Calcium is the single most abundant mineral in the human body and you don’t need me to tell you that it’s essential for strong bones and teeth – hence why it’s always emphasised for growing children and adolescents. It’s important in later life too, particularly for women, since we are at risk of osteoporosis (oestrogen having a protective effect on bones and declining at menopause). Women who are pregnant or breastfeeding also have higher calcium requirements.
As if all that wasn’t enough, there’s excellent research to show that adequate calcium also reduces the emotional, behavioural physical and psychological symptoms of PMS, including mood swings and depression. Getting enough calcium may also help with reducing period pain and helping to relieve migraines, which sometimes get worse during PMS. Continue reading →
Food Is The Best PMS Medicine I’m completely convinced that good nutrition can really help beat PMS in most cases, without the need for synthetic hormones. Eating a PMS-friendly diet can restore natural hormone balance, increase energy levels, and improve … Continue reading →
For many years, the standard advice to women with PMS was to take evening primrose oil to combat breast tenderness and to take vitamin B6 (pyridoxine) to deal with PMS mood problems.
First of all, it’s worth remembering how the link between vitamin B6 and PMS first came about. Back in the 1970s, vitamin B6 started being used to treat depression in women taking oral contraceptives (which had significantly different formulations then, compared to the second and third generation Pill that followed).
This led to interest in the possibility of vitamin B6 also treating PMS symptoms. This seemed logical given that vitamin B6 is needed for the production of serotonin and dopamine, the brain chemicals which lift mood and prevent anxiety. Women who are prone to PMS do seem to have lower levels of serotonin leading to the classic PMS symptoms of irritability, anxiety and depression.
However, scientific trials looking at whether vitamin B6 really reduced PMS symptoms have been anything but conclusive.
Very Little Evidence For The Effectiveness of Vitamin B6 in PMS
The British Medical Journal undertook a review of several research trials looking at the effectiveness of vitamin B6 in PMS treatment. The review noted the small numbers of subjects involved and problems with the study design in most cases, and concluded that:
[The studies were of] insufficient quality to draw definitive conclusions.
Three gave positive results for vitamin B6 in PMS treatment
Five gave ambiguous results for vitamin B6 in PMS treatment
Four with negative results for vitamin B6 in PMS treatment
Once again, the reviewers concluded that the studies were small and had design shortcomings. Several subsequent research trials, both published and unpublished, also found no significant benefit of vitamin B6 supplementation for women with PMS.
[There is] insufficient evidence of efficacy is available to give a recommendation for using Vitamin B6 in the treatment of premenstrual syndrome.
So the science does not back up vitamin B6 – used on its own – as an effective supplement for PMS.
This doesn’t surprise me, as my experience and studies tell me that vitamins seldom work best in isolation. And in any event, vitamins are generally best obtained from food, rather than pills, (unless there is a proven deficiency) because that is how your body best digests and absorbs the nutrients.
However, the whole family of B vitamins – obtained through good nutrition, naturally – are hugely important to reducing PMS symptoms. They have been shown to reduce stress and irritability, reduce bloating and help with food cravings.
Why ALL the B Vitamins are Important for PMS Management
Vitamin B6 is contained in some amounts in all foods. And food really is the best medicine for balancing hormones. So to boost your B vitamins, make sure you eat plenty of
If you DO decide to take Vitamin B6 as a supplement, it’s important not to take too much. Actual deficiency of Vitamin B6 is rare and the recommended dietary allowance for Vitamin B6 is around 2 mg per day (although some multivitamins include vitamin B6 at much higher levels).
Concerns have emerged that high doses of vitamin B6 as a supplement can lead to sensory neuropathy – tingling and numbness (pins and needles) in the hands and feet – which may cause nerve damage. Although to be fair, that seems to have only been reported in VERY high dosages (500mg taken for two years or more) and the effect is reversible.
Nonetheless, if vitamin B6 is used, doses should be limited to no more than 100 mg/day to avoid any risk of neuropathy, and the more usual dose is 10mg per day.
Thanks for reading! And let me know your experiences with vitamin B6 in the comments below, or on the PMS Warrior Facebook page.
I was very pleased to see that The Food Hospital series has been promoting the idea of food as medicine. And even better, it featured PMS in the episode screened just before Xmas (alongside case studies in IBS, high cholesterol and raw foodism). Watch it here.
