Foods to Manage the Menstrual Cycle
The suggestions for management here do not cover all manifestations of period symptoms. Those who have or suspect complications such as PMDD, PCOS, and/or Endometriosis should consult their healthcare provider. The recommendations are not substitutes for medical care.
Menstrual Cycle 101
As explained by Andrea Chisholm, MD, your menstrual cycle is a complex interaction between two structures in your brain and your ovaries. A very sensitive feedback loop controls the timing of estrogen and progesterone production by your ovaries which causes you to ovulate and menstruate at regular intervals. To better understand what is going on with your hormones, below is the break down the average 28-day menstrual cycle into three phases:
Day 1-14: Your menstrual cycle starts on the first day you bleed. At this time, both your estrogen and progesterone are at their lowest levels. Over the next 2 weeks, your estrogen or more specifically your estradiol level (the type of estrogen made by your ovaries) steadily and fairly rapidly increases to reach its peak value about day 13 just before ovulation. Progesterone levels remain low during this phase.
Ovulation: Ovulation happens on about day 14. At the time of ovulation, your estradiol levels drop rapidly and your progesterone levels begin to rise.
Day 14-28: During the second half or luteal phase of your cycle, progesterone dominates. Your level of progesterone rapidly increases and stays up until just before your period starts when it begins to rapidly decline to its lowest level. Also, during the second half of your cycle after dropping very low at ovulation, your estradiol levels increase and then decrease again just before your period. However, in the second half of your cycle, your peak estrogen level is much lower than it was in the first half of your cycle. And perhaps, more importantly, it is much lower relative to your progesterone level.
Lo’ & behold the Luteal Phase
What is it & why is it important?
So, there are a few things going on in the luteal phase that induce cravings for carbohydrates. But before then, let’s be clear about this phase. The menstrual cycle can be broken into two main parts: the follicular phase and the luteal phase.
The follicular phase is all about ovulation, and it’s when hormones trigger changes in ovarian follicles until, eventually, a mature egg is developed and ovulated.
The luteal phase is for preparing the endometrium—the lining of the uterus—and body for pregnancy. It’s the period—pun, yes—right before your period. Hence, the above-mentioned encouragement from the body to eat more calories. The body lowers its levels of estradiol in this second half of the cycle to induce the consumption of more calories so it can become pregnant and have the energy to sustain another life.
Progesterone is the dominant hormone in the luteal phase or second half of your menstrual cycle. It is thought that one of the effects of progesterone is that it stimulates your appetite. Your elevated progesterone level is also responsible for some of the other unpleasant premenstrual symptoms you might experience bloating, constipation, and breast tenderness.
Although, as I mentioned, we tend to crave more carbohydrates at this time, the body actually uses less carbohydrates and more fat. A recent study paired women with a diet that took these metabolic changes into account, lowering carb intake and raising healthy fats to match their cycles. The result? They experienced less bloating.
It’s important, however, to remember that eating is dynamic; what, how, and when we eat change according various factors such as age, stress levels, and environment. Cultural preferences—from that of a country or state to the microcosm of social media—may also shape what type of food you eat. However, the body’s built-in system will work balance whatever that food intake is with its energy output, mainly through the hormone estradiol. In this case, as is always, it’s important to also factor in intuitive eating and listening to the cycles of your hunger. We recommend Christy Harrison, RD and her programme on this if you’re not familiar.
In addition to listening to your body, try eating smaller, more frequent meals throughout the day to manage the spike in cravings induced by estrogen & progesterone. Be gentle with your body and listen to your hunger.
Medicalisation of the Menstrual Cycle
Womxn with menstrual cycles have a variety of sensations and experiences for several days before and during menstruation. These most commonly include mood swings; depression, which can be mild but occasionally severe; bloating or water retention; breast tenderness; and headaches. They can be mild or disrupt daily life; some womxn may feel more energetic and creative premenstrually while others might feel rained.
Premenstrual Syndrome (PMS) is the current term used as an umbrella for all of these experiences, which are re-termed as “symptoms” calling for “treatments.” This creates a covert paradigm of medicalising the natural occurrence of menstruation and its cyclical manifestations. Many doctors prescribe pills as Big Pharma uses this term as an excuse to sell more medications to womxn and distance themselves from their bodies.
Many of these are expensive treatments—progesterone, fluoxetine—that can also have serious side effects when taken I high doses over long periods of time, such as vitamin B6 and fluoxetine. Even more, one of such treatments, from progesterone to high-dose vitamins and minerals to evening primrose oil, have been shown to work better than placebo in well-controlled trials.
Since the studies so far suggest that most of these modalities of management all seem to work equally for many womxn, it may make more sense to try the least expensive and invasive approaches first. Most important is to find a balance in how you personally relate to your experience of your menstrual cycle as well your loved ones taking it seriously.
