• Tamoxifen Induced PMS


    [Forewarning: If there are any men reading, I’m about to talk about periods and cramps, so any squeamish guys in the audience are excused. This one’s for the ladies.]

    Tamoxifen, the estrogen blocking drug that I have to take for five years, causes terrible bloating and cramps about two weeks before my period. Cramps so bad I double over in pain. Cramps so bad I eat Ibuprofen like candy and chase it down with double shots of Pepto Bismal. Cramps so bad I snuggle up to a heating pad on the couch for a few hours while I negotiate with my ovaries to not claw their way out of my body.

    I never had cramps like this before I started taking Tamoxifen and my oncologist confirmed that, yes, the medication could be causing severe PMS symptoms.

    I emailed my gynecologist and asked if she had any recommendations. She suggested vitamin B6, changing my diet to avoid sugar and salty foods, and exercise.

    (On that last point, clearly she has too many patients and has forgotten who she’s talking to.)

    Stopping the Tamoxifen was an option I immediately took off the table. The cramps and bloating and hot flashes suck, but you know what sucks worse?


    Cancer sucks worse.

    So the second time I found myself on the couch after a double dose of Pepto Bismal and 800 mg of Ibuprofen with a heating pad at my back I swore to myself I’d find a way to live with this.

    Through trial and error, here are three totally natural and healthy ways I’ve come up with for combatting this rather frustrating time of the month.

    One: Water – Drink One Gallon a Day.

    I cannot overstate the power of this. Drinking water is hands down the number one way I found to proactively manage cramps and bloating. Water also has the side benefit of controlling all the crazy PMS cravings and making me feel more alert.

    If you want some real numbers as proof, here:

    This last Tuesday I stepped on the scale and weighed in at 150.4 lbs. I felt awful. I felt bloated and crampy and tired. But I had a day to get through, so I put on some stretchy clothes and for the rest of the day I focused on drinking 1 gallon of water.

    Wednesday morning the scale said 148.6 lbs. I felt ten bazillion times better. The bloating was gone and my clothes fit again.

    One gallon is equal to 128 ounces. I realize that’s a lot of water. So how do you eat that elephant?

    One bottle at a time.

    Here are some strategies I employed for drinking more water.

    Strategy 1: Pair water with meals.

    I find when I’m trying to start a new habit, I’m more successful if I pair it up with an existing habit. Drinking a gallon of water a day was no different.

    I eat six times a day: breakfast, a morning snack, lunch, an afternoon snack, dinner, and an evening snack. If I drink roughly 21 ounces of water with each meal there’s my daily gallon.

    I will say, though, I had to tweak this strategy so that I finished most of my water at work. If I drink a bottle of water right before bedtime I’ll be up all night running to the bathroom.

    Strategy 2: Make a schedule.

    This goes hand in hand with the first strategy. I wrote down a time for each bottle of water: 7am, 9am, 11am, 2pm and 6pm. Then I put a little box next to each. Every time I finish a bottle of water I check a box.

    I like checking boxes. It makes me feel like I accomplished something.

    Strategy 3: Never leave my desk without my water bottle.

    The water fountains are on the way to the bathroom. Since I go there frequently I make myself stop first and fill up the bottle. Then I’m ready with another full bottle of water.

    Strategy 4: Hold work hostage.  

    Sometimes I get so busy I forget to drink water. To combat this problem I hold the task I want/need to do hostage until I drink some water.

    This gets me closer to my one gallon goal and has the added bonus of improving my concentration when I get back to work.

    Two: Avoid Gas

    Stomach gas and indigestion triggers cramps so vicious I had to find a way to proactively manage the problem.

    Strategy 1: Herbal Teas

    I experimented with various teas to help with indigestion. Chamomile and peppermint tea work in a pinch, but my go-to is ginger tea. Now I buy that stuff in bulk and carry it in my purse.

    If I drink it after a meal, I’m less likely to get an upset stomach. If it’s a particularly bad day, I’ll double up the ginger tea bags in my cup.

    Strategy 2: Avoiding Sugar

    One of the worst bouts of indigestion and the resulting cramps came after eating a few pieces of Halloween candy. Three mini-chocolate bars had me laid out on the couch in tears for two hours.

    The brief joy found in the taste of the candy was not worth the aftermath and since then I’ve been avoiding super-refined sugar products.

    I’ve found that the more processed and sugary a food is, the more it upsets my stomach. So I do like Elsa in Frozen: Let it go.

    Strategy 3: Avoid Other Gas Causing Foods

    Unfortunately, it isn’t just sugary refined foods that cause gas. Certain natural foods don’t play well with my stomach either, no matter how healthy they are. With a little trial and error I compiled a list of the best foods and worst foods for bloating and indigestion.

    Best foods for bloating Worst foods for bloating
    Cucumbers Broccoli
    Bananas Cabbage
    Avocados Beans (no surprise there)
    Kiwis Dairy
    Oranges Salty foods

    (I stick with plain Greek yogurt with a little honey)

    Ginger Apples

    Three: Exercise, but not too much

    When my gynecologist recommended exercise she probably didn’t remember that I am already very active. To me, exercise means “working myself to exhaustion”. I think what she meant was, “take a stroll around the block.”

    Exercise helps to a degree. What she didn’t specify was low impact exercise.

    When I’ve got cramps and bloating strenuous exercise like running makes me feel worse, not better. But I can’t not exercise. I’ll lose my mind.

    So I experimented with what types of exercise worked best with feeling crappy. The best, by a long shot, was Yoga.

    On the really, really bad days when even walking is out of the question Gentle Yoga made me feel better.

    On the days when I feel semi-okay but running is still a day or two out of reach, I turn to Power Yoga.

    There are so many variations of Yoga practices that the topic is worth another blog post to call out my favorites. Suffice it to say in this blog post that Yoga is my new go-to for PMS days.

    So there you have it. Three totally natural ways for combatting the worst PMS symptoms.

    I hope it helps!



    Ps. I love comments! Don’t want to post a comment? Send me an email at gettingthewordswrong (at) gmail (dot) com.

2 Responsesso far.

  1. Kristine says:

    Very good article. The tough one for me is avoiding a cookie with my morning coffee and the salty foods (more so a week before my period- my will power goes down the tubes at that time! And then I feel bad and get hard on myself. It’s a viscous cycle. Tamoxifen has exacerbated my PMS symtoms. But like you said, reminder – tamoxifen is cutting your risk of recurrence. I need to accept that every couple of weeks this is my life, and I need to find the best way to cope! It’s very hard sometimes and many people don’t understand that going through this so often can be exhausting. I find I have to be easier on myself during this time or else I’ll spiral to a sad place. I come out of it fine after my period starts, but it happens all over again in next couple of weeks. Like you, I also love my intense workouts, helps greatly with my mood. Thanks for the great article.

    • Meghan says:

      Taking Tamoxifen for more than two years now has given me a sense of appreciation for my body that I never had before. It made me slow down and really take care of myself during the ‘bad’ weeks and makes me appreciate my ‘good’ weeks even more. And I’m with you on the salty foods!

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