36 PMS-Symptoms: How to Reduce Them Naturally

Article based on scientific studies

PMS | When | How Long | Symptoms | Reduce | Food | Supplements | PMDD

PMS is an actual condition whose symptoms can interfere with daily life causing significant physical and psychological discomfort.

In this article, you will learn everything about the symptoms of PMS and get practical tips on how to reduce these symptoms naturally.

What Is PMS (Premenstrual Syndrome)?

Premenstrual syndrome (PMS) is a constellation of mood, behavioral, and physical symptoms that occur in a cyclical pattern before menstruation (Mishra et al. 20221).

At least 80-90% of women experience signs of PMS at some point (Fatemi et al. 20192).

According to studies, 47.8% of women of reproductive age worldwide suffer from symptoms of PMS (Direkvand-Moghadam et al. 20143).

When Do PMS Symptoms Start?

Initial PMS symptoms may appear after ovulation (Kwan et al. 20154).

How Long Do PMS Symptoms Last?

PMS symptoms can last until the last day of menstruation.

Therefore, premenstrual syndrome spans from ovulation through the luteal phase to the next cycle’s menstrual phase (Gudipally et al. 20225).

The range of PMS signs can generally be divided into physical and psychological symptoms and up to six subcategories.

Physical PMS-Symptoms

We can divide the body-related symptoms of premenstrual syndrome into subgroups depending on whether they are primarily related to pain, swelling, or appetite.

Cramps and Pain

Physical symptoms characterized by pain include (Kwan et al. 20156):

  • Breast pain, swelling, and tenderness (premenstrual mastalgia)
  • Headache (migraine)
  • Back pain
  • Pain in general
  • Cramps in the abdomen
Pain in the abdomen is one of the symptoms of PMS

Swelling

Physical symptoms associated with bloating include (Kwan et al. 20157):

  • Bloating and swelling of the abdomen
  • Weight gain
  • Edema of the arms and legs
  • Water retention

Nausea and Cravings

PMS symptoms around appetite include (Kwan et al. 20158):

  • Increased appetite
  • Cravings (for carbs)
  • Nausea

Emotional and Behavioral PMS Symptoms

The psychological symptoms of premenstrual syndrome can be divided into subgroups depending on whether they are primarily related to depression, anxiety, or behavior.

Depression

Fall into the subcategory of PMS signs related to emotions and mood (Fathizadeh et al. 20109Kwan et al. 201510):

  • Depression and isolation
  • Loneliness
  • Avoidance of social activities
  • Crying
  • Sadness
  • Mood swings
  • Dejection
  • Anger outbursts
  • Forgetfulness
  • Confusion
  • Lack of concentration

Anxiety

Psychological PMS symptoms around anxiety include (Fathizadeh et al. 201011Kwan et al. 201512):

  • Tension
  • Nervousness
  • Restlessness
  • Irritability
  • Anxiety

Fatigue and Sleep

Psychological symptoms associated with behavioral and sleep problems include (Kwan et al. 201513):

  • Dizziness
  • Fatigue
  • Increased energy
  • Insomnia
  • Hypersomnia
  • Accident proneness
  • Decreased performance
  • Altered sexual interest
fatgue and decreased performance are PMS symptoms

PMS vs. Pregnancy Symptoms

Signs of early pregnancy may resemble those of PMS. Here are the main features that distinguish pregnancy from PMS (Anderson et al. 202214Gudipally et al. 202215):

  • Cramping: Pain occurs in the lower abdomen/back and is less intense.
  • Breast swelling: The breast tissue feels fuller and heavier. The swellings occur one to two weeks after conception and may last longer. If the texture of the nipples changes, this is a sign of pregnancy.
  • Appetite: cravings are often much more specific and limited to individual foods, not sweets in general.
  • Nausea: Morning sickness is a classic symptom of pregnancy.
  • Mood swings: Changes in emotions can last until the end of pregnancy, being more extreme in their outbursts, such as euphoria or crying.
  • Fatigue: Elevated progesterone levels can cause fatigue during pregnancy, sometimes even lasting until birth.
  • Bleeding: When pregnancy symptoms are present, the bleeding is usually much less than your regular period. The light bleeding never turns into a flow in most cases.

