Premenstrual Syndrome (PMS) is the term used to describe the group symptoms that occur in 1-2 weeks prior (also known as the luteal phase) to a women’s menstrual bleed.
It is estimated that somewhere between 70-90 percent of women experience some premenstrual symptoms, with 20-40 percent of those women describing their symptoms as bad enough to impact daily life. In some cases PMS may develop into premenstrual dysphoric disorder (PMDD), a more severe complaint associated with an adverse impact on quality of life.
PMS Symptoms include;
- headaches
- fluid retention
- fatigue
- breast tenderness
- abdominal cramps
- mood swings
- depression
- anxiety
- irritability
- forgetfulness
- acne
- dizziness or fainting
The cause of PMS is hormonal imbalance, in particular the ratio of estrogen and progesterone and there are many lifestyle and diet factors that can affect hormone levels in the body.
Unfortunately many women who suffer with PMS don’t seek help. Conventional treatment in Western countries is often in the form of antidepressants or analgesics, which may offer some relief but unfortunately don’t address the root cause.
The good news is that while PMS is common, it is not normal and doesn’t need to be endured. There are many lifestyle and dietary changes that can have a significant impact on PMS. If you experience any of the symptoms listed, some of these simple steps may help.
1. Diet
Diet should always be the starting point for good health. Without a good diet, no amount of supplements or fancy gimmicks can improve health. Start by eating 5 servings of vege and 2 pieces of fruit per day. Eat the rainbow and include as many different colors as possible. Add good quality protein such as chicken, fish, eggs and grass fed meats. Healthy fats should come from avocado, olive oil, oily fish, nuts and seeds. Fibre keeps the digestive tract healthy and comes from fruits and vegetables, seeds, nuts, beans and legumes.
Foods that have been associated with increased PMS symptoms include refined sugar, salt and alcohol, so reduce your intake of these.
2. Reduce caffeine
For many of us it may be tempting to ‘self-medicate’ with caffeine, but studies observe that caffeine intake has a tendency to increase the prevalence of and severity of PMS symptoms. The affects appear to be dose-dependent, so if total avoidance seems unbearable then at least reduce your caffeine intake if you suffer from PMS.
3. Stay hydrated
Drinking enough water is always important and is particularly important during menstruation.
Water has many important functions throughout the body. It supports excretion of waste via the bowel and kidney, improves blood circulation, and helps with nutrient absorption, just to name a few. Increased water intake is also associated with increased metabolic rate and energy levels. Staying hydrated may also help to reduce the risk of dehydration headaches during menstruation.
4. Consider taking a magnesium supplement
Studies show that magnesium supplementation can improve PMS symptoms such as abdominal bloating and breast tenderness. There is also evidence that a combination of magnesium and vitamin b6 may reduce anxiety related PMS symptoms. Keep in mind that magnesium is available in different forms and not all supplements are created equal. If you do opt for a magnesium supplement look for an organic form of magnesium such as citrate or glycinate.
5. Eat fish
There is evidence that fish oil supplementation may reduce premenstrual symptoms and their interference with daily activities. Oily fish such as salmon, mackerel and sardines are great sources of omega-3 essential fatty acids. But if you don’t like fish, look for a good quality supplement containing at least 1g of fish oil.
6. Look at your gut health
Gut health is important because healthy bacteria in the gut helps to metabolise hormones that are then eliminated via the bowel. Poor diet, nutritional deficiencies, stress and quality of sleep are common contributors to hormonal imbalance and poor gut health.
Repairing the microbiome can help improve estrogen and hormone metabolism. This is especially important if you have recently taken a course of antibiotics or have experienced a gut infection. If you know your gut function is not quite right but aren’t sure how to improve it, consider seeking help from a naturopath or nutritionist.
7. Get moving
There is evidence that exercise may improve symptoms of PMS. Both strength and aerobic training appear to show good results however aerobic exercise may be slightly superior, especially for those who experience premenstrual depression.
8. Meditate
Numerous studies have shown meditation to be effective for managing mood and anxiety. In fact one study found it to be as effective as anti-depressants in its ability to reduce symptoms of depression, anxiety, and pain. Pretty impressive considering SSRIs are often the drug of choice for treating moderate to severe PMS symptoms. Better yet meditation is free and not associated with any nasty side effects.
What next?
If you’ve made these changes and are still struggling to manage your PMS symptoms there may be some deeper hormonal issues at play. Hormonal testing may be an option for some people or consider seeing a naturopath who will take a detailed case history to help identify the underlying causes of your PMS.