Exercise. Physical activity can lift moods and improve depression. It’s believed that endorphins — feel-good brain chemicals that are released during exercise — may help counteract some of the hormone changes that may trigger severe PMS. “Exercising can also boost energy and help with cramps and bloating, which may help you feel better,” says Livoti. Aerobic exercise such as walking, running, bicycling, or swimming is recommended.
Small, frequent meals. Eating small meals throughout the day rather than two or three big meals may also help ease PMS symptoms. A large meal, particularly one high in carbohydrates, can cause blood sugar swings, which could worsen PMS. “Low blood sugar may contribute to crying spells and irritability that are often seen in women with severe PMS,” says Livoti. Try to eat six small meals a day to keep your blood sugar levels steady.
Calcium supplements. In a 2009 double-blind clinical trial of college women with PMS, those who supplemented their diet with 500 milligrams of calcium twice daily had significantly less depression and fatigue than those who didn’t. In fact, “a number of studies have shown that getting plenty of calcium can help ease mood changes related to severe PMS, although we don’t know exactly why,” says Livoti.
Avoid caffeine, alcohol, and sweets. Staying away from coffee and other caffeinated drinks for two weeks before your period may make a difference in your mood because caffeine can increase anxiety, nervousness, and insomnia. Cutting down on alcohol may also be helpful because alcohol acts as a depressant. And steering clear of candy, soda, and other sugary foods, especially in the week before your period, may help ease severe PMS symptoms by preventing mood swings associated with blood sugar fluctuations.
Stress management. Stress can make severe PMS symptoms worse, so finding ways to give stress the slip can help treat PMS. Try relaxation techniques such as meditation, deep breathing, and yoga. Individual or group therapy has also been found to be an effective PMS treatment for women with severe mood swings and debilitating emotional changes.
Antidepressants called selective serotonin reuptake inhibitors (SSRIs) that change serotonin levels in the brain have been shown to be helpful for women with severe PMS and PMDD. In fact, the U.S. Food and Drug Administration has approved three of these medicines — Zoloft (sertraline), Prozac or Sarafem (fluoxetine), and Paxil CR (paroxetine) — for the treatment of PMDD.
Talk to your doctor about which of these approaches might work best for any moderate or severe emotional PMS symptoms you’re experiencing.