The PMS and Food Connection

By Terry Mason, HealthAtoZ contributing writer

Eating your weight in chocolate and chips? Yelling at loved ones all week? Feeling bloated and crampy? Uh, oh. Check your calendar. It might be that time of the month.

It's estimated that 40 percent of women of childbearing age experience physical and emotional symptoms of premenstrual syndrome (PMS) that are severe enough to put a damper on daily routines and activities, reports the American College of Obstetricians and Gynecologists (ACOG). While PMS is a fact of life and the cause of much misery for many women, the exact cause of these monthly symptoms still is not completely understood. It appears that the hormones progesterone, estrogen and testosterone are involved, as well as serotonin, which is a brain chemical, according to the ACOG.

Among the most aggravating physical changes that may occur with PMS are weight gain and food cravings, says Judith Wurtman, Ph.D., a research scientist at Massachusetts Institute of Technology who has done extensive study on brain chemistry and PMS treatment.

Chocolate and chips are at the top of the list when women say they experience PMS food cravings. Food cravings associated with PMS are not the result of a nutritional deficiency, Wurtman says.

"It's a brain deficiency," she says. "It's a real phenomenon, provoked by changes in the brain when one's hormones are changing. The one chemical that drives all of this is serotonin. One way you can make serotonin is by eating carbohydrates. But you don't have to eat chocolate or potato chips to do that any more than you need to drink champagne to satisfy your thirst."

Marla Ahlgrimm, a registered pharmacist and co-author of the book Self-Help for Premenstrual Syndrome, notes that women typically reach for high-fat or sweet foods because they're a quick way to raise serotonin and endorphin levels. "It's not the only way or the best way," she says. "A snack of complex carbohydrates will do the same thing and may also allow the hormone progesterone to be metabolized fully."

"A lot of women crave sugar, salt, fatty foods. Sugary foods are a big one," agrees Susan M. Lark, M.D., author of Premenstrual Syndrome Self-Help Book: A Woman's Guide to Feeling Good All Month. "They eat the wrong foods; they eat Oreos or an ice cream bar or chocolates. That just makes it worse." The result is a quick upswing in your blood-sugar level; followed by a rapid decline - and then you're hungry again.

It sounds counterintuitive but foods can help relieve PMS cravings, says Lark. When PMS cravings strike, she suggests fighting back with grains and beans, tuna on a piece of rye crisp or a rice cake.

"If you want to slow down absorption of the carbs, add a little oil like mayonnaise or almond butter," Lark says. "That will really cut your craving."

Perhaps the best way to cut down on PMS cravings is to change how you eat more than what you eat, Ahlgrimm says. By eating six small meals a day, you can help keep your blood sugar stable. "Adopting this meal plan often helps women avoid cravings," she says. "You're not eating more, just small amounts more often."

There is no PMS diet, per se, but Ahlgrimm says she's found good results by following a "rule of halves" to manage cravings and other PMS symptoms.

For instance, breakfast can be a half-cup of whole grain cereal with berries and low-fat milk. At mid-morning, have a handful of whole-grain crackers with carrot or celery sticks or half a banana. At lunchtime, eat a half a sandwich made with lean turkey on whole-wheat bread and half an apple. Two to three hours later, snack on a half-cup of low-fat yogurt or cottage cheese, or the other half of your sandwich, with the rest of your apple.

"The rule of halves often helps alleviate women's concern that they will be eating too much and gaining weight," she says.

When you have levels of calcium and magnesium at the right ratio, chocolate cravings may ease, Ahlgrimm says. Magnesium is important to regulate muscle relaxation and blood sugar and to promote sound sleep - all particularly important during PMS. Magnesium also increases calcium absorption in the body.

The benefits of calcium and magnesium for PMS are well supported. A study in The American Journal of Obstetrics and Gynecology reported that 1,200 mg a day of chewable calcium carbonate reduced symptoms of PMS by nearly 50 percent. A study in The Journal of Women's Health found that 200 mg a day of magnesium reduced PMS fluid retention, breast tenderness and bloating by 40 percent.

Two important ways to reduce food cravings and weight gain is to follow the advice your grandmother probably gave you - drink six to eight glasses of water daily and exercise regularly.

"Often women with PMS avoid drinking an abundance of water because water retention is such a common PMS symptom. Drinking lots of water helps to flush the body out and actually reduces premenstrual bloating," explains Ahlgrimm.

Staying physically active also helps reduce PMS symptoms. Not only does exercise burn calories but it's a natural stress-reducer and mood enhancer.

The American College of Obstetricians and Gynecologists offers the following tips for controlling PMS:

• Eat complex carbohydrates, such as whole grain breads, pasta and cereals, fiber and protein. Cut back on sugar and fat.



• Avoid salt for the last few days before your period to reduce bloating and fluid retention.



• Avoid caffeine and alcohol.



• Studies have shown that taking 1,200 mg of calcium a day can help reduce PMS symptoms.



• Your doctor may suggest that taking a magnesium supplement can help reduce bloating, breast tenderness and mood symptoms. There is also some evidence that vitamin B6 and vitamin E can help reduce PMS symptoms.



• Talking with others about how PMS affects you can help. Sharing what you are going through will enable the people around you to be more supportive.



• Get moving with aerobic exercise. Work up to exercising 30 minutes, four to six times a week.



• Try new ways to relax and relieve stress, such as yoga or massage.



• Get plenty of sleep - about eight hours a night.

If dietary and lifestyle changes are not effective for severe symptoms, your doctor may recommend medication. Medications used to treat PMS include antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics or birth control pills.

Related Articles Is It More Than PMS? Women's Health Alternative Medicine

External Sources American College of Obstetricians and Gynecologists The National Cancer Institute

This article was reviewed and updated June 2007.

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