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Health Protocols

Premenstrual Syndrome (PMS)

Dietary and Lifestyle Considerations


Foods containing high amounts of simple sugars or salt may promote bloating and weight gain, and should be avoided (Alvero 2014). Some authors have theorized that consuming more complex carbohydrates during the luteal phase may increase serotonin levels and improve symptoms of PMS (Nevatte 2013). Women suffering from PMS should avoid caffeine and alcohol because they may exacerbate PMS (Rossignol 1990; Alvero 2014).


Four small studies examined the impact of exercise on PMS signs and symptoms; all of them found benefit. Breast tenderness, fluid retention, stress, anxiety, depression, muscle stiffness, cramps, tension, and restlessness improved in these trials (Dennerstein 1985). In a study comparing aerobic exercise (60 minutes, 3 times a week for 8 weeks) to no exercise in women with PMS, women who exercised had significant reductions in physical and psychological symptoms of PMS (Samadi 2013).

Stress Management

Managing stress may help reduce PMS symptoms (Alvero 2014). Speaking with friends or writing in a journal may help some women cope with stress. Additionally, yoga, massage, or relaxation therapy may be useful (OWH 2012; ACOG 2001). Adequate rest and sleep may improve response to treatment (Alvero 2014; NIH 2007). A more thorough discussion about strategies to manage stress is available in the Stress Management protocol.