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Harvard Commentaries
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Food for Thought Food for Thought
 

Seven Ways To Beat PMS


May 05, 2014

By Kelly Hanna, M.S.
Brigham and Women's Hospital

 

Do you have bloating, cramps, food cravings, crying spells and mood swings around the time of your period? If so, you're not alone. An estimated 85%-90% of women will experience mild symptoms of premenstrual syndrome (PMS) at some point in their lives.

PMS is a collection of symptoms that can occur in the days just before and during menstruation. These symptoms are thought to be caused by shifts in hormones and brain chemicals, though researchers are still trying to confirm the exact processes behind these shifts.

The most common symptoms of PMS include:

  • Depression
  • Irritability
  • Fatigue
  • Abdominal cramping
  • Breast tenderness
  • Headaches

While scientists are still trying to understand PMS, several diet and lifestyle strategies have been found to alleviate some of the symptoms associated with your menstrual period. Here are seven tips to try to help your PMS.

No 1: Avoid skipping meals

Have you ever noticed yourself becoming more irritable or tired as you get hungry? Eating meals and snacks regularly throughout the day helps keep your blood sugar steady. A steady blood sugar generally means a balanced mood and better energy level.

Be mindful of your hunger. Every couple of hours, make a point to take a minute to check in with your stomach. Does it feel empty? Are you counting the hours until lunch? If so, have a snack. Also, if you are hungry soon after eating, you may need to include more protein, fiber or healthy fat in your meals and snacks. Carbohydrates alone tend to be quickly digested, but pairing them with protein, fiber or fat keeps them in the stomach longer. And you feel full longer.

Here are some healthy snack ideas that include protein, fiber and healthy fats:

  • Apple or banana with peanut butter
  • Low-fat cheese and crackers
  • Vegetables and hummus
  • Nuts and seeds

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No. 2: Increase your calcium intake

Studies have shown that women who get at least the recommended daily amount of calcium a day (1,000 milligrams for women ages 19-50) have fewer symptoms associated with PMS, compared with women who do not get the recommended calcium intake. To be most helpful, you need to eaten calcium-rich foods daily.

Foods to boost your calcium intake include:

  • Low-fat milk, cheese, yogurt, cottage cheese
  • Fortified soy milk and tofu
  • Canned salmon and sardines
  • Bok choy, kale, turnip greens, seaweed
  • Almonds and sesame seeds
  • White beans and black-eyed peas

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No. 3: Watch your caffeine intake

Caffeine is commonly found in coffee, tea, energy drinks and sodas. There is some evidence to suggest that caffeine intake may increase moodiness and anxiety in some women around the time of their periods.

  • Consider substituting one or more of your drinks with a decaf version.
  • Pour your cup of coffee with ½ decaf coffee and ½ regular strength.
  • Reduce your intake of caffeinated sodas and energy drinks.

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No. 4: Limit salty foods

While you may be craving salty snacks, excess salt may worsen bloating and weight gain around your period.

  • Select low-sodium varieties of your favorite snack foods, such as unsalted nuts or low-sodium crackers.
  • Try herbs, spices or black pepper instead of salt
  • Snack on fruits and vegetables, which are naturally low in salt. Baby carrots, celery and apple slices provide a satisfying crunch without the salt.

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No. 5: Get enough B vitamins

B vitamins include thiamine, riboflavin, niacin, B-6 and folate. They are found in a wide variety of foods. A recent study found that women with higher intakes of thiamine and riboflavin from food had a lower incidence of PMS. No association was found between PMS and intake of niacin, B-6 or folate. Also, increased thiamine and riboflavin intake was only protective when if came from foods; supplements had no effect. The lesson: Get your B vitamins from foods, not supplements!

  • Foods rich in thiamine include sunflower seeds, beans, lentils, barley, oats and peanuts.
  • Good sources of riboflavin include soybeans, soy milk, dairy products, dark green vegetables and eggs.

