Three out of four menstruating women experience some form of premenstrual syndrome (PMS)
8% of women in the United States with PMS have symptoms that meet the diagnostic criteria for
premenstrual dysphoric disorder, a more severe, disabling form of PMS
Premenstrual syndrome (PMS) is the most common menstrual problem and is associated with more
than 150 symptoms, most notably cramps, bloating, irritability, breast tenderness, food cravings,
headache, and constipation PMS seems to be caused by hormonal changes during the latter half of the
menstrual cycle
Other problems include heavy and irregular bleeding, which tends to occur at the beginning and
end of a woman’s reproductive years, and missed periods, which is most likely caused by pregnancy
However, the menstrual cycle may also be interrupted by hormonal imbalances related to obesity,
diabetes, thyroid disease, a change in contraceptive pills, or an eating disorder such as anorexia
nervosa Women involved in high-level athletic training are prone to menstrual problems, because
they lack the critical amount of body fat to maintain adequate estrogen levels
Nutrition Connection
Many of the following suggestions are for PMS, which is the most common complaint, but a doctor,
gynecologist, or a dietitian can help address other menstrual issues:
Eat a balanced diet Eat regular, moderate meals, spaced throughout the day, with whole grains,
legumes, vegetables, and fruits Carbohydrate-rich foods can help by increasing production of
serotonin, a brain chemical that regulates mood
Eat foods that have a low glycemic load Foods with a lower glycemic load such as fiber-rich
apples and pears are best because they raise blood sugar levels more slowly, helping to control
appetite and possibly cravings
Avoid foods that may exacerbate PMS Fats, highly refined foods, and caffeinated drinks should
be avoided, and sodium intake should be reduced Alcohol can trigger or worsen many symptoms and
so should be avoided in the days before menstrual periods
67% of women lose sleep during their menstrual cycle every
month Doctors attribute this form of insomnia to a rapid drop in
the hormone progesterone
Get more calcium Calcium may help reduce mood disturbances, cramping, and bloating resulting
from PMS Some researchers believe PMS symptoms may be the result of low calcium levels, the
symptoms of which are like the symptoms of PMS Calcium sources include dairy products, fortified
soy beverages, canned salmon or sardines, and leafy greens
Add more magnesium Women with PMS often have low magnesium levels, which may
predispose them to PMS-induced headaches and depression Foods rich in magnesium include
sunflower seeds, nuts, lentils and legumes, whole grains, soybeans, figs, and green vegetables
Boost vitamin B6 Foods rich in vitamin B6 may help alleviate PMS symptoms Vitamin B6 may
help stimulate production of serotonin and reduce anxiety and depression caused by PMS Best food
sources are beef, pork, chicken, fish, whole grain cereals, bananas, avocados, and potatoes
However, if you take supplements, do not exceed the upper limit for adults of 100 mg per day Excess
has been associated with nerve damage
Indulge cravings carefully It’s okay to indulge in a piece of chocolate occasionally, but eating
large amounts of sugary foods adds empty calories and can worsen the craving for sweets by
disrupting normal blood sugar levels Opt for healthier, fiber-rich snacks, such as whole grain
crackers or fruit, which are metabolized at a slower rate than sweets and also help to prevent the
constipation that some women experience as part of PMS
Try herbal teas for painful cramps Raspberry leaf tea contains a substance that is thought to
relax the uterus and ease cramping Chamomile tea also has antispasmodic action
Try evening primrose oil This oil, available in capsules and in liquid form, contains an essential
fatty acid called gamma linolenic acid (GLA) This acid blocks the inflammatory prostaglandins that
contribute to cramps and breast tenderness
Eat lots of iron-rich foods if you bleed a lot Although heavy bleeding is rarely a sign of a more
serious condition, excessive blood flow may result in a loss of iron, increasing the risk of anemia An
adult woman needs 18 mg of iron daily Good sources are red meat, legumes, fortified cereals, leafy
green vegetables, and dried fruits To help the body absorb iron better, foods rich in vitamin C should
be eaten at the same meal
Beyond the Diet
The following strategies can help address your menstrual issues:
Exercise Women who exercise regularly are less likely to suffer from PMS
Take a warm bath or use a heating pad Both actions can help soothe cramps
Take an anti-inflammatory Prostaglandins, hormonelike substances that cause uterine
contractions, play a part in causing menstrual cramps Aspirin, ibuprofen, and other nonsteroidal anti-
inflammatory drugs (NSAIDs) can block prostaglandin production and alleviate menstrual cramps
Problematic periods A woman who experiences persistently heavy or irregular periods should
see a gynecologist to determine if she has a problem requiring treatment In some instances, painful
periods are related to other conditions, such as fibroid tumors or endometriosis A woman may also
be approaching menopause or have weight issues that lead to missed periods