I was already aware that they were looking for PMS sufferers, as the call for volunteers came out via The National Association for Premenstrual Syndrome earlier in the year. So I was curious and excited to see how they would tackle PMS using food.
In my experience – not to mention, the growing weight of research evidence – a diet based on good fats, complex carbs and junk-free whole foods (together with regular exercise and stress reduction) can deliver dramatic improvements in PMS for the vast majority of women. And it looked like the The Food Hospital would be singing from the same songsheet.
But I have to say, I was rather disappointed. Here’s why…
The PMS Case Study – Julie
Julie is only 26, but has been suffering from PMS for five years already – poor woman! – and reported that her symptoms had got worse around a year ago. She eloquently described ‘losing’ a week a month to PMS, and talked about how it made her feel “very angry, very down, with lots of mood swings and very anxious” and how it meant that she “couldn’t concentrate on anything, apart from being upset”.
Also around a year ago, she had given up dairy for the very good reason that it made her feel sick. (Surely your body’s way of telling you it can’t process dairy!). During this time she had lost weight, which had made her feel better in herself.
She had taken the contraceptive pill in the past, but commented that she continued to suffer from PMS symptoms during that time – which is not uncommon. She was clear that she didn’t want to take anti-depressants because she didn’t like the idea of not being in control of the chemicals going into her body. And she was already on the right track with thinking that what she ate had an impact on how she felt.
The programme’s nutritionist concluded that the reason for Julie’s worsening PMS was her reducing her dairy intake. There was no discussion shown about the other factors which would form part of a fuller assessment, such as other changes in her life during the period her PMS had got worse, such as her stress and activity levels, and any other diet changes. I would also have been interested to hear whether PMS ran in her family.
The Programme’s Recommendations for PMS
In my view, there was a mixture of good and bad advice.
But what I didn’t agree with was the fact that the PMS management plan hinged on increasing dairy intake – despite this being poorly tolerated by Julie. There was no mention of the importance of omega-3 fats, B vitamins,exercise, orstress management(to reduce cortisol levels) andstimulant reduction.
Although milk does contain calcium, it’s true, it also has an acid-forming effect in the body (which means it actually leaches calcium from our bones, making them weaker – a real issue for women who are at risk of osteoporosis). It is also high in saturated fat and protein, and contains no antioxidants or fibre. Remember that while milk may be the perfect rich food for babies while they’re growing, most babies – except human ones, that is – are weaned and stop drinking milk.
Even if you do want to include some dairy in your diet, the 4-5 daily servings a day recommended by the programme is way too much for good health. The China Study provides comprehensive and compelling evidence from a large-scale long-term study about the benefits of low (or no) dairy diets on all chronic diseases.
There are plenty of healthier plant-based non-dairy sources of calcium which are alkaline-forming (that is, they maintain the best pH levels for your health). The programme itself even mentioned calcium-enriched soya milk, almond milk or rice milk as alternatives for Julie, given that she struggled to eat dairy products. (I am a big fan of nutrient-packed smoothies, and there’s a good suggestion for a PMS smoothie on The Food Hospital website – which you could make with soya milk, rice milk, hemp milk, or almond milk)
Interestingly, in the update on The Food Hospital’s website about Julie, she had trouble increasing her calcium intake due to her dislike of milk so chose to eat more calcium rich vegetables, such as broccoli and asparagus, instead. So it seems it wasn’t really more dairy that improved her PMS anyway, but more calcium-rich whole foods.
(Oh, and one other thing. Presumably because of the demands of television, Julie was reassessed by the Food Hospital Team just six weeks later. That would only have been one menstrual cycle later, and in practice, the impact of any diet and lifestyle changes should be implemented over at least three cycles).
Wishing you a happy and healthy New Year. And thanks for reading!
When you’re already suffering from PMS, bloating around your middle just adds to the feelings of despondency. And if you’re feeling fat – even when you’re not! – you’re more likely to feel sorry for yourself and comfort eat, giving in to those premenstrual food cravings. So this post is about what you can do to make bloating go away – and better still, prevent it.
Why Do We Get Bloated?
Many women tend to retain more fluid in the days leading up to their period. This is because of rising oestrogen levels which make your kidneys hang on to more water and more salt. (Bloating can also be a problem during perimenopause when oestrogen levels are going up and down).
