Dr. Cass

Is it possible to go through all the hormonal changes and pms symptoms each month even if one does not have a period?

Q: Is it possible to go through all the hormonal changes and pms symptoms each month even if one does not have a period? I have had secondary amenorrhea off and on for most of my life due to an eating disorder and still seem to get crampy, bloated, weight gain, headache and mood swings rapidly each month even though there is so no actual menstrual flow. Also, Can one get pregnant if they have amenorhea?

I haven’t had my period in 3 months. I took 3 pregnancy tests and came back negative. What could be the cause of missing period?

Q: I haven’t had my period in three months. I took three pregnancy test and came back negative. What can be the causes of missing period?

Lately I have noticed that i got all the PMDD Symptoms. I’m 16 years old and its killing me, how to deal with it?

Q: Lately, I have noticed that i got all the PMDD Symptoms. I’m 16 years old and its killing me! How to deal with it? Is it a life time problem?

It is the day of a planned period with Implanon, but nothing since April 1st. Is there a chance I am pregnant?

Q: I have had the Implanon since march 2009, I have had a monthly
and steady period for over a year. My last period was 4-1-2011, I
normally have it for 6 days. It is 5-27- 2011 the day of a planned
started period, but nothing since April. Is there a chance I am pregnant?

Is it true that when you are pregnant, you will not have pms symptoms?

Q: I got pregnant in Jan but miscarriaed at 6 weeks. What suprised me is during Jan, i do not have any pms symptom. For me, PMS symptom usually start after ovulation, i will have breast tenderness. but when i got pregnant that month, there was no breast tenderness after ovulation. Is it true that when you are pregnant, you will not have any pms symptom?

Is the possibility of getting pregnant right before your period large?

Q: Last month my period was a couple days late due to stress. Right
before I got it, (less than 36 hours) I had sex for the first time in months. Today, my period is due and it is not here. I have all the symptoms of both PMS and pregancy: VERY tender breasts (this tends to always be my worst symptom), emotions, salt cravings, headaches an fatigue. Is the possibility of getting pregnant right before your period large?

A:You are not likely pregnant, since ovulation occurs in mid-cycle, and the egg that is produced dissolves within 24 hours. So, unless you

Can you have PMS for 2 weeks prior to your cycle?

Q: I have PCOS and until I gave birth to twins last December did not have a regular cycle unless taking medication to induce ovulation. Now I have had a cycle each month for the past 9 months. Since I was blessed with only one a year I don’t know much in regards to PMS. However I have
noticed that for the past 2 months that 2 weeks before my period I feel
weepy, down and achy all over and have what feels like light cramping.
The week before my period I am a bear and snappy and want to eat everything in sight. Can you have PMS for 2 weeks prior to your cycle?

I had my menstrual the 26 and then I got it again the following month on the 11th. Is this not too soon? And it last for 7 days.

Irregular periods can be a sign of many different conditions. I would need far more history as well as a physical exam to even attempt to give you a reason. If this shortened cycle persists, you should see your doctor for a check-up.

Q. Can we have extended pms symptoms when we are irregular?

Q. My pms has become severed in the last year. I am 42 years old now and
believe I’m entering perimenopause. The last three months my periods have
been irregular, so now I don’t know when my symptoms are pms or not. Can we have extended pms symptoms when we are irregular? Also, dizziness has increased tenfold for me, to the point where I can’t function, and fullness and ringing in my ears and sometimes headaches. I am not taking aspirin or ibuprofen. I had a bout of all of this a week ago, then felt
better a few days and now it’s back. I am currently at 32 days in what

What are some techniques to recognize pms while it is happening vs. after the fact when I see everyone runaway?

Be prepared! Also use the Monthly ‘Monstrual’ Chart in The Princess and the PMS to monitor your moods, aches and pains. This will give you a PMS road map to follow, helping you recognize when your demon double is coming to town.

I understand there is a new birth control that allows one to have their periods every three months. What are your thoughts?


I don’t like birth control pills altogether: they deprive women of hormones. Even though they are supposed to be a hormone pill, they are actually suppressing your own hormone supply, leading to depression, lack of sex drive (a big one for women on the pill!) and other side effects. Suppressing nature often backfires, and I believe that this new pill is one of those medications that manipulates the body’s normal function in a negative way.

I get horrible mood swings during PMS. One minute I am watching TV and the next I want to throw something at my husband…


Your responses are not uncommon. Self control is a good place to start. You could say you feel cranky— no need to act it out on the poor guy! Your best bet is to be prepared, and to take supplements all month long if you need to, in order to avoid getting PMS in the first place. Otherwise, start taking them at the first hint of being out of balance emotionally/hormonally. And watch your diet: minimize salt, sugar, caffeine, and preservatives.