Although women may have light bleeding during pregnancy, the absence of a period is the most prominent symptom of pregnancy that should prompt a pregnancy test.

However, not all missed or delayed periods are due to pregnancy. In any case, if a pregnancy test is negative but your period is one to two weeks overdue, it is advisable to see your trusted doctor.

Causes of PMS

Study results suggest that women with PMS are sensitive to the cyclical fluctuations of their reproductive hormones, leading to mood, behavioral, and physical symptoms (Halbreich 200316).

Precisely what causes PMS, researchers do not yet agree. However, several factors may contribute.

Hormones

Because PMS symptoms occur with the hormonal fluctuations of the menstrual cycle, a disproportionate increase in estrogen before ovulation or an excessive decrease in progesterone in the late luteal phase are hot candidates for causes.

The effect of progesterone on neurotransmitters such as serotonin may influence PMS symptoms.

In addition, estrogen levels, which fluctuate during the luteal phase, are most likely responsible for mood swings.

The drop in estrogen causes a decrease in the neurotransmitters dopamine and serotonin, which leads to insomnia, fatigue, and depression, which are common symptoms of PMS (Gudipally et al. 202217).

Inflammation

Researchers in California have found that the following PMS symptoms are significantly related to elevated levels of inflammation in the body (Gold et al. 201618):

  • Abdominal cramps
  • Back pain
  • Bloating
  • Breast pain
  • Cravings
  • Mood swings
  • Weight gain

Consequently, we should not be surprised that it is precisely pro-inflammatory foods that are another factor in causing PMS.

Diet

In a study of 1699 female college students, exciting correlations between PMS symptoms and diet were revealed. In particular, female students who suffered from PMS symptoms consumed more of the following foods than their peers (Cheng et al. 201319):

  • Sugary drinks
  • Desserts
  • Fruits
  • Fast food
  • Fried food
Junk food may exacerbate premenstrual syndrome

While PMS in this study was more likely to be associated with a history of smoking, female college students without PMS symptoms consumed alcohol and caffeine insignificantly more often.

In addition, other studies have also shown that consumption of sugary drinks is closely related to PMS symptoms (Rossignol et al. 199120).

Furthermore, another study of female college students supports the negative impact of junk food and sweet-tasting foods such as bananas and dates on PMS symptoms (Bu et al. 202021).

How to Reduce PMS Symptoms Naturally

Besides stress reduction, nutrition is an essential lifestyle factor that regulates hormone balance and reduces inflammation.

For this reason, here, you will find the best and worst foods for PMS. On top of that, based on recent studies, I have elicited why some diets may be beneficial in alleviating PMS symptoms.

Best Foods for PMS

A woman’s menstrual cycle and its impact on premenstrual syndrome are characterized by fluctuating estrogen and progesterone levels.

Therefore, below you will find the best natural foods to relieve PMS symptoms depending on the cycle phase.

The first main phase of the female cycle is the follicular phase. It can be divided into the menstrual phase and proliferation phase as follows.

Attention: The first signs of PMS start with ovulation in the middle of the cycle or only in the luteal phase afterward. They usually disappear again within a few days after the onset of menstruation (Gudipally et al. 202222).

Menstrual Phase (Day 1-4)

Menstruation defines the first days of the female cycle. During this time, there is an additional need for the following micronutrients:

While magnesium has been shown to help with PMS symptoms such as cravings, depression, and anxiety (Fathizadeh et al. 201023), omega-3 fatty acids from Ocean may work better against period cramps than ibuprofen (Zafari et al. 201124).

Last but not least, iron is useful. Since women excrete an average of half a liter of iron per year during menstruation, they are correspondingly more likely to suffer from iron deficiency than men (Weinberg 201025).

