View all
Women's Health

Premenstrual syndrome

by No comment(s)
Premenstrual syndrome

Hi Vibers! How are you? It’s been a while since we last wrote about women’s health on the blog. Today, we’re diving back into this topic by discussing premenstrual syndrome (PMS). PMS is a cyclic disorder occurring in the late luteal phase of the menstrual cycle, during which a woman’s daily functioning is affected by emotional and physical symptoms that significantly impact her quality of life. Today, we’ll explain why PMS has such a strong influence and how we can improve its symptoms.

What is the premenstrual syndrome?

Premenstrual Syndrome (PMS) is characterized by a combination of symptoms that include physical, behavioral, and psychological changes experienced by some women from about a week before until a few days after menstruation. The intensity of PMS varies among women based on hormonal, psychosocial, and physiological factors.

Additionally, PMS has been shown to be a significant limitation for women: it can lead to decreased work productivity, lower health-related quality of life, increased dependence on specialized healthcare, and interference with interpersonal relationships and daily activities. PMS can also increase the risk of hypertension, reduce work-related quality of life, negatively impact athletic performance and daily activities of athletes, and is significantly associated with academic performance decline. Like many other syndromes, PMS results from the interaction of various genetic behaviors (which may vary by race/ethnicity) and lifestyle factors, with dietary factors being the most influential.

Inflammation and premenstrual symptoms

 High-sensitivity C-reactive protein (hs-CRP) is an acute phase inflammatory marker associated with some risk factors for PMS, such as smoking, depressive symptoms, aging, and increased body mass index (BMI). Therefore, anti-inflammatory agents have been found to alleviate some PMS symptoms, suggesting that inflammation may be the mechanism by which these factors increase PMS risk.

In a cross-sectional study, elevated levels of hs-CRP above 3 mg/L, an acute phase biomarker of inflammation, were significantly associated with a 26%-41% increased likelihood of experiencing premenstrual mood symptoms, abdominal cramps/back pain, appetite cravings/weight gain/bloating, and breast pain.

The significant associations between PMS symptoms and elevated levels of C-reactive protein have clinical implications for the treatment and potentially the prevention of these symptoms. Advising women on factors such as smoking, overweight, and obesity—known to be associated with inflammation—could be beneficial in managing and preventing PMS.

Diet and premenstrual syndrome

For women experiencing mild premenstrual symptoms, supportive counseling and general measures aimed at maintaining a healthy lifestyle—such as regular exercise and a balanced diet—should be sufficient to improve symptoms. Lifestyle modifications should be the first approach for all women who experience premenstrual discomfort.

Dietary changes can have a significant impact on symptoms:

  • Reduce intake of: Salty foods, sugary foods, red meats, tobacco, and alcohol.
  • Increase intake of: Fruits, vegetables, legumes, whole grains, and water.
  • Include foods rich in: Magnesium, calcium, vitamin E, vitamin B6, and tryptophan.

Fruits and vegetables are rich in fiber, bioactive phytochemicals, and antioxidants. According to a study by Hashim et al. in 2019 (10), fruit consumption appears to protect against the psychological, physical, and general symptoms of PMS. Fruit, as part of a healthy Mediterranean diet, reduces the occurrence and severity of premenstrual pain and PMS symptoms. Additionally, the antioxidant power of various fruits may explain their protective role in PMS.

It’s well-documented that during this phase of the cycle, there is a stronger craving for carbohydrate-rich and sugary foods. This leads to a higher proportion of high-glycemic index foods in the diet, causing more pronounced glucose spikes. These spikes are associated with increased body inflammation, which can worsen PMS symptoms. Therefore, it is important to include complex carbohydrates that are rich in fiber and nutrients, and to pair them with plenty of antioxidant-rich vegetables, quality proteins, and healthy fats.

Serotonin levels also influence the mood of women with PMS symptoms. Therefore, including foods that promote the synthesis of this hormone can help improve mood. Foods particularly rich in tryptophan, which increases serotonin levels, include chicken, milk, cheese, fish, eggs, soy, pumpkin seeds, walnuts, and peanuts. However, to synthesize serotonin, the body also needs omega-3 fatty acids, magnesium, and zinc. For this reason, foods rich in magnesium, such as bananas, nuts, legumes, and vegetables, are also considered natural antidepressants, as they favorably increase serotonin levels.

Conclusions

Premenstrual syndrome (PMS) is a cyclical disorder occurring in the late luteal phase of the menstrual cycle, where a woman’s daily functioning is affected by emotional and physical symptoms that significantly interfere with her quality of life. Dietary factors are considered the most influential in this condition. An elevation in C-reactive protein (an inflammatory marker) above 3 mg/L has been significantly linked to an increased likelihood of experiencing premenstrual mood symptoms, abdominal cramps, back pain, food cravings, weight gain, bloating, and breast tenderness. Therefore, lifestyle modifications should be the first approach for all women experiencing premenstrual discomfort.

References

  • [1] Rapkin AJ, Winer SA. Premenstrual syndrome and premenstrual dysphoric disorder: quality of life and burden of illness. Expert Rev Pharmacoecon Outcomes Res. 2009 Apr;9(2):157-70.
  • [2] Potter J, Bouyer J, Trussell J, Moreau C. Premenstrual syndrome prevalence and fluctuation over time: results from a French population-based survey. J Womens Health (Larchmt). 2009 Jan-Feb;18(1):31-9. 
  • [3] Goker A, Artunc-Ulkumen B, Aktenk F, Ikiz N. Premenstrual syndrome in Turkish medical students and their quality of life. J Obstet Gynaecol. 2015 Apr;35(3):275-8. 
  • [4] Bertone-Johnson ER, Whitcomb BW, Rich-Edwards JW, Hankinson SE, Manson JE. Premenstrual Syndrome and Subsequent Risk of Hypertension in a Prospective Study. Am J Epidemiol. 2015 Dec 15;182(12):1000-9.
  • [5] Bertone-Johnson ER, Whitcomb BW, Rich-Edwards JW, Hankinson SE, Manson JE. Premenstrual Syndrome and Subsequent Risk of Hypertension in a Prospective Study. Am J Epidemiol. 2015 Dec 15;182(12):1000-9.
  • [6] Tolossa FW, Bekele ML. Prevalence, impacts and medical managements of premenstrual syndrome among female students: cross-sectional study in College of Health Sciences, Mekelle University, Mekelle, northern Ethiopia. BMC Womens Health. 2014 Mar 29;14:52.
  • [7] Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, Alardah LG, Qiblawi S, Al-Yateem N, Faris MAE. Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE. Nutrients. 2019 Aug 17;11(8):1939.
  • [8] Farasati N, Siassi F, Koohdani F, Qorbani M, Abashzadeh K, Sotoudeh G. Western dietary pattern is related to premenstrual syndrome: a case-control study. Br J Nutr. 2015 Dec 28;114(12):2016-21.
  • [9] Gold EB, Wells C, Rasor MO. The Association of Inflammation with Premenstrual Symptoms. J Womens Health (Larchmt). 2016 Sep;25(9):865-74.
  • [10] Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, Alardah LG, Qiblawi S, Al-Yateem N, Faris MAE. Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE. Nutrients. 2019 Aug 17;11(8):1939.