PMS is a familiar 3 letter acronym among menstruating women. It stands for premenstrual syndrome and it is characterized by a wide array of symptoms that you typically experience on a monthly basis up to 2 weeks prior to the start of your period.

According to the Mayo Clinic, 75% of menstruating women have experienced at least one symptom of PMS at some point during their monthly cycle and 10% of women have a severe form of PMS called, premenstrual dysphoric disorder (PMDD).

The Symptoms of PMS

By the time your period arrives, it is common for the symptoms of PMS to completely disappear. The symptoms of PMS can be debilitating and require time lost from employment and in some cases medication. Over 200 symptoms have been identified as PMS-related. This chart lists some of the most common ones.

The Physical Symptoms of PMS Include: The Emotional Symptoms of PMS Include:
• Back pain

• Abdominal cramps

• Acne

• Breast tenderness

• Joint pain

• Constipation and diarrhea

• Headache

• Fluid retention

• Mood swings

• Depression

• Anxiety

• Food cravings

• Irritability

• Fatigue

• Insomnia

• Low Libido

The cause of PMS is not clear which has lead scientists and medical professionals to believe that the likely cause is a multitude of interrelated factors that involves your hormones, nutrients and stress. The good news is that there are natural therapies and dietary strategies that may help reduce the severity of your symptoms or eliminate your symptoms altogether.

Nutritional Considerations for PMS

There are some foods that may make your premenstrual symptoms worse whereas some foods may help alleviate your PMS symptoms.

Foods to Avoid

A common strategy is to eliminate alcohol, salt, caffeine and sugar. If it seems impossible for you to avoid these foods altogether try to focus the elimination on the second part of the monthly cycle, after ovulation. This part of your cycle corresponds to the rise of estrogen and progesterone in preparation for pregnancy. If pregnancy doesn’t occur, these hormones drop and menstruation begins.

How can these foods make PMS worse? Salt can cause fluid retention. Alcohol and caffeine can cause dehydration and disturbed sleep patterns. An excess of refined sugar can contribute to mood changes.

Foods to Include

A balanced diet that includes adequate protein, a variety of vegetables and fruit, fibre and carbohydrates is the first place to begin to prevent and treat PMS. Eating regular, small meals throughout your day will keep your blood sugar and insulin levels stable. Spikes in your insulin and in blood sugar can worsen PMS symptoms such as fluid retention.

I encourage my patients to focus on calcium-rich foods such as organic grass fed cow or goat milk dairy, almonds, sardine and dark green leafy vegetables; magnesium-rich foods such as whole grains, nuts, avocado, and legumes and iron rich foods such as calf liver, eggs, beans, grass-fed meat, and organic, unsulphured black strap molasses.


Women who exercise regularly are less likely to suffer from severe PMS. Exercise increases chemicals known as endorphins which contribute to a positive mood and less fatigue. Weight lifting specifically has also been shown to increase testosterone which may improve sexual desire. Women with a high body mass index (BMI) are also more likely to experience PMS.

Regular exercise may help you to reduce your body fat, increase muscle mass and of course balance your mood and hormones.

Chaste Tree/Berry (Vitex agnus-castus)

Chasteberry extract is a common herbal remedy which has been used for centuries to treat PMS. It is a plant native to the Meditteranean which is thought to increase progesterone and reduce PMS symptoms such as anxiety and breast tenderness. In one placebo controlled, randomized study, the PMS symptoms were reduced by 50% in the 170 women studied. Remember that before you take an herbal remedy it is always a good idea to check in with your health care provider.

B Complex

The B vitamins play an important role in production of chemicals known as neurotransmitters that affect mood such as serotonin and dopamine. B6 supplementation has been shown to improve irritability and depression symptoms. Other B vitamins that are important include B1 (thiamine), B9 (folate) B3 (niacin), and B12 (methylcobalamin).

I often suggest that patients take a supplement that contains a full complement of the B vitamins. Red meat and whole grains, dark green leafy vegetables, fish and poultry are good sources of the B vitamins.

There are many natural strategies that can be applied to successfully reduce the severity of your PMS symptoms. It can take a few cycles to notice a difference; therefore the key is to be persistent with the changes that you make and to consult with a naturally minded health care practitioner, such as a naturopathic doctor or holistic nutritionist who can provide helpful advice and guidance.

Dr. Olivia Rose
About the Author

Dr. Olivia Rose is a naturopathic doctor and a registered acupuncturist with a family practice located in the Beaches area of Toronto. She graduated from the University of Guelph with a Bachelor of Science Honours degree in Nutritional and Nutraceutical Sciences. In 2006, she graduated from the Canadian College of Naturopathic Medicine where she completed 4 years of study and a clinical internship at the Robert Schad Naturopathic Clinic and at the Sherbourne Health Centre where she worked with patients afflicted with HIV/AIDS and Hepatitis C.

Olivia is also the director of Fertility Acupuncture Services, a program that brings acupuncture to couples undergoing in vitro fertilization and intrauterine insemination in Toronto fertility clinics. In practice, her special areas of interest include stress management, heart disease, digestive health, infertility, pediatrics and weight management.

In her free time, when she is not at the spa or spending time with her husband and tea-cup Yorkie, Dr. Rose guest lectures at corporate events, local groups and schools. She is featured regularly as a health expert on Global Toronto’s “News at Noon”. For more information on Dr. Rose's practice and upcoming events please visit,