Premenstrual Syndrome

Premenstrual syndrome (PMS) is defined as a recurrent, cyclic set of physical and behavioral symptoms that occurs 7–14 days before the menstrual cycle and is troublesome enough to interfere with some aspects of a woman’s life. PMS is estimated to affect up to 40% of menstruating women, and the most severe cases occur in 2%–5% of women who are between 26 and 35 years of age.1 PMS has been recognized as a medical disorder for many years; however, its cause remains a mystery. Increasing levels of estrogen and progesterone around this time may play a contributing role.

Exercise remains understudied in the scientific world because it does not fit well into the double-blind, placebo-controlled, study design. The few studies that have been conducted on the role of exercise in PMS have clearly shown that women who engage in regular physical exercise have fewer symptoms of PMS than women who do not. Women who exercise regularly note improvement in all symptoms of PMS.2 The frequency, rather than the intensity, of exercise appears to diminish the negative mood and physical symptoms that occur during the premenstrual period.3

Many people in the United States fail to eat a healthy diet, but some researchers have found this observation to be even more accurate for women with PMS. A 1983 report noted that women with PMS consumed 275% more refined sugar, 79% more dairy products, 78% more sodium, 62% more refined carbohydrates, 77% less manganese, and 53% less iron than women without PMS.4

A review of studies focusing on calcium for the management of premenstrual symptoms was published in the Annals of Pharmacotherapy.5 On the basis of the medical literature, the reviewer concluded, “Calcium supplementation of 1200–1600 mg/day, unless contraindicated, should be considered a sound treatment option in women who experience premenstrual syndrome.

Magnesium may be beneficial for women with significant bloating and cramping associated with their menstrual cycles and for women with menstrual migraines. Dietary sources of magnesium include green leafy vegetables, tofu, legumes, nuts, seeds, and whole grains.

Current thinking postulates that pyridoxine (vitamin B6) may ease symptoms of PMS through its ability to increase the synthesis of serotonin, dopamine, norepinephrine, histamine, and taurine.6 Serotonin is important for the regulation of sleep and appetite and the prevention of depression. Low levels of serotonin and dopamine may play a role in premenstrual symptoms.7

If you’d like to find out what other treatment modalities may apply to your specific case, please reach to us at RMRM for more information.

  1. American College of Obstetrics and Gynecology: Committee opinion. Int J Gynecol Obstet. 50:80 1995
  2. J. Aganoff, G. Boyle: Aerobic exercise, mood states and menstrual cycle symptoms. J Psychosom Res. 38:183-192 1994
  3. W. Johnson, R. Carr-Nangle, K. Bergeron: Macronutrient intake, eating habits, and exercise as moderators of menstrual distress in healthy women. Psychosom Med.57:324-330 1995
  4. G. Abraham: Nutritional factors in the etiology of the premenstrual tension syndromes. J Reprod Med. 28:446-464 1983
  5. M.W. Ward, T.D. Holimon: Calcium treatment for premenstrual syndrome. Ann Pharmacother. 33:1356-1358 1999
  6. M. Ebadi, P. Govitrapong: Pyridoxal phosphate and neurotransmitters in the brain. G.Tryfiates Vitamin B6 metabolism and role in growth. 1980 Food and Nutrition PressWestport, CT 223
  7. D.L. Taylor, R.J. Mathew, B.T. Ho, M.L. Weinman: Serotonin levels and platelet uptake during premenstrual tension. Neuropsychobiology. 12:16-18 1984