Premenstrual Syndrome

Description

Alternative Names

Lifestyle Changes

A healthy lifestyle is the first step for managing premenstrual syndrome, which includes regular exercise and a good diet. For many women with mild symptoms, such a lifestyle is sufficient to control symptoms.

Dietary Factors

The general guidelines for any healthy diet are recommended, including eating plenty of whole grains and fresh fruits and vegetables and avoiding saturated fats and commercial junk foods. Making dietary adjustments starting about 14 days before a period may help some women with premenstrual syndrome.

Fluid. Drinking plenty of fluids (water or juice, not soft drinks or caffeine) may help reduce bloating, fluid retention, and other symptoms.

Frequent Small Meals of Complex Carbohydrates. In one major analysis of dietary changes involved with PMS, only increasing carbohydrate intake was found to be helpful. Carbohydrates increase blood levels of tryptophan, an amino acid that converts to serotonin, the brain chemical important for feelings of well-being. Such meals should be high in complex carbohydrates, which are found in whole grains and vegetables. (Complex carbohydrates should always be preferred over simple carbohydrates found in sugar and starch-heavy foods, such as pastas, baked goods, white-flour products, and potatoes.)

Experts suggest eating frequent small meals with no more than three hours between snacks. It is very important to avoid overeating during these times. Unfortunately many women not only overeat during this phase but they tend to eat sugar-rich foods or high-fat salty snack foods--the worst choices for PMS. Studies in fact indicate that overeating such foods worsens some PMS symptoms, including water retention and negative moods.

Low-Fat, High-Fish Diets. A 2000 study reported that women who followed a low-fat vegetarian diet for two menstrual cycles experienced less pain and bloating and a shorter duration of premenstrual symptoms than those who ate meat. Women who are losing too much blood, however, may need meat to help maintain iron levels. Choosing more fish and eggs may be a helpful alternative.

More than one study has reported less menstrual pain with a higher intake of omega 3 fatty acids (fat compounds found in oily fish, such as salmon and tuna). In another, supplements of fish oil appeared to reduce heavy bleeding in adolescent girls.

Salt Restriction. Limiting salt may help bloating. One study found that restricting salt does not alleviate bloating or other symptoms, but salt reduction in the study was modest and may have been too small to effect improvement.

Reducing Caffeine, Sugar, and Alcohol. Reducing caffeine, sugar, and alcohol intake may be beneficial. The effects of alcohol are mixed. One study found that women who drank less wine had less menstrual pain than those who drank more wine. Another reported that regular consumption of alcohol lowered the risk for developing cramps, but it actually increased the length of cramping time in certain women. Alcohol is certainly not recommended in any case for relieving menstrual disorders.

Exercise

Evidence suggests that exercise, especially aerobic exercise, increases natural opioids in the brain called endorphins and improves mood. Exercise is also very important in maintaining good physical health. In one study, women who jogged an average of 12 miles a week for six months experienced reduced PMS symptoms while a comparable group of women who remained sedentary did not improve. Even just taking a 30-minute walk every day is beneficial. Although not an aerobic exercise, yoga releases muscle tension, regulates breathing, and reduces stress. This practice may also be helpful for women suffering from PMS.

Physical activity contributes to health by reducing the heart rate, decreasing the risk for cardiovascular disease, and reducing the amount of bone loss that is associated with age and osteoporosis. Physical activity also helps the body use calories more efficiently, thereby helping in weight loss and maintenance. It can also increase basal metabolic rate, reduces appetite, and helps in the reduction of body fat.

Minerals (Calcium, Magnesium, and Manganese)

Calcium. Evidence now supports the use of calcium to reduce PMS symptoms. In one study, for example, taking 1200 mg of calcium daily reduced all PMS symptoms by nearly half after three months. Some experts now recommend taking calcium before trying antidepressants. Calcium rich foods include dairy products, dark green vegetables, nuts, grains, beans, and canned salmon and sardines (which include bones).

Click the icon to see an image of sources of calcium

Magnesium. The effects of magnesium are not as significant as with calcium, but some evidence suggests that it may be helpful in reducing fluid retention in women with mild PMS. A 2001 analysis of three small studies also suggested that magnesium may help women with menstrual cramps. A number of conditions can cause magnesium deficiencies, including intake of too much alcohol, salt, soda, coffee, as well as profuse sweating, intense stress, and excessive menstruation. Magnesium can be toxic in high amounts and can interact with certain agents. Women should discuss supplements with their physician.

Manganese. One small study reported that women with diets poor in manganese experienced improvement in PMS symptoms. But researchers who performed the analysis could not recommend a specific regimen or dose. Manganese can be toxic, but generally only in people who are highly exposed, such as those work in manganese mines.

Vitamins

Specific vitamins have been investigated.

Vitamin B6. Limited clinical evidence suggests that vitamin B6 may be beneficial in reducing PMS symptoms, including depression, although comparison studies with a placebo reported no additional benefits with this vitamin.Typically, women take 100 mg per day, although one study suggested that a lower dose (50 mg) may have the same effect. It should be noted that very high doses (500 mg to 2,000 mg daily over long periods) can cause nerve damage with symptoms of instability and numbness in the feet and hands. It is unknown if these effects could endanger fetuses in pregnant women. In addition, people who have been taking more than 50 mg for some time and stop suddenly are at risk for a so-called rebound deficiency. When people stop, they should taper off slowly. Food sources of B6 are meats, oily fish, poultry, whole grains, dried fortified cereals, soybeans, avocados, baked potatoes with skins, watermelon, plantains, bananas, peanuts, and brewers yeast. (Women prone to Candida vaginitis, the so-called yeast infection, should not increase their intake of dietary yeast.)

Click the icon to see an image of the benefits of vitamin B6.

Click the icon to see an image of vitamin B6 sources.

Vitamin E. Several randomized controlled trials have shown that vitamin E may improve both physical and emotional symptoms. It should be noted that high doses may cause bleeding problems, particularly in people taking anti-clotting medications. Some research now indicates that vitamin E, like other antioxidants, may have damaging effects in high doses.

Click the icon to see an image of the benefits of vitamin E.

Click the icon to see an image of vitamin E sources.

It should also be noted that there is no strong proof that any of supplements can reduce menstrual cramps and high doses of certain supplements may not be harmless. No one should take large doses of any supplement without first talking with a physician.

Improved Sleep

Many women with PMS suffer from sleep problems, either too much or too little; achieving better sleep habits may help relieve symptoms.