When does PMS start?

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When does PMS start?

Healthylife Pharmacy1 July 2017|3 min read

‘Menarche’ is the term given to the time in a female’s life when menstruation first begins. Typically, this happens between 12 and 13 years of age, but anywhere between 9 and 18 is considered normal. During these years, when young women are beginning to menstruate, they experience a range of physical and emotional changes. For some, these changes happen with no obvious problems, while for other girls, there may be an array of issues and symptoms.

Depression and anxiety are the most common mood changes experienced during the years when the menstrual cycle and hormones are becoming established and regular. This can be related to hormonal fluctuations or to other factors that become harder to deal with because of the additional stressors of puberty.

What is Premenstrual Syndrome (PMS)?

PMS is the combination of symptoms that women may experience a week or so before their period. Symptoms appear before the period starts and often disappear as soon as the period begins or soon after. Symptoms can affect both the body and the brain, and the intensity of these symptoms can vary from person to person.

Symptoms of PMS

There are a wide variety of symptoms that young women may experience at the time of their period. These may include the following.

  • Abdominal bloating
  • Acne
  • Anxiety 
  • Clumsiness 
  • Confusion 
  • Depression and low mood 
  • Difficulty concentrating 
  • Memory lapses 
  • Digestive upsets (constipation and diarrhoea) 
  • Drop in self-esteem and confidence 
  • Fluid retention 
  • Food cravings 
  • Headache and migraine 
  • Increased appetite 
  • Irritability, mood swings 
  • Weepiness 
  • Sleep changes (insomnia or excessive sleepiness) 
  • Swollen and tender breasts.

In addition to all these physical and mental changes comes a dramatic increase in nutrient requirements for young women as rapid physical maturation and growth is taking place. Calcium, magnesium, iron and zinc are in especially high demand and it can also mean that deficiencies in any given nutrient may contribute to particular PMS symptoms.

Key nutrients for young women

Calcium

Calcium is essential during puberty because of the rapid growth of bones. A young woman’s calcium requirements increase by 50% during these years. Calcium is better absorbed and maintained in bone when magnesium intake is also sufficient. Calcium supplements may relieve water retention, mood changes, food cravings, and pain in young girls with PMS. The Recommended Dietary Intake (RDI) for calcium for girls between 12-18 years is 1300 milligrams per day.

Magnesium

Magnesium deficiency has been associated with depression and depleted levels of dopamine. Dopamine improves feelings of alertness and relaxation, but low levels may lead to tension, irritability and anxiety. Magnesium is also necessary for normal sugar metabolism. A deficiency leads to increased insulin secretion and may cause blood sugar instability premenstrually. Magnesium supplementation may therefore help reduce PMS symptoms such as aches and pains, depression, irritability, mood swings and fluid retention. Magnesium deficiency has been linked to menstrual headaches and migraines, particularly when calcium levels are relatively high in relation to magnesium. The RDI for 9-18-year-old girls is 240-360 milligrams per day.

Iron

Iron is vital for transporting oxygen in the bloodstream. With the onset of menstruation and monthly blood loss comes additional iron requirements.

Iron deficiency is common in young girls and is associated with anaemia, fatigue, reduced resistance to infection, dizziness, faintness and poor concentration. This need for iron also increases as a consequence of rapid growth and the expansion of blood volume and muscle mass. As young women's bodies change and they gain muscle mass, more iron is needed to help their new muscle cells obtain oxygen for energy.
The RDI for iron is between 8-15 milligrams per day, depending on age.

Zinc

Zinc plays a vital role in the metabolism of hormones linked to sexual maturation and growth and the biochemical functions of various endocrine organs. It is especially important for its role in helping to prevent the development of acne and may be especially useful when acne is excessively inflamed, as it is also a key component of collagen. Additionally, zinc is necessary for the formation of insulin and, therefore, plays a role in blood sugar balance. The RDI for females between 14-18 years of age is 7 mg per day.

Herbs

There are a number of herbs that may regulate these hormonal changes and help with symptom relief. Vitex agnus-castus is traditionally used in Western Herbal medicine to help relieve the symptoms of PMS. Licorice and White Peony (Paeonia lactiflora) may support female hormone levels. If you think a herbal supplement may be beneficial, ask your healthcare professional for tailored advice. 

What parents can do to help

Menarche may be challenging for young women and parents alike. Relationships with teenagers can be strained as they strive for independence, and the additional hormonal changes can add to the stress. 

Listed below are some health tips that may be implemented to help young women and parents cope with the changes that menarche may bring.

Tips

  • Reduce stress and ensure your child has time themself. Encourage activities that they enjoy. Some examples include listening to their favourite music, going for a walk in the park or at the beach, or relaxing in a bath.
  • A good diet. Talk to your teenager about the importance of healthy eating at this time of rapid change and growth. 
  • Encourage healthy snacks throughout the day to keep blood sugars regulated and support their increased nutrient requirements.
  • A full night’s sleep every night is important, even on weekends. Teenagers may need up to 10 hours of sleep per night.
  • Encourage exercise and explain the importance of it. Exercise may help lift mood and help with sleep. As well as increasing energy levels. Light stretching may also help with period pains and menstrual cramps.
  • Be available for social support and keep the lines of communication open while also respecting their new need for privacy.

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References

  1. Lacroix, A. E., & Langaker, M. D. (2019). Physiology, Menarche. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470216/
  2. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/premenstrual-syndrome-pms
  3. Hadeel Ali Ghazzawi, Alhaj, O. A., Nicola Luigi Bragazzi, Alnimer, L., & Haitham Jahrami. (2023). Menstrual cycle symptoms are associated with nutrient intake: Results from network analysis from an online survey. Women’s Health, 19.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10350787/
  4. https://www.betterhealth.vic.gov.au/health/healthyliving/calcium#people-with-special-calcium-needs 
  5. Meng, S.-H., Wang, M.-X., Kang, L.-X., Fu, J.-M., Zhou, H.-B., Li, X., Li, X., Li, X.-T., & Zhao, Y.-S. (2021). Dietary Intake of Calcium and Magnesium in Relation to Severe Headache or Migraine. Frontiers in Nutrition, 8.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973018/ 
  6. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ 
  7. Ozdemir, N. (2015). Iron deficiency anemia from diagnosis to treatment in children. Türk Pediatri Arşivi, 50(1), 11–19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462328/
  8. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/ 
  9. Nasiadek, M., Stragierowicz, J., Klimczak, M., & Kilanowicz, A. (2020). The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients, 12(8), 2464.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468694/
  10. Shaw, S., Wyatt, K., Campbell, J., Ernst, E., & Thompson-Coon, J. (2018). Vitex agnus castus for premenstrual syndrome. Cochrane Database of Systematic Reviews.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494412/
  11. Wang, J., Song, C., Gao, D., Wei, S., Sun, W., Guo, Y., Sun, S., Tian, X., Li, H., & Qiao, M. (2020). Effects of Paeonia lactiflora Extract on Estrogen Receptor β, TPH2, and SERT in Rats with PMS Anxiety. BioMed Research International, 2020.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081021/
  12. https://www.betterhealth.vic.gov.au/health/healthyliving/Parenting-children-through-puberty 
  13. https://www.betterhealth.vic.gov.au/health/healthyliving/teenagers-and-sleep 
  14. https://www.womenshealth.gov/getting-active/physical-activity-menstrual-cycle