The bottom line is a selection of foods that can supply all three micronutrients in excellent balance:

Salmon and beef are the right diet for PMS symptoms

Proliferation Phase (Day 5-13)

The second section of the follicular phase is the only period when any symptoms cannot be attributed to premenstrual syndrome. However, estrogen levels rise sharply during the proliferation phase, a sensitive issue.

In addition to the cycle itself, estrogen regulates female curves, fat distribution, mood, and in some cases, even memory function (Delgado et al. 202126Shors et al. 200327).

Therefore, unbalanced estrogen levels can lead to depression, insomnia, or brain fog.

Accordingly, you should ensure that your estrogen levels remain in balance during the proliferation phase. Fortunately, one of the most effective ways to regulate estrogen levels is diet.

When it comes to healthy estrogen levels, one type of all-rounder combines all the positive effects: cruciferous vegetables. These include, in particular:

  • Cauliflower
  • Broccoli
  • Kale
  • Cabbage
  • Brussels sprouts

Cruciferous vegetables contain as many as three active compounds that can naturally regulate estrogen levels:

  • Indole-3-Carbinol (I3C): These plant compounds can help remove excess estrogen from the body. Studies even suggest that cruciferous vegetables may protect against hormone-dependent cancers such as breast cancer in women (Michnovicz et al. 199132).
  • Dietary fiber: Although cabbage vegetables are generally low in carbohydrates, they are rich in dietary fiber, which helps to lower estrogen levels while progesterone levels remain unaffected (Rose et al. 199133).
  • Phytoestrogens: Lignans in cruciferous vegetables may block estrogen action in some tissues and increase SHBG, which regulates estrogen levels. In addition, the antiestrogenic effects may help reduce the risk of hormone-related cancers, such as breast, uterine, or ovarian (Wang 200234).

Other good sources of these phytoestrogens are flaxseeds and berries.

In addition, polyphenol-containing beverages such as green tea, red wine, and even coffee provide lignans that may be beneficial during the proliferation phase.

Ovulation (Day 14)

While some women do not even notice their ovulation, others experience the first PMS symptoms during ovulation. These include, in particular, cravings, breast pain, or bloating during ovulation (Kwan et al. 201531).

Fortunately, even these early signs of premenstrual syndrome can be alleviated with the right foods. The following nutrients are crucial in this regard:

  • Proteins
  • Healthy fats
  • Vitamin B6

Whole foods with a large load of proteins and healthy fats are the first choice to stimulate the release of the satiety hormones cholecystokinin, peptide YY, GLP-1, or leptin  (Perry et al. 201232).

Low leptin levels and high sugar consumption and other carbohydrates are usually the cause of PMS-related cravings (Krishnan et al. 201633).

If you experience PMS symptoms around ovulation, which may be due to water retention, vitamin B6 is that micronutrient that can help you (Fathizadeh et al. 201034).

In addition to bloating and abdominal discomfort, vitamin B6 can help with breast pain and tenderness in particular (Shobeiri et al. 201535).

In summary, a few foods again stand out as being able to both fight cravings and maximize vitamin B6 intake:

  • Salmon (*)
  • Eggs (*)
  • Chicken liver (*)
  • Beef (*)
  • Pistachios (*)

In addition to the numerous animal foods, pistachios are an excellent vegan option for early PMS symptoms. On the one hand, they are rich in healthy fats and proteins, and on the other hand, just one cup of pistachios can provide the entire daily requirement of vitamin B6 (*).

Luteal Phase (Day 15-28)

Cramps, mood swings, depression, low mood, insomnia, or headaches are more common during the luteal phase.

You can prevent this full range of PMS symptoms by additionally focusing on the following foods:

  • Magnesium
  • Anti-inflammatory foods

Researchers were able to find elevated inflammatory markers in 20 women who suffered from premenstrual syndrome, especially in the middle and toward the end of the luteal phase (Koshikawa et al. 199236).

