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What to eat to ease the pain of PMS: Dr MEGAN ROSSI on the meals for that time of the month 

Did you know that diet can affect how women feel at that time of the month?

I don’t just mean that craving for chocolate or other sweet things. But what you eat can have a direct impact on your symptoms, including mood and gut symptoms — meaning there are things you can do to reduce them.

Up to 50 percent of women report having premenstrual syndrome (or PMS) to varying degrees.

More than 150 symptoms have been associated with PMS, which broadly fall into two categories: emotional (eg, irritability, insomnia) and physical (eg, bloating and headache).

Strictly speaking, to be diagnosed with PMS, according to the American College of Obstetricians and Gynecologists (the standard is generally used worldwide), symptoms must begin in the five days before a period of at least three menstrual cycles in a row, end within four days after a menstrual period begins and interfere with some normal activities.

More than 150 symptoms have been associated with PMS, which broadly fall into two categories: emotional (e.g., irritability, insomnia) and physical (e.g., bloating and headaches)

More than 150 symptoms have been associated with PMS, which broadly fall into two categories: emotional (e.g., irritability, insomnia) and physical (e.g., bloating and headaches)

But even if you don’t meet all of these criteria, I think most of us definitely notice some physical and psychological changes leading up to and in the early days of our periods.

The good news is that there’s plenty of evidence to show that diet and lifestyle can really help alleviate those symptoms. And especially the Mediterranean diet seems to make a difference.

For example, a study published in the journal Nutrients found that women who followed the Mediterranean diet were less likely to suffer from PMS (according to the above criteria) compared to those who typically ate higher amounts of processed foods, red meat, etc. (55 percent vs. 74 percent).

Another study, published in 2020 and involving more than 300 university students from Spain, found that women who ate less than two pieces of fruit a day were three times more likely to have menstrual cramps, while those who consumed olive oil daily had significantly lighter periods.


This sweet treat contains the anti-inflammatory benefits of olive oil and appetite-satisfying fiber, plus prebiotics that feed our gut bacteria.

Serves 10

l 200 g white chocolate

l 2 tsp extra virgin olive oil

l 50 g dark chocolate (70 percent plus)

l 50 g dried mango

l 50 g ground pistachios

Melt the white chocolate in the microwave for 40 to 60 seconds, stirring quickly every 15 seconds. Stir in the olive oil. Pour the mixture onto a baking tray lined with baking paper, spread it out thinly and sprinkle over the fruit and nuts. Place in the fridge for a few minutes to set.

Meanwhile, in a separate bowl, melt the dark chocolate in the microwave (stirring again every 15 seconds).

When the white chocolate mixture is firm, drizzle over the dark chocolate with a fork. Place in the fridge or freezer until they are rock hard, then take them out and break them into pieces. Enjoying!

The Mediterranean diet is rich in a range of plants and omega-3 fatty acids (found in the fish and nuts found in this diet).

Omega 3 fatty acids have an anti-inflammatory effect, which is why they are so good for our brains, hearts and gut bacteria, and may help explain such findings.

This anti-inflammatory effect is also important for mood – and let’s face it, this is probably the symptom most of us think of when we talk about PMS.

And researchers are increasingly thinking that mental health problems like depression are linked to inflammation.

PMS is also worse in women who are stressed (which can also increase inflammation levels in the body).

This explains why studies show that de-stressing techniques, including yoga, mindfulness, and exercise, can significantly reduce the severity of PMS.

Indeed, a study published last month found that women with PMS who used a mindfulness app for eight weeks significantly reduced their emotional and physical symptoms compared to those who did not receive mindfulness education.

But probably one of the most common monthly symptoms is menstrual poop — or diarrhea. This happens because of the effect of hormone-like chemicals called prostaglandins.

Just before your period, the cells in the uterus produce more prostaglandins, which act on the smooth muscles, causing them to contract and shed the endometrium.

But guess what? Your gut also has smooth muscle and this contracts more, speeding up the movement of food through the digestive system, with that tell-tale effect, menstrual poo, starting one or two days before your period – although for about a quarter of women it lasts for one or two days. or two days after their period has started.

