Sugar and spice and everything nice? What about breast pain, bloating, weight gain and acne? Or cramping, headaches, food cravings and mood swings? When it comes to describing that aspect of womanhood known as premenstrual syndrome (PMS), nice isn't exactly the first word that pops to mind.
Common might be the word that better describes this complex of problems brought on by fluctuating hormone levels. About half of all American women between the ages of 20 and 50 have PMS, and upward of nine in ten women may experience at least some of its symptoms. But even though PMS brings on many kinds of discomfort, luckily there are also plenty of treatments.
Finding the best ones for you, however, may take some experimenting. PMS seems to be affected by stress, doctors say, and they agree that diet may be a large factor. So if the up-and-down symptoms of PMS are all too familiar, you might begin by looking at what's on your menu.
Get the saturated fat off your plate. Eating a lot of fatty foods will increase PMS symptoms and pain, according to Guy Abraham, M.D., a PMS researcher in Torrance, California, and former professor of obstetrics and gynecologic endocrinology at the University of California, Los Angeles. It helps to avoid fatty cuts of beef, lamb and pork. Better yet, substitute poultry and fish. And replace butter (which is high in saturated fat) with polyunsaturated oils such as flaxseed, corn and safflower, suggests Dr. Abraham.
Go without salt. "People don't realize that foods with a high salt content can contribute to water retention," says Susan Lark, M.D., medical director of the PMS and Menopause Self-Help Center in Los Altos, California.
Most snack foods and other processed foods are high in salt--and some fast-food meals can be extremely high. So stay away from these foods if you're going on a low-salt diet, suggests Dr. Lark. Also, some boxed cereals and many condiments are higher in salt than many people realize. So read labels on packaged and processed foods, and whenever possible, choose fresh fruits and vegetables.
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Counter the cravings with carbohydrates. Food cravings are common during PMS, and often those cravings focus on sweets and snacks such as ice cream, chocolate and potato chips. But you'll do yourself a favor if you can switch to other kinds of fare when you get the cravings.
"Eating complex carbohydrates such as whole grains, pasta, cereal and bagels is probably the best way to ward off food cravings experienced during PMS," says Dr. Lark. These foods also are a good source of fiber, which helps clear excess estrogen from your body, according to Dr. Lark. (High levels of the hormone estrogen have been shown to contribute to PMS.)
Eating high-carbohydrate, low-sugar foods provides another benefit as well, according to Judith Wurtman, Ph.D., a researcher at the Massachusetts Institute of Technology in Cambridge. She has found that cereal and other high-carbohydrate foods actually relieve the psychological symptoms of tension, anxiety and mood swings that accompany PMS.
Dr. Wurtman suggests having a heaping bowl of unsweetened cereal when you get hungry. (Reminder: Read the package label first, and choose a low-salt variety.) "It works like Valium," says Dr. Wurtman. In general, she has found, women who have PMS are more alert and happier when they eat high-carbohydrate foods rather than high-protein, low-carbohydrate foods.
Go for locomotion. When your mood takes a walk on the wild side, take a walk. "Exercising has been found to significantly reduce many physical and psychological PMS symptoms," says Ellen Yankauskas, M.D., director of the Women's Center for Family Health in Atascadero, California. That's because exercise releases endorphins, brain chemicals that ease pain and produce a sense of well-being. And in PMS sufferers, that means less crying and anxiety. Exercise has also been shown to help reduce breast tenderness, food cravings, fluid retention and depression.
"It's best to exercise at least three times a week, even when you don't have PMS," she says. "Walking is the exercise I recommend, because weight-bearing exercises help keep bones strong." She suggests going out for at least 12 minutes, though 30 minutes or more is even better.
Screen out foods with caffeine. If you happen to be caffeine-sensitive (and some people are more so than others), then you should avoid coffee, tea, colas and chocolate, according to Annette MacKay Rossignol, Sc.D., professor and chairman of the Department of Public Health at Oregon State University in Corvallis. Studies have suggested that the risk of PMS is between two and seven times greater in women who consume two or more cups of coffee or tea each day, according to Dr. Rossignol. Caffeine is a stimulant and can contribute to anxiety and irritability. Caffeine may also contribute to painful breast tenderness.
Read labels on pain relievers. Since caffeine can worsen PMS symptoms, you should make sure any pain relievers you take are caffeine-free. "You have to be a label reader," says Dr. Yankauskas. An over-the-counter pain reliever that contains caffeine can actually make your PMS symptoms worse.
Stay on the wagon. Alcohol is a depressant and diuretic that can worsen PMS headaches and fatigue and can accentuate depression, adds Dr. Yankauskas.
For this reason, it's advisable to avoid drinking any alcoholic beverages, including wine or beer, when you've been having trouble with PMS, according to Dr. Yankauskas.