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No. 6: Manage your stress

No. esearch has shown that increased stress during one menstrual cycle can increase the number and severity of PMS symptoms during the next menstrual cycle. A good reason to consider trying some new ways to manage your stress!

  • Physical activity: While exercise itself has not been definitively proven to have a direct effect on PMS symptoms, many women find it to be quite helpful in managing stress. Try taking a brisk walk for 20 to 30 minutes during your lunch hour, walking your dog a few extra blocks, or going to the gym for your favorite workout.
  • Try the relaxation response technique: Sit quietly with your eyes closed for 15-20 minutes and breathe deeply through your nose. With each exhale, silently say the word "one" to yourself. Then, starting with the top of your head and working your way down to your toes, imagine your muscles relaxing, one by one. This particular technique has been scientifically tested and found to reduce PMS symptoms by about 58% in research study participants.

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No. 7: Indulge in a little chocolate

Researchers have yet to determine why so many women seem to crave chocolate around their periods. While chocolate isn't necessarily a "health food" due to its sugar content, a little indulgence every now and then is okay. Here are a few tips for keeping your craving in check:

  • Pick dark chocolate over milk chocolate. Dark chocolate has less sugar and a richer flavor. You may find yourself satisfied with just a few bites.
  • Savor the experience of eating chocolate, from unwrapping it to feeling it melt in your mouth. You may find a smaller amount enough to satisfy your cravings.  
  • Try cacao nibs instead. They're roasted cocoa beans that have a deep, somewhat nutty flavor. And they have no sugar. Can't find cacao nibs at your grocery store? Hazelnuts or walnuts are a good alternative for a satisfying crunch.

While mild PMS is a completely normal part of being a woman, please let your doctor know if you experience severe symptoms. These include: 

  • Inability to carry out your usual daily activities, such as going to work or school
  • Thoughts of harming yourself or others
  • Symptoms that interfere with your relationships with others
  • Sudden onset of new PMS symptoms or increase in severity

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The Bottom Line

PMS symptoms are very common, but that doesn't mean you have to suffer. These seven tips may help to lessen your symptoms.

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Kelly Hanna holds a Master's degree in nutrition from Bastyr University and a Bachelor's degree in women studies from the University of Washington. She is currently a dietetic intern at Brigham and Women's Hospital.


Bertone-Johnson ER, Hankinson SE, Bendich A, Johnson SR, Willett WC, Manson JE. "Calcium and vitamin D intake and risk of incident premenstrual syndrome." Archives of Internal Medicine. 2005; 165:1246-52.

Chocano-Bedoya PO, Manson JE, Hankinson SE, Willett WC, Johnson SR, Chasan-Taber L, Ronnenberg AG, Bigelow C, Bertone-Johnson ER. "Dietary B vitamin intake and incidence of premenstrual syndrome." American Journal of Clinical Nutrition. 2011; 93:1080-6.

Gold EB, Bair Y, Block G, Greendale GA, Harlow SD, Johnson S, Kravitz HM, Rasor MO, Siddiqui A, Sternfeld B, Utts J, Zhang G. "Diet and lifestyle factors associated with premenstrual symptoms in a racially diverse community sample: Study of Women's Health Across the Nation (SWAN)." Journal of Women's Health. June 2007; 16(5):641-56.

Gollenberg A, Hediger ML, Mumford SL, Whitcomb BW, Hovey KM, Wactawski-Wende J, Schisterman EF. "Perceived stress and severity of perimenstrual symptoms: The BioCycle Study." Journal of Women's Health. 2010; 19(5):959-67.

Goodale IL, Domar AD, Benson H. Alleviation of premenstrual symptoms with the relaxation response.

Thys-Jacobs S, Starkey P, Bernstein D, Tian J, Calcium carbonate and the premenstrual syndrome: "Effects on premenstrual and menstrual symptoms." American Journal of Obstetrics & Gynecology. 1998; 179: 444-52.

Yonkers KA, Casper RF. Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed March 18, 2014.)

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