EP.146/ Endo and PMS: The Key to Reducing Mood Swings, Anxiety and Low Moods in Your Luteal Phase
Okay so a while ago I ran a poll about PMS and endo, and I wanted to know what symptoms you struggle with.
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Turns out, the majority of you get low moods during your luteal phase. In fact, out of the hundreds of you who entered the poll, 93% of you said you struggle with low moods and mood swings during your luteal phase.
So today’s episode is the first in a two part series. Today I’m going to take you through one of the key causes of PMS mood swings and I’m going to provide you with my go-to strategy for starting to tackle it, and then in the second episode, I’ll be taking you through the secondary causes and strategies.
So number one, where we’re starting, is to balance your blood sugar, and truly, this is one of the most important things you can do if you want to improve your moods during this time, lower inflammation and balance your hormones. This is really key and this is why I’m starting here. If you’ve got your blood sugar sorted, then clearly this isn’t your main cause and the next two causes in the future episode will be more relevant, and they are low progesterone and low neurostransmitter levels. But we’re starting with blood sugar because this is foundational to hormone health and plays a really big role in PMS, and could be the reason why you have low progesterone anyway!
So let’s look at what blood sugar has to do with moods specifically.
Blood sugar is the measurement of glucose in our blood. Glucose comes from complex carbohydrates like fruit, vegetables, beans, whole grains, etc. and it is our body’s and brain’s primary fuel. For us to feel energised and have stable energy levels all day long, we need to have a steady drip of glucose filtering into our blood. When we’re eating a diet that consists of complex carbohydrates, that also includes healthy fats, proteins and lots of fibre, this ensures good blood sugar levels.
But glucose also comes from refined carbohydrates, such as sugars like honey, maple syrup and standard white sugar, and baked processed products like bread, cake and pizza. These foods contain a lot of carbohydrate and little fibre, they are made of simple carbohydrates, meaning that they break down very, very quickly in the gut. Complex carbohydrates are called complex carbohydrates because their chemical structure is made of long chains of glucose linked together, which takes the body longer to break down. In contrast, simple carbs are made up of very short chains of glucose that are easy for the body to break down. This creates a huge surge of glucose that’s pumped quickly into your blood stream.
What then happens is that your body panics. It’s a stressor to the body to have this much glucose in the blood at any one time, so it releases a hormone called insulin. Insulin usually delivers glucose to our cells for fuel, but when we have too much glucose, it’s released in really high amounts and pushes it into the liver and fat cells for storage. This equally happens quickly, in fact, a little too quickly and the insulin accidentally takes too much glucose out of the blood in its rush to clean things up, and our blood sugar levels plummet. This leaves us hungry soon afterwards, and we end up on a blood sugar rollercoaster, needing more refined carbs and sugar to fuel us and get our blood sugar levels back up to a healthy level. Of course, eating more sugar or processed carbs won’t take us to healthy levels, but will spike our blood sugar levels once more – so we’ll temporarily feel good, only to crash again, so the cycle continues.
The result is that we spend our days going through highs and lows, and this blood sugar rollercoaster feels like:
· Hanger
· Irritability
· Anger
· Moodiness
· Tearfulness
· Anxiety
· Shakiness
· Feeling sleepy after meals
· Having mid-morning and mid-afternoon energy slumps
· Cravings for caffeine, sugar or refined carbohydrates
· Trouble falling asleep, waking up in the night or struggling to wake in the morning
· Feeling thirsty a lot
You don’t have to have all of these symptoms, but if you have a few of them, it’s likely your blood sugar levels need improving.
So what’s this got to do with PMS? Well, in the first half of our cycle, from menstruation to ovulation, as oestrogen rises, we’re actually more insulin sensitive because oestrogen actually boosts the effectiveness of insulin. This means we respond well to insulin so we’re getting in glucose and making energy effectively, we’re satisfied more easily and we feel satiated for longer. Basically, we’re more responsive to insulin and that in turns helps us to have balanced blood sugar levels and stops us from craving all the sugar.
But in contrast, in the second half of our cycle, when progesterone rises, we actually become less insulin sensitive because progesterone can dampen the effectiveness of insulin. That means the same meal you ate the week before, may no longer satisfy you because your body is not taking in the glucose from insulin in the same way. It also means, as a result, you may be more susceptible to blood sugar highs and lows and you might end up eating more refined carbs, sugar, etc. because you still feel hungry or less energised, so your body is telling you to eat foods with a quick energy fix. This is likely why 84% of you say you get cravings during this time!
This of course can create those blood sugar crashes that leave you feeling anxious, tearful, irritable, or moody. This is one of the key reasons we can feel low during the luteal phase, which is why we start here. In the follow up episode I’m going to take you through the other causes, but by working on your blood sugar levels, you’ll actually be preventing the other causes from happening in the first place in many cases, so this is the foundation we really want to have in place. Once this is in place, we can clearly and accurately see whether there’s any other issues left over affecting your moods in this part of your cycle.