Other factors, such as stress and certain foods, can also contribute to bloating. But if your bloating comes around on a monthly cycle, the cause is hormone changes.
Constipation can also be a problem during PMS, which adds to the uncomfortable feelings around your middle.
Foods that fight PMS: avocados (on the left) are one source of magnesium. And if you can find artichokes as big and beautiful as the ones on the right anywhere in the UK, I recommend you snap them up! Photo via Wikimedia Commons
Luckily, there are plenty of sources of magnesium in many everyday foods – for example, green leafy vegetables are particularly good sources of magnesium. Yet magnesium deficiency is not unusual.
Could this be because it’s quite common for people to see greens, beans, and grains as more of an optional side dish than the main event? I think so. I’ve also noticed that while people these days are more aware of getting their ‘Five a Day’ portions of fruits and vegetables, they tend to gravitate towards fruit rather than vegetables – especially rufty tufty vegetables like kale and beetroot tops, which are so good for you. And for many people nuts and seeds just don’t appear on their radar.
Well, if this is you, I hope to convince of the benefits of changing your ways!
Why Does It Matter Whether I Get Enough Magnesium?
Magnesium is important for your nerves, your muscles (including your heart) and your immune system. It helps your metabolism to function and is as important as calcium in forming strong bones.
If you don’t get enough magnesium, you could suffer from any of the following symptoms:
Irritability, agitation and anxiety
Restless leg syndrome (RLS)
Insomnia
Nausea and vomiting
Irregular heartbeat
Hyperventilation
Muscle spasm or twitching
Slow nail growth
Headaches
Scientific studies suggest that magnesium supplements (which are easier to study in isolation than whole foods) help to relieve many of the physical symptoms that women with PMS experience, including bloating and fluid retention, weight gain, breast tenderness and insomnia.
Although magnesium supplements exist in a variety of forms (and with varying levels of absorption and effectiveness), Nature provides plenty of dietary sources of easily absorbed magnesium. A whole-foods plant-based diet will definately ensure that you get plenty of magnesium.
Leafy greens are particularly great – full of the minerals potassium, magnesium and calcium – but if you’re not keen, there are other options too. Here are some magnesium-rich foods to include in your meals. They not only help beat PMS, they’re great for lowering cholesterol and keeping your heart healthy too:
Leafy green vegetables (like kale, cabbage, beetroot tops, chard and spinach)
The amount of magnesium that your cells can absorb also partly depends of the level of vitamin B6 in your body. Vitamin B6 supplements are traditionally recommended for PMS management and I examine the evidence for how effective this actually is in a separate post. But what initial studies do seem to show is that vitamin B6 combined with magnesium seems to work better than B6 alone (or indeed, a magnesium supplement on it’s own).
Magnesium supplementation is also often recommended in combination with calcium tablets for PMS. This is also something I will also write about in a later post.
But if you are susceptible to PMS (and why else would you be reading PMS Warrior?) you do need to be careful. Follow these top ten tips for a safe detox that WON’T send you hurtling towards bad PMS:
A golden rule of PMS management is to eat little and often – every three hours at least. This keeps your blood sugar levels stable and prevents the rollercoaster that causes your energy levels to plummet and food cravings to take hold. It also helps to keep serotonin levels stable, which is great for fighting anxiety and depression. So whatever the detox books say, don’t starve yourself. Small but nutrient-dense meals, combined with grazing on PMS-healthy snacks in between, is the PMS-friendly way to go. And ironically, eating more – but better – can also help you lose weight, since drastic dieting or fasting can send your body into crisis mode, which is when it holds on to fat more.
Cut out sugar, alcohol, stimulants like caffeine, and processed foods, all of the time – not just when you’re detoxing. It’ll help your PMS, and you’ll have less to detox from. If you only go ‘cold turkey’ when you’re detoxing, you’ll be more likely to suffer withdrawal symptoms like headaches. And as one of my readers commented under the previous post, fruit juice (often relied on in detoxing to keep vitamin levels up) is full of sugar. So if you really want to go down the juice fasting road, mix your juice half and half with water to slow down the digestion process and prevent blood sugars spiking.
