What Are Common PMS Symptoms?

Each woman will experience PMS differently, however, the most common PMS symptoms include the following:

• mood swings
• feeling upset, anxious, or irritable (moodiness)
• Tiredness, restlessness, or trouble sleeping
• bloating or stomach pain
• breast tenderness
• headaches
• spotty skin
• greasy hair
• changes in appetite and sex drive
• Cramping

PMS symptoms can start a week or even 2 weeks before your period begins and can last up to 7 days.

Why Do Some Women Get Worse PMS Symptoms Than Others?

Determining what to take for PMS will depend greatly on your unique PMS symptoms. No two women share an identical experience of PMS, we’re all different and so are our cycles.

Speaking with Dr. Shweta Shah MBBS, MS- Obstetrics & Gynecology, she states that “There are a variety of factors that can contribute to why some women experience worse PMS symptoms than others. Hormonal imbalances, nutritional deficiencies, stress, and even certain medications can all play a role in exacerbating PMS symptoms.”

Furthermore, Dr. Shah explains that “some women may be more sensitive to hormonal changes during their menstrual cycle, underlying health conditions, such as anxiety or depression, can contribute to the severity of PMS symptoms. If you're struggling with particularly severe PMS symptoms, it's best to talk to your doctor to see if there are any underlying causes that can be addressed. In the meantime, there are some lifestyle changes that may help to lessen the severity of your symptoms, such as exercising regularly, eating a balanced diet, and getting enough sleep.”

Are There Any Risk Factors For PMS to be Aware Of?

Yes, there are a variety of risk factors that may contribute to the development of PMS as well as its severity. Dr. Shah mentioned the following factors as contributors:

• Age: Women in their late twenties and early thirties are more likely to experience PMS than older women.
• Reproductive history: women who have never been pregnant or who have had fewer pregnancies are more likely to experience PMS than those who have had more pregnancies
• Family history: Women with a family history of PMS or other mood disorders are more likely to develop PMS themselves.
• Diet: Women who consume a diet high in salt and fat, sugar, and caffeine have been linked to an increased risk of developing PMS
• Smoking: Women who smoke and consume alcohol are more likely to develop PMS.
• Psychological factors: women who are under a lot of stress or have a history of depression or anxiety are more likely to experience PMS than those who do not.

Are There Any Vitamins That Help With PMS?

Lately, we’ve seen a lot of questions about vitamins and PMS; do they help? I asked Anisa Woodall, MS CN, for her thoughts on vitamins and PMS and she shared that “PMS is often related to a state of estrogen dominance, high estrogen in relation to progesterone in the second half of the menstrual cycle.

Excess estrogen may result from Overweight/obesity, Peri-menopause (surges of estrogen), Diabetes, PCOS, Estrogen supplementation (ERT), Poor liver clearance, Gut Dysbiosis, Environmental xenoestrogens (BPA and plastics), Alcohol, Ovarian cysts, Stress, and Inflammation.”

She continues explaining that “some key nutrients essential in helping the body to metabolize excess estrogen include, but are not limited to vitamin B12, vitamin B6, folate, and magnesium. I usually recommend these in food form as they are more bioavailable through food.”

Of course, not everyone has the time, budget, or knowledge to obtain their essential vitamins and minerals through the foods they eat, which is where adding vitamins, minerals, and other supplements to your diet can play a critical role in your PMS symptoms and your overall health.

Dr. Greg Marchand MD, FACS, FACOG, FICS finds that “a daily women’s multivitamin is a great idea to make sure you aren’t deficient in anything.”

We recommend finding a women’s multivitamin that contains key essential nutrients for women between the ages of 18-49, like Ritual’s Women’s Multivitamin, as it contains the necessary nutrients for menstruating women.

Can a Vitamin Deficiency Make PMS Symptoms Worse?

According to Dr. Marchand, “absolutely!  A deficiency of any vitamin, or even some electrolytes like potassium can definitely make symptoms worse.”

Dr. Shah adds that “There is some evidence that certain vitamin deficiencies can make PMS symptoms worse. For example, a lack of vitamin B6 has been linked to increased levels of the hormone prolactin, which can cause breast tenderness and other PMS symptoms. Vitamin D deficiency has also been linked to an increased risk of premenstrual dysphoric disorder (PMDD), a severe form of PMS.”

This is why focusing on eating a nutrient-dense, macro-balanced diet and potentially supplementing with a women’s multivitamin is so crucial not only to your menstrual health but also to your overall health and well-being.

What Should Women Take for PMS Besides Vitamins?

For Dr. Marchand’s patients, “the mainstays of therapy for PMS are going to be acetaminophen, ibuprofen, and aspirin.  For some women, caffeine can also be an important part of treatment as it can fight bloating and tiredness. Other commonly used medications to fight PMS include antidepressants and birth control pills, but these require a prescription.”

He also adds that“a lot of supplements combine a lot of good stuff that can help with PMS symptoms.”

There are many PMS medications and supplements available that contain herbs and other ingredients that have been shown in studies to be effective for the relief of various PMS-related symptoms. Our list of the top PMS vitamins includes some of the best available options.