So there are a few key strategies for balancing blood sugar, but let’s start with the main strategy to get you going. Ideally, we want to practice this all month long because it’s going to lower inflammation and regulate your hormones so your PMS will be better and your pain will be better too, but at the minimum, it will be helpful to bring this strategy in from ovulation onwards until your period so we can manage those blood sugar levels.
So, the strategy is to eat healthy fats, fibre, complex carbohydrates, and protein with every single meal. And so this looks like:
· 50% of your plate (or half your plate) should be covered with low starchy veggies. This is where your complex carbs and fibre will come from. This is important because the carbs give you energy and the fibre slows down the release of glucose, because it takes longer to digest foods with fibre. So think asparagus, broccoli, kale, tomatoes, peppers, cucumber, aubergine, cauliflower, etc.
· 25% of your plate should be protein (or a quarter of your plate). And that should be equal to the size and thickness of your palm. We need about 20g of protein per meal on average, so that’s not 20g of beans or chicken, but how much protein is actually in the food itself. Don’t worry, you don’t need to be weighing things up, just start with the ratios first, the portion sizes. If you’re still getting hungry after meals, check how much protein you’re actually eating and up it if need be. For meat, it works out at about 3-4 oz of animal protein. If you’re eating beans or a protein rich grain like quinoa or brown rice, you’re probably going to need to up your levels with say a dressing made of nut butter, or an egg, or maybe a tablespoon or two of seeds. Also, remember that beans and grains also count as complex carbs, so keep that in mind for when I get to the complex carbs bit!
· Next up, we want the final 25% to be split between more starchier complex carbs and healthy fats. For healthy fats, we’re looking at a two golf ball sized serving, or two heaped tablespoons and that could be equal to half an avocado, two tablespoons of olive oil, two tablespoons of nut butter, etc. Fat helps to slow the blood sugar release down, and is actually essential for hormone production by the way!
The starchier carbs would consist of a small handful of something like root veggies such as sweet potato or parsnips, or maybe some quinoa or beans if you haven’t had them already as your protein source. And so this is where it has to be very individual as if you already have beans or grains, you might not need that extra starch boost and instead, you could just add some extra veggies so your plate is around 60-65% veg. But if you have say beans on your plate for your protein source and you tend to burn a lot of energy during the day because you’re a very active person, you might need a little sweet potato too or some grains. And if you’ve got meat as your protein source and you’re very active, that serving of starchier carbs might need to be a bit bigger than someone who isn’t very active. It has to be tailored to you and what your body needs.
For example, my blood sugar cannot tolerate beans and grains in the same meal, I crash and burn hard! But I have a job where for the most part, other than using a standing desk a few times throughout the day and my usual exercise routine, I don’t have a physically demanding lifestyle. But if you’re say a nurse in a busy hospital, a dance teacher or an athlete, you’ll probably feel like you do better with that extra fuel. In fact, one of my clients who’s a dance teacher always needs some kind of grain with her meals or her blood sugar would get too low, because she was always burning it off!
Another thing I want to mention here is how our blood sugar responds to grains is very personal too. Some people find that grains give them a steady release of fuel, others find they spike their blood sugar levels quickly and then crash. That’s me! Especially after oatmeal, I can have a big, filling bowl but find myself starving and shaky an hour later, if not sooner. So if you do respond like that to grains but you want to eat them regularly, you might need to up you fat and protein to really slow down that glucose release.
So, this is where we get started. It might sound a little fiddly, but over time, you’ll gradually grow accustomed to it and notice when one of these food groups is missing! In the show notes, I’ve linked to a great diagram of how this looks on a plate, so you can always print that off and have it on your fridge.
Now there other steps to balancing your blood sugar, but it can take some time to adjust to this one, so this is where I’d suggest for you to start and then you can revisit my past blood sugar episodes to learn more, or I think I’m probably going to release a standalone workshop on this in the future so you can always sign up to that if you’d like a deep dive and a step by step process.
But start here, give it at least one cycle and see how you’re doing. Of course, if you’re constantly spiking your levels with chocolate and sweets, then balancing your meals won’t cancel that out, so just be mindful of that!
And I just want to leave you with one last tip, to really get off on the right track, make sure your breakfast is fat and protein rich, don’t skip these two! If you’re just having oatmeal, you’re going to need to add a lot of nut butter, some protein powder or have two eggs on the side to balance out the carb content. Keep that in mind when you start the day and you’ll find balancing your blood sugar levels much easier as go through the rest of your day.
Show Notes
How to Build a Healthy Plate Diagram by Amelia Freer
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