Do a foul mood, weight gain and uncontrollable food cravings sound all too familiar? Your diet could be making your premenstrual syndrome (PMS) symptoms worse.

PMS affects up to 30% of women during their childbearing years. For those who struggle to control their symptoms every month, it can be quite a nightmare.

The symptoms can be varied and may include anxiety, mood swings, depression, tearfulness, irritability, fatigue, breast tenderness, swelling and pain, weight gain, water retention, insomnia, dizziness, headaches, migraine, cramps, backache and cravings for various types of food.

These symptoms usually start about 7 to 10 days before the onset of menstruation, increasing in severity as menstruation approaches. Most women experience the worst symptoms during their actual period and, in some cases, afterwards.

PMS occurs more commonly in women over the age of 30.

Possible causes


Research on PMS is still in its early stages, and no single nutritional or hormonal imbalance has been consistently identified as the cause of this syndrome.

However, a variety of theories have been proposed. These include:

Hormonal imbalances


Not just imbalances of the female hormones such as progesterone and oestrogen, but also of hormones produced by the adrenal glands, which may be involved with water-retention symptoms.

Imbalances in neurotransmitters


For example, an imbalance in serotonin production could cause symptoms such as cravings for sweet foods and depression.

Fatty acid metabolism disorders


An imbalance in the omega-6 and omega-3 fatty acid ratio (due to inadequate or unbalanced intakes) can lead to the production of certain compounds called prostaglandins. These can affect brain and nerve function, and/or cause inflammatory-type reactions.

Deficiencies of nutrients, such as vitamin B6


This could lead to irritability, depression and other symptoms.

Research results


International research studies have produced the following preliminary results:

    • In one study, test subjects who took 50mg of vitamin B6 a day reported improvements in depression, irritability and fatigue, but not in other symptoms of PMS.

    • Studies using essential fatty acids have produced positive outcomes in relieving symptoms, particularly breast tenderness, swelling and pain. The use of 1 to 2g of evening primrose oil (gamma-linolenic acid, an omega-6 essential fatty acid) significantly reduced PMS symptoms, particularly painful breasts.

    • Another study found that women who took up to 1,200mg of calcium on a daily basis reported significantly fewer PMS symptoms than women in the control group.

    • Some studies indicate that there’s also a link between stress and PMS, i.e. women who struggle to cope with stress often struggle with PMS symptoms, which are often also more severe than in women who are more relaxed.



Solutions to PMS


At this stage, scientists and doctors can only make general recommendations for the control of PMS symptoms. Try some or all of the following steps, eliminating those that don’t produce a beneficial effect after 3 months:

    • Consult your doctor or gynaecologist to check if you’re suffering from hormone deficiencies. If you lack female hormones (either progesterone or oestrogen, or both), your doctor may prescribe hormone supplements.

    • Ask your doctor to prescribe a mild diuretic that you can take during the 7-10 days when the symptoms appear. This should help to control swelling and water retention.

    • Do everything in your power to control stress: do yoga, Pilates or another form of exercise, do a few breathing exercises, meditate, or consider psychotherapy to learn how to manage your stress.

    • Do regular exercise – not just when the symptoms strike (when you may not feel up to doing exercise anyway).

    • Get sufficient sleep and, if you suffer from insomnia, try drinking a glass of warm, low-fat milk before you go to bed. Milk is rich in tryptophan, an amino acid that boosts serotonin production.

    • Follow a balanced diet that contains plenty of fresh fruit and vegetables, unprocessed cereals and grains, lean meat, fish, low-fat milk and dairy products, and margarine or oils rich in polyunsaturated fatty acids and vitamin E.

    • Take B-complex supplements that contain vitamin B6.

    • Take a calcium supplement if you’re not drinking sufficient low-fat milk or eating other high-calcium foods such as low-fat yoghurt, cottage cheese, and other cheeses.

    • Reduce your intake of caffeine (coffee, tea, cola and energy drinks containing caffeine) and sweetened cold drinks.

    • Don’t smoke.

    • If you suffer from cravings, try to resist them, as eating large amounts of salty or sweet foods will make the symptoms worse. Nibble on healthy snacks such as fruit (fresh and dried, for potassium that controls water retention), wholewheat crackers or bread with cottage cheese (provides B6 and calcium) or fresh vegetables like carrots and celery sticks (also high in potassium), and low-fat milk drinks or yoghurt (for calcium and tryptophan).

    • Take evening primrose oil supplements to increase your omega-6 intake or, better still, take a supplement that contains both omega-6 and omega-3 fatty acids.



Selective serotonin reuptake inhibitors (SSRIs) are increasingly used as therapy for severe PMS. Speak to your doctor about a possible prescription of one of these antidepressants if none of the above steps improve your symptoms.

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