Alongside this, other studies show that women struggling with PMS symptoms often have low magnesium levels (Facchinetti et al 199137).

This could be why some women are craving chocolate (cocoa) when experiencing PMS. Hence, the appetite is often less about satisfying a sweet tooth and more about the mood-regulating effects of magnesium.

Research shows that women who take magnesium and vitamin B6 experience less premenstrual depression, anxiety, and cravings (Fathizadeh et al. 201038).

Fatty fish is ideal for PMS

Because they contain magnesium, protein, healthy fats, and other anti-inflammatory nutrients, following foods combat cravings and other PMS symptoms during the luteal phase:

  • Mussels (*)
  • Halibut (*)
  • Salmon (*)
  • Cocoa nibs (*)
  • Almonds (*)
  • Pistachios (*)
  • Walnuts (*)

Seafood is on top of this list for a reason. Marine omega-3 fatty acids are not only anti-inflammatory but more effective against period cramps than common medications (Zafari et al. 201139).

While nuts have fewer anti-inflammatory properties than fatty fish, they impress with abundant magnesium and vitamins B6 and E, which help combat PMS symptoms (Fathizadeh et al. 201040Shobeiri et al. 201541).

Raw cacao nibs offer a standout mix of magnesium, potassium, iron, vitamin B6, fiber, healthy fats, and protein (*).

However, don’t reach for conventional chocolate. Most chocolates below 90% cocoa contain surprising amounts of sugar.

For example, chocolate with 72% cocoa is 26% sugar (*), which you should avoid if you have PMS.

PMS Foods to Avoid

Since premenstrual syndrome goes hand in hand with inflammation in the body, it is essential to avoid foods that promote inflammation (Gold et al. 201642).

Sugar is one of the most pro-inflammatory foods out there. If you suffer from PMS symptoms, avoiding sugar from ovulation to the menstrual phase can make all the difference.

Researchers have found that the fructose in sugar increases the hunger hormone ghrelin, supporting cravings (Teff et al. 200443).

In addition, numerous studies have shown that consumption of sugary drinks and foods is closely related to PMS symptoms (Rossignol et al. 199144Cheng et al. 201345Bu et al. 202046).

However, foods and beverages sweetened with sugar and other refined carbohydrates promote inflammation in the body (Buyken et al. 201447).

Refinement means that foods have been separated from natural fiber, widely processed, and preserved.

Accordingly, here is a summary of these pro-inflammatory foods:

  • Bread
  • Pasta
  • Crackers
  • Tortillas
  • Cookies
  • Cakes
  • Pretzels
  • Juices
  • Sodas (coke etc.)
  • Sports drinks
  • Energy drinks
  • Sweetened tea and coffee beverages

Refined seed oils are equally pro-inflammatory (Marchix et al. 201548).

Therefore, for a healthy female cycle, it is crucial to avoid the following oils, fried foods, and especially hydrogenated trans fats such as margarine:

  • Safflower oil
  • Peanut oil
  • Corn oil
  • Canola oil
  • Cottonseed oil
  • Soybean oil
  • Sunflower oil
  • Sesame oil
  • Grapeseed oil
  • Partially hydrogenated oils

Last but not least, alcohol cannot be utterly unmentioned among the worst foods for PMS symptoms. It distracts the liver from other metabolic or detoxification tasks, such as eliminating excess estrogen, which serves a hormonal balance.

Best Supplements for PMS

If you’ve been reading my blog for a while, you know I’m not a big fan of supplements. Ultimately, they often have sugar, multiple sweeteners added, and questionable bioavailability.

Therefore, even if you experience PMS, you should prefer natural foods from fatty fish to cruciferous vegetables to nuts.

If you still want to turn to supplements due to severe PMS symptoms, here are the best options on the current market (affiliate links):

organic pms supplements

Your body can absorb the anti-inflammatory omega-3 fatty acids EPA and DHA even better from krill oil than fish oil (Ulven et al. 201149). And according to studies, regular fish oil already combats period cramps better than ibuprofen (Zafari et al. 201150).

