What can I add to my diet to lessen PMS?

I always crave chocolate before my period. But is there anything else I can add to my diet to lessen PMS?

Elizabeth Ricanati, M.D.

Elizabeth Ricanati, M.D.

Elizabeth Ricanati, M.D., is the founding medical director of Lifestyle 180, an innovative Cleveland Clinic program aimed at treating and... Read more

We can thank the monthly drop in estrogen and progesterone right before our periods for all those fun symptoms associated with premenstrual syndrome, or PMS. These declines create a domino effect that results in yet another temporary drop in levels of the “feel-good” hormone serotonin as well as endorphins. In addition to feeling irritable, depressed and tired, women also commonly report bloating, breast tenderness and dizziness. Symptoms can last anywhere from three to 14 days.

The good news: Herbal and nutritional supplements, certain foods, exercise and stress management have all been shown to be effective in reducing the symptoms of PMS. The really good news, as you’ve discovered: Chocolate can help! Chocolate has natural mood-boosting endorphins. Dark chocolate offers the most health benefits; and it contains less sugar than milk chocolate and no milk. For maximum benefit, make sure the nutrient-rich cacao quantity is at least 72 percent and limit servings to 150 calories per day, which is roughly one ounce.

Chaste tree berry (Vitex agnus-castus) extract (made from the dried ripe fruit of the chaste tree) can also help brighten your mood by relieving irritability, depression, headaches and breast tenderness. Studies show that it appears to increase progesterone by stimulating the release of luteinizing hormone from our pituitary gland. It may also block prolactin, a hormone that can worsen your PMS symptoms. The average dosage is one 20 to 40 mg capsule per day; the extract is slow acting, so it may take a few cycles before your symptoms subside. (Women who are pregnant or breast-feeding or who have hormone-sensitive cancers [breast or uterine] should not use chaste tree berry.) As with any supplement, check with your physician before you start using it.

Upping your calcium intake can help too. Studies have shown that calcium levels are lower in women with PMS, and that those who had the highest intake of calcium from food sources reported the mildest PMS symptoms. Beyond fortifying bones and teeth, calcium also helps regulate hormones. In addition to dairy products, calcium-rich sources include green leafy vegetables (think spinach and kale), tofu and salmon. You can also cover yourself by taking a daily calcium supplement. Premenopausal women need 1,200 mg of calcium per day; postmenopausal women should get 1,500 mg daily. For optimal absorption of calcium, evenly divide the recommended daily amount and take one dose in the morning and one in the evening. Other vitamins and minerals that have been shown to be effective in reducing one or more of the symptoms associated with PMS are vitamin B6, vitamin E and magnesium.

Modifying your diet a few days before and after your menstrual cycle can also mitigate symptoms of PMS.

  • Skip the French fries and the sugary sodas. Reducing sugar and salt intake helps decrease bloating, swelling of the hands and feet, breast tenderness and dizziness. Water retention is a common PMS symptom for many women. While its causes are mostly unknown, researchers believe it is a result of fluctuating hormone levels.
  • Limit the lattes. Reducing or eliminating caffeine can decrease feelings of anxiety and depression. Swigging three or more cups of a caffeinated beverage a day not only may make you anxious, irritable, nervous and sleepless, but can also trigger depression. Many women use caffeine to counteract insomnia-related PMS and unknowingly exacerbate PMS symptoms.
  • Avoid alcohol. Alcohol is a depressant, and studies have shown that it can also aggravate PMS symptoms.

Most days of the month, you need to make time for exercise and stress management, which are key to maintaining overall wellness. Regular aerobic exercise, such as walking, jogging, swimming or cycling, not only is a natural stress buster, but also produces mood-elevating endorphins, which enhance feelings of well-being while easing anxiety, depression and mood swings.


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