Are there any dietary habits that could aggravate menstrual symptoms like pms, cramps etc?

A staggering 150 symptoms are now believed to form part of PMS. Among the most common are mood swings and irritability, anxiety and tension, bloating and water retention, breast tenderness and swelling, acne, tiredness, weight gain, headaches or migraines, crying spells or depression, sugar and food cravings, constipation and dizziness.

Using your diet
The most crucial dietary change you can make is to keep your blood-sugar levels steady: the higher your sugar intake the more severe your symptoms are likely to be. My advice is to cut out sugar completely. Don’t add it to drinks or cereal or anything else. Avoid sweet foods such as chocolate and refined foods such as white flour and watch out for hidden sugars by reading labels.

Another way to balance blood sugar is to eat a healthy meal or snack every three hours. This “little-and-often” approach prevents your blood-sugar levels from dropping excessively and stops your adrenal glands releasing adrenaline, which blocks the utilisation of progesterone in the second half of your cycle.

Which foods should women eat and which ones should they avoid during the different stages of the cycle to maximise energy levels?

To get the maximum benefit these dietary recommendations need to be done all month and not just premenstrually.

Foods to treat symptoms
Include unrefined starchy carbohydrates (whole grains, brown rice and oats and so on).  These can not only help keep your blood-sugar levels stable, they increase your energy, and boost levels of the calming brain chemical serotonin to lift your mood and curb food cravings.

 If you suffer from breast tenderness, cutting out caffeine (in coffee, black tea, green tea, chocolate, cola, decaffeinated coffee and some medications) will reduce your exposure to methylxanthines, the substances in caffeine that research shows increase problems with painful, lumpy and tender breasts.

To combat water retention limit your intake of salt and fatty foods and drink plenty of pure, filtered water – if you don’t drink enough, your body will think there is a shortage and try to retain any water you have.  

Period pains are caused by substances called prostaglandins. Many prostaglandins are healthy; however, some increase your body’s sensitivity to pain and can cause your muscles to spasm and are termed “bad” prostaglandins.

What you eat during the month can decrease or increase the levels of “bad” prostaglandins in your system. Cut down on caffeine (found in coffee, tea and chocolate) and saturated fat (found mainly in dairy and animal products) as they encourage the body to produce bad prostaglandins. Also, increase the amount of essential fats in your diet, from foods such as oily fish, as well as nuts and seeds (see supplements, below), as essential fats are vital for your body to produce good prostaglandins.

How can exercise affect menstrual symptoms and do you have any dietary tips to help manage this?

(For example, keep on top of your hydration levels by drinking lots of water during/after exercise to avoid making menstrual cramps, headaches etc worse)

You may feel so tired during the pre-menstrual period that you simply do not have the energy to exercise. However, it can be just what you need to feel invigorated and full of energy again. It can also help with PMS and menstrual symptoms.   The best option in this situation is to go for a long walk in the fresh air, which gives your brain and body the oxygen it needs to lift the feelings of fatigue.

If premenstrually or during your period you find it hard to sleep then try to exercise early in the day. Exercise can be enormously stimulating, and some women may find it difficult to sleep following a late session. Furthermore, vigorous activity delays melatonin secretion. If you exercise in the morning, you will reinforce healthy sleeping habits that lead to regular melatonin production.  Melatonin is a hormone secreted by the pineal gland in the brain which responds to light and helps to regulate the sleep cycle and may play a role in regulating the menstrual cycle.

It is now known that exercise can directly affect PMS. Women who engage in moderate aerobic exercise at least three times per week have significantly fewer pre-menstrual symptoms than sedentary women. Regular exercise also helps to improve your body’s ability to keep your blood sugar in balance which is especially important in eliminating pre-menstrual symptoms.

Exercise releases brain chemicals called endorphins, which help us to feel happier, more alert and calmer. These endorphins can have a dramatic and positive effect on the depression, stress and anxiety associated with PMS.

The importance of exercise to relieve stress, boost energy and create a sense of wellbeing is now thought to be an essential part of any treatment for PMS.

It seems also that the type of exercise you choose can make a difference to how beneficial it will be in reducing pre-menstrual symptoms. When comparing aerobic exercise to strength training, it has been found that while both types of exercise help with general pre-menstrual symptoms, aerobic exercise has the best effect on the most symptoms, particularly pre-menstrual depression.

And there’s more. Exercise not only has an antidepressant effect, but it also send blood surging through the tissues, supplying them with energy-generating oxygen. It helps to eliminate waste, which could encourage water retention, headaches and irritability. It also increases the ability of the body to keep the blood sugar in balance, which is so important in the prevention of pre-menstrual symptoms. Finally, working up a sweat increases the circulation and helps to optimise the functioning of the lymphatic system.

Is supplementation useful in the control of pre-menstrual and menstrual symptoms?

Certain nutrients can also be helpful to be taken on a daily basis and the most important ones for period pains are the Omega 3 fatty acids.  These vital nutrients provide the raw materials for the production of good prostaglandins.  Try to find one containing more than 700mg EPA and 500mg of DHA in two capsules (see NHP’s Omega 3 Plus from health food stores or go to www.naturalhealthpractice.com).  Also take a multivitamin and mineral containing good levels of the B vitamins (research has shown that the B vitamins can significantly reduce the intensity of period pains), vitamin E (which has been shown to reduce painful periods), magnesium (which acts as a muscle relaxant and your womb is a muscle) and zinc) which converts Omega 3 fatty acids into beneficial prostaglandins (see NHP’s Healthy Woman Plus). 

For the general PMS symptoms, herbs are brilliant. 

Agnus Castus is the herb of choice for premenstrual symptoms.  It has a balancing effect on the female hormones.  Its effects have even been compared to an anti-depressant for the severe form of PMS termed premenstrual dysphoric disorder and there was no statistically significant difference between how well the drug worked versus the herb.  When we have a natural solution that works equally well as the drug it seems logical to use the natural remedy. 

Black cohosh (Cimicifuga racemosa)

This herb is particularly helpful for the anxiety and tension symptoms of PMS and also headaches and migraines that occur premenstrually. 

Skullcap (Scutellaria lateriflora)

While the agnus castus is working on hormone balance, the skullcap together with the black cohosh has a calming effect on your body. 

Milk Thistle (Silymarin marianum)

This improves liver function. It is your liver that has to detoxify your female hormones so you want it to be working efficiently. 

(The organic combination of these herbs that I use in the clinic is NHP’s  Agnus Castus Plus (from health food stores or go to www.naturalhealthpractice.com)