Lifestyle Changes

A healthy lifestyle, including regular exercise and a healthy diet, is the first step towards managing premenstrual syndrome. For many women with mild symptoms, lifestyle approaches are sufficient to control symptoms.

Dietary Factors

Women should follow the general guidelines for a healthy diet. These guidelines include 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 control premenstrual symptoms.

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, 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. 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 white potatoes.)

Experts suggest eating frequent small meals with no more than 3 hours between snacks. It is important to avoid overeating. Unfortunately many women not only overeat during the premenstrual stage but they also tend to eat sugar-rich foods or high-fat salty snack foods--the worst choices for PMS. 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 2 menstrual cycles experienced less pain and bloating and a shorter duration of premenstrual symptoms than those who ate meat. Women who lose a lot of blood during menstruation, however, may need meat to help maintain iron levels. Choosing more fish and eggs may be a helpful alternative.

Salt Restriction. Limiting salt may help bloating.

Reducing Caffeine, Sugar, and Alcohol. Reducing caffeine, sugar, and alcohol intake may be beneficial.

Exercise

Evidence suggests that exercise, especially aerobic exercise, increases natural opioids in the brain (endorphins) and improves mood. Exercise is also very important for maintaining good physical health. In one study, women who jogged an average of 12 miles a week for 6 months experienced reduced PMS symptoms while a comparable group of women who remained sedentary did not improve. Even taking a 30-minute walk every day is beneficial. Although not an aerobic exercise, yoga releases muscle tension, regulates breathing, and reduces stress.

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 and vitamin D to reduce PMS symptoms. Food sources provide the most nutritional value, but studies also suggest that supplements may be helpful. The recommended dietary intake is 1200 mg/day for calcium and 400 IUD/day for vitamin D. Calcium-rich foods include dairy products, dark green vegetables, nuts, grains, beans, and canned salmon and sardines.

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 drugs. Women should discuss supplements with their doctor.

Vitamins

Specific vitamins have been investigated.

Vitamin B6. Limited clinical evidence suggests that vitamin B6 may help reduce 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. Very high doses (500 - 2,000 mg daily over long periods) can cause nerve damage with symptoms of numbness in the feet and hands. When stopping vitamin B supplementation, it is best to taper off slowly.

Food sources of B6 include meats, oily fish, poultry, whole grains, dried fortified cereals, soybeans, avocados, baked potatoes with skins, watermelon, plantains, bananas, peanuts, and brewer's 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 suggest that vitamin E may improve both physical and emotional symptoms. However, high doses of vitamin E may cause bleeding problems, particularly in people taking anti-clotting medications. Research also indicates that vitamin E, like other antioxidant vitamin supplements, 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.

Improved Sleep

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