PMS Prevention Plan: 10 Tips For a Happy Menstrual Cycle

by Dr. Mahalia Freed, ND

Umm, happy? Isn’t that taking things a bit far? No, no it is entirely possible and reasonable. Read on. Premenstrual Syndrome (PMS) is not inevitable or unavoidable. PMS is common, but it is not “normal”.
Did you know that PMS can include over 100-300 different symptoms? While mood changes like anxiety, depression, irritability and lability (moodiness) are the most recognized, other common symptoms include breast pain or swelling, bloating, bowel changes (e.g. constipation, diarrhea), insomnia, headaches, migraines, food cravings, acne, back pain, fluid retention in the legs, and fatigue. For some people, PMS takes the form of increased clumsiness and brain fog. For others, it means less vocal range (an issue if you are a professional vocalist!), or even seizures. Finally, many women notice that their immunity is decreased at this time of the month. It is a time when cold sores or genital herpes might erupt, when asthma symptoms may flare, or when a yeast infection could make itself known. It is considered PMS if the symptoms occur in a cyclical pattern, related to the menstrual cycle, over several months. Symptoms may begin at ovulation (around day 14), or 1-2 days before the period begins.
The majority of women will experience PMS symptoms at some point in their lives.
So, shouldn’t we all know how to stay healthy, happy and stable in the face of Premenstrual Syndrome?  

Here are my Top 10 Tips for PMS Prevention:


  1. Nourish yourself with food. Eat lots of vegetables, eat home-made, eat clean protein. Eat organic whenever possible (in this case because xenoestrogens in pesticides impact your hormone balance). Remember that organic junk food is still junk food. Enjoy your treats.

Careful with caffeine. Most of us have figured out the therapeutic power of good chocolate, and I won’t be the one to take this away, but caffeine does make breast tenderness worse, and it can destabilize mood and worsen digestive symptoms. Consider cutting down on coffee.

  1. Cut the sugar. Refined sugar and processed foods aggravate pain and mood issues, even though they seem like a good idea in the moment. (Except a bit of good, dark chocolate).


  1. Move your body. Regular movement of any kind is effective, but yoga stands out in its efficacy in the clinical trials.


  1. Increase target micronutrients with supplementation:
  • B6: especially helpful for mood symptoms, B6 is essential for the metabolism of estrogen. Take it as part of a good-quality B complex.
  • Cal-Mag: Both calcium and magnesium are proven effective for managing premenstrual symptoms, from fatigue to depression to cramps. Consider supplementing with one or both.
  • Fish Oil (especially EPA): while more researched for other health concerns, fish oil is known to be effective for mood balance, and for shifting physiology to decrease inflammation. Thus, it is a good choice for certain types of PMS.

5. Work with an herbal ally or few

  • Herbs to consider for PMS include: St John’s Wort, Vitex agnus-castus, gingko, black cohosh, kava, motherwort, skullcap, passionflower. The specific herbs best for you will depend on your particular symptoms. Some people use combination formulas, while others see great results with only one or two herbs. Ask me for a personalized herbal prescription.


  1. Regulate your sleep schedule. Women with a regular sleep routine have more stable hormone levels than those whose sleep patterns are all over the place. Go to bed at the same time every night. For maximum benefit, go to sleep well before midnight, and sleep in total darkness (see melatonin, below).


  1. Increase your melatonin. You know how it feels like your hormones are crazy when you have PMS? Well, in fact the only hormonal difference scientists have found between women with severe PMS and controls is melatonin levels. That’s right, no estrogen excess or deficiency, no progesterone excess or deficiency. The other hormone issues are believed to stem from changes in hormone receptor sensitivity. But, this is still theory. In the meantime, you can increase your melatonin naturally:
  1. Sleep in complete darkness (blackout curtains, an eye mask if light is unavoidable)
  2. Start sleeping sooner. Melatonin production is higher before midnight.
  3. Ensure you give your body the building blocks. Pumpkin seed is a great source of tryptophan, the amino acid precursor to serotonin and melatonin. The reaction requires B6 (see above).
  4. Alternate nostril breathing can stimulate the pineal gland to increase melatonin production (and generally promotes calm when done before sleep).
  5. If you have been diagnosed with Premenstrual Dysphoric Disorder (PMDD), consider supplementing with melatonin. Start with 3 mg per day before bed. And, contact me for more (nonprescription) options.