These contractions also contribute to menstrual pain.

Prostaglandins are part of the body’s inflammatory response. Therefore, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help with menstrual pain because they block the effects of prostaglandins.

Of course, your diet cannot control this process of smooth muscle contraction, but some of the things you consume can make it worse.

These include caffeine, alcohol, spicy and fatty foods, all of which stimulate the gut muscles.

This leads to faster food transit and thus less time for nutrient absorption, leading to looser stools.


Blueberries and black beans are full of the plant chemical (or phytochemical) anthocyanin, which is associated with better brain function and memory.

So avoiding these foods and drinks a few days before your period can reduce the effect of menstrual poop.

Just like eating smaller and more frequent meals – dividing what you would eat in three meals into five or six.

This puts less pressure on the gut, avoids the ‘dumping’ effect and supports your body to maximize nutrient absorption.

You can also try reducing your intake of foods high in FODMAP a few days before your period.

As a reminder, FODMAPs — or fermentable oligosaccharides, disaccharides, monosaccharides and polyols — are carbohydrates found in a wide variety of foods.

Because they are poorly absorbed in the small intestine, they end up in the large intestine.

This, in turn, draws more water into your gut (due to those poorly absorbed nutrients).

Going low-FODMAP means cutting back on wheat, barley and rye-based foods, some sugars (including honey and sweeteners), beans, and some fruits (e.g. apples and peaches) and vegetables (broccoli, garlic, mushrooms) — there are plenty of good swaps on my website,

Most of us will also get breakouts around the time of our period, and unfortunately I can’t wave my magic wand in front of your skin.

I’ve never been able to avoid this problem either and I think it’s just one of those things you have to accept.

As for those chocolate cravings, these are believed to be related to fluctuations in your hormones leading up to your period (known as the luteal phase).

Your diet doesn't affect this smooth muscle contraction process, but some things you eat can make it worse, including caffeine

Your diet doesn't affect this smooth muscle contraction process, but some things you eat can make it worse, including caffeine

Your diet doesn’t affect this smooth muscle contraction process, but some things you eat can make it worse, including caffeine

These changes can affect chemical messengers in your brain, such as serotonin.

This is one reason we may be driven to those high-carb foods (chocolate coated anyone?); “self-medicating” with food to boost our serotonin levels — and, in turn, our mood — is incredibly common.

And while there’s nothing wrong with taking chocolate therapy, as you may have experienced, it can be hard to stop at just a few pieces.

Try my prebiotic chocolate bark instead (see recipe). It only takes five minutes to make and in addition to that all-important sweet hit, it packs the anti-inflammatory benefits of olive oil and the appetite-satisfying effects of the prebiotics and fiber.

These feed our gut bacteria, and changes in our gut bacteria, you might not be surprised to hear, are now being linked to PMS as well.

Ask Megan

I have been diagnosed with prostate cancer and after a course of radiotherapy I have just had my six-monthly hormone shot – which I will receive for the next two years. I am 75.5 ft 11 in and weigh 17 st. I have gained a stone and a half, but know that I have to lose at least 3 sts. I estimate I only eat/drink about 1,400 calories a day and I try to walk 5,000 steps a day, but I can’t lose weight. Any advice?

Mike Bowker.

Congratulations on completing the radiotherapy course – that can be difficult.

Hormones can definitely play a role in weight management, but the good news is that with a few adjustments to your diet, you should still be able to reach your happy weight.

Instead of counting calories to reach your goal, my number one piece of advice would be to include more vegetables in your breakfast, lunch, and dinner.

They feed your gut bacteria that can help regulate your appetite hormones (keeping you fuller for longer) and can even affect how your body stores fat.

For breakfast, try grating carrot into some oatmeal along with your fruit (it tastes like carrot cake).

Try using two cups of salad or one and a half cups of vegetables for lunch and dinner (frozen vegetables are a good option and can be mixed with bolognese sauce, curries, etc.).

Ideally I would also replace cold cuts (eg sausage rolls) with a boiled egg, regular fish (fresh, frozen or canned) or a can of pulses, eg chickpeas or butter beans. Let me know how you get on it.