One to two weeks before their periods, many women experience a troubling combination of physical and emotional symptoms - bloating, headaches, cramping, irritability, food cravings, breast tenderness, depression, and mood changes are just some of the symptoms.
While most experience these symptoms mildly or moderately, less than 5% of women experience a severe form of premenstrual syndrome (PMS). 1 Why does this occur? A simple explanation is because of fluctuating levels of hormones - especially estrogen and progesterone - after ovulation.
Can diet help, though? Yes! Nutrition can play a role in managing PMS. It is generally known that salt, sugar, alcohol, and caffeine can worsen symptoms. 3
+ Salt can lead to fluid build-up, breast tenderness, and bloating.
+ Sugar can contribute to irritability and fatigue due to unstable blood sugar levels.
+ Alcohol and caffeine can interfere with sleep and are associated with cramping. 2
+ Caffeine is associated with anxiety, insomnia, and irritability.
+ All four - sugar, salt, alcohol, and caffeine - have been associated with increased levels of the stress hormone cortisol. 2 They are also all associated with lower levels of serotonin, which can negatively impact mood.
Can nutrition have a positive impact on PMS?
Healthy Weight - Studies reveal that BMIs greater than 30 are predictive of PMS, especially symptoms of swelling, cramping, diarrhea, constipation, cravings, crying, and irritability. 4 Therefore, strive to achieve and maintain a healthy weight to minimize intensity of symptoms.
Herbal Supplements - Chasteberry is the only herbal supplement with reliable evidence from scientific studies. One study showed that chasteberry reduced PMS symptoms by half.
Calcium - Choose calcium-rich foods, such as milk or yogurt, nuts, dark leafy greens like kale, beans, canned salmon, canned sardines or fortified foods, such as soymilk and tofu. Higher calcium intake is linked with less PMS symptoms.
Vitamin D - Women experiencing PMS symptoms may be somewhat deficient in vitamin D. Interestingly, boosting vitamin D intake through food sources alone is linked with a 31% reduction in PMS symptoms. 6 Vitamin D-rich foods include eel, salmon, trout, tuna, mushrooms, and eggs.
Vitamin B6 - This vitamin has an important role in the manufacturing of serotonin and dopamine, neurotransmitters that affect our mood. This may be the reason why several studies have noticed its potential to alleviate PMS symptoms. 7
Magnesium - This mineral may help reduce some bloating associated with PMS. Foods rich in magnesium include leafy greens, nuts, fish, seeds, beans, legumes, whole grains, and avocados. 8
While diet alone won't resolve all PMS-related issues, it can definitely serve a useful purpose as a first line of defense!
1. Potter, J., Bouyer, J., Trussell, J., Moreau, C. (2009). Premenstrual Syndrome Prevalence and Fluctuation over Time: Results from a French Population Survey. Journal of Women’s Health; 18(1): 31–39.
2. Premenstrual syndrome. University of Maryland Shore Regional Health website. http://umm.edu/system-hospital-sites/shore-health/health/medical/reports/articles/premenstrual-syndrome. Updated September 20, 2013.
3. Public Health Nutr. 2019 Oct 15:1-10. doi: 10.1017/S1368980019002192. [Epub ahead of print]
4. Bertone-Johnson ER, Hankinson SE, Willett WC, Johnson SR, Manson JE. Adiposity and the development of premenstrual syndrome. J Womens Health (Larchmt). 2010;19(11):1955-1962.
5. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized placebo controlled study. BMJ. 2001;322(7279):134-137.
6. Bertone-Johnson ER, Chocano-Bedoya PO, Zagarins SE, Micka AE, Ronnenberg AG. Dietary vitamin D intake, 25-hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population. J Steroid Biochem Mol Biol. 2010;121(1-2):434-437.
7. Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutr. 2000;19(1):3-12.
8. Walker AF, De Souza MC, Vickers MF, Abeyasekera S, Collins ML, Trinca LA. Magnesium supplementation alleviates premenstrual symptoms of fluid retention. J Womens Health. 1998;7(9):1157-1165.