Don’t completely cut out complex carbohydrates. I don’t mean filling up on bread and pasta. Fruits, vegetables, salads, grains and beans all contain carbohydrates, and in moderation, they can help you eat more simply during your detox. But remember that juicing removes all the fibre and carbohydrates from fruit and vegetables. Stick to whole foods.
Avoid detoxing in the second half of your period, and particularly in the week before your period. This is when food cravings are likely to be highest and your need for a diet full of energy-giving and mood-boosting healthy carbs is likely to be greatest. If you eat badly during this period, you’ll know about it.
Don’t do an extended detox. A weekend of eating really pure foods, or less food than normal, won’t destabilise you. But four days or more of detoxing – unless you’re under expert supervision – can play havoc with your PMS and leave you feeling worse.
Don’t do a detox and then overindulge immediately afterwards. Psychologists call this the licensing effect. Like the woman I heard about recently who detoxed for a week in the run up to her holiday – then went overboard on all the rich food and alcohol on offer on the day (and felt very ill as a result).
The best way to capture ALL the goodness of fruit and vegetables is to make smoothies and soups. They’re nutritious, delicious, and easy to digest – but with no loss of fibre or nutrients. But don’t just gulp down your liquid meals. ‘Chew’ your smoothies and soups to allow the saliva in your mouth to break down the nutrients (and to really savour the taste too, of course).
The best way to give your digestion a rest is to concentrate on simplifying your meals for a day or two. Try eating just one or two foods at a sitting; for example, just quinoa and vegetables, or whole grain rice and vegetables. This is also a great time to eat big and varied salads.
Whatever you’ve heard about drinking gallons of water for your skin and for clearing out your system, evidence is now emerging that drinking too much water is actually unnecessary, and probably even harmful. For example, too much water flushes minerals known as electrolytes from your body. Listen to your thirst instinct and stay hydrated the natural way by eating water-filled fruits and vegetables, smoothies and soups. (This will also help you get rid of the environmentally toxic plastic water bottle habit). And don’t gulp down herbal teas, water and juices – sip them to allow your body to allow the liquid to do its work.
Enjoy eating healthily and sensibly to feel good the whole month through. Make detoxing an event and a special time and use it as a chance to slow down and simplify, and to transition to better habits. But don’t sacrifice all the things you need to obliterate your PMS.
I’m always interested in hearing your detox and PMS stories.
Detoxing – particularly juice-fasting – is all the rage. Endorsed by a roll call of svelte celebrities, and trotted out every January to coincide with our New Year Resolutions, it’s promoted as a way of undoing the damage caused by too much rich food, too many late nights, and too much exposure to the toxic load placed on your body by modern life. And of course, it’s a quick way to lose weight too.
Detoxing can feel like the right thing to do if you’ve been overdoing things, been ill, or want to mark the start or end of something – a job, a relationship, the college year, the changing seasons – or perhaps to kick start a new healthier lifestyle. And you can detox at home, or head off to a spa or a retreat – far away from all temptations.
Expert opinion is divided about exactly how valuable detoxing is in dealing with toxins – after all, your body is already equipped with a toxin processing unit that works 24/7. (It’s called your liver). But it certainly feels natural to want to clear out your system from time to time, whether by fasting or just by reducing and simplifying the food you eat.
We know that stress makes PMS worse, and detoxing is also a good opportunity to slow down the pace of life and take some time for yourself. You’re encouraged to flop about reading, sipping herb teas, drinking vegetable juice and taking aromatherapy baths. (You’ll feel too weak to do much more than that anyway!)
As a result of the purging, you might get a breakout of spots (explained as the toxins coming out of your skin) or a detox headache (usually a sign of withdrawal from stimulants like caffeine). But a few days later, you’ll come out the other side, lighter, brighter, and with sparkly eyes and more energy.
At least that’s the theory.
My PMS and Detox Adventures Around The World
chapter one: Thailand
I always say you should try everything once. And on that basis, a few years ago I tried a fasting holiday in a spa in Thailand.
I know. Going all that way to not eat anything. A little bizarre, right? But sometimes you have to cut off completely from your old habits. And I’d read about people coming home transformed, never wanting to eat another doughnut or a meat cutlet ever again.
