PMS – How can nutrition support us through our menstrual cycle?

By Laura Jennings

 
 
 

Premenstrual Syndrome (PMS) refers to the psychological and physical symptoms some women may experience in the luteal phase of the menstrual cycle (1 to 2 weeks prior to the onset of a period). Symptoms usually last a few days and disappear with the onset of menstruation. Approximately 47.8% of women of reproductive age globally are affected by PMS. In 20% of cases, symptoms are severe and can cause significant disruption to a woman’s daily life.

So what are the symptoms of PMS and how is it diagnosed?

There are no specific tests to diagnose PMS, as hormone levels are in the normal range. Diagnosis relies upon a woman’s medical history and a description of her symptoms. Some of the symptoms of PMS include:

  • Abdominal bloating

  • Abdominal pain

  • Nausea

  • Changes in appetite

  • Breast swelling or tenderness

  • Digestive disruptions such as constipation or diarrhoea

  • Back pain

  • Fatigue and Restlessness

  • Anxiety

  • Irritability

  • Mood Swings

  • Tearfulness


    Changes in appetite and food cravings are some of the most frequently reported symptoms of PMS. But do nutrient requirements actually change in the lead up to menstruation?

Nutrients that have been linked to PMS:

Vitamin D and Calcium

Studies have shown that both calcium and vitamin D levels tend to be lower in women who experience PMS and that supplementing both these nutrients might reduce the severity of symptoms. In particular, there is evidence that taking a calcium supplement significantly reduces specific PMS symptoms including, mood swings, irritability and food cravings. If you would like to increase your calcium from dietary sources, good sources of calcium are dairy, nuts, and dark leafy vegetables. Examples of dietary sources of vitamin D include, salmon, tuna, mushrooms and eggs.

Carbohydrates

Increased intake of carbohydrate-rich foods, (e.g. sugary cakes) are reported among women with PMS. Carbohydrates provide tryptophan, which converts into serotonin. Increased serotonin levels ultimately boost mood. PMS symptoms have been shown to coincide with a reduction in serotonin levels. Therefore, there is something to be said in honoring your body’s cravings during this luteal phase! However, it should be noted that whilst the body might crave carbohydrates not all carbohydrates have a positive effect on PMS related symptoms. Refined carbohydrates (sugar and alcohol) can cause insulin levels to spike, worsening symptoms of irritability and bloating. There should be a focus on consuming complex carbohydrates (whole grains and vegetables) in order to manage blood sugar and reduce the severity of PMS related symptoms.

Magnesium

There is evidence to suggest increased magnesium intake during the luteal phase may combat bloating by reducing fluid retention. The journal of women’s health published a study that showed daily supplementation of magnesium-reduced reports of weight gain, bloating, and breast tenderness after two months of consumption compared to a placebo.  Magnesium rich foods include, fish, avocados, whole grains, beans and legumes.

Iron

Iron is responsible for the synthesis of serotonin and dopamine (our happy and motivation hormones) so if iron levels are low women are more likely to experience mood related PMS symptoms. Studies have shown that high intakes of plant-based sources of iron (above the recommended RDI of 18mg/day) are associated with a lower risk of PMS. However, this same benefit has not been identified with animal sources of iron (haem iron).

How Nutrition can support PMS

There is some evidence to suggest that women might burn slightly more calories during the luteal phase of their cycle, but this caloric increase is only very small (around 100-200 extra calories). This would be the equivalent of an extra slice of toast! The focus should be on the quality of the calories consumed instead of the quantity in order to reduce and alleviate PMS. Focusing on the below food groups in the run up to menstruation should help to better manage PMS:

Fruit

Fruit appears to be protective against both physical and psychological PMS symptoms. Fruits are rich in antioxidants and may protect against the increased oxidative stress that occurs with PMS.

Non-starchy vegetables

Non-starchy vegetables are vegetables that are fibrous and rich in vitamins and minerals including, peppers, asparagus, cauliflower mushrooms, leeks. Non-starchy vegetables have antioxidant and anti-inflammatory properties that may offset PMS symptoms.

Oily fish

The onset of PMS symptoms has been associated with increased levels of inflammatory markers in the body. The consumption of omega 3’s has been shown to be anti-inflammatory and protective against such inflammation.

Complex carbohydrates

Focusing on small frequent meals that contain whole grains, such as brown rice and whole meal bread are higher in iron, b vitamins and help keep blood sugar stable. Complex carbs may help to reduce irritability, breast tenderness, bloating and weight gain.

Foods to avoid – Sugar, alcohol, caffeine and sodium are elements of the diet that have been linked to the worsening of PMS symptoms.

*It should be noted that in some cases symptoms may be so debilitating that they will not be able to be managed by diet alone. In such cases, women should consult with their GP for other treatments.

 
 
 

ABOUT THE AUTHOR:

Laura Jennings

After five years working in the corporate world in luxury fashion and technology, Laura trained as a yoga teacher and joined the team at My Method, curating exciting and diverse wellbeing programmes for private clients and corporates.

Laura has a passion for holistic wellbeing and nutrition and has joined the Be Well team to support with content creation, workshop development and more. She is progressing in the world of health and wellness and has recently completed a Masters in Nutrition at King's College London.

 
Gut Health, NutritionSarah Macklin