Everyone keeps telling me to drink more water during PMS time. Is there nothing else I can drink that will help?


You can drink herb tea, warm or cool, or diluted fruit juice—enough for flavor but not enough to cause problems due to sugar overload. Remember, sugar at any time is unhealthy and worse during PMS. Soft drinks, coffee, and caffeinated tea are not considered part of your water intake, and in fact, are “anti-nutrients” in that they cause your body to leach calcium, magnesium and other precious nutrients.

There is so much confusing information about holistic remedies for PMS. Which one is the best? Do they help different symptoms?


Everyone’s chemistry is different, so sometimes you just have to try the various remedies until you find a combination that works for you, and that can change over time, as well. When I developed my PMS formula, I kept that in mind, so included a variety of nutrients that are known to be effective and work in synergy.

Is it possible that I am suffering from PMS even though I am pregnant?


Hormones shift throughout pregnancy, and can cause symptoms that may be similar to those associated with PMS. It’s important that your body is producing enough progesterone to sustain a pregnancy. Since PMS is often due to low levels of

It seem like my senses of smell and taste are stronger when I have PMS.


You’re not hallucinating or losing your marbles. Hormones govern a lot of different brain functions, including taste and smell. You may become more sensitive to taste, smell and even touch. I find that magnesium is often helpful in reducing this hypersensitivity and recommend taking 250-400 mg daily. Of course, if your superwoman vibes make you enjoy life’s rich banquet more, just sit back, relax, and inhale, or visit a local farmers’ market and sample the fresh produce of the season. Just steer clear of department stores where the perfume spritzing terrorists could induce sensory overload!

How can I avoid the tired feeling during PMS?


Your adrenal glands and/or thyroid gland may be sluggish, made worse by the hormone shifts that accompany this part of your cycle. This can cause you to feel tired. Besides checking with your doctor, you could take specific herbs called “adaptogens” that support your adrenals. My Energy Balance Formula contains eleuthero, rhodiola, and reishi mushroom, plus tyrosine (an amino acid) and B vitamins. These boost your adrenal or energy glands, thyroid gland, and feel-good brain chemicals.

Sometimes I feel nauseous during PMS. Is that normal?


This nausea could be due to “estrogen dominance” in which the normal ratio of estrogen to progesterone is too high. This means that you have too much estrogen and too little progesterone. To get your hormones back in whack, you can take herbal formulas such as my PMS Balance, or natural progesterone supplements. You can also take a combination of calcium-d-glucarate, a compound that breaks down the excess estrogen, plus a progesterone cream, applied on any skin surface twice daily during this time.

Are there steps I can take to avoid acne breakouts around my periods?


Yet again, hormones are the culprit: acne is due to an imbalance of hormones. Avoid sugar, white flour, chocolate, and greasy foods like the plague. Stick to lots of fresh fruits and veggies, lean protein, and drink a minimum of eight glasses of water a day. Eat foods containing Omega 3 oils such as salmon, spinach, and mustard greens. They act as natural anti-inflammatories, and we all know that nothing is quite as inflammatory as a biblical plague of pimples. You can also take 2 grams (2 caps) of Super EPA daily.

My co-workers claim that I’m bitchy when I have PMS. On the off-chance that they’re right, what should I do?


Lock yourself in a closet for a week and come out when you can be civil. If that won’t work for economic reasons, see this post.

When I have PMS, my breasts swell and hurt. How can I prevent the monthly misery?

Skip the salt to prevent water retention, and neither you nor your breasts will feel (and look) like water balloons. Eat lots of fruit, vegetables and protein, avoid sugar and salty foods, and get a move on! Exercise helps your body eliminate excess fluid. Though you wouldn’t offer a drowning man water, make sure you drink plenty of H2O, no matter how bloated you feel. Women need at least 64oz (or 8 cups) of water a day to keep the blimp away.

Why do I eat everything that doesn’t move a few days before my period?

Your blood sugar is on a death-defying rollercoaster ride, thanks to changes in your hormone levels. Don’t try to starve yourself to manage the ups and downs. Eat!

I tend to overreact to pretty much everything when I have PMS. What can I do to prevent this?

Here’s a good strategy that works during PMS or anytime you’re stressed: Whether it’s your boss, your husband, your kid or burly men carrying a straightjacket with your name on it, take a deep breath before you respond! It’s guaranteed to calm you down. Plan ahead to protect yourself and your loved ones by taking charge of your health–both mental and physical. Choosing a healthy diet, supplements and getting some exercise* can send your PMS packing. At the very least, it will minimize the effects and maximize your wellbeing.