Prevention: What you do with your body during the weeks and months before your period can influence how your body handles the hormone roller coaster.
Move more. Ideally, move until you sweat for thirty minutes and then do it again five days each week. But if you can't quite do that, keep steadily increasing your exercise. Women who exercise regularly are less likely to have symptoms of PMS, says the University of Maryland Medical Center.85
If you smoke, quit. Women between the ages of twenty-seven and forty-four who smoke are twice as likely to develop PMS, according to a study published in the American Journal of Epidemiology.86
Try a low-fat diet. Studies have linked higher dietary fat, especially diets high in saturated and trans fats, with higher prostaglandin levels, which cause PMS aches and pains.87
Become a vegetarian. Women following a low-fat vegetarian diet significantly reduced menstrual pain and PMS symptoms, according to a study conducted by the Physicians Committee for Responsible Medicine with Georgetown University's Department of Obstetrics and Gynecology.88
Check out possible food allergens, including dairy, wheat (gluten), soy, corn, preservatives, and food additives.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy), or beans for protein. Use healthy cooking oils, such as olive oil or vegetable oil.
During the Premenstrual Week: While the following are good things to do regularly, they can help even if you wait until the premenstrual week to do them.
Decrease your consumption of salt, caffeine, alcohol, artificial sweeteners, and sugar. You don't have to suffer; just pick one thing to reduce or eliminate for a month or two to see if it makes a difference.
Stay hydrated. Drink six to eight glasses of water a day and/or get some liquid from your fruits, veggies, and other foods. Water flushes toxins and can help reduce bloating.
Increase your calcium intake. Eat calcium-rich foods, including beans, almonds, and dark green leafy vegetables, such as spinach and kale. Calcium-enriched soy milk helps with symptoms of PMS. (See more about supplements below.)
Move. Yes, I'm repeating myself. Movement/exercise raises serotonin and balances dopamine and norepinephrine (all mood neurotransmitters). It stabilizes a broad range of variables, toning down the ripple effect of shifting hormones. Push through the inertia and get the payoffs from moving.
Medications: Your doctor or medical team may prescribe or suggest the following medications:
Diuretics for bloating and water retention.
Ibuprofen (Advil, Motrin) and naproxen (Aleve), which are nonsteroidal anti-inflammatory drugs (NSAIDs) that help with headaches, cramps, and levels of the inflammatory prostaglandins.
Antidepressants to relieve many mood symptoms, especially if your emotions overtake you. Working with a doctor experienced with these medicines can help you find the one that's right for you.
Birth control pills to stop ovulation and keep hormone levels stable.
Supplements: For the one or two of us who don't have perfect diets, these supplements can be helpful to our brains on PMS:89
Multivitamins. Choose one containing the antioxidant vitamins A, C, and E; the B-complex vitamins; and trace minerals, such as magnesium, calcium, zinc, and selenium.
Calcium. If you don't get enough in your diet, several studies suggest that taking 500 to 1,000 mg calcium citrate daily and 400 IU vitamin D daily. These may reduce PMS symptoms and are also good for your bones.
Magnesium. Take 400 mg daily. Magnesium is a calming mineral and a muscle relaxant, which makes it good for cramps. It may also reduce breast tenderness, bloating, migraines, and fluid retention. High doses of magnesium can lower blood pressure and may cause loose stools.90You can get some magnesium in greens, halibut, nuts such as almonds and cashews, sesame seeds, flax, and whole grains. And there's some in chocolate, too.
Omega-3 fatty acids, such as fish oils. One or two capsules daily of about 1,050 mg of EPA and 150 mg of DHA or one tablespoonful of oil helps reduce menstrual cramps (per University of Maryland Medical Center) and internal inflammation.91 Omega-3s may also prevent or alleviate bloating and improve brain function, which contributes to mood balance and emotional health.92Talk to your doctor if you're taking any blood-thinning medication.
Herbs: Herbs have been used for millennia as natural medicines, which means they are medicines. They can interfere with other pharmaceutical medications and may have side effects. Let your doctor know what herbs you're thinking of taking and ask his or her opinion.
Herbs come in many formats including pills, teas, tinctures, and liquid extracts. Make sure you have a standardized extract with consistent potency in each dosage.
Chaste tree or chasteberry (Vitex agnus castus) may help reduce symptoms of PMS, including headache, irritability, and breast tenderness, say several studies. Take 400 mg daily before breakfast. It may interfere with medications, such as birth control pills, antipsychotics, and estrogen supplements. If you have a hormone-sensitive condition, such as endometriosis or breast cancer, check with your doctor before taking.
Dandelion (Taraxacum officinale) leaf tincture, 5 to 10 mL taken two or three times a day, will help with the fluid retention associated with PMS. You can also prepare teas from the leaf. Dandelion can interact with a number of medications, including lithium and some antibiotics, and can cause a reaction in persons allergic to ragweed.
Black cohosh (Actaea racemosa), 20 to 40 mg, two times a day, is sometimes suggested to reduce PMS symptoms, though scientific evidence doesn't consistently support its effects. Black cohosh may interact with a number of medications. If you have a history of hormone-related conditions or of liver or kidney disease, ask your doctor before taking black cohosh.
Evening primrose oil (Oenothera biennis), 500 to 1,000 mg daily, is a source of gamma linolenic acid (GLA); you can convert about 5% of it to the longerchain omega-3 oils our brains need. It may increase the risk of bleeding. Although some clinical trials have shown a benefit of evening primrose oil for PMS, the best-designed trials found no effect.
St. John's wort (Hypericum perforatum), 300 mg taken two to three times per day may relieve the depression associated with PMS. St. John's wort interacts with a number of other medications and herbs, especially birth control pills. It must be taken consistently throughout the month for best results. Direct sun exposure may cause rashes in some people taking it.
Emotional Care: You can help with PMS by learning to respond differently to your emotional reactions, instead of just blasting those who bug the hell out of you.
Psychological acupressure. Techniques such as the Emotional Freedom Technique (EFT) and Tapas Acupressure Technique (TAT) can help you release body tension and habitual patterns of emotions before you blow up. They’re described in chapter 7.
Body care. Use this time to be gentle and loving with your body, indulging in a longer bath, taking an extra yoga class, or getting someone to rub your back—try a little massage roller ball.
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