Premenstrual syndrome (PMS) is one of the most common disorders affecting women of a reproductive age, with 90% of women being affected to varying degrees. For most women, PMS symptoms start during the luteal phase of the menstrual cycle, right after the ovulation and approximately six days before menstruation. It is widely accepted that PMS symptoms are driven by a fluctuation in hormone levels. Reduced levels of serotonin can lead to depression and food cravings, whilst noradrenaline release can trigger fatigue, poor memory and reduced concentration.  

It’s natural for your hormones to shift and fluctuate throughout the month, but when you experience uncomfortable symptoms, it’s time to listen to the message your body is sending. Symptoms are your body’s way of letting you know that your hormones are not in balance. Research shows that women who don't treat hormonal imbalances like the ones behind PMS are more likely to experience problems such as heart disease and diabetes. So, it’s more than worth your while to crack the code of your PMS and to treat the symptoms and their root causes at the same time.

The key to balancing your hormones lies largely in making consistent lifestyle changes. Here’s a check list of simple changes you can make throughout the month reign in your PMS. 

Check list:

• Prioritise sleep. If you don't get enough good quality sleep throughout the month, you will be more likely to become irritable and you will gain weight. Aim for 7-8 hours every night. This article on sleep hygiene and nutrition for better sleep will help you.
• Drink more water. Estrogen and progesterone influence your body’s hydration levels, and when the two are rollercoastering, like when you’re in the throes of PMS, you may need to increase your fluid intake to stay hydrated. 
• Exercise regularly. Exercise not only helps to keep a balanced body composition but it also produces ‘happy hormones’ such as dopamine, serotonin and endorphins that reduce stress and anxiety.
• Keep your insulin levels stable by eating three meals and two snacks every day. Also, ensure that you have some protein every time you eat. Protein slows the release of sugar from food into the bloodstream which helps to prevent irritability and mood changes. 
• Limit your salt intake. Sodium can worsen PMS symptoms due to its role in fluid retention, which leads to bloating and swelling of the extremities. Moreover, high sodium intake can lead to a higher risk of developing hypertension over the time. Look out for excess salt in condiments, dressings, soya sauce, processed food and fast foods such as ham, bacon, sausage, canned products, pasta, bread and crackers.

Tip- instead of using salt to give flavour to your meals, why not try some herbs or spices such as: basil, bay leaves, garlic, paprika, parsley, pepper, rosemary, sage, saffron, thyme, nutmeg, paprika, cinnamon and vanilla.

Your PMS symptoms might also be exacerbated by nutrient deficiencies, so it’s important to ensure that you are getting enough of the following:

Calcium & vitamin D 

Calcium plays an important role in hormone secretion. In the week leading up to the period, many women appear to have abnormally high levels of a substance called secondary parathyroid hormone in their body. This hormone can cause a long-term imbalance in the body's calcium levels and lead to an increase in PMS symptoms. Most women do not get enough calcium throughout the month, some good food sources include:

Animal-based- dairy products, milk, yogurt, cheese, buttermilk, salmon and sardines.

Plant-based- green leafy vegetables such as broccoli, collards, kale, mustard greens, turnip greens, and bok choy or Chinese cabbage, almonds, brazil nuts, sunflower seeds, sesame seeds, tahini, white beans and tofu.

Vitamin D is required to optimise calcium absorption. Vitamin D is the sunshine vitamin, synthesised on your skin during sun exposure. Many of us don’t get enough sunlight throughout the year, so I generally recommend a good quality supplement. Food sources include: fatty fish (such as tuna, salmon, and mackerel), beef liver, cheese, and egg yolks.

Vitamin B complex

B vitamins play an essential role in the regulation of mood and impact psychological imbalances, particularly depression. This effect is related to the production of serotonin, and tryptophan metabolism. B vitamins are therefore particularly helpful if you suffer from headaches, irritability, tiredness or depression. Good food sources of vitamin B include avocado, banana, legumes (dried beans, chickpeas, lentils, soya, etc), beef and pork, poultry, nuts and whole grains.

Magnesium

Magnesium keeps your electrolytes in balance, so when you don't get enough, you retain water. You can get magnesium from cooked leafy greens or, as those with premenstrual sweet cravings will be happy to hear, dark chocolate.

Some individuals who suffer from PMS can also be dealing with endometriosis, fibroids, polycystic ovarian syndrome (PCOS), and premature ovarian failure (POF), and other fertility issues. If you believe that you have a more complex hormone imbalance, you could arrange a full consultation with a nutritionist. Some nutritionists will be able to order any necessary hormone tests and create a bespoke nutrition, supplement and lifestyle programme for you.