The real cause of PMS + how to tame it

The real cause of PMS + how to tame it

Premenstrual Syndrome is not normal.

It’s as common as pasta in Tuscany, but just because it’s common, doesn’t mean it is normal. It’s actually a symptom of imbalanced hormones, a warning of health risks later in life. And while we mask the symptom with anti-inflammatories and birth control, we’re ignoring the root of the problem and “kicking the can down the road”. Adequate soluble fiber intake is one of the easiest things you can do to relieve symptoms and boost your long-term health. Read on to learn more. 

PMS occurs for most women within the week before menstruation, and for some, the PMS turns into "MS", lingering throughout the cycle. As you can see in the image above, our hormones rise and fall in an essential rhythm, essentially changing every day.

During the days prior to menstruation, progesterone and estrogen should dip, together, to a low level which trigger bleeding. However, in those that experience PMS, their estrogen remains too elevated. This imbalance between estrogen and progesterone can cause:

  • Anxiety
  • Depression
  • Irritability
  • Cramping
  • Breast tenderness
  • Food cravings
  • Insomnia
  • ...and more.

The severity may vary, but research clearly links this constellation of symptoms to higher levels of estrogen.

Now, we must ask why some women have more estrogen than others, leading to this imbalance. To answer this, it’s critical to understand the following three questions:

  1. How much estrogen do you make?
  2. Some women naturally make more estrogen than others. Often, women that generate more estrogen develop larger breasts and hips throughout puberty, have more PMS symptoms, may develop fibroids more easily, may have higher levels of anxiety, and may experience dense breasts. Estrogen is made primarily in the ovaries, but also in fat tissue.

    When you make a lot of estrogen, your body is tasked with excreting more estrogen. This happens though the liver and gut.

  3. How well do you metabolize estrogen through the liver?
  4. Your amazing liver makes bile out of cholesterol. Bile acts as a garbage truck for compounds the body wants to get rid of including toxins, estrogen and other waste. Imagine the liver piling garbage bags onto the bile to take to the dump (that’s your toilet).

    The liver attaches estrogen "waste" to a bile molecule and sends it to the gallbladder and subsequently into the small intestine. However, the efficiency of attaching estrogen to bile in the liver is largely based on three factors; 1) genetics that affect methylation (MTHFR), 2) having enough of the vitamins and minerals needed for this biochemical process, and 3) how much additional pressure you’re putting on your liver (i.e. alcohol, medications and other factors that reduce liver function).

    Some women need much higher levels of methylfolate, B vitamins and other nutrients to effectively bind and move estrogen through this process.

  5. How consistently and effectively do you bind estrogen in the gut?
  6. Remember that when estrogen is metabolized through the liver, it eventually ends up in the small intestine attached to bile. This gets tricky because bile has a secondary job, to help us absorb the fat from our food. If bile comes in contact with fat in the digestive tract, it attaches to it and together the bile, estrogen and fat are absorbed back into the bloodstream! 

    All the work your liver did to get rid of estrogen is for not. Now the estrogen metabolite is back in your body and increasing total estrogen levels (and symptoms) again.


You consumed soluble fiber with your meal. If bile comes in contact with soluble fiber in the small intestine, it can remain bound to estrogen and dietary fat, but the soluble fiber will render it non-absorbable. Soluble fiber “traps” the waste and fat and instead of all of these molecules making their way back into your body, they head towards the toilet (Bonus! this is also why soluble fiber reduces body fat and cholesterol levels).

Back to the real cause of PMS

Some women have more estrogen than others because they are not getting rid of the estrogen their body is making. If you’re a woman that makes a lot of estrogen, you need to excrete it more efficiently than a woman that makes less.

If you have PMS, this is because some combination of estrogen excess is occurring in your body and this is compounded in years such as puberty or peri-menopause (when progesterone begins to drop).

While PMS ranges from annoying to outright miserable, it’s a sign of hormone imbalance that should be addressed. The same imbalances that lead to PMS increase risk of hormone-related cancers later in life. By listening to the symptoms of PMS and improving estrogen detoxification, we are proactively preventing disease and improving our quality of life in the process.

Look back at the image at the top of this article and check out the optimal relationship between estrogen and progesterone just before menstruation. Soluble fiber is crucial to that balance.

Getting 20 grams of soluble fiber per day from food alone each and every day can be really tough. Florasophy makes it easy to stay on track; it's 3 teaspoons a day that can make a world of difference in your PMS + hormone balance simply by binding excess estrogen and moving it out of your body. 

Added bonus: Check out our clinically curated hormone add-on to boost estrogen clearance through the liver and support healthy estrogen metabolism. I use this with my patients all the time to enhance their natural estrogen detoxification pathways. 

About Megan Barnett, MS, CNS

Megan Barnett, MS
      Megan Barnett is a functional medicine practitioner in Portland, Oregon. In herclinical practice, she helps patients identify the root cause of their health problems, then designs individualized and evidence-based approaches to alleviate symptoms and help their bodies heal. She has a Bachelor of Science in Dietetics from Kansas State University and a Master of Science in Nutrition and Functional Medicine from University of Western States.