Contents
Introduction
The week or 2 before your period is not simply a bad mood, or low energy – it’s something more. It’s not just “I’m really PMS”. You enter a depressive state, you are on edge, everything seems to shift your mood instantly, you are weepy, and are only craving chocolate ice cream. And even though you have heard your whole life about the impact of menstruation and legends of PMS somehow this is worse.
You find out that it’s not just PMS (premenstrual syndrome) as you suspected, but PMDD or Premenstrual Dysphoric Disorder. PMDD is a more severe form of PMS. Some common symptoms include – depression, high anxiety and irritability, extreme fatigue, self-critical thoughts, change in sleep and appetite, physical changes such as bloating and breast tenderness.
Although there is no clear cause, PMDD affects 3-8% of women of reproductive age.
PMDD can impact your whole demeanor for a week plus, dominoing into your daily life and with the extreme fatigue – also your physical well-being.
The good news is that nutrition plays a key role in the management of both PMS, as well as PMDD. Although we can’t cure it, we can help manage some of the symptoms to lessen the impact on your day-to-day life.
Understanding PMDD
We’re still learning about the causes of PMDD. Hormone fluctuations throughout the menstrual cycle are a major focus, as they may contribute to severe PMS symptoms. Serotonin (a brain chemical that regulates mood) also fluctuates throughout the cycle, and some women may be more sensitive to these changes.
Because of this connection to the endocrine system, our hormones, and brain chemistry – what we eat and what we do matters. The nutrients we supply our body can influence the severity of these symptoms.
Key Nutrients To Consider
There are specific nutrients to be mindful of in your daily diet that may be supportive in managing PMDD symptoms. These nutrients support various functions in the body that are related to symptoms experienced.
Magnesium is a mineral involved in hundreds of reactions throughout the body, most notably regulating mood, supporting nervous system function, and reducing inflammation. Insufficient dietary intake may worsen PMDD symptoms, while adequate intake of magnesium may help relieve anxiety, irritability, water retention, breast tenderness, and headaches.
- Food sources: Dark leafy greens, nuts and seeds, legumes, dark chocolate, avocado, and fatty fish
B vitamins, particularly vitamin B6, are also important for PMDD management. This water-soluble vitamin plays a vital role in producing neurotransmitters like serotonin, dopamine, and GABA – all crucial for mental and emotional well-being.
B6 has two key functions relevant to PMDD: 1) it facilitates the conversion of tryptophan to serotonin for mood stabilization, and 2) it supports the metabolism of estrogen and progesterone – the hormones that drive the menstrual cycle.
- Food sources: Poultry, fish, potatoes, chickpeas, bananas, nuts, and organ meats
Omega-3 fatty acids are essential fats that play crucial roles in brain health, hormone regulation, and inflammation control. For those with PMDD, omega-3s may help reduce inflammatory processes in the body, potentially relieving symptoms like depression, bloating, and breast tenderness.
- Food sources: Fatty fish (especially salmon, sardines, and mackerel), flaxseeds, chia seeds, and walnuts
Iron levels tend to run low in those who menstruate, and since it’s an essential mineral for body function, addressing deficiency may help relieve PMDD and PMS symptoms. Iron deficiency can lead to fatigue, difficulty concentrating, irritability, and low mood due to its role in producing neurotransmitters like serotonin and dopamine.
Food sources:
- Heme iron: Meat, organ meats, poultry, and seafood
- Non-heme iron: Legumes, dark leafy greens, tofu, and dried fruit
Understanding iron absorption: Dietary iron comes in two forms – heme iron (from animal sources) and non-heme iron (from plant sources). Heme iron is more bioavailable and better absorbed by the body. To improve non-heme iron absorption, pair plant-based sources with vitamin C-rich foods like citrus fruits, bell peppers, or strawberries.
Foods to Limit or Avoid
What you limit or avoid is just as important as what you include when managing PMDD symptoms. Be mindful of:
High-sugar and ultra-processed foods: These offer little nutritional value and can spike blood sugar, leading to fatigue, energy crashes, and mood swings.
Caffeine and alcohol: In excess, both can worsen symptoms like anxiety, disrupt sleep, and increase breast tenderness.
High-sodium foods: Convenience foods and heavily salted items can worsen bloating and water retention.
Lifestyle & Meal Timing Tips
As we like to say at DWN: it’s about what you eat and how you eat. Be mindful of fueling yourself during daytime hours when your body needs energy and nourishment most. Start your day with a balanced breakfast and maintain a steady meal pattern throughout the day. This supports gut health, sustains energy levels, and helps manage PMDD symptoms.
Stay hydrated: It’s simple but effective. Proper hydration supports energy metabolism and helps reduce inflammation and bloating.
Stay active: Regular physical activity may significantly impact PMDD symptoms by regulating mood, reducing stress, and decreasing inflammation.
Aim for moderate exercise like walking, yoga, swimming, or cycling for at least 30 minutes most days of the week. During the luteal phase (the two weeks before your period), when symptoms may be most intense, gentler movement like stretching or low-impact activities can still provide benefits without overtaxing your body.
Listen to your body and adjust intensity as needed – consistency matters more than intensity when managing PMDD.
Practice mindful eating: Whether through journaling or simply slowing down during meals, mindfulness may improve mood and digestion while helping you identify potential PMDD symptom triggers.
1 Day Sample PMDD-Friendly Menu
- Breakfast: Spinach & vegetable omelet with oatmeal, berries, & walnuts
- AM Snack: Greek yogurt with chia seeds and cinnamon
- Lunch: Quinoa bowl with salmon and roasted vegetables
- PM Snack: Apple with almond butter
- Dinner: Meat stew with lentils, sweet potatoes, and greens
Key Takeaways
- PMDD affects 3-8% of women with severe symptoms like depression, anxiety, fatigue, and physical discomfort—but nutrition can help manage it
- Prioritize four key nutrients: Magnesium, vitamin B6, omega-3 fatty acids, and iron to support mood, hormones, and energy
- Build meals around: Fatty fish, poultry, dark leafy greens, legumes, nuts, seeds, and whole grains
- Limit: High-sugar foods, excess caffeine/alcohol, and high-sodium items that worsen symptoms
- Practice consistent habits: Regular balanced meals, hydration, mindful eating, and moderate exercise – especially gentler movement during your luteal phase
To learn more about what Dining With Nature offers for nutrition care – hit the Explore The DWN Programs button below or take a look at our Services page.
Disclaimer: The information in this post is for general educational purposes only and should not be considered personalized medical advice or a substitute for professional guidance. Always consult with your doctor or a registered dietitian before making any changes to your diet, lifestyle, or supplement routine.
