What Supplements can Help Ease Your PMS Symptoms? Mood, Cramps, and More

PMS is a regular part of the menstrual cycle for many people, and symptoms can range from mildly annoying to overwhelming and debilitating. Between mood fluctuations and physical discomfort, it’s not anyone’s favorite time of the month. Some diet and lifestyle changes might be able to provide some balance from the PMS rollercoaster, while some dietary supplements may also support comfort. Everyone is different in how they experience PMS, but one thing’s for sure: you aren’t alone in searching for healthy support.

What is PMS?

PMS is short for premenstrual syndrome. It refers to a collection of physical, physiological, and/or psychological symptoms that typically start a few to several days before a period is due. PMS usually ends within a few hours to one day after menstruation begins. Most people who experience PMS have it recurrently before each cycle.

PMS can vary in how strongly it affects you from one cycle to the next, but most who have it experience a consistent set of symptoms. It is usually managed based on the specific symptoms, how much they affect your everyday activities, and other health-related factors.

PMS is pretty common and affects between 80-90% of people who have regular menstrual cycles. Around 20% who experience PMS will find that it is disruptive to daily activities, while the rest may only have mild or moderate symptoms.

Whether you experience PMS that makes it hard to function or you have a few mildly annoying symptoms, it’s natural to want to find ways to feel your best. Since PMS isn’t a disease, there isn’t really a way to cure it, but there are certainly things that can support the body to be more comfortable during hormonal fluctuations and menstrual cycle phases.

Consider these 13 supplements if you’re searching for healthy PMS support.

1. Calcium

Sure, calcium is best known for its bone health benefits, but it’s also a nutrient of importance for that time of the month. Research has found an association between lower serum calcium levels and PMS, and that calcium supplements had the potential to significantly improve PMS-related symptoms. In double-blind, randomized clinical research, 500 mg of calcium was found to be a helpful intake of this important mineral. The recommended dietary allowance (RDA) of calcium is 1,000 mg per day for menstruating adults, and even though it is found in many food sources, not everyone gets enough from food.

2. Magnesium

Like calcium, magnesium is a mineral that is associated with comfort during PMS. It supports healthy muscular contraction, nerve signaling, and cellular energy processes. While some research notes that low intakes aren’t linked as a cause or trigger of PMS, other research has found associations between lower serum magnesium and PMS symptoms.

The magnesium RDA for menstruating adults is between 310-320 mg. Magnesium is in many commonly consumed foods, but it is also a nutrient that many don’t get enough of. Magnesium supplements are widely available, but some research has found better PMS supportive effects when magnesium is taken together with vitamin B6.

3. Vitamin B-6

Speaking of vitamin B6, this member of the B-complex family is a cofactor for a hundred enzyme reactions in the body. Because of this, it plays a role in neurotransmitter synthesis, which may be why research has found that it can help with PMS-related symptoms like mood changes, irritability, forgetfulness, and nervous tension. While the best quality research on vitamin B6 and PMS has come from a small trial of only 94 people, the results yielded statistically significant improvements.

If you want to try B6 for PMS, the research protocol involved taking 80 mg every day for three menstrual cycles. As noted above, it may work best when you pair it with magnesium. You can also get vitamin B6 from foods like chickpeas, tuna, salmon, potatoes, and bananas.

4. Omega-3 Fatty Acids

You may have heard that omega-3 fatty acids are beneficial for supporting heart health. These essential fatty acids (EFAs) may also be great for helping support comfort during PMS. A meta-analysis found that omega-3s could help reduce PMS symptom severity, both the physical discomforts and the mood-related changes. The analysis noted that greater benefits were found the longer that omega-3s were consumed, however, there didn’t seem to be a single mechanism for the improvements. More research has to be done to fully understand a cause and effect relationship between the two.

Still, omega-3s have an extensive list of health-supporting properties. The richest food sources are cold-water fatty fish like salmon, mackerel, tuna, sardines, and herring. Fish oil is one of the most commonly consumed types of dietary supplements.

5. Vitamin E

Vitamin E is a fat-soluble antioxidant vitamin that is widely noted for its beneficial effects for reproductive health. It can also help with PMS symptom relief, supporting both physical and mood-related comfort.

Vitamin E is found in foods like sunflower seeds and nuts, and is often included in prenatal and multivitamin formulas. You can also take standalone vitamin E.