How Does Nutrition Play a Role in PMS Symptoms?

There’s no question that our nutrition is vital for nearly every function of our bodies, so it goes without saying that it plays a role in our menstrual cycle and any symptoms we may experience as well.

Speaking with Anisa Woodard, who has her Master’s in Clinical Nutrition and Dietetics, recommended the following when it comes to nutrition and PMS:

“When trying to manage PMS symptoms and hunger/sugar cravings associated with it, the main focus should be placed on balancing blood sugar with anti-inflammatory foods with the additional aim of having foods they truly enjoy. From a preventative perspective, women should be maximizing the nutrient density of their diet and optimizing liver clearance of estrogen.”

She continued to say that “Women should avoid having sources of pro-inflammatory, refined and ultra-processed seed and vegetable oils such as corn, soybean, grapeseed, canola, etc and avoid sources of refined grains such as cakes, cookies, crackers, pastas, etc as they can spike blood sugar drastically. Women should reduce alcohol intake, ideally avoiding alcohol altogether for optimal hormone health. They should also be mindful to reduce overall toxic load, especially plastic use and BPA exposure (found also in receipts) to reduce the burden of these xenoestrogens on the liver.”

Overall, a sensible, balanced diet that’s full of nutrient-dense whole foods and free of junk and artificial ingredients is going to take you a long way not only with your PMS but with your overall health and wellness.

Should You Try Products Marketed as “PMS Supplements?”

If you’re skeptical about trying a PMS supplement, we don’t blame you. The supplement industry is largely unregulated and there’s, unfortunately, a lot of misinformation and junk out there to weed through.

I asked Dr. Shah’s thoughts on the topic and she shared that “there is no one-size-fits-all answer to this question, as the effectiveness of PMS supplements depends on a variety of factors. However, some research suggests that certain supplements may be helpful in reducing the symptoms of PMS.” 

“For example, one study found that taking calcium and vitamin D supplements reduced the severity of PMS symptoms by up to 50%. Other research has shown that taking a daily multivitamin may also help reduce the symptoms of PMS. Additionally, some herbal supplements, such as chasteberry and St. John's wort, have been shown to be effective in treating the symptoms of PMS.”

She adds that “it is important to speak with a healthcare provider before taking any supplements, as they may interact with other medications. Additionally, it is important to be aware that the FDA does not regulate supplements, so there is no guarantee of their safety or effectiveness. Therefore, it is important to only purchase supplements from reputable sources.”

What About Natural PMS Remedies?

If you’re on the fence about starting a PMS supplement, there are several natural remedies that you can implement into your monthly routine in an attempt to diminish your PMS symptoms and find more ease during your time of the month. Dr. Shah recommends that you try the following:

• Herbal teas: chamomile or ginger tea can help to soothe stomach cramps, while lavender tea can help to reduce stress and anxiety.
• Supplements: taking a calcium supplement can help to relieve cramps, while vitamin B6 can help to reduce bloating and water retention.
• Diet changes: eating more complex carbohydrates like whole grains can help to regulate blood sugar levels and reduce mood swings while cutting back on salt can help to reduce bloating.
• Exercise and relaxation techniques such as yoga or meditation can also be helpful.
• Relaxation - Try taking a warm bath with lavender oil or drinking chamomile tea.

“Of course, every woman is different and what works for one may not work for another. It’s important to experiment to find what works best for you. Try incorporating some of these techniques into your routine and see how they work for you,” says Dr. Shah.

What to Do When All Else Fails

Unfortunately, even with dietary changes, pain relievers, PMS vitamins and supplements, and natural tips and tricks, some women continue to deal with debilitating PMS symptoms month after month. If you feel as though you’ve tried everything but are still dealing with your symptoms, Dr. Marchand recommends that you go see your doctor.

“Severe PMS needs treatment.  For some women that can be antidepressants or hormonal birth control, and for some women, it makes sense to use birth control injections or different patterns of taking birth control pills to make periods disappear altogether.  I would encourage any women whose symptoms are severe enough to interfere with their quality of life to see their doctor. Above all, women should know that these symptoms are very common and you are not the only one going through this.”

Final Thoughts on What to Take for PMS

Knowing what to take for PMS symptoms isn’t as cut and dry as we’d like it to be. For some women, a couple of aspirin on their crampiest day will do the trick. For others, a PMS supplement or daily women’s multivitamin might decrease the occurrence of symptoms. And others might need to seek professional advice from their doctor for severe, life-altering symptoms.

The point is that each and every woman is unique, and we should be approaching our PMS care with the knowledge that it will likely take some time and experimentation to determine what works best for you. Our experts all agree that making healthy lifestyle choices and ensuring you’re getting proper nutrition is universally accepted as step one for managing your PMS. From there, you have a ton of options to explore and choose from.

PMS might be inevitable, but we don’t have to grin and bear it month after month. Having the knowledge and resources to optimize your nutrition, supplements and lifestyle might help you to reduce symptoms and feel your best all month long.