On top of that, krill oil can help build muscle.

The combination of magnesium and vitamin B6 has been shown in research to be the all-around nutritional supplement for PMS symptoms (Fathizadeh et al. 201051).

In addition to B6, vitamin E supplementation has also been shown to counteract breast pain, one of the first occurring PMS symptoms (Shobeiri et al. 201552).

In the women’s supplement listed above, the two vitamins are complemented by other vitamins and minerals, which could be beneficial during menstruation.

Keto and Intermittent Fasting

For various reasons, a ketogenic diet is suitable for relieving PMS symptoms. The best foods to naturally regulate hormone balance for a healthy cycle have one thing in common: plenty of healthy fats!

In contrast, the worst foods for PMS contain large amounts of carbohydrates. In summary, we get a low-carb, healthy-fat (LCHF) diet like the keto diet.

It has also been shown to boost memory function while reducing inflammation in the body (Krikorian et al. 201253).

Similarly, numerous studies show that interval fasting can also lower inflammatory markers (Faris et al. 201254).

Moreover, a ketogenic diet can alleviate the most classic PMS symptoms by inhibiting the release of the hunger hormone ghrelin, thereby curbing cravings (Sumithran et al. 201355).

Similarly, a study on uncontrolled eating behavior showed that intermittent fasting reduces cravings and depression after only two months. Furthermore, fasting positively affected the participants’ body perception (Hoddy et al. 201556).

Another common feature of both diets is the increased release of BDNF, a neuronal growth hormone in the brain (Jamshed et al. 201957Hu et al. 201858).

For this reason, some people on both keto and fasting often report improved concentration.

A study conducted on 14 women, which showed that intermittent fasting could significantly improve sleep quality and concentration, supports this thesis (Michalsen et al. 200359).

The bottom line is that these are all excellent arguments for stopping constant snacking and preferring healthy fats to carbohydrates to prevent PMS symptoms naturally.

PMDD (Premenstrual Dysphoric Disorder)

In rare cases, more severe PMS symptoms may occur, referred to as premenstrual dysphoric disorder.

In this 5% to 8% of women, symptoms significantly limit personal, social, professional, or sexual life.

PMDD is classified as a depressive disorder. For it to be diagnosed, at least 5 of the following 11 symptoms must be severe (Mishra et al. 202260):

  • Depressed mood, feelings of hopelessness, or self-deprecating thoughts
  • Anxiety, tension, or nervousness
  • Anger, irritability, or increased interpersonal conflict
  • Affective lability
  • The subjective feeling of being out of control
  • Decreased interest in usual activities (e.g., hobbies)
  • Difficulty concentrating
  • Fatigue or lack of energy
  • Insomnia or hypersomnia
  • Change in appetite, overeating, or cravings
  • Physical symptoms, such as weight gain, chest pain, headaches, joint pain, or muscle pain

In addition, PMDS symptoms must be related to the menstrual cycle and not just a worsening of symptoms from another condition.

For this reason, you should see a doctor you trust if you can’t relieve your PMS symptoms naturally so that they severely affect your health and daily life.

The Takeaway

The premenstrual syndrome describes physical and psychological symptoms that can significantly limit daily life.

These symptoms are primarily due to fluctuations in reproductive hormones during the female cycle and their effects on serotonin.

Lifestyle factors, first and foremost diet, are the first port of call for managing PMS. A low-carbohydrate, high-fat diet helps regulate hormone levels in various ways, alleviating premenstrual syndrome symptoms.

Likewise, intermittent fasting can improve blood sugar, inflammation, cravings, lack of concentration, and sleep quality.

Intermittent fasting can also improve blood sugar, inflammation, food cravings, lack of concentration, and sleep quality.

Learn how to improve your quality of life with my new book Intermittent Fasting 16/8 for Women: Achieve Hormone Harmony to Lose Weight Fast Without Losing Your Mind – Incl. 30-Day Fasting Challenge and Meal Plan.

