Using Nutrition to Help with Premenstrual Syndrome
Picture this: a woman wakes up feeling tired before she even gets out of bed. Getting the kids off to school and herself off to work—but not before picking a fight with her partner—she “white knuckles” it through the day, fueled by caffeine and chocolate. On top of that, she’s been dealing with a sore back all day long, from sleeping in a bad position. On her way back from work, while stopped at a red light, she bursts into tears for no apparent reason. Then, as soon as she gets home, she gets her period. The mess of a day “makes sense” to her now: it was “just” PMS.
Many of us can relate to this very stereotypical PMS experience or something like it. The embedded cultural ideas of PMS range from the denial of its very existence to the belief that it is a medical condition requiring prescription drugs. The prevailing negative stigma of menstruation as shameful, dirty, or something to keep hidden invariably impacts a woman’s experience and even her potential for PMS symptoms, as research shows that the social environment can influence the severity of a woman’s PMS. According to herbalist Rosemary Gladstar, “PMS creates a recurring monthly anxiety for many women and certainly inhibits some women from enjoying this cycle of womanhood. Instead of their moon time being a special moment to enjoy their unique ‘womanness’, it marks a period of stress, pain, and discomfort.”
PMS is complex, not fully understood, and uniquely expressed in every individual. Neither normal nor inevitable (although extremely common, and despite most of us tolerating it), PMS is actually our bodies telling us that something is out of balance, relaying messages that range from subtle whispers to loud screams.
Premenstrual syndrome defined
PMS is a collection of physical and/or emotional symptoms that come on during the ten days before the arrival of a period and disappear during or soon after its arrival. The list of potential symptoms is long (over 150!) and typical ones include irritability, anxiety, depression and sadness, bloating, changes in digestion and/or bowel movements, cravings, abdominal/back/leg/breast pain, acne, and headaches.
True PMS symptoms typically last two to seven days, and relief arrives on or within two days of the onset of a period. It’s important to note that PMS is not just a worsening of baseline symptoms, but include new ones that appear and disappear in the aforementioned specific timeframe most months.
Eighty percent of women experience some level of PMS, with twenty to forty percent describing their symptoms as causing difficulty in some way, and it is most often experienced by women in their thirties and forties. One in twenty women are affected by a more severe version of PMS known as premenstrual dysphoric disorder (PMDD) which results in severe premenstrual depression, irritability, or anxiety. As PMS is very individual, what works to manage one woman’s symptoms might not apply to another, and most women opt out of seeking medical attention and instead self-treat.
The root cause of PMS isn’t fully understood, but the multifaceted symptoms mean it’s most likely from a variety of sources. What we do know is that imbalances between estrogen and progesterone, inflammation, stress, blood sugar imbalance, thyroid health, and negative societal connotations all play a role. While daily and monthly fluctuations are natural and healthy—these rhythms are responsible for the orchestra of events that help a woman regulate her mood, body composition, metabolism, bone health, fertility, stress response, and more—symptoms can develop depending on each hormone level, how they interact with one another, and how our bodies are able to tolerate and manage the variation.
No matter what the root cause of your PMS, nutrition can play a large role in preventing and treating symptoms. The goals of any good diet include nourishing natural anti-inflammatory processes, smoothing detoxification, balancing blood sugar, and correcting nutrient deficiencies to support the pathways of healthy hormone balance, and PMS is no less likely to benefit from foods and nutrients that support these functions.
Ditch the disruptors
A great nutritional start includes decreasing or eliminating caffeine, alcohol, sugar, and refined carbohydrates as these are highly inflammatory, can directly disrupt hormones, and can also cause spikes in blood sugar. Furthermore, many women feel better when they reduce or eliminate wheat and dairy.
Heap-on the helpers
Since increasing all kinds of vegetables, raw nuts and seeds, legumes, and fish seems to help improve symptoms, many patients have reported that following a Mediterranean-style diet has worked well for them. Including more sulphur-containing foods like onions, garlic, beans, and broccoli; antioxidants and vitamin C and E-containing foods like citrus, strawberries, almonds, and spinach; and fibre from ground flax and legumes can be helpful as well. These foods work to increase liver function and detoxification which helps create balance between estrogen and progesterone. As well, many of these foods contain phytoestrogens, weak estrogen-like compounds that help buffer the ups and downs of stronger estrogens in the body.
If allowed to persist, imbalances and deficiencies in the following nutrients in particular will contribute to worsening PMS. They can be optimized with either a nutrient-dense whole foods diet, or through supplementation.
Calcium: yogurt, kefir, sardines, almonds
Magnesium: spinach, figs, bananas
Zinc: pasture-raised grass-fed meat, eggs
B vitamins: romaine lettuce, nutritional yeast, edamame, chicken
Essential fatty acids: sardines, oysters, chia seeds
There is a great deal of overlap in the foods that support a healthier menstrual cycle, so it’s easy to double-up on some nutrients with a single food! Since no two individuals will have the same needs, always visit your healthcare provider for an individualized assessment and treatment plan that also includes appropriate dosing of supplements, if recommended.
Magnesium: the champion of PMS support
Magnesium helps in hormone production, especially progesterone (which is needed to keep estrogen in check). It also reduces inflammation, regulates stress, enhances calming neurotransmitters, brings calm to the nervous system, and helps with sleep. Magnesium improves blood sugar balance, thyroid health, and promotes healthy estrogen metabolism. Found in nuts, seeds, dark leafy greens, figs, avocado, and beans, magnesium is great for relieving an array of PMS symptoms!
I would be curious to know how differently PMS symptoms would be reported if women felt supported, empowered, informed about their bodies, and were encouraged to look at menstruation as a time to celebrate with their fellow “cycling” sisters (anyone read The Red Tent?). In any case, know that if you are experiencing PMS you are not alone, and suffering needn’t be your lot in life. Most PMS responds very well to natural treatments like the above dietary changes, and I encourage you to pay attention to your body’s call. As you learn about and become confident in your biology, be reassured there are answers out there for you. Let’s share this wisdom and reclaim our periods as a healthy, wonderful time—evidence of our ability to give life or simply a barometer of our health—and let's work to make PMS something we don’t have to give a thought to.