Book Appointment1 877-508-1177
How It WorksOur ServicesWhat We TreatAestheticsAbout UsOur DoctorsFAQArticlesEventsContact
Facebook LinkInstragram Link
Dark chocolate and rapberries

How Poor Gut Health Can Cause PMS + 5 Steps for Improving Gut Function

Holtorf Medical Group

It is further suggested that it may be possible to limit PMS and its related symptoms by making dietary changes that support gut health. Recognizing the relationship between the gut and PMS with subsequent optimization of your diet may prove to be an effective way to relieve symptoms of PMS.

A Quick Review of PMS

Most people have a general understanding of PMS. But for those who do not or need a refresher, here is a simple summary.

PMS is a common condition that brings with it a collection of frustrating physical and mental symptoms that range in severity depending on individual patient factors. PMS is most often triggered by estrogen imbalance. Estrogen is a powerful hormone that influences fertility, weight, mood, brain function, cardiovascular health, cell replication, bone building, and more. In healthy systems, estrogen and another regulatory hormone called progesterone are maintained at a specific ratio to facilitate healthy bodily function.

Typically, PMS symptoms are worst near the middle of the menstrual cycle just after ovulation and ending once menstruation has occurred. This is because during the first half of menstruation, estrogen levels increase significantly. If the body is unable to regulate estrogen values or produce enough progesterone to maintain hormonal equilibrium, it is nearly assured that PMS symptoms will develop or worsen.

PMS is almost exclusively experienced by women between the ages of 12 and 52 in their childbearing years. About 75 percent of all women experience PMS attended by a variety of symptoms. Some of the most common symptoms of PMS include:

  • Aches, pains, and cramping
  • Acne
  • Anxiety
  • Bloating
  • Breast tenderness
  • Changes in mood
  • Cravings
  • Depression
  • Fatigue
  • Headaches or migraines
  • Increased emotional sensitivity
  • Insomnia
  • Irritability
  • Weight gain

Generally, PMS symptoms are mild to moderate in severity. However, an estimated 20 percent of women with PMS experience exceptionally severe symptoms requiring medical care.

The Estrogen Regulating Role of the Gut

The gut is a highly integrated system that impacts numerous areas of wellness. Without a healthy gut, many important functions including immune activity, brain function, and hormone balance can quickly become dysfunctional.

Recent studies show that certain qualities of the gut play a pivotal role in estrogen regulation and by extension the occurrence of PMS. The gut contains a selection of bacteria called the estrobolome. These bacteria metabolize and remove estrogen from the body. They accomplish this by producing a specific amount of an enzyme called beta-glucuronidase, which supports estrogen homeostasis. If healthy gut function is impeded or bacteria balance becomes skewed, also known as dysbiosis, beta-glucuronidase activity may become irregular. This can result in estrogen deficiency or dominance thereby contributing to estrogen-related conditions such as PMS.

In addition to influencing the development of PMS, gut function may also impact the severity of its symptoms. When the gut microbiome is imbalanced, immune activity and blood sugar values become unstable. This encourages hormone dysfunction that can exacerbate PMS. Furthermore, a dysfunctional gut is unable to extract vitamins, minerals, and other important nutrients from food and supplements. Without proper nutrient acquisition, the body can’t support hormone balance, symptom reduction, and healing.

Woman clutching her stomach due to PMS

What You Can do to Improve Gut Function

It is clear that healthy gut function is important in the prevention of PMS and the reduction of its symptoms. One of the best ways to support gut function is by optimizing your diet. Incorporating the following practices into your existing diet plan may help resolve gut problems and alleviate PMS.

Eliminate Inflammatory Foods

There are several allergenic and inflammatory foods that have become a regular part of the western diet. Foods like dairy, sugar, caffeine, alcohol, and especially gluten can cause a significant amount of intestinal irritation and inflammation. Even if your body isn’t sensitive to these foods, they can still contribute to poor gut health and subsequent hormonal disruption.