  1. Honor the wisdom within you. If you are exhausted and feel irritated by anyone talking to you, maybe this is the time of the month to carve out a couple hours to curl up with a novel, or journal, rather than pushing yourself to maintain your usual pace. For those who experience intense shifts in mood, think of PMS as the time when the tide is out, and all the feelings and nagging thoughts that you can push down (under the water) the rest of the month are exposed. Sometimes PMS emotionality is just PMS, but often there are important nuggets of truth buried in the sad or mad or irritable state. Look for these truths and give them space at other times in the month. If the nagging thought is “this (job/relationship/etc.) doesn’t feel right”, then make space to explore that. Make changes. As things in your life shift in response to you listening to your inner voice, watch your PMS symptoms abate.


  1. Cultivate a happy microbial community:
  • Eat fermented or cultured foods regularly (e.g. unpasteurized sauerkraut, kimchi, kosher-style dill pickles).
  • Consider reseeding your flora with a quality probiotic supplement, especially if you have taken antibiotics.
  • (Good gut flora are associated with better mood, and good gut flora are also important for hormone balance)


  1. As always, I highly encourage you to seek out personalized naturopathic care to help map out the big picture, and tunnel down to the right supports for you. Constitutional homeopathy, acupuncture, flower essences, therapeutic nutrition and custom formulated herbal medicines can all offer incredible healing & resolution for PMS symptoms. With professional guidance and the advantage of an outside eye, meet your health goals faster, with less time lost to the contradictory information offered by Dr Google.

Contact me for information on becoming a client/patient.

Flower Essences: A Powerful Healing Tool in Naturopathic Practice

By Mahalia Freed, ND

Naturopathic Doctor, BodyTalk Practitioner, Writer, Speaker, Educator, Kale Crusader

St John’s Wort in bloom

Flower essences are energetic, or informational, remedies made from the flowers of plants.  They are gentle and deep acting, and are most commonly used to support emotional health and personal growth. One familiar example is Rescue Remedy, a combination of flower essences (from the Bach line) popular for anxiety and shock. Many people carry Rescue Remedy in their bag, finding it effective emotional first aid for calming down enough to drive home after a fender-bender, facing their ex’s divorce lawyer without breaking down, getting through a funeral.

In my practice I use flower essences to support heart healing, move through grief or trauma, overcome tobacco addiction, develop healthy body image, allow for true personal expression, help someone find their life path, and so much more. The subtle, powerful healing of a correctly prescribed flower essence is magical to witness, and gratifying to experience.

These days, I often choose a flower essence as part of someone’s naturopathic treatment plan. It may complement a homeopathic, or fill in the gap between counseling regarding relationship patterns and a custom tincture for a lung infection.

Case example:

“Sally”, a perimenopausal woman in her 50s who came to me for help resolving her hot flashes, digestive discomfort (bloating) and fatigue. When Sally first came to see me, she was depressed, but she had felt like that for so long, it had started to feel like all there was. As is common for people who are used to doing everything themselves rather than trusting others to help, she was not very expressive or open with me at first. We started out by improving her diet, increasing exercise, and ensuring that all her particular nutrient needs were met. For Sally, this meant more leafy green vegetables, less packaged food, and more variety in grains. She decided to begin yoga classes, and start walking more regularly. I prescribed a couple foundational supplements for energy and mood, and custom-formulated a botanical tincture to help decrease her heavy menstrual bleeding and eliminate hot flashes. I also suggested a journaling exercise. She came back and reported that she felt slightly more energy, as well as no more hot flashes, and no more heavy menstrual bleeding. Progress, right? Great, but her mood was still very “up and down”, and in my office she seemed down even while positive about the changes thus far. Next step: botanical formula for mood. Follow-up: helped a bit, but still “up and down”. Meanwhile, her periods continued to improve, and her bloating resolved once we identified and eliminated her particular food sensitivity.

