the stress, we
    are allowing the adaptogens to increase the timeframe of your body adapting to stress
    and decrease the over-fatigued state of being over-stressed or over-trained.

During peri-menopause time, we already have an increase in cortisol levels with fluctuating
estrogen levels.

  • Train your schedule where you can have 2 days on, 1 day of with active recovery such
    as easy run or long walk, then 2 days on again, and weekend of as you dedicate one of
    the weekend days to your favorite activity or family time or sport and other weekend
    day is complete rest and walking as active recovery.

While this is NOT a cookie cutter, as everyone has different schedules and needs. This is an
example of what I have written up a schedule for her 8-weeks program consisting of the
following work-out days as well as recovery days.

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Easy Run
HIIT
HIIT warmup
LHS Lower
Long Bike or
Easy Run
HIIT warmup
LHS Upper
Easy Run
HIIT
Family/
Phys
Activity
Rest &
Soul

If you’re intrigued to learn how to increase or decrease your training intensity as you feel like
nothing seems to be working and your body is changing, call me up! I’d be happy to help you
and write an 8-weeks program specifically for you as you learn to set yourself up for optimal
body composition, performance, and success for the rest of your life.

AUTHOR

Runners' Edge Alaska

"We Empower Active Alaskans Of All Ages To Return To The Activities They Love Safely And Efficiently…For Life"
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