Category Archives: premenstrual syndrome


Women’s Health: Tips to beat PMS cravings

Tips to beat PMS cravings

Why do women suffer with cravings when suffering with PMS?

As many as 85% of women experience at least one symptom of PMS (premenstrual syndrome), the disruptive physical and emotional changes that can strike anytime in the last 2 weeks of the menstrual cycle. A common symptom women suffer from is PMS related food cravings, which has the potential to sabotage your diet.

Fortunately, a better understanding of PMS in general and food cravings specifically can keep women from getting caught in a diet-destroying cycle. When food cravings do hit its generally for high fat sugary foods and/or salty foods; like chocolate, sweets, ice cream or crisps.

The hormonal ups and downs that occur throughout a woman’s cycle are the major culprits in PMS. As levels of oestrogen go up and down, so do levels of the stress hormone cortisol. And when cortisol levels are high enough, the body turns on its fight-or-flight response, a woman becomes more metabolically charged, and her appetite is stimulated. This, in turn, causes a woman to seek out carbs and fat, the fuels needed for the fight-and-flight response.

Other research has linked PMS to low blood sugar or hypoglycaemia that occurs in the second half of the menstrual cycle.

Whether it’s blood sugar or cortisol levels that are out of whack, experts say eating huge servings of ice cream, chocolate and chips are the worst ways to bring levels back in balance. Proper nutrition and lifestyle habits will achieve a better balance, with long-lasting results.

Is there anything in terms of diet and lifestyle that a woman can do to reduce such cravings?

Eating a balanced diet containing complex carbohydrates, vegetables, protein and healthy fats is key in providing the body the nutrients required to balance symptoms associated with PMS. Healthy fat and protein in particular help to balance blood sugar levels as they have a slower digestion and make you feel fuller for longer. Foods high in essential fatty acids omega 3 and omega 6, such as nuts, seeds and their oils will slow absorption of carbohydrates, stabilize the blood sugar and stop cravings in their tracks. Try a baked sweet potato with tuna and salad for lunch. Drizzle over an organic seed oil such as Udo’s Choice Ultimate oil blend for healthy fats.

Remember to drink plenty of water. 2 litres a day helps to flush the body out and reduce bloating.

It’s best to avoid all processed sugar if you are suffering from food cravings. Simple sugars increase insulin secretion, which lowers blood sugar. If insulin levels shoot up enough, your appetite for carbs and bad fats increases.

Lifestyle wise, you want to get plenty of sleep, with 8 hours per night being ideal. This will make you less tired throughout the day and more likely to exercise and make better food choices. Any form of physical activity should be done for 30 minutes a day, from swimming, brisk walks to jogging, activities that raise the heart rate will lower cortisol levels.

Are there any nutritional supplements that can help?

A well-rounded women’s multi-vitamin is beneficial to get all the nutrients one needs, as well as an omega 3 supplement that contains EPA/DHA, which will help with balancing female hormones.

Additionally, chromium is a mineral needed for blood sugar control and metabolism of carbohydrates, fats and proteins. Liquid chromium supplements are available. Take 1-2 drops under the tongue before each main meal.


Magnesium as an aid to PMS symptoms

Last week I wrote about premenstrual syndrome (PMS) and how calcium can be helpful to some women suffering from the condition.  I mentioned in the post that calcium and magnesium work well together and a combined supplement is preferable to a single nutrient supplement.  Magnesium and calcium work together in the body and magnesium is necessary for the efficient absorption and use of calcium but magnesium has benefits in PMS that go beyond simply acting in conjunction with calcium.

Back in 1973 some French scientists first reported that supplementing women with 400mg a day of magnesium seemed to help their PMS symptoms (1).  Studies followed which reported that the red blood cell levels of magnesium were significantly lower in patients who suffered with PMS than in those who did not suffer from the condition (2,3,4).  Subsequently supplementation trials in women with PMS have found that supplemental magnesium can reduce PMS symptoms (5,6,7,8).  Specifically magnesium supplements seemed to have a positive effect on symptoms related to mood (5), migraines (6) and fluid retention (7).

A small preliminary study (5) found that women who were being given a magnesium supplement had significant reductions in their total PMS symptoms in the second month of treatment compared to women taking the placebo.  It was also noted that a significant reduction in ‘negative mood’ occurred in women who were taking the magnesium compared to those taking the placebo.  Another study (7) found that, compared to placebo, magnesium supplementation at 200mg per day over two months significantly improved PMS symptoms, especially symptoms related to fluid retention such as breast tenderness, abdominal bloating, swelling of extremities and weight gain.

A more recent study (8) found that PMS symptoms improved during magnesium treatment.  The women were given 250mg magnesium for 3 months.  After three months the PMS score, as assessed by a specific research questionnaire called the Moos’ Modified Menstrual Distress Questionnaire, was significantly lower than before therapy. During the same period, the mean PMS scores, as recorded in patients’ diaries, also showed significant improvements . The authors conclude that magnesium supplementation was effective in reducing premenstrual symptoms in women with PMS in this preliminary study.

