Updated 08 April 2013

Your diet and PMS

Foul mood, weight gain and uncontrollable cravings. Is your diet making your PMS worse? DietDoc gives advice.


PMS is a condition that affects up to 30% of women during their childbearing years. For those who struggle to control their moods, weight and cravings every month, it is a nightmare.

What is PMS?

PMS is defined as “symptoms that occur around the time of menstruation that 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.”

This definition indicates just how varied the symptoms of PMS can be and how debilitating they are for women who suffer from more than one symptom at a time.

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 of PMS

Research on PMS is still in its early stages and we cannot as yet say with conviction what exactly causes PMS. No single nutritional or hormonal imbalance or deficiency has been consistently identified as the cause of this syndrome.

A variety of theories have been proposed to try and explain why some women suffer so badly for nearly a third of each month. These theories include the following: 

  • Hormonal imbalances - not just of 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 neurotransmitter synthesis - for example an imbalance in serotonin production could cause symptoms such as a craving for sweet foods and depression
  • Fatty acid metabolism disorders - an imbalance in the omega-6 and omega-3 fatty acids due to inadequate or unbalanced intakes, which can lead to synthesis 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, which could lead to irritability, depression and other symptoms

Research results

The studies that have been conducted to date have produced the following preliminary results: 

  • In one study, test subjects who took 50 mg 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 2 g of evening primrose oil (gamma-linolenic acid, an omega-6 essential fatty acid), significantly reduced PMS symptoms, especially those associated with monthly mastalgia (painful breasts)
  • Another study found that women who took up to 1 200 mg of calcium on a daily basis reported significantly fewer PMS symptoms than women in the control group
  • Some studies indicate that there is also a link between stress and PMS, i.e. women who cannot cope with stress develop more PMS symptoms, which are often also more severe than in women who are more relaxed

Solutions to PMS

Because of the preliminary nature of the above-mentioned research results and our inability to identify a single causative factor for PMS, one can only make general recommendations for the control of PMS symptoms.

Some women may benefit considerably when applying the suggestions made below, while others may not. If you suffer from PMS you could try some, or all of the following suggestions, eliminating those that do not produce a beneficial effect after 3 months:

The following interventions may assist in controlling the symptoms of PMS: 

  • Consult your doctor or gynaecologist to check if you are suffering from hormone deficiencies. If you lack female hormones (either progesterone or oestrogen, or both), the doctor will prescribe hormone supplements to correct these deficiencies
  • Ask the doctor to prescribe a mild diuretic which 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 - yoga, other types of exercise, deep breathing exercises, and psychotherapy to learn how to manage stress
  • Do regular exercise, not just when the symptoms strike (when you may not feel up to doing exercise)
  • 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, which contains plenty of fresh fruit and vegetables, unprocessed cereals and grains, lean meat, fish, low-fat milk and dairy products (to provide calcium without the fat) and margarine or oils rich in polyunsaturated fatty acids and vitamin E
  • Take B-complex supplements, which contain Vitamin B6
  • Take a calcium supplement if you are 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, and do not smoke
  • If you suffer from cravings, try to resist them, as eating large amounts of salty or sweet foods will make the symptoms worse. Substitute healthy snacks like 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 carrot 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

Hopefully researchers will come up with a definite answer to the problem of PMS one day soon, but in the meanwhile you can at least try some of the above-mentioned dietary and lifestyle changes to combat PMS and make your life worth living again.

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Read more of her articles.


Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.