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Does Caffeine Help or Cause PMS?
Caffeine is the go-to stimulant for most people. It is found in teas and coffees as well as in energy and soda drinks. While some praise caffeine, others believe that it does more harm than good. For women with PMS, there is little doubt that caffeine is bad. Sure, it improves symptoms for a short while but then it worsens PMS symptoms for much longer. How does caffeine affect women with PMS? How does it influence neurotransmitters in the brain and hormonal balance? Read on to find out.
by Brad Chase
Caffeine is the most popular legal stimulant drug taken by man. It is found in teas and coffee drinks as well as some soft drinks and energy drinks.
Caffeine is an alkaloid found in the seeds, leaves and fruits of certain plants. As a plant chemical, it is meant to be an insecticide. However, once extracted from plants, the bitter and white crystalline compound is safe in low to moderate doses for humans.
Caffeine stimulates both the central nervous system and general metabolism. Therefore, caffeine is used to provide quick energy burst.
It can also promote wakefulness, mental focus as well as cognitive and physical performance. However, this benefits are later lost and replaced by fatigue, restlessness, insomnia and impairment of motor coordination.
People who regularly consume large amounts of caffeine develop a condition known as caffeinism.
Caffeinism refers to a dependency on caffeine. It also causes physical and mental symptoms such as nervousness, irritability, anxiety, headaches, rapid heartbeat, sleeplessness, diuresis and dehydration.
Caffeine does produce a number of complex psychological effects. While low dose and infrequent consumption of the stimulant may help boost mood and reduce anxiety, these benefits are lost with high doses and regular consumption.
In addition, suddenly getting off caffeine can trigger a series of paradoxical symptoms that represents a withdrawal syndrome.
The body of scientific studies investigating the clinical effects of caffeine has only produce conflicting results regarding the merits and demerits of caffeine consumption. However, experts agree that caffeine affects each individual differently.
While people with high caffeine sensitivity are likely to suffer the adverse effects of the stimulant faster, others are tempted to believe that caffeine does no harm only to end up getting hooked on caffeinated drinks.
Caffeine is both soluble in water and lipid. This dual solubility means that it readily crosses the blood-brain barrier.
In the brain, caffeine basically impersonates adenosine. Adenosine is an inhibitory neurotransmitter and it is structurally similar to caffeine. Therefore, caffeine competes with adenosine for adenosine receptors in the brain.
Once bound to adenosine receptors, caffeine blocks them and prevents adenosine from binding there.
This action reduces the activities of adenosine and produces the wakefulness and mental alertness craved by caffeine consumers.
However, reducing the activities of adenosine also affects the activities of other neurotransmitters in the brain.
At first, this inhibition of adenosine raises the levels of dopamine, serotonin, noradrenaline and acetylcholine. When ingested in large amounts, caffeine can also increase the levels of other neurotransmitters such as adrenaline and glutamate as well as cortisol, a stress hormone, and endorphins.
Because serotonin and dopamine are involved in mood while adrenaline, noradrenaline and glutamate are excitatory neurotransmitters, the immediate results of caffeine consumption are increased mental and physical energy.
However, caffeine overdraws the reserves of these neurotransmitters. Therefore, it expends them quickly and then when its effects wear off, the levels of these neurotransmitters drop sharply.
This drop leads to the psychological adverse effects of caffeinism and caffeine withdrawal. It can also worsen PMS symptoms after a short period of caffeine-fueled improvements.
But more importantly, caffeine blocks the activities of GABA (gamma aminobutyric acid) in the brain.
The inhibition of GABA activities directly results in caffeine-induced anxiety, insomnia and sharp increase in heart beat and respiration rates.
Lastly, the blockage of adenosine activities also means that the benefits of adenosine are lost.
Adenosine plays a neuroprotective role in the brain. To protect the brain, adenosine reduces brain activity, increases blood flow to the brain and induces sleep.
Caffeine disrupts these neuroprotective mechanisms and can, therefore, cause significant changes in brain activities, progressive damage to neurons and disruption of the sleep-wake cycle.
When it moves across the blood-brain barrier, caffeine becomes a non-selective antagonist at adenosine receptors.
As described above, this displacement of adenosine leads to desirable outcomes in the short-term but only ends up tiring out neurotransmitter reserves.
Therefore, the tiredness, fatigue, nervousness, irritability and short attention span you feel hours after consuming caffeine are simply the manifestations of depleted neurotransmitter reserves. And both the highs and lows of caffeine consumption happen within a few hours of each other.
This means that regular caffeine consumers experience signs of caffeinism and/or caffeine withdrawal every day.
For women with PMS, these manifestations of the after-effect of caffeine consumption will worsen PMS symptoms.
Unfortunately, PMS is often a reason to take up caffeine consumption in the first place. As women aim to blunt PMS symptoms such as fatigue, depression and loss of mental focus, they may increase their caffeine consumption while experiencing PMS.
Even though caffeine can improve PMS symptoms immediately, the oncoming crash hits even harder.
As caffeine stimulation uses up available neurotransmitter stores, the result is an imbalance in neurotransmitter activity and uncoordinated neuronal firing. These outcomes can immediately cause headache, jitters, fatigue and insomnia.
However, caffeine can worsen PMS symptoms even while it is boosting the levels of neurotransmitters such as serotonin, dopamine and noradrenaline.
By blocking GABA and increasing the levels of cortisol, caffeine increases stress while affording the body little opportunity to rest and recover.
One of the effects of caffeine is to raise the level of cortisol in a bid to increase carbohydrate metabolism and generate immediate energy.
Unfortunately, cortisol is also known as the stress hormone and a rise in its level is indicative of increasing stress. But more importantly, cortisol is synthesized from progesterone.