When things are getting better on a physical level, but seem “stuck” on an emotional

Larch branch

level, a flower remedy can help. In Sally’s case, we started with Larch, a Bach essence for self-confidence and speaking your truth, often indicated for women with thyroid concerns as part of their picture. After one month on twice daily Larch drops, the effect was clear: Sally shared more with me than she ever had previously – confidence in speaking your truth. Amazing progress! We continued to incorporate flower essences into the treatment plan over the next 6 months, with consistent healing progress. Recent update: Sally and I are now working on the next level of her health. That is, with the help of the flower essences and the development of trust in our relationship, she is able to access deeper information from within herself regarding her true purpose. Further, Sally is now able to contemplate the changes needed to bring her current life into alignment with her passions and sense of what she meant to be doing. As she integrates this information and begins to make changes, I have seen her physical health concerns shift and lift even further. Witnessing her healing and that of many other clients affirms for me that personal growth is part of health. It is so clear that supporting personal growth must be part of truly holistic care, and flower essences are an ideal tool with which to provide this support.

Flower Essence Q&A

Q: How do flower essences work?

A: There is now solid science – from Einstein on forward – demonstrating that matter is energy. We know that the energy contained in a liquid can be used to influence human energy fields to help resolve ailments. This is what flower essence liquids do. When you take flower essences, the energy they contain affects your energy field, which in turn may shift your physical, mental, emotional, and spiritual state.

Q: Is this the same as essential oils?

A: No. Essential oils contain concentrated biochemical components of the plants from which they are extracted, while flower essences are closer to homeopathic remedies in nature, in that they are energetic imprints of their source.

Q: How do you make a flower essence?

A: A flower essence is made by infusing the blossoms of a particular plant, bush, or tree in water in the sun. The liquid is then diluted and “potentized” in a method similar to the preparation of homeopathic remedies, and preserved with brandy (or a nonalcoholic substance, if need be). The result is a highly diluted, “potentized” substance that embodies the energetic patterns of the flower from which it is made.

Q: Is there scientific evidence that flower essences are effective?

A: Yes, there is both clinical and double blind placebo-controlled study evidence that shows clear efficacy of flower essences. For example, this study, titled, “Flower essences reduce stress reaction to intense environmental stimulus” found that two flower essence combos outperformed placebo in calming specific areas of the brain that respond to stress.

Q: How do I choose which essence or essences are right for me?

A: There are many flower essence repertories and guidebooks available. My favorite one is here:

You can choose remedies for yourself, based on the particular emotional state you are working with. In some cases, this can be amazingly effective. However, I strongly suggest working with a practitioner in choosing essences. Prescribing accurately requires a certain amount of objectivity that most of us cannot muster about ourselves. Despite my familiarity with the flower essences, and my training, I do not prescribe to myself, as I know I do not have the best perspective from which to do so.

Meditation is good for you. The Evidence from a Reluctant Meditator

by Mahalia Freed, ND

It took me years of resisting and suffering to develop and sustain a regular meditation practice. I share my tips and lessons in this article, Confessions of a Reluctant Meditator, or Tips for Fitting Meditation into Your Life.

If you are the kind of person who likes to know the why of things, here is a very brief summary of why meditating will be beneficial for you, too:

The evidence

As a naturopathic doctor I am well-versed in the evidence and clinical applications for meditation. It is amazing how effective various kinds of meditation can be. An unsophisticated PubMed search on the term “meditation” yields 2, 215 studies. Depression? Meditation may be as effective as medication. Cancer? Meditation improves mood, sleep, immune system, quality of life. Stress? Meditate to lower blood pressure. Heart disease? Yup. Meditation helps. Indeed, mindfulness-based stress reduction for heart disease, chronic pain and many other conditions is taught at hospitals and in private practices across North America based on the work of Jon Kabat-Zinn, PhD.

Even more compellingly, my clients are a fantastic and inspiring bunch. They tell me that meditation practice helps them manage anxiety, gives them energy when their work involves long hours and traveling, keeps them happier, helps them connect more with their friends and family. So not only do I know about the benefits from reading the studies, I know about it from clinical practice.

