How to Combat PMS

What is PMS?

Yes, PMS is actually a thing. Those mood swings, aches, and pains--that overall feeling of pure crappiness--is not in your head. Premenstrual syndrome (PMS) is a cyclical set of physical and behavioral symptoms that occur 7 to 14 days before the menstrual cycle and stop with the start of menstruation[1]. Common symptoms include anxiety, depression, irritability, mood swings, insomnia, constipation, diarrhea, fatigue, brain fog, back pain, sugar cravings, and headaches. It’s estimated that more than half of all menstruating women experience symptoms of PMS, with up to 5% experiencing symptoms severe enough to impact their everyday lives. It’s difficult to pinpoint the exact cause of PMS, but it is most likely the result of fluctuating hormone levels that naturally occur during the menstrual cycle. Changes in estrogen and progesterone levels can lead to anxiety, depression, and irritability. Aldosterone, a hormone that regulates blood pressure and fluid retention through sodium and water absorption from the kidneys, tends to be elevated during the menstrual phase after ovulation and before your period starts. This could be the reason behind common PMS symptoms like water retention, weight gain, and bloat[2].

So what’s the connection with food?

Fiber

THE SCIENCE

Believe it or not, fiber actually plays a very interesting and very essential role in hormone regulation: it is required for the removal of excess estrogen. The liver processes excess estrogen and sends it to the gut to be excreted. Fiber has the important role of binding estrogen so it can then be passed out of the body via your stool. Without adequate fiber, estrogen will re-enter the bloodstream, and your body will continue to feel the consequences of the extra estrogen. 

THE BOTTOM LINE

Studies have shown that consuming high-fiber diets can significantly lower serum estrogen and reduce symptoms of PMS [3]. 

Nourish RX:

• Eat 25-30 grams of fiber a day to maintain hormone balance. If you’re new to eating fiber-rich foods, add them in slowly to avoid abdominal discomfort. 

• Add two tablespoons of flaxseeds either to smoothies or sprinkle on salads or veggies

Magnesium

THE SCIENCE

Magnesium is a super mineral in my book. It helps ease headaches and anxiety, treat depression, and reduce muscle cramps and tension. In hospitals, it’s used to help save lives during seizures and heart arrhythmias and is used to prevent preterm labor. Low magnesium levels have been found in women who experience PMS. One study found that after three months of taking 250mg of magnesium daily, PMS symptoms like cramps, headaches, anxiety, and insomnia were reduced by over 30% [4,5].

THE BOTTOM LINE

Nourish RX: 

• Try to get a least 2-4 cups of leafy greens a day (particularly spinach, kale, and collard greens) for fiber, magnesium, and calcium 

• Enjoy a piece or two of Dark Chocolate (70% or more cocoa) 

• When going for a piece of fruit, pick bananas or figs, which are two fruits that contain the most magnesium. 

Vitamin B6 

THE SCIENCE

Vitamin B6 is essential for the synthesis of many important neurotransmitters, such as serotonin, dopamine and GABA, making this vitamin vital in memory, depression, anxiety, sleep, and mental functioning. 

THE BOTTOM LINE

Studies have proven B6 supplementation can reduce the symptoms of PMS. While you can easily find vitamin B6 and other B vitamins in pretty much every multivitamin supplement, it’s also easy to get sufficient amounts through food. 

Nourish RX:

• Eat Grass-fed meat and chickpeas 

From the Doc: It’s important to consume grass-fed and organic meat because conventional meat is pumped with antibiotics and hormones, which will only further contribute to gut and hormonal disturbances.

Calcium

THE SCIENCE

Calcium is important not only for bone health but for regulating muscle contraction, signaling of neurotransmitters, and cell communication. Calcium levels fluctuate during the menstrual cycle, decreasing when estrogen levels are increased. Studies have shown that getting anywhere from 500-1200mg of calcium a day can reduce the severity and symptoms of PMS [5]. 

THE BOTTOM LINE

Nourish RX:

•  Eat an ounce of parmesan cheese, which has more calcium than most other cheeses

• Try eating canned salmon or sardines for a quick lunch that offers a non-dairy alternative to calcium 

• Make your smoothies with a good quality whey protein 

• Add a couple of tablespoons of chia seeds to your smoothie, or make a chia seed pudding for a vegan source of excellent calcium. 

Sources: 

1. Rakel D. Integrative Medicine. Philadelphia, PA: Elsevier; 2018.

2. Szmuilowicz ED, Adler GK, Williams JS, et al. Relationship between Aldosterone and Progesterone in the Human Menstrual Cycle. The Journal of Clinical Endocrinology & Metabolism. 2006;91(10):3981-3987. doi:10.1210/jc.2006-1154.

3. Rose DP, Goldman M, Connolly JM, Strong LE. High-fiber diet reduces serum estrogen concentrations in premenopausal women. The American Journal of Clinical Nutrition. 1991;54(3):520-525. doi:10.1093/ajcn/54.3.520.

4. Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iranian Journal of Nursing and Midwifery Research. 2010;15(Suppl1):401-405.

5. Quaranta S, Buscaglia MA, Meroni MG, Colombo E, Cella S. Pilot Study of the Efficacy and Safety of a Modified-Release Magnesium 250mg Tablet (Sincromag??) for the Treatment of Premenstrual Syndrome. Clinical Drug Investigation. 2007;27(1):51-58. doi:10.2165/00044011-200727010-00004.

6. Shobeiri F, Araste FE, Ebrahimi R, Jenabi E, Nazari M. Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstetrics & Gynecology Science. 2017;60(1):100-105. doi:10.5468/ogs.2017.60.1.100.