NYC psychotherapist Colette Dowling, LMSW, author of the following aticle on premenstrual cravings, has written eight books on womens issues, including The Cinderella Complex: Women's Hidden Fear of Independence, which was published in 23 languages.
Premenstrual cravings for carbohydrates have long been known to plague women. While those with binge eating problems will ratchet into high gear when they're premenstrual, even women whose eating patterns are usually normal will notice over-the-top cravings during the week or so before their periods.
The first to uncover fascinating data on both the "why" of premenstrual cravings and a new way of taming them were Dr. Richard J.Wurtman, a professor of neuroscience and brain chemistry and his wife, Dr. Judith Wurtman, a cell biologist and nutritionist. The Wurtman's research showed that depression, premenstrual cravings, and some other symptoms of PMS can be significantly reduced with antidepressant medication--OR by judiciously eating certain foods that are rich in complex carbohydrates. The Wurtmans' theory is that supplying the brain with a minimal amount of good (complex) carbohydrates prevents women from hungering for them and going on wild binges.
How did they come up with their theory about premenstrual cravings?
To find out, my daughter Gabrielle and I interviewed Judith Wurtman in her lab at MIT. Dr. Wurtman told us she'd begun wondering about the scientific basis for premenstrual cravings after she heard innumerable stories from her women patients about how thier eating habits changed around the time of menstruation. "Right before they get their periods many have an irresistible craving for sweet and starchy foods. You'll hear them say,'I could kill for chocolate!'"
The Wurtmans wanted to find out whether women with premenstrual cravings actually do increase food intake--in particular sweet and starchy food--"or whether they simply think they do because their craving is so pronounced."
These researchers tested a group of women who were experiencing PMS symptoms and another group who weren't. All were given a choice of a variety of foods--some high in carbohydrates (potatoes, rice, cookies, candy, pretzels) and others high in protein (chicken, cheese, tuna salad). "What we found," Judith told us, "was that the women with PMS were eating large amounts of carbohydrate foods, but only for about three or four days before their periods. The control women--the women without PMS--didn't increase their food intake at all."
The two scientists had the same women consume a carbohydrate dinner at the beginning and at the end of their menstrual cycle. The meal consisted of a large bowl of corn flakes--"a neutral, high-carbohydrate food," said Judith Wurtman. Before eating the dinner the women's moods were tested--did they feel happy, sad, irritable?--and again an hour afterward. The reason for this? Eating a large carbohydrate meal increases the level of serotonin in the brain, Wurtman continued." And when brain serotonin is increased there's an improvement in certain types of emotional states. People feel less depressed, more calm, less irritable, more focused, less confused, less distractible, more tranquil. We knew that if the carbohydrates--in this case the cornflakes--were going to do anything, they would probably do it by increasing the serotonin."
After the meal, the women reported that they were indeed less depressed. "They were substantially calmer, substantially less tired and more alert," said Wurtman. "This was a wonderful finding because it means that when women choose to eat carbohydrates at the end of their menstrual cycle, they're doing so in order to make themselves feel better. And it also confirmed for us that this brain chemical, serotonin, may be involved in some of the mood changes of premenstrual syndrome."
So what about premenstrual cravings? Judith Wurtman told us she thinks that in the week or so before they get their periods women should go into a "high-carbohydrate-mode of eating." This high-carb eating will not go on forever, as it has its own natural beginning, middle and end. And, of course, such a mode of eating doesn't involve fats. Wurtman suggested that premenstrual women eat complex carbohydrates like rice, potatoes, pasta, lentils, or beans, "along with, perhaps, some sweet carbohydrates if their craving is strong enough for those foods."
The Wurtmans were among those who pioneered the use of antidepressant medication in the treatment of PMS. Today, the gold standard for medical treatment of PMS is a very low dose of antidepressant medication that ONLY has to be taken during the premenstrual week. Unlike antidepressant medication taken for depression, which can take weeks to build to adequate levels in the blood stream, the same medication used for the treatment of PMS shows positive effects on the day it's first taken. For the depressed woman who has premenstrual "break-through" of her symptoms in spite of already being on an antidepressant, a psychopharmacologist will often suggest adding very low doses of an additional medication--sometimes drops of Prozac--during the premenstrual week.
In addition to having their premenstrual syndromes treated with
medication, women also find therapy to be helpful. For example, women
with a history of premenstrual cravings and other symptoms find that
their self esteem is affected. They may believe they should be able to
control their mood swings and cravings and feel shame because they
haven't succeeded. Therapy can be very useful in helping women to
increase self esteem and overcome the shame associated with premenstrual
cravings and mood swings.
AUTHOR BIO AND CONTACT INFORMATION
Colette Dowling, LMSW, has a graduate degree from The Smith College School for Social Work and has done advanced training at the Institute for Contemproary Psychotherapy, in New York. She is trained in the use of EMDR for the treatment of trauma.
Colette specializes in working with women and couples. For further information, or if you wish to schedule a consultation, e-mail firstname.lastname@example.org, or call 718-594-0201.
For information on Colette's therapy practice see Psychology Today.
To hear Colette speaking on the anxiety of beginning work with a new therapist click the audio button.
Copyright Colette Dowling, 2006-2010