Magnesium is an incredibly important mineral and acts as a multi-functional nutrient in the body where it is present in all cells!  It takes part in around 300 processes in the body and is vital to many bodily functions such as energy production, nerve function, muscle relaxation, bone and tooth formation, heart rhythm and aids in the production and use of insulin (it is involved in blood sugar regulation which is thought to be an important factor in PMS)

Specific functions of magnesium relevant to PMS:
* Magnesium acts as a muscle relaxant (as it is needed for nerve to muscle signal transmission) and hence may be useful for fatigue symptoms.
* Many of the body’s energy pathways need magnesium – in this way it may be important to help restore vitality and prevent lethargy/tiredness.
* Inflammation is implicated in some forms of PMS (especially when breast tenderness is experienced).  Magnesium is needed for the metabolism of essential fatty acids, a good balance of fatty acids is needed in order to prevent inflammation.
* Low magnesium status may be responsible for promoting hormonal imbalance in women.  A low magnesium status may affect the aldosterone to oestrogen ration.  Enhanced levels of aldosterone can promote potassium and magnesium loss in the urine and may also promote sodium retention – this could induce fluid retention.
* As briefly mentioned above, magnesium is involved in blood sugar control.  Low magnesium levels can be implicated in two ways – by decreasing the ability of the liver to handle glucose and by increasing insulin secretion in response to glucose.  This may affect changes in appetite and cravings.
* The reduced dopamine (mood chemical in the brain) levels which are thought to be partly responsible for anxiety and irritability in PMS may be worsened by low magnesium levels.
* Low magnesium levels may enhance stress reactions and emotional stress such as anxiety can further increase our bodily need for magnesium.

In the UK it is currently recommended that women aim to include 270mg of magnesium per day into their daily diet.  However The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (9) found that quite a shocking number of women in the UK are not achieving adequate daily magnesium intakes with 74% of women age 19-64 not reaching the RNI (reference nutrient intake) for magnesium and 85% of 19-24 year old women not beaching the RNI for this vital nutrient.  Modern society does not eat as many whole grains, seeds, beans and nuts as in previous times and it is these sources that are rich in magnesium.  Processed foods contain little of this vital mineral.  Good dietary sources of magnesium include dried figs, almonds, hazelnuts, walnuts, cashew nuts, sunflower seeds and dark chocolate (minimum 70% cocoa solids!).  Wholegrains such as brown rice and oatmeal also contain good amounts.

The ideal amount of magnesium has yet to be determined for PMS improvement but practitioners often recommend a supplement of 200-400mg daily.  Symptoms seem to show improvement after 2-4 months.  It may well be worth supplementing with magnesium if you don’t routinely eat magnesium rich foods to see if it helps your symptoms – especially if you suffer from anxiety, low mood, stress, food cravings or water retention.  As mentioned in the post relating calcium and PMS – consider taking the two minerals together. 

1.Nicholas, A.  1973.  Traitement du syndrome  pre-menstrel et de la dysmenorrhee par l’ion magnesium.  First International Symposium on Magnesium Deficit in Human Pathology.  261-263.
2.Abraham, GE.  Lubran MM.  1981.  Serum and red cell magnesium levels in patients with premenstrual tension.  Am J Clin Nutr.  34:2364-2366.
3.Sherwood, RA et al.  1986.  Magnesium and the premenstrual syndrome.  Ann Clin Biochem.  23:667-670.
4.Rosenstein, DL et al.  1994.  Magnesium measures across the menstrual cycle in premenstrual syndrome.  Biol Psychiatry.  35:557-561
5.Fracchinetti, F. et al.  1991.  Oral magnesium successfully relieves premenstrual mood changes.  Obstet Gynecol.  78:177-181.
6 Fracchinetti, F.  et al.  1991.  Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.  Headache.  31:298-301.
7.Walker, AF et al.  1998.  Magnesium supplementation alleviates premenstrual symptoms of fluid retention.  J Womens Health.  7:1157-1165.
8.Quaranta S et al.  2007.  Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet (Sincromag) for the treatment of premenstrual syndrome.  Clin Drug Investig. 27(1):51-8.
9. Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.

Written by Ani Kowal


Calcium supplements may help women who suffer from PMS

Specific figures vary but it has been estimated that anywhere between 80-95% of the western female population experience premenstrual syndrome (PMS) to some level with up to about 35% seeking some kind of medical help.  Premenstrual syndrome, or PMS, is the presence of physical and/or psychological symptoms 1-2 weeks prior to the start of your period (menstruation).  These symptoms will typically be relieved within 2 days of the start of your period.

Over 150 different PMS symptoms have been described in various sources of literature! These can range from irritability, anxiety, mood swings and depression to fluid retention, breast tenderness, stomach bloating and headaches.  Symptoms may vary in nature and intensity between monthly cycles.  PMS is complex and varied, affecting individual women in different ways, it is definitely not predictable or easy to categorise.

