Putting an End to Monthly Discomfort
Ask ten women what premenstrual syndrome feels like, and you'll probably get ten different answers.
A few of those answers will be pretty predictable: bloated, sore, headachy. Other women feel okay physically but ride an emotional roller coaster of anxiety and depression.
And--something you probably don't want to hear if you have premenstrual syndrome--some women don't experience any premenstrual symptoms at all.
Experts estimate that as many as 50 percent of menstruating women in the United States have some degree of premenstrual syndrome, or PMS. Whether you're one of them depends on a variety of factors, including your genetic inheritance, how much stress you're under, whether you drink alcohol or caffeine and how much you exercise. Age is also a factor: Women in their thirties and forties are more likely to get PMS than younger women.
And finally, some researchers believe that nutrition exerts a powerful influence on how a woman feels both before and during her period. PMS researcher Guy Abraham, M.D., became so convinced of the importance of nutrition that he left his teaching position at the University of California, Los Angeles, UCLA School of Medicine to found Optimox, a Torrance, California, company that manufactures nutritional supplements. "Nutrition is the single most important factor in whether or not a woman will have PMS," says Dr. Abraham. "This is why we see so much PMS among women in their thirties. Most of them have been pregnant, which has depleted their bodies of nutrients, so they're more likely to be deficient in the B vitamins and magnesium."
Here's what researchers have learned about the nutrition connection.
How you feel in the days before your period depends at least in part on what you eat and drink all month long.
Don't turn to the bottle. Resist the temptation to unwind with a cocktail. While it has been said that severe premenstrual syndrome (PMS) drives some women to drink, research suggests that drinking is more than a reaction to monthly discomfort. Studies show that women who drink moderately throughout the month (ten or more drinks per week) are more likely to have premenstrual symptoms than lighter drinkers or teetotalers.
Don't be so refined. If you experience PMS every month like clockwork, it's possible you're just too refined, at least as far as your diet is concerned. Some studies show that women who get PMS eat more refined sugar and carbohydrates, such as breads, cakes, pastas and other starchy foods made of white flour.
"These foods are generally poor in vitamins, minerals and fiber. So if a woman gets most of her calories from them, she's going to wind up deprived of essential nutrients," says PMS researcher Guy Abraham, M.D., founder of Optimox, a Torrance, California, company that manufactures nutritional supplements. Replacing these refined foods with their heartier cousins, whole-grain breads and cereals and naturally sweet fresh fruits, will result in a more nutrient-dense diet and possibly fewer premenstrual symptoms, he says.
Kick the can.The cola can, that is. While the caffeine in your coffee, tea or soda doesn't cause PMS, it can aggravate symptoms in some women, says Dr. Abraham.
Go easy on sugar and salt.This can be difficult when you're craving But regardless of where you live, you can
enjoy the benefits of an Asian diet by limiting the meats and other
animal products that you eat or by eliminating these foods
altogether. "Vegetarian women seem to have much milder
premenstrual symptoms or none at all," says Dr. Abraham.
But regardless of where you live, you can enjoy the benefits of an Asian diet by limiting the meats and other animal products that you eat or by eliminating these foods altogether. "Vegetarian women seem to have much milder premenstrual symptoms or none at all," says Dr. Abraham.
Calcium: Woman's Best Friend
If you've picked up a health book or magazine lately, you know all about calcium's role in preventing osteoporosis, the brittle-bone disease that incapacitates thousands of women (and men) each year. But if scientific studies are any indication, there may be another, more immediate reason to add a calcium supplement to your medicine chest.
A study conducted at Metropolitan Hospital in New York City found that a daily supplement of 1,000 milligrams of calciumreduced premenstrual symptoms in 73 percent of the women who took it. The women, who normally experienced premenstrual symptoms every month, reported less breast tenderness and swelling and fewer headaches and abdominal cramps when they took the calcium supplements every day during the preceding month. They also reported less discomfort during their periods.
It isn't clear exactly why calcium relieves PMS, but the researchers suspect that it eases the muscular contractions that lead to cramping.
And this isn't the only study to find a connection between calciumand PMS. A small study at the U.S. Department of Agriculture Grand Forks Human Nutrition Research Center in North Dakota found an intriguing connection between a diet low in both calciumand the trace mineral manganeseand PMS. Women who experienced PMS on a low-calcium, low-manganese diet had fewer symptoms when their diet was supplemented with the two minerals.
What's interesting, says James G. Penland, Ph.D., head researcher at the Grand Forks Human Nutrition Research Center and one of the authors of the study, is that the diet that produced the worst premenstrual symptoms is actually closest to the way most American women eat. Dr. Penland's studies show that most women get about 587 milligrams of calcium a day, nowhere near the 1,000 milligrams they're supposed to get to build healthy bones and prevent osteoporosis.
Manganese intake among American women is only about 2.2 milligrams a day. That's a little more than the Daily Value for this mineral.