Most often the term “PMS” may encourage a sense of relation to premenstrual experiences as medical “problems” to “fix” rather than a natural occurrence. However, for those dealing with excruciating pain such as due to Endometriosis, not recognising it as medical can also feel dismissive and manifest additional emotional pain. Find what works for you in recognising this natural aspect of your body that, at times, can rear itself in seemingly unnatural or dissociative ways.
Womxn across cultures have been sharing menstrual remedies for centuries. Because each body is unique and has different reactions, ay attention to how the remedy you choose affects you. Plant intelligence is powerful and, as many medications are also derived from plants, they can have effects comparable to Western biomedical drugs. Be cautious and listen to your body’s responses.
Dysmenorrhea or Cramps
Cramps can occur due to the liver is producing more inflammatory C-reactive protein during menstruation. Anticipation of it can often worsen it by causing tension. As it may be caused by a certain type of prostaglandin “leaking” into the intestines, a class of drugs called antiprostaglandins, originally developed for arthritis, may be an option for those who have debilitating cramps. We don’t know the long-term effects of these drugs, however. The two most effective drugs are ibuprofen (Advil, Motrin) ad mefanamic acid (Ponstel). If you’re resistant to taking medication but are experiencing pain, please consider what you are prioritising and how you’re treating your body effectively. Remember applying complementary medicine rather than exclusively alternative medicine. Below are some additional anti-inflammatory and calming modalities:
Mood Swings are a natural part of the swing or stages within the cycle, which affect the serotonin & dopamine levels in the body. As they drop after ovulation, we can experience emotional irritability. Try the following systems of support for management
B vitamin complex • St. John’s Wort • Complex carbohydrates, such as gluten-free grains, winter squashes, and sweet potatoes • Testing Iron & Ferritin levels if fatigue is an issue for you and if they’re low or borderline, taking a supplement
Bloating can best be managed by ensuring adequate hydration and managing carbohydrate intake. It’s important to eat intuitively but if this is a recurring issue for you, you might want to consider watching your carbohydrate intake during menstruation to manage bloating. Intuitively listening to the body isn’t only about its hunger cues but also the various other discomforts, such as bloating. This happens because the glycogen in carbohydrates is what draws more water into cells to be stored, metabolising more fat as opposed to carbohydrates. Make sure to add electrolytes to your water during this time and other options below:
Electrolytes • Cranberry Tea • vitamin B6 • Eating water-rich foods, such as celery, cucumbers, tomatoes, and strawberries • Eating healthy fats • Increasing Iodine, through foods like seaweed or through supplementation
Heavy or irregular bleeding
Heavy periods can occur if you did not ovulate (e.g., if you are in menopause); if you are under severe stress; if you are using an IUD for birth control; if you are having a miscarriage; or if you have fibroids or a tumour in your uterus. Therefore, it’s important to consult your healthcare provider about it. Irregular bleeding or off-cycle menstrual flow can be caused by entering menopause or other health problems. Again, please consult your healthcare provider.
Eating high-vitamin C foods and bioflanavoids (also called vitamin P) • Cod Liver Oil, which is high in vitamin A*
*Be cautious about this as excessive vitamin A can be toxic although it is not very common. If you start to feel nausea, ski irritation ,itching, or other changes, discontinue use.
Mild and Severe Depression
Mild Premenstrual Depression can best be managed through a support system, whether it’s through therapy (for which there are affordable options like Better Help) or simply taking note of it literally. Here’s what a reader wrote:
“A week before my period comes I go through a few days of feeling more helpless stuck, or down about things in my life that have been there all along. Sometimes I appreciate being more in touch with the underside of my feelings. Other times it really gets me. The voices inside my head which are overly critical of what I do get much ore insistent when I’m premenstrual. Recently, I’ve identified them more quickly. I’ll start to get down on myself . . . and I’ll say “Those are your critical voices—go easy on yourself!” It helps.”
However, Severe Premenstrual Depression or PMDD might have to be managed differently. Recently, the antidepressant drug mentioned above of fluoxetine (Prozac), which blocks the breakdown of the brain chemical serotonin, has been found to be effective for treating severe premenstrual depression. Again, if severe depression has been a continuing issue for you, be cautious and curious about your response of trying Prozac. Remember that medication is not black or white and it’s not permanent. You can try this option and you always can stop it if you no longer want to take it or don’t see a benefit.
About the Author
Almila Kakinc-Dodd is the Founder, Editor-in-Chief of The Thirlby. She is also the author of the book The Thirlby: A Field Guide to a Vibrant Mind, Body, & Soul. She is currently pursuing her Master’s in Nursing as a Dean’s Scholar at Johns Hopkins University. Her background is in Anthropology & Literature, which she has further enriched through her Integrative Health Practitioner training at Duke University. She lives in the Washington, D.C. Metro Area, where she regularly contributes to various publications. She is a member of Democratic Socialists of America and urges others to join the movement.