Progesterone is an ovarian hormone. Its chief role is to counteract the activities of estrogen, the other ovarian hormone.
Ideally, progesterone level is high during the luteal phase of the menstrual cycle while estrogen level is low. However, studies show that women with PMS have lower levels of progesterone and higher levels of estrogen than women without the condition.
These observations suggest that estrogen dominance is one of the characteristics of PMS.
Because estrogen is also synthesized from progesterone, high estrogen level during PMS means that progesterone is being sacrificed in favor of estrogen.
Stress or increased cortisol production only further lowers progesterone levels and deepens estrogen dominance.
Furthermore, both estrogen (in the form of beta estradiol) and progesterone can cross the blood-brain barrier and affect the activities of certain neurotransmitters. Studies show that estrogen reduces the activities of adenosine much in the same way as caffeine.
On the other hand, progesterone boosts the activities of adenosine.
These outcomes show that the combination of high estrogen levels and regular caffeine consumption only serve to further disrupt the balance of neurotransmitters in the brain and then worsen the symptoms of PMS.
Therefore, caffeine consumption while experiencing PMS can do more harm than good.
The diuretic effect of caffeine is often discussed and hotly contested. It seems that caffeine promotes increased urination at first but this effect may be lost in some regular consumers.
The diuretic effect of caffeine may be good for losing some water weight but it can also lead to the loss of essential minerals and vitamins.
Caffeine promotes the increased urinary excretion of water-soluble vitamins and minerals. Such vitamins include B vitamins which show promise at reducing PMS symptoms as well as magnesium and potassium which have also been proven to help.
However, the negative effects of caffeine on essential nutrients do not stop with increased elimination. Caffeine also blocks the absorption of these vitamins and minerals.
Furthermore, caffeine is acidifying. To counteract its acidity, the body uses up alkalizing nutrients such as calcium and magnesium to remove the acidic metabolites of caffeine from the blood. Unfortunately, calcium is pulled from the bones and magnesium is removed from the enzymes and functional molecules that need it.
The importance of maintaining optimum calcium levels in women with PMS has been conclusively demonstrated. Therefore, by promoting calcium loss, caffeine increases the risks of hypocalcemia and PMS.
The effects of caffeine on PMS is a rather difficult subject to study chiefly because of the complex effects caffeine may have on the body, the different dietary sources of caffeine and the shifting definition of PMS.
A number of studies found that the degree and pattern of caffeine consumption were the same in women with PMS and those without. While this observation can lead to the erroneous conclusion that caffeine has no effect on PMS, it is important to note that both the effects of caffeine and the risk of PMS vary from one premenopausal woman to another.
In all likelihood, women with PMS will benefit from discontinuing or at least cutting down their caffeine consumption.
The studies discussed below demonstrate the many ways by which caffeine affects PMS symptoms.
A 1985 study published in the American Journal of Public Health investigated the link between caffeinated beverages and PMS symptoms in young women.
The researcher recruited 295 college sophomores and collected data about their beverage consumption and PMS symptoms with self-administered questionnaires. After analyzing the data collected, the researcher concluded that caffeine consumption was strongly linked to both the presence and severity of PMS symptoms.
In addition, the results showed that caffeine consumption worsened most of the PMS symptoms identified.
A 1990 study published in the same journal, and involving the researcher from the 1985 study, expanded on the past study to measure the relative risk of PMS with the consumption of caffeinated beverages.
The researchers gathered data from 841 female students of the University of Oregon about their daily fluid consumption as well as menstrual and premenstrual health.
Once again, the data showed that caffeine consumption was strongly linked to PMS.
In addition, the results showed that for the women with the most severe PMS symptoms, the severity of symptoms was dependent on the daily dose of caffeine consumed.
From the study’s results, the researchers concluded that the relative risk of PMS rose from 1.3 (compared to non-consumers of caffeine with a value of 1) for those who drank only 1 cup of caffeinated beverage per day to 7.0 for the women who drank 8 – 10 cups per day.
The researchers further noted that this increased risk of PMS was present for both tea/coffee consumers and caffeinated soda drink consumers.
Although this study was not rigorous, it did provide a clear idea of the relationship between caffeine and PMS.
While it confirmed that caffeine consumption can worsen PMS symptoms, the real revelation from this study was that the amount of caffeine ingested was more important than the source of caffeine as a determinant of the severity of PMS symptoms.
This 2012 NIH-sponsored study published in The American Journal of Clinical Nutrition provided fresh perspectives on the possible effects of caffeine on PMS symptoms.
Specifically, it investigated the relationship between caffeine intake and estrogen levels and the variation of this relation with ethnicity.
In this rigorous and well-designed study, the researchers recruited 259 premenopausal women. Then over 2 menstrual cycles, the diets and hormone levels of these women were measured.
The results of the study provided some indications into the differences in caffeine effect on hormonal balance between women from different races. The researchers found that moderate caffeine consumption (greater than or equal to 200 mg/day) lowered estrogen (beta estradiol) levels in white women but raised the level of the hormone in Asian women.
However, the results also showed that the consumption (1 cup per day or more) of green tea and caffeinated soda raised estrogen levels in all of the women irrespective of race.
These results are rather puzzling because they clearly show that the source of caffeine is quite important to estrogen levels (and possibly the severity of PMS symptoms).
Out of the 4 caffeine sources (coffee, black tea, green tea and caffeinated soda) considered, only green tea and caffeinated soda raised estrogen levels in women across different races (whites, blacks and Asians).
Do these results mean that coffee and black tea are safer for white women with PMS than Asian women with PMS? Are Asian women more sensitive to caffeine or more prone to estrogen dominance? Further studies are needed to replicate and explain these findings but it is clear that caffeine raises estrogen levels and can, by extension, worsen PMS.
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