While researchers continue studying the connection between calciumand manganeseand PMS, a daily supplement that includes both minerals can't hurt and might help if you're prone to PMS, says Dr. Penland. Check to see if your multivitamin/mineral formula provides 2 to 5 milligrams of manganese. As for calcium, "I would recommend increasing your intake of low-fat, calcium-rich foods such as low-fat yogurt and milk. If that is difficult, then I suggest taking 500 to 1,000 milligrams of supplemental calcium a day," he says.
Prescriptions for Healing
Getting the right nutrients can make a big difference in whether you suffer monthly symptoms of premenstrual syndrome. Here's what some experts recommend.
Nutrient Daily Amount
Vitamin B6150-200 milligrams
Vitamin E400 international units (d-alpha-tocopherol)
MEDICAL ALERT: If you have heart or kidney problems, you should talk to your doctor before taking magnesium supplements.
High doses of vitamin B6 can cause side effects and should be used only under the supervision of your doctor.
If you are taking anticoagulant drugs, you should not take vitamin E supplements.
Magnesiumis another mineral that seems to have a beneficial effect on women with PMS. A few studies have found lower magnesiumlevels in women with PMS than in women without symptoms. Other studies suggest that increasing magnesium levels might reduce or eliminate premenstrual discomfort, especially emotional symptoms such as tension and anxiety.
Magnesium deficiency causes a shortage of dopamine, a chemical found in the brain that regulates mood, according to Dr. Abraham. This shortage may have something to do with the premenstrual tension and irritability that many women experience.
In one Italian study of 28 women with PMS, a magnesium supplement of 360 milligrams was associated with fewer cramps, less water retention and an overall improvement in premenstrual symptoms.
The Daily Value for magnesiumis 400 milligrams. The best sources of magnesiumare nuts, legumes, whole grains and green vegetables, all of the staples of a low-fat, high-fiberdiet. But if your diet leans more toward white bread, white rice, meats and dairy products, your body is probably coming up short on magnesium.
To help even things up, Dr. Abraham recommends a magnesium supplement of 300 to 400 milligrams. "Your body will tell you exactly how much magnesiumyou need within that range. Too much will cause diarrhea, so I tell women to take magnesium to bowel tolerance." If you have heart or kidney problems, be sure to talk to your doctor before taking magnesium supplements.
Vitamin E Smooths Out Rough Edges
Vitamin Ealso seems to lessen the severity of premenstrual symptoms. In two separate studies, a team of Baltimore scientists examined the effect of vitamin Esupplements on women prone to PMS. The women received vitamin Ein the form of d-alpha-tocopherol every day for two consecutive menstrual cycles. The supplement made a substantial difference in premenstrual symptoms such as mood swings, cravings, bloating and depression.
The women in the study, like most women with PMS, had normal dietary intakes of vitamin E. But the amount of vitamin E in the typical diet apparently isn't enough to treat some PMS, according to Robert S. London, M.D., assistant professor of obstetrics and gynecology at Johns Hopkins University School of Medicine in Baltimore and one of the authors of the study.
"The average person consumes a small amount of vitamin E in foods such as vegetable oils, but this certainly isn't enough to have any effect on PMS," says Dr. London. "The effect was clearly dose-responsive: 400 international units was much more effective than 200 international units. It's impossible for a woman to get these levels of vitamin E through diet alone."
It isn't clear why vitamin E has an effect on PMS. Some experts have suggested that it works by slowing the production of prostaglandins, hormonelike substances thought to play a role in premenstrual symptoms.
If you'd like to try vitamin E for PMS, experts generally advise a dosage of 400 international units daily. Take it for at least six weeks to give it a chance to work, advises Dr. London. "It usually takes about that long," he says. The d-alpha-tocopherolform of vitamin E used in the study is readily available; just check the label before you buy. (Other forms of the vitamin haven't been studied for PMS.)
Beat PMS with B6
Finally, if you're bothered by premenstrual weight gain and emotional symptoms, vitamin B6 can help control them, says Dr. Abraham. In a study of 25 women with PMS, Dr. Abraham found that a high-dose supplement of B6 reduced premenstrual weight gain and lessened the severity of other premenstrual symptoms.
The women in the study were given high doses of vitamin B6: 500 milligrams a day for three months. (The Daily Value is only 2 milligrams.) B6 at this level eases PMS by changing blood levels of two female hormones, estrogen and progesterone, according to Dr. Abraham. But high doses of the vitamin can be dangerous, so supplementation should be used only under the supervision of your doctor.
If you'd like to try vitamin B6 for premenstrual symptoms, Dr. Abraham recommends taking it as part of a B-complex supplement. "B6 taken by itself can cause deficiencies of other nutrients, so it's important to balance it with the other B vitamins," he says.
You should also make sure you're getting enough magnesium, he adds. "I generally recommend taking twice as much magnesiumas vitamin B6. So if you're taking 300 to 400 milligrams of magnesium, you need 150 to 200 milligrams of B6."