9 Natural Ways to Minimize PMS Symptoms to Maximize your Training

Training days during the week before your period can be some of the most difficult to get your workout in. Bloating, low mood, and breast tenderness turn every move you make into a struggle. Luckily, there are several actions you can take to combat these symptoms for training sessions just like every other day. 

PMS Symptoms for Weight Lifting Resistance Training Exercise Featured Image Girl in Gym with Headphones

Bloating

How it affects performance:

Bloating on a micro level is excess fluid in your tissues outside your blood vessels. The excess fluid in your muscle cells prevents the muscle fibers from overlapping correctly and being able to pull against each other to contract.

The excess fluid throughout your body also means that your arms, legs, and entire body are simply heavier and therefore more difficult to move.

Why it happens:

Progesterone is particularly high at this time in your menstrual cycle.

Progesterone is similar in shape (but not in function) to another hormone in the body called aldosterone which tells your kidneys to keep sodium in your blood. When the similarly shaped progesterone is high, it gets in the way of aldosterone acting in the kidney and causes your kidneys to get rid of excess sodium from the blood [1,2].

When sodium in the blood is low but still higher in your muscles and tissues, extra water will push its way into the muscles and tissues causing bloating.

What to do about it:

Since the problem here is your body getting rid of a bit too much sodium, the solution is to increase your intake of sodium. 

Sodium, 300mg as needed

Sodium in Salt for PMS Symptoms Bloating for Weight Lifting Resistance Training Exercise

This is a very controversial idea since most major sources suggest decreasing sodium during this time to decrease bloating. Looking at the clinical research and based on human physiology, decreasing sodium during this time makes no sense.

I can only assume that this is so widely suggested because according to the American Heart Association, 90% of Americans eat significantly more than the maximum recommended intake of sodium and the average daily intake of sodium is close to double the recommended level for heart health.

So yes, this sky-high amount of sodium will cause bloating in anyone, anytime and the vast majority of people need to decrease the amount of sodium in their diet for way more important reasons than bloating.

But this doesn’t apply to the average competitive or amateur athlete who pays attention to the foods they are eating, mostly opting for whole foods which are naturally low in sodium and skipping highly processed and high sodium foods. 

So assuming you are actually regularly consuming somewhere between the recommended maximum 1500-2300mg of sodium daily, increasing your sodium intake by about 300mg of sodium during the week before your period will decrease bloating and make your muscles feel significantly less sluggish.

Beware though: this really only amounts to an extra 1/8th teaspoon of salt per day! Don’t overdo it.

Mood Symptoms

Depression, anxiety, irritability, poor concentration, fatigue, mood swings, brain fogginess, on and on. PMS causes a whole host of annoying mood symptoms, varying between people and between hours in some. 

How it affects performance:

Any physical training is mostly a mental game. Your body can do almost anything, it’s your mind you have to convince.

When these debilitating PMS mental symptoms hit, convincing yourself to do anything except sit on the couch and eat ice cream is a workout in itself.

Why it happens:

Dunno. Seriously. Many articles have pointed out that both estrogen and progesterone can interact and affect serotonin in the brain but no clear mechanism has been confirmed.

What to do about it: Omega-3s, Vitamin B6, Magnesium, Calcium

Important note: all of these effects on mood symptoms were found by taking the supplements every day throughout the entire cycle to prevent these symptoms. Unlike the sodium which is only on days of symptoms, these should be taken every day for effect. 

Omega 3 fatty acids, 1-2g daily 

Omega 3s in Salmon for PMS Symptoms Mood Swings Irritability Depression for Weight Lifting Resistance Training Exercise

Many, many well-done studies have shown significant effects of Omega-3 fatty acids helping all sorts of mood symptoms of depression and anxiety and especially in PMS [3,4].

Some articles have postulated that it has an anti-inflammatory effect in the brain, possibly causing better blood flow to the brain [5].

Nonetheless, the amount and quality of evidence on how well omega-3 fatty acids do in preventing the PMS mood symptoms is pretty conclusive that these help considerably.

You can take a supplement daily or commit to eating a full serving of fish 3-4 times per week. Three weekly servings of salmon amounts to about 1g of omega-3 fatty acids daily.

Vitamin B6, 50mg daily

Vitamin B6 in Poultry for PMS Symptoms Breast Tenderness Mood Swings Irritability Depression for Weight Lifting Resistance Training Exercise

Vitamin B6 had previously been studied in treating depression caused by progesterone oral contraceptive pills so it makes sense that it would also work for PMS when progesterone is naturally high.

A well-done review of many trials found that taking 50mg per day of vitamin B6 (pyridoxine) significantly decrease depression and irritability symptoms of during PMS time [6]. 