When natural remedies fail to relieve PMS symptoms and these significantly limit daily life, it’s time to seek professional help.

Severe PMS symptoms may require a more comprehensive treatment approach from the doctor you trust.

Reduce PMS Symptoms Naturally FAQ

How early do PMS symptoms start?

Early PMS symptoms can start around ovulation.

What are the 150 symptoms of PMS?

There are physical, emotional, and behavioral PMS symptoms divided into pain, depression, anxiety, fatigue, craving, and swelling-related subgroups – find the complete list in this article.

What happens 5 days before your period?

Progesterone and estrogen levels drop five days before your period, which might cause severe PMS symptoms.

How can I stop PMS?

Reducing stress, carbohydrates, and sugar and eating foods with omega-3 fatty acids, magnesium, and vitamins B6 and E can reduce PMS symptoms naturally.

Studies click to expand!

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38Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. PubMed PMID: 22069417; PubMed Central PMCID: PMC3208934.

39Zafari M, Behmanesh F, Agha Mohammadi A. Comparison of the effect of fish oil and ibuprofen on treatment of severe pain in primary dysmenorrhea. Caspian J Intern Med. 2011 Summer;2(3):279-82. PubMed PMID: 24049587; PubMed Central PMCID: PMC3770499.

40Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. PubMed PMID: 22069417; PubMed Central PMCID: PMC3208934.

41Shobeiri F, Oshvandi K, Nazari M. Clinical effectiveness of vitamin E and vitamin B6 for improving pain severity in cyclic mastalgia. Iran J Nurs Midwifery Res. 2015 Nov-Dec;20(6):723-7. doi: 10.4103/1735-9066.170003. PubMed PMID: 26793260; PubMed Central PMCID: PMC4700694.

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51Fathizadeh N, Ebrahimi E, Valiani M, Tavakoli N, Yar MH. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010 Dec;15(Suppl 1):401-5. PubMed PMID: 22069417; PubMed Central PMCID: PMC3208934.

52Shobeiri F, Oshvandi K, Nazari M. Clinical effectiveness of vitamin E and vitamin B6 for improving pain severity in cyclic mastalgia. Iran J Nurs Midwifery Res. 2015 Nov-Dec;20(6):723-7. doi: 10.4103/1735-9066.170003. PubMed PMID: 26793260; PubMed Central PMCID: PMC4700694.

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56Hoddy KK, Kroeger CM, Trepanowski JF, Barnosky AR, Bhutani S, Varady KA. Safety of alternate day fasting and effect on disordered eating behaviors. Nutr J. 2015 May 6;14:44. doi: 10.1186/s12937-015-0029-9. PubMed PMID: 25943396; PubMed Central PMCID: PMC4424827.

57Jamshed H, Beyl RA, Della Manna DL, Yang ES, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans. Nutrients. 2019 May 30;11(6). doi: 10.3390/nu11061234. PubMed PMID: 31151228; PubMed Central PMCID: PMC6627766.

58Hu E, Du H, Zhu X, Wang L, Shang S, Wu X, Lu H, Lu X. Beta-hydroxybutyrate Promotes the Expression of BDNF in Hippocampal Neurons under Adequate Glucose Supply. Neuroscience. 2018 Aug 21;386:315-325. doi: 10.1016/j.neuroscience.2018.06.036. Epub 2018 Jun 30. PubMed PMID: 29966721.

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60Mishra S, Elliott H, Marwaha R. Premenstrual Dysphoric Disorder. 2022 Jan;. PubMed PMID: 30335340.

Mag. Stephan Lederer, MSc. is an author and blogger from Austria who writes in-depth content about health and nutrition. His book series on Interval Fasting landed #1 on the bestseller list in the German Amazon marketplace in 15 categories.

Stephan is a true man of science, having earned multiple diplomas and master's degrees in various fields. He has made it his mission to bridge the gap between conventional wisdom and scientific knowledge. He precisely reviews the content and sources of this blog for currency and accuracy.

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