6. Chasteberry

Chasteberry, also known as Vitex, is an herb with a long history of use in Asia and the Mediterranean. It works best when taken consecutively across three menstrual cycles, and supports PMS comfort by positively impacting several PMS related symptoms:

• Bloating
• Hot flashes
• Mood changes and feelings of irritability
• Occasional sleep disturbances
• Uterine cramping

In clinical trials, chasteberry frequently outperforms placebo, and seems to work by two mechanisms:

• Modulates prolactin by having a similar effect to dopamine
• Supports beta-endorphins (which are neuropeptides) that tend to be low during PMS and play a role in pain perception and body comfort

7. Vitamin D

The sunshine vitamin plays a role in mood, and that includes PMS-related mood symptoms and quality of life. Researchers have found that low serum calcium and vitamin D levels could be a cause or a trigger for worse PMS symptoms compared to people whose levels were adequate. Other research has found that inadequate vitamin D status was associated with physical changes during PMS, including cramps and reduced libido. Another study of 300 college-aged people found that vitamin D deficiency was one of the most important contributing factors for PMS symptoms.

Most people can’t get enough vitamin D from food alone, and even sun exposure year-round is typically not adequate to support a stable vitamin D status. Dietary supplements that contain 15 mcg, or 600 IU, provide the RDA intake for this important nutrient.

8. Ginkgo Biloba

Ginkgo biloba is an herbal supplement made from the leaves of the tree that bears the same name. It is used primarily to support healthy cognition. Some older research found ginkgo to be beneficial for PMS-related breast discomfort and some neuropsychological symptoms, while more recent research noted that ginkgo was associated with reduced severity of both physical and psychological PMS symptoms.

Overall, there have not been any large-scale clinical trials looking at the impact of ginkgo on PMS, but the potential benefits likely stem from two types of bioactive compounds, flavonoids and terpenoids, that can scavenge free radicals and modulate platelet activity. More research is needed, and due to potential interactions, anyone who takes medications, is pregnant or could be, or who is lactating should not take ginkgo biloba.

9. St. John’s Wort

St. John’s Wort is an herbal supplement that has a highly effective mechanism of action. The primary bioactive compound, hypericin, seems to decrease the reuptake of serotonin and to a lesser extent dopamine and norepinephrine. It is often used to support a healthy outlook or mood, although individual responses can vary. Some research has found St. John’s Wort to be beneficial for mood variability that can occur during PMS, although more research is needed.

Because of its neurotransmitter activity potential and interactions with phase I liver enzymes, St. John’s Wort has a lengthy list of potential drug, supplement, and food interactions. On its own it has not been found to cause any liver-related side effects, but because it can alter the metabolism of other medications, it could affect how other compounds affect the liver. People who are pregnant, could become pregnant, are lactating, have any diagnosed conditions, or take any medications should not take St. John’s Wort unless directed to do so by a healthcare professional.

10. Evening Primrose Oil

Evening primrose oil, or EPO, is a supplement that is made from primrose seeds. It is a rich source of gamma-linolenic acid (GLA), an omega-6 fatty acid. While studies have looked at EPO for its impact on PMS, hot flashes, breast pain, and more, there is not broadly conclusive evidence that it has definitive mechanisms of action. The National Center for Complementary and Integrative Medicine notes that EPO is not more effective than placebo for breast discomfort, and when it comes to PMS, there is insufficient evidence for benefit. Other research notes that EPO may have some benefits for PMS, though results may not be felt until after 4-6 months of use.

11. Dong Quai

Dong quai, also known as angelica sinensis, is an herb used in Traditional Chinese Medicine (TCM). It is sometimes referred to as “female ginseng” and in TCM, is utilized as a tincture or natural support for PMS and many other hormone-related symptoms. Some research, mostly in animals, has found that phenolic compounds in dong quai can help with menstrual-related cramps, while other animal and in vitro studies have found that it stimulates contractions.

The message on dong quai for PMS is mixed. With no large-scale clinical trials, it’s hard to say whether dong quai might help with PMS comfort. But research has also generally found that dong quai is well-tolerated, although it should not be consumed by pregnant or lactating people because the effects in utero or how it passes through breast milk are unknown.

12. Black Cohosh

Black cohosh is a North American herb that has been used in indigenous medicine for centuries. In recent years interest has grown in the potential benefits for supporting hormone-related symptoms like hot flashes and mood. Anecdotal and small-scale research results have been published for more than 50 years, but larger studies and those that examine black cohosh’s impact on PMS symptoms have been largely inconclusive with no consistency in beneficial outcomes. A Cochrane review also found no definite evidence that black cohosh is beneficial for PMS, but notes that the compound still warrants future research.

Black cohosh may cause gastrointestinal discomfort as a common side effect. LiverTox gives black cohosh the highest rating for potential liver injury, although it notes that the specific component for toxicity is unclear. In several cases, black cohosh supplements were found to be a different herb altogether. Black cohosh itself may be safe, but ensuring that the supplements you take come from reputable, high-quality, third-party tested manufacturers is essential.

13. Zinc

Zinc is an essential dietary mineral that supports healthy immune function and even plays a necessary role in how well you can smell and taste. Zinc may also have benefits for PMS symptoms, since research has found an association between higher zinc serum and a reduced chance of PMS symptoms. It may take 12 weeks or longer to notice benefits, though.

