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經前症候群/經前煩憂症
PMS and PMDD

Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms which are related to the menstrual cycle. The condition affects most women of child-bearing age, most commonly in the two weeks prior to menstrual flow. Most women experience some premenstrual symptoms, while approximately a third of women experience distress as a result of a number of symptoms. Between five and ten per cent of women are thought to suffer with premenstrual dysphoric disorder (PMDD) - an extreme and incapacitating version of PMS.

Omega fatty acids play a vital role in the healthy functioning of every living cell; forming the building blocks in the brain, they are essential for normal physiological function in humans. Omega-3 fatty acids, particularly EPA, and the omega-6 fatty acid GLA, have several health-giving properties; as well as nourishing phospholipid cell membranes, these highly unsaturated fatty acids act as powerful free radical-scavenging antioxidants. Virgin evening primrose oil (EPO) is rich in botanical substances called triterpenes, which protect against the oxidative cell damage caused by free radicals;[i] together these fatty acids provide a natural boost to the immune system which is often depressed whilst women are menstruating.

Important metabolites of EPA and GLA from virgin evening primrose oil (eicosanoids - prostaglandins and leukotrienes) regulate several important bodily functions including inflammation, pain, blood clotting and fluid balance. The synergistic properties of EPA and GLA help with several symptoms of pre-menstrual syndrome (PMS) including:

- Breast pain and tenderness
- Emotional mood swings
- Irritability
- Poor concentration - the "scatter-brain" tendencies which affect some women
- Muscle tenderness and cramps
- Menstrual pain
- Bloating
- Tiredness and lack of energy
- Low immune system

In one double-blind placebo-controlled trial, menstrual pain (dysmenorrhea) was inversely associated with omega-3 fish oil intake.[iii]The study found that omega-3 fatty acids from fish oil substantially decrease menstrual cramps, which are believed to be prostaglandin-mediated. By providing the omega-3 EPA without DHA (another omega-3 fatty acid), our supplements maximise the production of EPA metabolites. Crucial for countering the inflammatory effects of short-chain omega-6 vegetable oils, which are so prevalent in the modern diet, eicosanoids (important anti-inflammatory by-products of EPA) compete with DHA for desaturase enzymes. [iv] By supplementing the diet with pure EPA, the body is able to convert the EPA into DHA as and when the body needs it, without interfering with the healthy production of the anti-inflammatory eicosanoids.

Studies suggest that omega-3 fatty acid supplementation (particularly EPA) may be beneficial in helping to balance the brain chemicals serotonin and dopamine, which are thought to be affected by the pre-menstrual fall in the sex hormones oestrogen and progesterone prior to bleeding. These chemicals are responsible for the changes in mood, particularly affecting those with premenstrual dysphoric disorder (PMDD) - the most extreme form of PMS.

The symptoms of PMDD - including severe depression, anxiety, irritability and anger - are similar to those experienced by many women with PMS, except they are much more extreme. Some women find that their hormones severely impact their quality of life, affecting social and personal relationships at home and at work. PMDD affects between 3 and 5 per cent of women.

Comprising an important component of the phospholipid layer of cell membranes, fatty acids are also vital for effective cell communication and healthy brain function. Shortages of the highly unsaturated fatty acids force the body to replace these flexible good fats in the brain with more commonly consumed rigid bad fats (found in margarines, pastries and deep-fried foods), which harden the phospholipid layer and slow the transmission of electrical signals. This harmful process can, over time, lead to an imbalance of the levels of the mood-enhancing neurotransmitters serotonin and dopamine. In fact, treatment for PMDD is often in the form of anti-depressants (SSRIs) which inhibit the reuptake of serotonin and help to stabilise levels. With a wealth of harmful side effects it is no wonder, however, that most women do not want to resort to prescription anti-depressants.

For those seeking a more natural solution, they'll be pleased to know that certain natural fatty acids are extremely effective in terms of easing symptoms of PMDD. GLA from cold-pressed non-raffinated virgin EPO and concentrated EPA from marine fish oil, nourish and modify the phospholipid layer to restore the efficacy of electrical messaging and normalise neurotransmitter levels. They work harmoniously to produce eicosanoids that prevent the uptake of serotonin and dopamine, thus keeping them in the system for longer, in a similar way to SSRIs - but without the harmful side effects. For the same reason, these fatty acids are extremely effective in easing symptoms of depression.

Another important factor in PMDD is the relationship with the hormone cortisol. Stress, a not unfamiliar state of being for many people, raises cortisol levels in the body. A long term consequence of the "flight or fight" response, cortisol upsets the normal balance of the mood-enhancing neurotransmitters dopamine and serotonin. Supplementation with EPA can restore the balance to normal healthy levels, by reducing the amount of cortisol in the blood, thereby lifting one's mood.

As well as ensuring you consume the right amounts and types of fat daily, it is helpful to make some lifestyle changes in order to reduce symptoms during menstruation. Ensure that you minimise stress, which can trigger biochemical changes including the over-production of cortisol. Exercise is also thought to play a part in the severity of PMS symptoms - both in terms of its ability to lower stress and ease menstrual cramps. Other important dietary factors to consider are limiting the foods that can aggravate various symptoms, including sugar, caffeine, alcohol and salty foods - all of which can encourage fluid retention. Of course, it is also important to ensure that you drink enough water, which is crucial for many biological processes to function properly.