Vitamin B6 is found in a wide, wide variety of foods such as pork, poultry, fish, bread, wholegrains, eggs, vegetables, soya beans, peanuts, milk, and potatoes. 

It’s important not to overdo it here though. Eating more than 200mg daily of Vitamin B6 for an extended period of time can cause you to lose feeling in your hands and feet, possibly irreversibly.

Since most healthy diets already include a high proportion of foods high in B6, I’d advise increasing your intake of the foods above rather than taking a pill supplement of B6 to avoid taking too much of the vitamin. 

Magnesium, 200-250mg daily

Magnesium in Dark Chocolate for PMS Symptoms Irritability Mood Swings Breast Tenderness Depression for Weight Lifting Resistance Training Exercise

This trial was a double-blinded, randomized, placebo-controlled trial (which is the best kind of research that can be done and produces the most trustworthy data).

It showed that Magnesium had a significant effect on mood symptoms but also showed that a combination of Magnesium and Vitamin B6 had the biggest reduction in mood symptoms.

Of note, it also had a significant decrease in the placebo group (where participants received fake pills) but there was still a large, and statistically significant difference, between the effect of the placebo and the effect of Magnesium as well as Magnesium plus Vitamin B6.

Overall, this is very convincing evidence that Magnesium and Vitamin B6 really do help with PMS mood symptoms. [7]

Magnesium is found in dark chocolate, avocados, nuts, legumes, tofu, seeds, whole grains, fatty fish, bananas, leafy greens. Consider increasing intake of these foods, or supplementing is generally safe if you have healthy kidneys.

Calcium, 1g daily

Calcium in Cheese for PMS Symptoms Mood Swings Irritability for Weight Lifting Resistance Training Exercise

Calcium is also an effective supplement showing great results treating PMS irritability and depression. Many studies have shown significant effects of calcium, primarily with doses 1g-2g but even showing effect at 500mg. Effects are seen best after 3-4 cycles. [8]

Other than dairy products (such as cheese, yogurt, milk, and whey protein) which we all know contain high amounts of calcium, other foods will also contribute such as seeds, legumes, almonds, leafy greens, and soy.

One scoop of whey protein contains about 200mg of calcium which I would assume if you’re reading this blog you are already consuming this daily but there is further room for supplementation if you feel this may help.

Breast Tenderness

How it affects performance:

Swollen breasts are much harder to stuff into restrictive sports bras and the sore milk glands make this an even more painful process. In higher impact training, this pain can prevent some women from giving their all and performing their best.

Why it happens:

Progesterone, the hormone highest in the week before your period causes your milk ducts to swell, preparing for a possible pregnancy. This is why you may feel lumps in your breasts that go away as soon as your period starts. 

What to do about it: mild pain medicines, Vitamin B6, Magnesium, Vitamin E

Mild pain medicines, as needed

Tylenol Acetaminophen NSAIDs Aspirin Advil Ibuprofen for PMS Symptoms Breast Tenderness for Weight Lifting Resistance Training Exercise

The first thing I would try is taking some Tylenol and/or an NSAID pain killer during this time. This is often enough to get you through the day, and your workout.

Plan to take Acetaminophen plus an NSAID one hour before hitting the gym.

If basic pain killers don’t work, consider some of the options below, though keep in mind, these supplements need to be taken every single day throughout the month, not just when symptoms hit, like you would with the pain medicines above.

Both Vitamin B6 and Magnesium, previously mentioned for mood symptoms, have also been shown to help with symptoms of breast soreness in PMS, often in the same studies. 

Vitamin B6, 50mg daily

Vitamin B6 in Poultry for PMS Symptoms Breast Tenderness Mood Swings Irritability Depression for Weight Lifting Resistance Training Exercise

The same large systematic review that showed Vitamin B6 has an effect on low mood in PMS also showed that B6 has a clinically significant effect at reducing breast tenderness as well at the same dosage [6]. 

Again, good sources of Vitamin B6 include pork, poultry, fish, bread, wholegrains, eggs, vegetables, soya beans, peanuts, milk, and potatoes.

But, as above, be careful not to take too much and consider just relying on these food sources instead of supplements to avoid the dangerous effects of too much.

Magnesium, 200-250mg daily

Magnesium in Dark Chocolate for PMS Symptoms Irritability Mood Swings Breast Tenderness Depression for Weight Lifting Resistance Training Exercise

The same well-done, double-blinded, randomized, placebo-controlled trial mentioned above that showed magnesium’s effect on PMS mood symptoms also had a clinically significant effect on reducing breast tenderness. It similarly showed that the combination of Magnesium and Vitamin B6 reduced these symptoms even further [7]. 