Admittedly, while we were being pumped full of psyllium husk (to help you feel fulll and keep you ‘regular’, pineapple juice and coffee enemas (don’t ask), other holiday makers were feasting on luscious fruits and freshly prepared vegetarian cuisine. Oh well. We were feeling righteous. And suffering must be good for you, right?
What I can tell you is that hardcore fasting does give you a kind of high after a few days. And without food prep and consumption filling your thoughts, there’s more time and space to think and reflect. After several days of non eating, your first bites of real food are postively orgasmic too. Which is a plus!
But when I came off the holiday, however svelte and clear-eyed I looked, physically, emotionally, I was all over the place. Straight after the fast, I had the most epic episode of PMS. Ever.
chapter two: Poland
I should have seen it coming. Some time before, I’d spent a couple of weeks on a health farm in Poland. The countryside was beautiful, the weather was glorious, and there we were, voluntarily restricting ourselves to a very minimal food intake for two weeks.
The group was mainly made up of health-conscious women in our 30s, and I remember noticing how tetchy many of us got during the extended fast. When we talked about it afterwards (once we’d had a good wholesome meal and stopped PMS-ing), it came out that several of us had fasted during what was the second half of our menstrual cycles. Ah, so it hadn’t been purely hunger (and if I’m honest, boredom) that has made us scratchy and irritable. Looking back, it was clearly PMS.
In fact, even some women who said they didn’t normally suffer from PMS experienced the typical PMS symptomsas a result of an extended fast.
chapter three: WALES
My theory was finally confirmed when I spent a week juice-fasting in a cottage in Wales with a friend. By this time, I had already changed to a plant-based whole foods diet, and we weren’t doing a particularly extreme juice-fast. Nonetheless, I watched as my lovely, easy-going friend became short-tempered, emotional, and cranky. I recognised the PMS dip and we immediately upped our intake of carbohydrates and whole foods. There was an instant improvement in her mood.
Are You Detecting a Pattern?
The danger of detoxing (or juice-fasting) is that it can leave you short on essential nutrients and fuel, which is damaging to your hormone balance and can therefore aggravate PMS.
One factor is that juices just don’t have the fibre and nutrients we need to prevent PMS. They’re not whole foods, as this pithy little video (sorry!) shows:
So while it’s great that detoxing emphasises less junk food, less sugar and fewer stimulants, an effective anti-PMS dietis as much about what you DO eat as about what you DON’T. I like the fact that detoxing emphasises anti-oxidants and plant-based foods – after all, no spa in the world has a detox programme where you load up on dairy, meat and saturated fat. But there’s a right way – and a wrong way – for women with PMS who want to detox. To maintain blood sugar levels and serotonin levels in the brain for mood, women with PMS need a steady supply of complex carbohydrates, omega-3s fatty acids, B-vitamins and minerals.
Next time, I’ll give you ten top tips for how to do a cleanse WITHOUT making your PMS worse.
I was in London recently (talking about PMS on a breakfast TV show, as it happens) and it seemed that every second person was striding down the road holding a large lidded cardboard coffee cup and with a different coffee shop every few steps along the street.
Coffee shops have become THE places we head to for a break, to meet work colleagues or friends, and at the start (or end) of the day to pep us up. And there’s no longer such a thing as a ‘small’ or normal coffee: there are infinite variations on the standard coffee and double shots are not unusual. Whether at home or at work – or in the journey between the two – coffee is used by many of us to punctuate the day.
Well, I don’t want to sound like a killjoy, but if you have PMS, you need to think about what effect all that caffeine is having on how you feel, especially in the second half of your cycle. You might be missing an important element of what’s aggravating your PMS.
And I’m not just talking about coffee. Tea – a fundamental part of British life – also contains caffeine, as do cola-type drinks (including the sugar-free ones) and the powerful ‘energy drinks’ we reach for when we need a pick-me-up .
How Caffeine Makes PMS Worse
Research conducted at Oregon State University on over 800 women students found that the risk of PMS was between two and seven times greater in women who consumed two or more cups of coffee or tea each day. So, although individuals vary in their sensitivity to caffeine, the association between caffeine and PMS overall is pretty conclusive.
The caffeine in coffee (and caffeine-rich other drinks and foods) contributes to making us feel worse during PMS in a number of different ways:
At some point, everyone has got a little too ‘wired’ drinking coffee, so you’ll already know that caffeine is a STIMULANT which raises your heart rate, your breathing, your body temperature, and your blood pressure. It increases levels of adrenaline and cortisol (known as the ‘stress hormone’) which in turn can lead to food cravings, anxiety and irritability.