The bullet points:

  • It feels good.
  • It is free.
  • It can help restore emotional clarity and balance, making you feel better if you are stressed or sad.
  • It can energize you when you feel tired (though it’s not a substitute for quality sleep, you type A’s out there!).
  • It can help you tap your inner wisdom when you feel uncertain about a decision.
  • It can reclaim stillness from the frenzied pace of modern day life, readjusting the skewed balance between being and doing.
  • It can reconnect you with your intuition and creativity.
  • It will give you unexpected gifts (for me this has included concrete reassurance when things felt dire, and recently, the name of a remedy I hadn’t consciously heard of that was the perfect fit for someone in my care with a complex clinical case).
  • It doesn’t have to be hard.

Want some tips to help you find a way to integrate meditation into your full life? Get started here. And please share what works and doesn’t for you!

Creating Lasting Change, from the Inside, Out

by Dr. Mahalia Freed, ND

People come in to consult with me because they want something to be different. They want to be able to sleep, they want to have a baby, they want enough energy to enjoy their downtime, they are tired of struggling with depression, they are tired of picking up every bug during cold & flu season. While the details of treatment are unique for each person, every healing journey involves the integration of new lifestyle habits and/or ways of thinking. This means more than simply trying something new and finding that it makes you feel good, but truly integrating a change so that things ARE different from now on. This means going beyond the latest wonder-supplement for immunity or depression. Instead, we go within, to discover what it is that has thrown off your body’s natural balance in the first place.

What formula can we follow to get you there?

I can’t count how many times I have seen variations of the following scenario: I am working with someone and we come up with a plan, eg. work out 4 days a week. At their follow-up, they have been to the gym once, and then … it fizzled. They resolve to meet the same goal again. And again, despite telling me it is what they want to do, and telling me how they know they will feel better, they don’t do it.

Why not do it?

Why would someone tell me they want to exercise, ask for and agree to the plan, and then not do it?? I don’t view this as a patient being “noncompliant”. This is your care, your process. Your responsibility is to yourself, not to me. My job is to help you get where you want to go, to help you find balance in your life and within yourself. The question, then, is what is the obstacle to you taking this step that you tell me you want to take? What is the gap between what you say will be good for you, and what is right for you now, in this moment?

I have some theories.

I think that it often comes down to whether or not we are listening – truly listening – to our bodies. Is the voice that says I “should” exercise coming from outside of you, when instead your body just wants some stillness? Are you exhausted? Are you resolving to do weights because your read somewhere that doing weights is the best for your bones, but what really resonates for you is ballroom dancing? Or, it might be a matter of being stuck in all-or-nothing thinking: “I have to be a saint, and never allow a morsel of sugar or white flour to pass my lips. Otherwise there is no point and I should just eat a whole package of cookies since I’ve messed it up anyway”. The accompanying guilt, shame and blame when we set ourselves to “fail” in these ways paralyzes us into inaction. And, well, we all know how good – or not good – this kind of cycle feels when we are stuck in it.

What can we do instead?

  1. Observe where you are, and practice compassion. Judging oneself harshly only leads to shame and blame, and lasting change cannot be built on these emotional states. Are you are feeling exhausted because you are watching tv or surfing the internet each night until the wee hours? Observe this pattern. Perhaps you will notice that this habit allows you to fall into sleep without feeling something (loneliness, sadness, fear, grief) that you wish to avoid. Be kind & gentle with yourself.
  2. Look underneath the behaviour you want to change, and try to track it back to the root. So, if you are eating cookie dough ice cream each evening because you are sad, rather than resolving to stop eating the ice cream, resolve to address the sadness.
  3. Identify goals that come from within you. Find yoga yucky but love being outside? Make walking your restorative exercise time.

Sustainable change comes from a place that is rooted deeply inside you. By looking at what you are doing and why, you can come to understand the root of the behaviour. From this root, guided by the principles of observation and compassion. you can rebuild a strong foundation that will take you where you want to go.

Mahalia Freed is a naturopathic doctor happily living and practicing in downtown Toronto. In her family practice, Mahalia has a special focus in endocrinology (including PMS, PCOS, thyroid concerns), mental health, oncology, fertility, and perinatal care.