16 Jan

Pre-Menstrual Syndrome (PMS) and Nutrition

You are not alone if you suffer from PMS. I do and so do up to 95% of women of childbearing age according to National Institute for Health and Care Excellence. (NICE) (2014)

 Symptoms include: mood swings, irritability – for me most people annoy me for no apparent reason! Some people experience more serious symptoms such as feeling out of control, depression and/or anxiety. My sleep is certainly affected and some people also crave certain foods especially carbohydrates. Given this happens monthly and 13% of ladies take time of work because of it, it is something that should be helped and managed.

 Physical symptoms range from bloating, headaches, abdominal cramps, backache (that’s me) and exacerbation of a chronic illness. (NICE 2014) I used to get frequent sore throats around the time before my period, so the immune system is also a factor to be considered.

Food matters

Diet plays an important role when dealing with PMS symptoms, however as usual in nutrition there is not a one size fits all. The principles below is a good place to start when trying to tackle the symptoms. Make sure when you make changes they are daily not just when you are suffering. In time the changes you make should make a difference to how you feel. Give it time and when struggling with dietary changes such as reducing sugar, think forward to how you feel when you have PMS. I have benefited from making changes, I do need to still work on it though. So relaxation is the the key one for me.

An excellent start would be a diet rich in whole-foods including vegetables, fruits, whole-grains, good quality proteins and good fats.


Other factors

The liver has a role in managing the hormones involved in the menstrual cycle so supporting the liver is important. Avoiding foods that contain external oestrogens and improving detoxification may help reduce symptoms. It is also important to support blood sugar levels and identifying any foods that may exacerbate the problem.

What dietary and lifestyle changes can you make to improve symptoms?

I have listed below the factors that may be impacting on your symptoms and how to help you feel better. I have also given you real food ideas to be able to put it into practice. If you understand what might be going on then have the tools to fix it, the easier it is to apply in real life.

  • Support blood sugar by eating protein and or fat with every meal including snacks. For example an apple and a handful of almonds, oatcake with tahini and a couple of slices of banana. For breakfast make a muesli with porridge oats with ground mixed seeds and nuts, served with some plain natural yoghurt and berries. Limit sugar based foods especially the white refined carbohydrates so biscuits, cakes, white bread and rice. Eat complex carbohydrates such as brown rice, whole grains and vegetables. Eat regular meals and do not skip any meals.
  • Concentrate on digestion by enabling the body to go to the toilet everyday and avoiding constipation. Oestrogen is excreted once the liver has broken it down. However if you are not able to go to the toilet daily it may be recirculated back into the body. Eat fibre rich foods such as flaxseeds, oats, vegetables and fruit. Make sure you drink water regularly throughout the day – 6-8 glasses. Herbal teas count and foods such as soup, smoothies and vegetables also help towards hydration.
  • Opt for organic meat and dairy products, they may have less exogenous oestrogens, consider keeping them low if you suffer with PMS. Observe if it makes a difference. The evidence is mixed whether we absorb the hormones and how much oestrogen’s are in meat and dairy products. I would encourage you to play around with it and eat in moderation. If you are having a glass of milk at breakfast, a latte mid morning, cheese sandwich for lunch then creamy pasta at dinner regularly then look for alternatives at some point in the day so you are not overloading on one food.
  • Some fruit and vegetables should be organic over others. Check out EWG’s web site https://www.ewg.org/foodnews/ to find out when to choose organic. For example kale and apples are better organic as a lot of pesticides are used in these products. Where as avocados are ok to buy non-organic. Pesticides may interfere with normal hormone production.
  • Plastics, water bottles, containers and tins that contain Bisphenol A (BPA) should be avoided or limited. Animal studies have shown a link between BPA and hormone disruptions. Links have been found between BPA consumption and endometriosis and infertility. It is difficult to completely avoid but be wary of it and make changes around the home and shopping habits to reduce the load. Use glass bottles of tomatoes instead of tinned. Look at glass containers and buy a water filter jug or water bottle and fill up from the tap.

This web site gives you useful information on toxins and the impact it has on hormones in the body: https://www.niehs.nih.gov/health/topics/agents/endocrine/

  • Caffeine may aggravate PMS, if you think it does limit or avoid. The link is really about the symptoms of PMS and side effects of caffeine are very similar. However caffeine may help you when you are feeling tired because of PMS. Though calming the nervous systems is the focus when addressing PMS. Chocolate may be the answer! It contains magnesium, a calming mineral and a small amount caffeine but opt for 75%+ dark chocolate, have 2-3 squares a day or avoid completely if even that amount of caffeine is too much.
  • Inflammation may play a role in PMS. Eat oily fish and or flaxseeds and walnuts for their anti-inflammatory role. These foods contain omega 3 fat, omega 3 and omega 6 fat must be in ratio of about 1:2. However in a typical western diet where consumption of foods containing omega 6 are higher the ratio can typically be more like 1:10, this can be inflammatory to the body. Reduce processed and fried foods such as chips and crisps. A study in 2004 of 823 nurses showed that a diet high in trans fats increased inflammation.
  • Eat foods to support liver – foods that contain sulphur such as garlic, onion, leeks and eggs. Beetroot supports detoxification – try roasting in the over with some olive oil, seasoning for 25 minutes and serve with guacamole for a snack or starter. Cruciferous vegetables are also helpful, steam broccoli and cauliflower, serve with a olive oil, apple cider vinegar, salt and black pepper dressing. You could add a little plain natural yoghurt or coconut yoghurt if dairy free and tahini to thicken the dressing up and add a different dimension!
  • Vegetables also contain B vitamins; B vitamins support the reproductive system and therefore may help with PMS symptoms. Try to make half your plate vegetables based. This is not that hard as pulses, beans, chickpeas and lentils also count as vegetables. An ideal meal could be: oven baked fillet of salmon marinated in lemon juice, lemon rind, salt, black pepper and spring onions with steamed broccoli with a olive oil dressing and herby lentils.
  • Calcium and magnesium are important minerals for PMS, sesame seeds; humus and green leafy vegetables are good sources of both these minerals.
  • Stewed apples are supportive for digestion and combine with plain natural yoghurt for the extra boost of digestive helper’s probiotics also will support the menstrual cycle.

Relax – if you are in a challenged frame of mind this may make PMS worse, so find ways to relax. This might be reading, meditating, walking, going to the cinema or meeting up with a friend. My perfect form of relaxing is having a bath with magnesium and sulphur rich Epsom salts and reading my book. Listening to music or dancing may be enough to change your state of mind and mood. You can learn relaxation techniques very easily now through Apps and the Internet. Or seek professional guidance to help you relax.

Move! Activity is what is important – gardening, walking, yoga, swimming. Do something you enjoy. It will increase the amount of blood flow and oxygen to tissues, as well reducing irritability and anxiety. Supporting your abdominal muscles through exercise especially something like Pilates may prevent back pain and cramps. Exercise can improve posture which is a cause of PMS. Increasing exercise 1 or 2 weeks before your period may have an increased affect.

This is a long list, do it in stages if it is easier. Trying everything at once is never a good idea so don’t overwhelm yourself. Each change you make is a step to feeling better, motivating yourself to do more.