If you experience Premenstrual Dysphoric Disorder (PMDD), you know the cyclical surge of
symptoms such as anxiety, irritability, depression, and fatigue is debilitating.
While PMDD often requires clinical support there’s robust evidence that what you eat, sometimes alongside nutrition supplements, can fundamentally stabilise your body’s response to hormonal shifts. PMDD is closely linked to systemic inflammation and dysregulated neurotransmitter response (the hormones such as serotonin and GABA that help you to feel calm and motivated). By making targeted diet changes, you can help soothe these underlying biological stressors which are having such a significant impact on how you feel. Here are the most practical, evidence-based steps you can take today to help manage the challenging symptoms that emerge in the days/weeks before your period.
1. The Foundational Diet:
Stability is Key The primary goal of a PMDD diet is stability. When your blood sugar crashes, so does your mood, and this instability fuels inflammation. To help anchor blood sugar levels make high quality, real foods, especially protein the centrepiece of each meal. Base each meal around protein foods such as eggs, fish, meat, pulses, tofu and dairy. Be aware of when you are eating. Specifically, how often you eat and how much you snack in the evening. Eating later in the day causes our blood sugar levels to spike more intensely which can impact sleep and severity of symptoms the next day. Cravings may be magnified with hormonal f luctuations, especially in the evenings. To help with this ensure you have plenty of protein at each meal-it’s been shown having at least 30-35g of protein at breakfast can reduce cravings right through to the evening. Source your B Vitamins from Food. B vitamins are critical for supporting brain chemistry which becomes even more crucial premenstrually. Research strongly suggests that high consumption of B Vitamins like Thiamine and Riboflavin from food sources (like beef, pork, poultry, fish, dairy and almonds) is associated with a significantly lower risk of developing premenstrual symptoms. Women who had the highest intake of riboflavin had a 35% lower risk of developing PMS compared to those with the lowest intake
2. Reducing the agitators
Certain substances are agitators that can amplify PMDD symptoms, particularly anxiety, tension, and physical discomfort Caffeine is a stimulant that amps up your nervous system. If you are dealing with PMS or PMDD symptoms like anxiety, feeling jumpy, tension, or trouble sleeping, caffeine can make those feelings much worse. Because of this it’s often recommended women with PMDD experiment with cutting back or completely stopping drinking caffeine. Sugar and alcohol are known to make PMDD/PMS symptoms much harder to handle.
Sugar: Eating sugar causes your blood sugar to shoot up quickly, then crash. These steep drops can severely worsen your mood swings and irritability. Plus, the crash can leave you tired and interfere with getting deep, restorative sleep.
Alcohol: Drinking alcohol can throw your hormones out of balance and often leads to dehydration. This combination makes emotional stress, physical tension, and mood swings much worse. Even though alcohol can make you feel sleepy at first, it actually fragments and disrupts your sleep cycle, leading to poor sleep quality which isn’t restorative. Consider a short term reduction of alcohol/sugar or both. To make it feel easier to make this change f ind alcohol free alternatives you enjoy such as Mother Root or Trip drinks and get stocked up with alternatives to chocolate or biscuits to make things easier. For example dark chocolate Brazil nuts or Greek yoghurt with shredded coconut-warm frozen raspberries in the microwave to make them slightly oozy and tip over the yoghurt. Avoiding dehydration - being dehydrated can elevate blood glucose levels increasing feeling of anxiety and stress. It can also lead to tiredness, headaches, poor concentration, increased pain perception and make sleep more difficult. Give yourself a target for your daily water intake and include foods such as broth and watermelon to help with hydration.
3. Fill crucial nutrient gaps
There are specific nutrients which can be particularly helpful for supporting you if you have PMDD.
Calcium There is clear evidence that calcium can help ease premenstrual symptoms. