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A Nutritionist’s Approach to Managing Premenstrual Syndrome

A huge number of women experience premenstrual symptoms at some point in their lives. Premenstrual Syndrome (PMS) can affect up to 90% of women of childbearing age with 2-10% experiencing severe symptoms affecting their everyday activities. PMS includes emotional, behavioural and physical symptoms such as breast pain, abdominal pain, headaches, irritability, mood swings, anxiety, insomnia and food cravings; they are characterised by being cyclical and usually occur during the week or so prior to menstruation. Does this sound like you?

It is thought that #women experience these symptoms due to hormone imbalances like too much or too little progesterone, abnormal secretion of oestrogen or even excess cortisone, or possibly due to psychological, social or genetic reasons. Whilst there are a number of pharmaceutical and hormone therapies available, you might be more inclined to manage your #PMS symptoms naturally. As a nutritionist, I suggest trying the following nutrition and lifestyle interventions.


Research suggests that women with diets rich in #omega3 fatty acids, #calcium and #vitaminD, and low in animal fats, salt and caffeine have less incidence of PMS symptoms. I therefore recommend that you:

  • Eat plenty of fatty fish like salmon, trout, mackerel and sardines (2-3 x/week) and raw (activated ideally), fresh nuts and seeds e.g. walnuts, linseeds, chia seeds.

  • Eat plenty of plant-based foods e.g. grains, vegetables, legumes and fruits.

  • Consume adequate Calcium and Vitamin-D rich foods e.g. salmon, sardines, eggs, yoghurt, tofu, legumes and dark leafy green vegetables.

  • Limit red meats to once or twice a week to reduce the inflammatory effects, however, for many women, it’s still important to consume some red meat to maintain adequate levels of iron.

  • Restrict salt intake to avoid bloating, fluid retention and breast swelling/tenderness.

  • Restrict caffeine to reduce irritability, insomnia, cramping and pain.

Nutritional Supplements

There are several studies that support using vitamins and minerals to manage PMS symptoms. These include:

  • #VitaminB6 and #vitaminB1, for pain management and general symptoms

  • #VitaminE, for pain management

  • #Magnesium, for pain management and mood changes

  • Calcium, for pain management, fluid retention, mood changes and food cravings

  • #Zinc, for pain management and cramping

  • Omega-3 fatty acids, for pain management

However, as the choice of supplement and dosing is important, I recommend that you seek professional help from a nutritionist or other health professional, rather than self-prescribing.

Stress Reduction

Women with significantly more #stress and a poorer quality of life appear to be linked to higher PMS symptom severity. It, therefore, makes sense to aim to reduce stress, and to practice #relaxation and that massage may help reduce the physical symptoms, in the short-term.


It is common for women to experience premenstrual sleep disturbances due to variations in core temperature, metabolic rate and hormone activity. A regular, structured #sleep schedule is recommended to minimise PMS symptoms, with evidence from women working night-shifts and hence disruption to their circadian rhythm, often reporting menstrual irregularities, longer menstrual cycles and mood changes. I recommend a regular bedtime and wake time and reducing blue light exposure prior to your bedtime.


Regular exposure to #sunshine appears important in regulating hormones and sleep patterns as it affects melatonin and circadian rhythms, and thus the menstrual cycle is affected. Vitamin D is also acquired from exposure to the sun which may also play a role in normalising menstrual cycles, regulating moods, and more. I recommend daily exposure to the sunshine either early morning or late afternoon to avoid the negative impacts of overexposure to the sun’s rays.

Physical activity

Research suggests that exercise may improve PMS symptoms, particularly regarding pain, anxiety, irritability and tension. Women that participated in regular aerobic #exercise had less symptoms than sedentary women. I recommend aiming for at least 30 minutes physical activity daily. Taking this activity outside (early morning or late afternoon) would also enable your safe exposure to the sun and Vitamin D.

There is significant evidence for using alternative therapies such as dietary and lifestyle modifications to manage PMS symptoms. So why not see if these natural interventions can help you?

If you would like support managing your PMS symptoms naturally, please book an appointment with me here.


Kotsirilos V, Vitetta L & Sali A, 2011, A guide to evidence-based integrative and complementary medicine, Retrieved from

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