It is common in my practice to hear women talk about exhaustion, their cravings for junk food, skin break-outs, moodiness, bloating and puffiness prior to their menstrual cycle, followed by a severely heavy and crampy period. It is also common for these symptoms to not be hormonal concerns, but signs of a congested lymphatic system.

Let me explain…

The collecting ducts of the lymphatic system that line the intestines transport triglycerides through the lymphatics to be used as an energy supply for in-between-meal energy. (1,2) When the lymphatic system becomes congested, the flow of energy (in the form of triglycerides) can stall or become blocked, leading to an experience of fatigue or exhaustion. The brain responds to this fatigue by craving energy in the form of all sorts of comfort foods. I had one patient who had insatiable, uncontrollable cravings for greasy fried food, chocolate, coffee and ice cream. The brain knows how to get happy!

The reproductive system drains into pelvic lymphatic channels that may be responsible for many of the menstrual issues described above. (3) According to Ayurveda, prior to the menses, there is an internal detoxification process of waste through these lymphatic channels. The prevalence of swollen and tender breasts, breaking out and bloat can all be traced back to congested lymph during this pre-menstrual detox.

The lymphatic system originates in the collecting ducts or lacteals of the intestines, and if there is any intestinal distress, there can be resultant congestion in the lymphatic vessels that surround the intestinal tract. Intestinal lymph congestion has been linked to the aging process (5), and if this intestinal irritation and resultant lymph congestion happens prior to menstruation, a series of lymph-congestive symptoms can be commonly misinterpreted as a hormonal imbalance.

The lymphatic system is systemic and pervasive throughout the body. If the lymph around the gut and intestines becomes congested due to intestinal distress, the entire lymphatic system may become congested in short order. When the skin-associated lymph becomes congested, you may see mild skin rashes, hives or other skin discomfort. You may experience brain fog and mood-related concerns when the newly discovered brain lymph vessels, or glymphatics, become congested. (4)

My Top 5 Lymphatic-Based Solutions for PMS:

1. Manjistha—Ayurveda’s premier lymphatic mover. Read more on this in my article, “Menopause and Menstrual Cycle Symptoms: It May Not Be Hormonal.” Take two 500mg capsules with breakfast and before bed.*
2. Brahmi—Centella asiatica or Gotu Kola. Brahmi is natural brain tonic and lymphatic mover. Take two 500mg capsules per day with the manjistha.*
3. Sip hot water throughout the day, 10-14 days before the onset of cycle.
4. Drink fennel tea with meals 10-14 days before the onset of the cycle.
5. Aim to not schedule vigorous activities or exhaustive activities right before or during the cycle.

*The brain glymphatics drain toxic waste from the brain during sleep. (6) Poor brain lymphatic drain during menses can affect brain function and sleep.

References:

1. J Cardiovasc Dis Res. 2011 Jul-Sep; 2(3): 141–152. doi:  10.4103/0975-3583.85260
2. Biochemistry. 5th edition. Section 22.1Triacylglycerols Are Highly Concentrated Energy Stores
3. Europe PMC. Anatomy of the pelvic lymphatic system. PMID:24007954. DOI: 10.1016/j.canrad.2013.05.010
4. Rejuvenation Res. 2013 Dec;16(6):518-23. doi: 10.1089/rej.2013.1530.
5. Lymphat Res Biol. 2013 Mar; 11(1): 35–42. doi:  10.1089/lrb.2012.0025
6. Rejuvenation Res. 2013 Dec;16(6):518-23. doi: 10.1089/rej.2013.1530.

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Author: Dr. John Douillard

Image: 阮芊菡 JUAN CHIEN-HAN

Apprentice Editor: Bretton Keating; Editor: Yoli Ramazzina