What is premenstrual syndrome?
Premenstrual syndrome (PMS) is a collection of physical and psychological symptoms that occur before menstruation and resolve shortly following its start.1 The most common symptoms include fatigue, bloating, and irritability.1
While the cause of PMS has yet to be elucidated, there are certain risk factors known to increase the likelihood of experiencing PMS. These predisposing factors include heredity, obesity, stress, and a diet lacking in certain nutrients (calcium, magnesium, and B6).2,3
The treatment of PMS focuses mainly on symptom relief. 1 Certain lifestyle modifications, such as getting sufficient rest and following a healthy diet, can help alleviate PMS symptoms.1
In practice
- Premenstrual syndrome is a very common condition that may be alleviated with certain lifestyle modifications, such as following a healthy diet.
- Dairy products have been associated with a lower risk of developing PMS and milder symptoms.
- The benefits of dairy have been attributed in part to its high calcium and vitamin D content, two nutrients that have demonstrated beneficial effects on managing PMS.
Premenstrual syndrome: the role of dairy
Research suggests that certain foods, such as dairy, may be particularly beneficial for PMS. In the Nurses’ Health Study that followed over 20,000 women, those who consumed more low-fat milk products were less likely to develop PMS.4 Dietary calcium and vitamin D intakes (but not calcium or vitamin D supplements) were associated with reduced PMS. Much like in the general Canadian population, this American sample’s main source of calcium and vitamin D was dairy products.4,5
Dairy’s role in reducing PMS have been attributed in part to its high content in certain micronutrients. 6, 7 Notably, dietary calcium and vitamin D have demonstrated benefits on the frequency and intensity of PMS symptoms.
Premenstrual syndrome: Dairy’s key micronutrients
Calcium. In 2020, a systematic review of 13 studies that included 2,645 participants indicated that individuals with PMS had lower levels of calcium in their blood.6 In patients with PMS, calcium supplementation had beneficial effects on symptoms, such as anxiety, fatiguability, and water retention.6 These findings are supported by a second systematic review including 8,576 women that linked a calcium-rich diet to milder PMS symptoms.7
A clinical trial found that women who were in the group who consumed the daily recommended amount of dietary calcium (1,000 mg) by incorporating milk, cheese, and yogurt had significant improvements in PMS symptoms after 2 months.8
Vitamin D. Increasing interest is being dedicated to the relationship between vitamin D and PMS. A 2019 systematic review including 8,576 women found that lower vitamin D levels were linked to an increased risk of PMS and more severe symptoms.7,9 A Canadian study of 998 women associated low vitamin D levels with an increased likelihood of experiencing certain symptoms, such as cramps, fatigue, and anxiety.10 Emerging evidence suggests that vitamin D supplements may be helpful in attenuating these symptoms.7,9
References
- UpToDate. 2021. Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics). Accessed July 5, 2021.
- Milewicz A and Jedrzejuk D. Premenstrual syndrome: from etiology to treatment. Maturitas 2006;55:S47-S54.
- Yonkers KA et al. Premenstrual syndrome. The Lancet 2008; 371 :1200-1210.
- Bertone-Johnson ER et al. Calcium and vitamin D intake and risk of incident premenstrual syndrome. Arch Intern Med 2005: 165;1246-1252.
- Vatanparast et al. Calcium Intake from Food and Supplemental Sources of Decreased in the Canadian Population from 2004 to 2015. The Journal of Nutrition 2020; 150:833-841.
- Arab A et al. Beneficial Role of Calcium in Premenstrual Syndrome: A Systematic Review of Current Literature. International journal of preventive medicine 2020;11. doi: 10.4103/ijpvm.IJPVM_243_19.
- Abdi F et al. A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstetrics & gynecology science 2019: 62; 73-86.
- Yurt M et al. Effect of dairy products intake in women with premenstrual syndrome: a randimozed controlled trial. Progress in nutrition 2020: 22;137-145.
- Arab A et al. The Association Between Vitamin D and Premenstrual Syndrome: A systematic Review and Meta-Analysis of Current Literature. Journal of the American College of Nutrition 2019: 38;648-656.
- Jarosz AC et al. Association between vitamin D status and premenstrual symptoms. Journal of the Academy of Nutrition and Dietetics 2019: 119; 115-123.
