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Table of Contents | |
PMS - PREMENSTRUAL SYDROME
J Am Coll Nutr 2000 Apr;19(2):220-7 |
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Micronutrients and the premenstrual syndrome: the case
for calcium.
Thys-Jacobs S
Metabolic Bone Center, St. Luke's-Roosevelt Hospital Center, College of
Physicians and Surgeons, Columbia University, New York, New York 10019, USA.
Premenstrual syndrome afflicts millions of premenopausal women and has been
described as one of the most common disorders in women. Research over the
past few years suggests that a variety of nutrients may have an important
role in the phase related mood and behavioral disturbances of the
premenstrual syndrome. There is scientific evidence, at least for a few of
these micronutrients, specifically calcium and vitamin D, supporting cyclic
fluctuations during the menstrual cycle that may help explain some features
of PMS. Ovarian hormones influence calcium, magnesium and vitamin D
metabolism. Estrogen regulates calcium metabolism, intestinal calcium
absorption and parathyroid gene expression and secretion, triggering
fluctuations across the menstrual cycle. Alterations in calcium homeostasis
(hypocalcemia and hypercalcemia) have long been associated with many
affective disturbances. PMS shares many features of depression, anxiety and
the dysphoric states. The similarity between the symptoms of PMS and
hypocalcemia is remarkable. Clinical trials in women with PMS have found
that calcium supplementation effectively alleviates the majority of mood and
somatic symptoms. Evidence to date indicates that women with luteal
phase symptomatology have an underlying calcium dysregulation with a
secondary hyperparathyroidism and vitamin D deficiency. This strongly
suggests that PMS represents the clinical manifestation of a calcium
deficiency state that is unmasked following the rise of ovarian steroid
hormone concentrations during the menstrual cycle.
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