Balance Your Blood Sugar

Improving blood sugar values can support gut function thereby improving hormone activity. Several foods have been shown to support better blood sugar balance. Try including low glycemic and high phytonutrient foods into your diet. Some of the best options include avocados, nuts, seeds, olive oil, and high-protein foods such as eggs, wild salmon, and grass-fed beef.

Build Up Good Bacteria

The gut’s microbiome is made up of billions of bacteria; some good some bad. Keeping these bacteria balanced is essential for healthy gut function. You can boost levels of good bacteria by eating more fermented foods and probiotics. Some powerful bacteria-boosting foods include kimchi and sauerkraut. You may consider taking probiotic supplements to further support good bacteria in the gut – we recommend HoltraCeuticals’ UltraBiotics.

*Always ask your doctor before beginning supplementation

Incorporate Micronutrients

Nutrient deficiency is an increasingly common problem because many diets lack the micronutrients necessary to support healthy gut function. Some problem areas in western diets are vitamin B12, magnesium, vitamin D, zinc, and selenium. Increasing intake of foods containing these nutrients can be beneficial. Some people may need to use supplements to get the requisite amount of these and other important nutrients.

Include Healthy Sources of Fiber

Fiber is necessary for healthy intestinal motility and supports better hormone balance. Healthy sources of fiber include vegetables, nuts, seeds, beans and whole grains. A particularly powerful estrogen regulator is flax seeds. Increasing flax intake can improve hormone metabolism thereby reducing the risk of estrogen dominance and PMS.

Support Your Gut to Improve PMS

The gut is a critically important system for overall wellness. In addition to regulating numerous functions throughout the body, the gut also plays an important role in maintaining healthy hormone balance. As such, gut dysfunction can lead to irregular levels of various hormones including estrogen. Increased values of estrogen, or estrogen dominance, is associated with greater occurrence and severity of PMS. Therefore, maintaining healthy gut function is essential. You can better combat PMS by following a gut-centric diet and employing the tips shared above.

Want to take the next step in creating a gut-supporting diet plan? We’d like to help you take the hard work out of finding the right diet for you. Our nutritional services are designed completely around you and will help you achieve your goals. If you are among the 80% of women suffering from PMS symptoms and believe your poor gut health may be the cause, contact us to see how we can help you!


  1. OWH Staff “Premenstrual syndrome (PMS).” WomensHealth.Gov.
  2. Mayo Clinic Staff. “Premenstrual syndrome (PMS).” Mayo Clinic.
  3. Kwa, Maryann et al. “The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer.” Journal of the National Cancer Institute vol. 108,8 djw029. 22 Apr. 2016.
  4. James M. Baker et al. “Estrogen–gut microbiome axis: Physiological and clinical implications.”
  5. Lisa Lindheim et al. “Alterations in Gut Microbiome Composition and Barrier Function Are Associated with Reproductive and Metabolic Defects in Women with Polycystic Ovary Syndrome (PCOS): A Pilot Study.”
  6. Yanjie Guo et al. “Association between Polycystic Ovary Syndrome and Gut Microbiota.”
  7. Javurek, Angela B et al. “Effects of exposure to bisphenol A and ethinyl estradiol on the gut microbiota of parents and their offspring in a rodent model.” Gut microbes vol. 7,6 (2016): 471-485.
  8. James M.Baker et al. “Estrogen–gut microbiome axis: Physiological and clinical implications.” Maturitas Volume 103, September 2017, Pages 45-53.

Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.

more from: Women's Health

Jason Dobruck

7 Easy Ways to Remember to Take Your Supplements

80% of those who take supplements, forget to take them!

Holtorf Medical Group

The Link Between Menopause and Low Libido (+ What You Can Do About It)

There are many hormones impacted by menopausal shifts

Holtorf Medical Group

Is Your Diet Responsible for Your Low Libido?

One area that is closely associated with diet is sex drive.

Stay up to date

By submitting this form, you consent to receive marketing and promotional emails from Holtorf Medical Group. You may unsubscribe from this list at any time. View Privacy Policy.