Magnesium is found in dark chocolate, avocados, nuts, legumes, tofu, seeds, whole grains, fatty fish, bananas, leafy greens.

Consider increasing intake of these foods, or supplementing is generally safe if you have healthy kidneys.

Vitamin E, 1,200 IU daily

Vitamin E in Vegetable Oil for PMS Symptoms Breast Tenderness for Weight Lifting Resistance Training Exercise

The research is a bit less clear on Vitamin E helping with breast tenderness during PMS with one trial showing a statistically significant decrease [9] and one trial showing a trend to decreased pain but not statistically significant [10]. If nothing else helps, it’s worth a shot. 

Foods containing high amounts of Vitamin E are nuts, seeds, vegetable oils, green leafy vegetables, and fortified breakfast cereals. 

Important Note: If you notice a lump in your breast that does not go away after a few days of your period, if a lump does not move easily, if you notice a dimple over the skin of your breast, or if your nipple which previously pointed outward now points inward (or is inverted), call your primary care doctor or OBGYN as soon as possible as these are signs of possible breast cancer that need to be evaluated by a doctor sooner than later.

In Summary

Bloating
Sodium, increase 300mg daily (if daily intake </= 2,300mg daily)
Reduce sodium intake as much as possible (if daily intake > 2,300mg daily)
Mood Symptoms (Depression, anxiety, irritability, poor concentration, fatigue, mood swings, brain fogginess, etc)
Omega 3 fatty acids, 1-2g daily
Vitamin B6, 50mg daily
Magnesium, 200-250mg daily
Calcium, 1g daily
Breast Tenderness
Mild pain medicines (Acetaminophen/Tylenol plus NSAID), as needed
Vitamin B6, 50mg daily
Magnesium, 200-250mg daily
Vitamin E, 1,200 IU daily

Whether it’s bloating, mood symptoms, or breast tenderness, here are a variety of solutions when PMS symptoms make your workout almost too difficult to accomplish.

Feel free to email me with further questions at belleofthebarbell@gmail.com

Happy Lifting!
– Dr. Elle, MD

Sources:

  1. Landau, Richard M.D.,  Lugibihl, Kathleen A.B. INHIBITION OF THE SODIUM-RETAINING INFLUENCE OF ALDOSTERONE BY PROGESTERONE. The Journal of Clinical Endocrinology & Metabolism, Volume 18, Issue 11, 1 November 1958, Pages 1237–1245, https://doi.org/10.1210/jcem-18-11-1237
  2. OELKERS, W.,  SCHÖNESHÖFER, M.,  BLÜMEL, A. Effects of Progesterone and Four Synthetic Progestagens on Sodium Balance and the Renin-Aldosterone System in Man. The Journal of Clinical Endocrinology & Metabolism, Volume 39, Issue 5, 1 November 1974, Pages 882–890, https://doi.org/10.1210/jcem-39-5-882
  3. Sohrabi, N., Kashanian, M., Ghafoori, S. S., & Malakouti, S. K. (2013). Evaluation of the effect of omega-3 fatty acids in the treatment of premenstrual syndrome:“a pilot trial”. Complementary therapies in medicine, 21(3), 141-146.
  4. Mandana, Z., & Azar, A. (2014). Comparison of the effect of vit E, vitB6, calcium and omega-3 on the treatment of premenstrual syndrome: a clinical randomized trial. Annual Research & Review in Biology, 1141-1149.
  5. Logan, A. C. (2003). Neurobehavioral aspects of omega-3 fatty acids: possible mechanisms and therapeutic value in major depression. Alternative medicine review, 8(4), 410-425.
  6. Wyatt, K. M., Dimmock, P. W., Jones, P. W., & Shaughn O’Brien, P. M. (1999). Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review. BMJ (Clinical research ed.), 318(7195), 1375–1381. https://doi.org/10.1136/bmj.318.7195.1375
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27878/
  7. Fathizadeh, N., Ebrahimi, E., Valiani, M., Tavakoli, N., & Yar, M. H. (2010). Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iranian journal of nursing and midwifery research, 15(Suppl 1), 401–405.
  8. Shobeiri, F., Araste, F. E., Ebrahimi, R., Jenabi, E., & Nazari, M. (2017). Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstetrics & gynecology science, 60(1), 100–105. https://doi.org/10.5468/ogs.2017.60.1.10
  9. Parsay, S., Olfati, F., & Nahidi, S. (2009). Therapeutic effects of vitamin E on cyclic mastalgia. The breast journal, 15(5), 510-514.
  10. Pruthi, S., Wahner-Roedler, D. L., Torkelson, C. J., Cha, S. S., Thicke, L. S., Hazelton, J. H., & Bauer, B. A. (2010). Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Alternative Medicine Review, 15(1), 59.
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