There is no clear or definitive cause of PMS.  This accounts for the number and variety of symptoms that occur in women and also makes treatment difficult.  It seems that there may be many plausible factors at play including:
– Hormones
– Neurotransmitters (brain chemicals – a group of hormones formed within nerve cells)
– Prostaglandins (a type of fatty acid produced by the body that act in a similar way to hormones)
Diet and lifestyle

There is a lot that I could write about PMS and nutrition and I hope to revisit the topic in the very near future but today I wanted to look at the role that calcium supplementation may play in the treatment/prevention of this distressing condition.

Calcium has been implicated by many scientists as being important in PMS.  Women who consume more calcium from their diet seem less likely to suffer from PMS than women who consume little calcium (1) and low levels of calcium in the blood have been linked to an increased likelihood of suffering with PMS (2).  A number of well carried out clinical studies have found that calcium supplements can relieve PMS symptoms in women (3,4,5)

Recent evidence published this year (6,7,8) has also found that calcium supplementation is very useful in the treatment of PMS.  One of these studies (8) compared the effects of hormone therapy (dydrogesterone) with a calcium and vitamin D supplement in women with severe PMS and found that the nutritional supplement was as effective as the dydrogesterone for the treatment of PMS.  This was a well designed trial which involved over 150 women.  The women were randomly assigned to take a tablet containing either 5 mg of dydrogesterone, 500 mg of calcium plus 200 mg of vitamin D, or a placebo twice daily from the 15th to the 24th day of the cycle for 2 cycles.  Treatment with dydrogesterone or calcium plus vitamin D decreased symptom severity in a similar way.  The authors conclude that “Treatment with dydrogesterone or calcium plus vitamin D had a similar effect on symptom severity in women with PMS”. 

In the UK it is currently recommended that women aim to include 700mg of calcium per day into their daily diet.  In the USA, however the recommendation is 1000mg daily.  The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 (9) found that many women in the UK are not achieving adequate daily calcium intakes.  Calcium plays a role in hormone and neurotransmitter responses in the body.  This may account for some of the benefits that women with PMS gain from calcium supplementation, especially mood and pain related symptoms.  The hormone fluctuations which occur in PMS may also interfere with the way that calcium is regulated in the body causing low circulating levels which may lead to worsened PMS symptoms.

If you suffer with PMS it might be worth trying 500mg calcium daily for 3 menstrual cycles, as well as trying to boost your dietary calcium intakes, to see if you get any relief.  Good dietary sources of calcium include:nuts, especially almonds, and seeds especially sesame seeds, milk and dairy products, dried fruit (especially figs), canned fish and broccoli (The calcium found in plant foods such as pulses and wholegrain cereals does not represent a good source of available calcium – this is because these sources contain phytates which lock up the calcium and limit the amount that the body can absorb)

If you decide to take supplemental calcium it is always advisable to take magnesium as well, since the two minerals work closely together in the body and a balance is needed, magnesium deficiency has also been implicated in PMS.  For every 500mg calcium 250mg of magnesium is advised.  Vitamin D is essential for the efficient absorption of calcium into the body and also regulates blood levels of calcium.  Some studies suggest that blood vitamin D levels are lower in women with PMS and that women with the lowest vitamin D intakes are more at risk of suffering from PMS than women with the highest intakes (10).  Many supplements are available that combine these three nutrients.

For information on PMS and support please visit National association for premenstrual syndrome (NAPS) website.  NAPS is the only advocacy group in the world promoting the interest of PMS sufferers

1.  Bertone-Johnson ER et al.  2005.  Calcium and vitamin D and risk of incident premenstrual syndrome.  Arch Intern Med.  165:1246-1252. 
2.Shamberger RJ.  2003.  Calcium, magnesium and other elements in the red blood cells and hair of normals and patients with premenstrual syndrome.  Viol Trace Elem Res.  94:123-129.
3.Thys-Jacob S et al.  1989.  Calcium supplementation in premenstrual syndrome: a randomised crossover trial.  J Gen Intern Med.  4:183-189.
4.Penland, JG.  Johnson, PE.  1993.  Dietary calcium and manganese effects on menstrual cycle symptoms.  Am J Obstet Gynecol.  168:1417-1423
5.Thys-Jacobs, S et al.  1998.  Calcium carbonate and the premenstrual syndrome: effects on premenstrual and menstrual symptoms.  Premenstrual Syndrome Study Group.  Am J Obstet Gynecol.  179:444-452 
6. Whelan AM et al.  2009.  Herbs, Vitamins and Minerals in the Treatment of Premenstrual Syndrome: A Systematic Review.  Can J Clin Pharmacol. 16(3):e407-e429.
7. Ghanbari Z et al.  2009.  Effects of calcium supplement therapy in women with premenstrual syndrome. Taiwan J Obstet Gynecol. 48(2):124-9.
8. Khajehei M et al.  2009.  Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome. Int J Gynaecol Obstet. 105(2):158-61.
9.Henderson L et al.  2003.  The National Diet and Nutrition Survey: Adults aged 19-64 years.  HMSO London.
10.Bertone-Johnson, ER.  Hankinson, SE.  Benedich, A.  et al.  2005.  Calcium and vitamin D and risk of incident premenstrual syndrome.  Arch Intern Med.  165:1246-1252
Written by Ani Kowal