Premenstrual syndrome [PMS] is a recurrent, variable cluster of troublesome physical and emotional symptoms that develops 7 – 14 days before the onset of menses, and subsides when menstruation occurs. Approximately, one-third of all pre-menopausal women are affected, primarily those between 25 – 45 years of age.
The symptoms of premenstrual syndrome include behavioural changes like nervousness, anxiety, irritability, mood swings, fatigue, lethargy and depression. Abdominal bloating, diarrhoea or constipation, appetite changes with cravings for sugar, salt or chocolate can add to gastrointestinal changes in the body. In addition to these, reproductive changes like tissue tenderness and swelling, uterine cramping, or altered libido can also occur. Other symptoms include headache, backache, acne, ankle, finger swelling, breast pain, sense of weight gain, and skin disorders.
What causes PMS?
Various nutrient deficiencies and dietary patterns may play a central role in the cause of menstrual discomfort. The mainstream literature now cites deficiencies in calcium, magnesium, manganese, B-vitamins, vitamin E, and gamma-linolenic acid as being linked to PMS. A high-sugar diet and consumption of large amounts of caffeinated beverages or alcohol have also been identified as factors contributing to PMS. In this regard, a number of clinical studies have shown that certain nutrition and supplementation interventions can be effective in the management of PMS, and should be considered in the overall treatment plan.
Role of dietary supplements
Specific dietary supplements have proven value in improving PMS frequency and severity.
B-vitamins: More than a dozen double-blind clinical trials suggest that vitamin B6 supplementation is useful in the treatment of PMS. Vitamin B6 is a co-factor in oestrogen detoxification in the liver, in the synthesis of mood elevating neurotransmitters [brain chemicals], and in the formation of anti-inflammatory prostaglandin hormones.
In some of these applications, vitamin B6 works synergistically with other B-vitamins, such as niacin, folic acid, and vitamins B12 and B2. Some studies suggest that vitamin B6 taken in conjunction with 300 – 400mg of magnesium per day is beneficial in PMS management. Vitamin B6 works with magnesium in many enzyme systems, and thus are synergistic nutrients with proven value in the treatment of PMS. Along with vitamin B6, Vitamin B12, also helps to counter weakness and enhance emotional wellbeing.
Some natural sources include bananas, potatoes, lentils, other whole grains, chilli peppers, green vegetables, eggs, dairy products, and meats including turkey, tuna, and liver.
Vitamin E: Supplementation at 400 IU per day can reduce various symptoms of PMS, including nervous tension, headache, fatigue, depression, insomnia, breast tenderness, anxiety, and food cravings.
Among the natural sources are soybeans, raw nuts and seeds, cold-pressed oils [like olive oil], peanuts, cornmeal, sweet potatoes, broccoli leaves, raw spinach, and asparagus.
Magnesium: Having 200 – 400 mg per day, helps relieve PMS symptoms. Some natural sources are whole grains, nuts, legumes, dark leafy vegetables, shellfish, figs, lemons, grapefruit, yellow corn, almonds, seeds, apples, lentils, split peas, tofu, peanuts, cashews, wheat germ, bean sprouts, spinach, milk, cheddar cheese, American cheese, chicken, beef, and pork.
Calcium: One large, well-designed trial found that 1,200mg of elemental calcium per day was effective in reducing depression, water retention, pain, food craving, fatigue, and insomnia in women with PMS. Soybeans, green leafy vegetables like turnip greens, mustard greens, broccoli, and kale are some natural sources of calcium.
Manganese: A study indicated the PMS sufferers with increased mood and pain scores had low manganese status. The dose for supplementation should not exceed six mg per day according to experts in this area. The recommended dietary allowance [RDA] for manganese is 1.8mg.
Evening primrose oil: There is evidence that supplementation with evening primrose oil may be beneficial in the management of PMS due to its content of gamma linolenic acid [GLA], which is reported to be low in the cell membranes of PMS sufferers. GLA is a precursor to the production of prostaglandin series-1, which has anti-inflammatory effects and may thereby be of benefit in the management of PMS. EPO has been shown to be effective in reducing the symptoms of PMS, including irritability, depression and breast pain. This supports research findings that a dietary deficiency in fatty acids may contribute to PMS.
Gingko biloba: Preliminary research shows that Ginkgo biloba might ease PMS symptoms such as breast discomfort and emotional shifts.
Apart from this, eat less animal fat, consume more grain fibre [wheat bran, psyllium] and like cruciferous vegetables such as cabbage, cauliflower, broccoli and brussels sprouts.