female_health

PMS / PMDD Support

75% of menstruating women experience some PMS; 3-8% meet PMDD criteria. Combined lifestyle + (if PMDD) SSRI or oral contraceptive reduces severity > 60%.

Nutrition

Pattern

Mediterranean + low-sodium luteal phase

Foods to emphasise

Complex carbs (oats, sweet potato) — serotonin precursor
Leafy greens (magnesium)
Fatty fish (omega-3)
Calcium-rich foods
Berries

Foods to limit

Sodium in luteal phase (bloating)
Caffeine (anxiety + breast tenderness)
Alcohol (worsens mood)
Ultra-processed

Exercise

Aerobic

150 min/wk; rated #1 lifestyle intervention for PMS.

Strength

2-3×/wk.

Flexibility

Yoga in luteal phase; reduces cramps + bloating.

Weekly target

150 minutes

Supplements

Calcium

1200 mg/day

RCT

Best PMS evidence.

Vitamin B6 (P5P form)

50-100 mg/day

RCT

Do not exceed 200 mg long-term (neuropathy).

Magnesium glycinate

200-400 mg/day

RCT

Chasteberry (Vitex)

20-40 mg/day

RCT (mixed)

Some PMS + breast pain benefit; avoid with hormonal contraceptive.

Monitor + cadence

What to track

Symptom diary across 2-3 cycles (PMDD diagnosis requires luteal-phase pattern)
Functional impairment
Suicidal ideation in luteal phase

Red flags — seek care

Suicidal ideation cyclic in luteal phase → PMDD diagnosis + urgent SSRI consideration
Severe functional impairment → gynae + psych

Sources

ACOG Practice Bulletin 218 (2019)
RCOG Green-top 48 PMS (2017)

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