Like alcohol, caffeine gives you a short-term boost but ultimately LOWERS THE LEVELS OF SEROTONIN – the brain’s feelgood chemical – in your system and leaves you feeling low on energy. This of course leads you to seek out more coffee to get you back ‘up’. And so the cycle continues…
Coffee is often described as DIURETIC (meaning it makes you go to the toilet more often) although the actual evidence for this is negligible. However, it definitely does have a ‘loosening’ effect which may contribute to washing out valuable vitamins and minerals from your system. Did you know for example, that coffee is often used in spas and retreats – in coffee enemas!
Caffeine also blocks the proper absorption of vitamins and minerals. It’s ACID-FORMING, meaning that your body will automatically try to restore it’s alkaline balance by pulling minerals like calcium from within, e.g. out of your own bones - a compelling reason for why women with osteoporosis should avoid coffee.
Coffee RAISES BLOOD SUGAR LEVELS when keeping sugar levels steady (e.g. by eating regularly and including complex carbs in your diet) are essential to PMS prevention, particularly for maintaining a good mood, high energy levels and for beating food cravings.
Proper rest and recharging are essential components of any PMS self-care plan but caffeine INTERFERES WITH THE NATURAL SLEEP CYCLE (which is why I’ve never understood the habit of taking strong coffee after dinner!)
And as if all that wasn’t enough, drinking coffee INCREASES breast tenderness – a common PMS symptom.
Several years ago, I discovered a powdered drink from America specifically designed for women with PMS called PMS Escape. It had been developed by Dr Judith Wurtman while she was Director of the Program in Women’s Health at the MIT (Massachusetts Institute of Technology) Clinical Research Center and was a clinically tested and patented blend of carbohydrates and vitamins.
I’ve already written about how carbohydrates are essential to managing PMS symptoms, but the great advantage of PMS Escape was that it served up a balanced mix of carbs in a quickly digested convenient form, giving almost instant relief. Taken on an empty stomach, PMS Escape would have a calming, soothing effect within 20 minutes or so. The effect was rapid and astonishing, and a lifesaver in a crisis – for example, when you had to get it together to face a challenging day at work despite your PMS.
I’ve kept a little stockpile of PMS Escape in my cupboard and it has bailed me out on several occasions. Just yesterday I had an unexpectedly ratty day after I let my blood sugar levels plummet by forgetting to eat from breakfast till 3pm. Fatal. I got shaky and irritable, impatient and muddle-headed, but nonetheless I needed to get myself together to meet someone. Due to very poor planning, I didn’t have the time or the ingredients to prepare and eat a sensible carbohydrate-rich plant-based meal which would have got me back onto an even keel. So I reached for the PMS Escape – the sticking plaster solution. And it worked a treat. I was able to face the world and get on with my day. It also saved me from the potato crisps and chocolate fingers – which would have given me a short-lived energy and mood boost but would have left me feeling worse in the long run.
I’ve only used PMS Escape occasionally but when I have, it’s been very effective. So as far as I could see, the only downside was the cost – about £12 for enough for 3 days’ usage (a month’s supply) – and the fact you could only order it online.
Well, I don’t need to worry about either of these any more, as it’s now been discontinued.
I’m sorry to drop that bombshell – especially if you’ve got excited because I’ve just waxed lyrical about it – but you have to understand … I’m grieving too! PMS Escape is now showing ‘out of stock’ or ‘sold out’ pretty much everywhere. What a shame that the one thing that has been proven to be fast-acting, safe and effective, has been withdrawn.
PMS Escape Withdrawn – So Now What Do We Do?
At first I suspected that PMS Escape had stopped being imported into the UK because of new health food regulations, but I see that it’s the American side of the operation that has withdrawn it. So that seems pretty final. (If anyone knows exactly why it’s been discontinued, I’d be interested to know. I’ve tried emailing the manufacturer / distributor, Enzymatic Therapy, and got no response).
But as the saying goes, perhaps it’s better to have loved and lost than not to have loved at all. It’s time to move on and find an alternative PMS emergency fix. But first a little about how and why PMS Escape worked so well. Continue reading →