Is it normal to experience ovulation pain?
Symptoms of PMS are common but range in severity and affect each individual differently. For one in 20 sufferers, the symptoms affect their day-to-day life. Hormones are the cause of PMS, but could certain foods help improve symptoms like low mood, headaches and bloating?
Lifestyle and diet might help you to better manage PMS symptoms, but it is unrealistic to expect these changes to eradicate symptoms completely. Dr Karen Morton, consultant gynaecologist for Dr Morton's - the medical helpline, suggests first getting to the root of your menstrual health issues.
The hormones oestrogen and progesterone can be blamed for most symptoms, she explains.
"Oestrogen dominates in the first half of the cycle and progesterone in the second. It's the progesterone which causes gut bloating and bowel changes, together with a bit of fluid retention and spottiness," she explains.
For many patients who experience troublesome PMS symptoms, she recommends using the combined oral contraceptive pill back to back to eradicate your period altogether. Having a Mirena coil or similar Intrauterine system (IUS) fitted may have the same effect, although irregular bleeding can be an issue, especially in the early months. But these treatments won't be suitable for everyone. It's important to speak with your doctor and find the right option for you.
How your lifestyle can help
Morton admits that maintaining a healthy lifestyle and keeping active can help with premenstrual symptoms though.
"Of course exercise and diet are the key to every aspect of our health and this applies to PMS as well," she says.
"Boosting exercise at that time of the month will boost endorphins, which are the body's own morphine, and also other brain agents which enhance mood. Being kind to yourself and practising mindfulness are also strongly recommended. Talking to friends and loved ones about how you are feeling rather than bottling it up ready for an explosion is a good idea."
Morton's advice to those struggling with PMS symptoms such as low mood, bloating and headaches? "Unfortunately there are no really 'proven' [non-hormonal] treatments for this distressing problem but women find various diets may be helpful. Experiment with supplements, but don't spend a fortune!"
Keep an eye on your blood sugar
Nutritional therapist Jackie Lynch, from well-well-well.co.uk, believes maintaining healthy blood sugar levels is crucial for managing PMS symptoms.
"When your blood sugar drops, you feel tired, irritable, shaky, headachy, all of which can be PMS symptoms," she explains. "Every time your blood sugar drops, you're going to be more prone to sugar cravings because stress hormones are released and they will encourage the body to release sugar stores from the liver and they'll generate a big craving via the brain for sugar to redress the balance."
The stress hormones released can have a big impact on your cycle, she continues.
"Cortisol is the one that generates cravings. But if you're constantly releasing adrenaline, because your blood sugar drops or because you're under chronic stress generally, then that's going to prevent your body from being able to use progesterone properly in the second half of your cycle."
To keep blood sugar levels stable, make sure to eat plenty of snacks and meals containing complex carbohydrates and protein as they will keep you going for longer says Lynch.
"Protein is hard to digest so it slows down the release of that complex carbohydrate in the body, keeping you going for longer. Wholegrain foods like wholemeal bread, brown rice, oats or vegetables are brilliant sources of complex carbohydrates."
Lynch recommends foods containing magnesium for those experiencing PMS because of its all-round benefits. Dietary sources of magnesium include dark green leafy vegetables like spinach, broccoli and wholegrain foods.
"It can really help when you're feeling jittery and anxious because one of the things that it does is calm the nervous system and help regulate the body's response to stress, keeping you feeling on top of things."
Magnesium also regulates muscle function. "That's not just the obvious muscles that you might think of but, for example, the muscle in the gut. Magnesium stimulates peristalsis. Peristalsis is the contraction and relaxation of the gut as it pushes food through. Quite often before their period, women can find themselves a bit constipated and bloated. Magnesium makes sure you're more regular."
Magnesium can also help ease the pain of PMS-related headaches, continues Lynch, "It helps to relax the blood vessels as well and if you're low in magnesium, that can often cause them to go into spasm. It's one of the main causes of menstrual headaches."
B vitamins are important
B vitamins could be especially useful in improving low mood caused by PMS says Lynch.
"Low levels of B vitamins, in particular B6, have a strong association with anxiety and depression, whether it's PMS-related or not."
Most foods contain a small amount of B vitamins so a broad diet of quality sources of protein through meat, fish or eggs, as well as plant proteins and plenty of vegetables, is recommended to get a good intake. Levels of B vitamins can be depleted by a few things, including alcohol and stress, so it's good to monitor both throughout the month.
When to see a doctor
If your PMS is causing you to feel suicidal or attempt self-harm, it is critical that you speak with a health professional as soon as possible as this may be a symptom of PMDD (premenstrual dysphoric disorder) or part of a wider mental health issue.
Persistent low mood, depression, anxiety, feelings of helplessness, low self-esteem and trouble sleeping are also cause for a visit to your GP. It's important to make them aware if these symptoms only occur or worsen during certain phases of your menstrual cycle.
If your symptoms of PMS are unmanageable, don't improve with lifestyle changes or are affecting your day-to-day life, don't be afraid to seek further help.