The RDA for zinc is 8 mg for menstruating adults. Oysters, beef, and pumpkin seeds are particularly great food sources of this mineral. Zinc Supplements with 50 mg have been shown to potentially support PMS symptoms.

Best foods for PMS

So what should you eat (or not eat) when you want to minimize PMS symptoms? For starters, research shows that there is an association between diet and PMS symptoms. There’s also a link between alcoholic beverages, high-sugar foods, and the severity of PMS.

Support healthy muscular and mood comfort during the luteal phase with foods that provide calming nutrients (like calcium, magnesium, and vitamin B6), such as:

• Yogurt
• Kale
• Beans
• Tofu
• Bananas
• Turkey
• Whole grains
• Fortified cereals

Hydration is important, too, so make sure to drink plenty of fluids throughout the day.

Other PMS Questions

PMS comes around on a monthly basis for many, but there are some basics about it that may not commonly be known. Here’s what you need to know about PMS basics.

What are the symptoms of PMS?

Your PMS may look very different from someone else’s. PMS may also fluctuate over seasons or years to be more or less severe for a person. Because PMS is a syndrome, which is a grouping of possible symptoms, and not a clinical disease, it is not diagnosed like other disorders. PMS is usually recognized based on the timing of the menstrual cycle and the presence of one or more common associated symptoms, such as:

• Appetite changes and nausea (wanting to eat more or less, desiring certain types of food more strongly than at other times in the cycle, or having an intermittent upset stomach)
• Weight gain or bloating (typically, the weight that appears to be gained during PMS is not true weight gain, but is water retention or changes to how the gastrointestinal system functions for those few days to a week)
• Abdominal pain or discomfort (uterine cramping, intestinal discomfort, gas pains, etc.)
• Low back pain or discomfort (which can be associated with overall tense muscles, uterine cramping, or the intestines)
• Headache or neck tension (from hormone changes or fluid balance changes)
• Breast tenderness or changes (may occur in one or both breasts and can include aching, shooting pains, or mild swelling; leakage from the nipples or lumps are not PMS symptoms, so if you ever notice those, see your OBGYN right away)
• Bowel changes (constipation or diarrhea)
• Mood changes (irritability, sadness, annoyance, easy frustration, restlessness, tension, angst, and more)
• Fatigue (extra tiredness or lack of motivation, even if you get the same amount of sleep)
• Skin changes (skin breakouts or skin dryness)

What lifestyle choices make PMS worse?

While many menstruating people may experience mild forms of PMS monthly, some things may make PMS worse, including:

• Drinking too much alcohol
• Consuming too much coffee
• Dehydration
• Eating more processed foods or lots of sugar
• Poorly managed stress
• Not getting enough rest or quality sleep
• Too little physical activity

Minor dietary and lifestyle adjustments might make a big difference in how PMS affects you.

How do estrogen and progesterone levels affect PMS?

Estrogen levels can vary widely in menstruating people and still be considered normal, but some research has found that higher estrogen levels in the luteal phase may be associated with worse PMS symptoms. Similarly, lower progesterone levels leading up to menstruation may have an influence on severity of PMS.

How do neurotransmitters affect mood during PMS?

Neurotransmitters like gamma-aminobutyric acid (GABA), serotonin, and catecholamines are influenced by progesterone, which also plays a role in the luteal phase of the menstrual cycle. Some people naturally have lower levels of progesterone, while other factors can influence hormone levels, like age, reproductive history, genetics, stress load, and more. Overall, menstrual cycle hormone changes likely exert a stronger influence on neurotransmitters than the other way around.

Does tryptophan affect PMS symptoms?

Tryptophan is an amino acid that the body uses to synthesize serotonin in the brain. It can also be used when the brain makes melatonin, a naturally occurring hormone that helps balance the circadian rhythm. PMS symptoms that involve mood changes, tiredness, and sleep disruptions are influenced by progesterone and its effect on brain chemicals like serotonin.

Are there any natural ways to treat PMS?

Besides taking supplements, another way to balance PMS symptoms is with lifestyle changes. Finding healthy ways to manage feelings of stress and overwhelm may help to minimize PMS symptoms.

Support your overall well-being, hormone balance, and a positive outlook by getting back to the basics:

• Regular physical activity is a great way to alleviate stress, and yoga is especially helpful for PMS, mood balance, and muscular discomfort.
• Good quality rest, and a regular sleep schedule, are important for everyday health, but especially when you want to support resilience.
• Aromatherapy can be an effective way to unwind at the end of the day, especially if you feel tense. Warm baths or using a heating pad can also induce a spa-like relaxation if your muscles are tense.

Acupuncture and massage therapy may also be helpful therapeutic ways to alleviate PMS symptoms.

If your PMS symptoms feel overwhelming, make it hard to function, or get worse over time, talk to your medical provider.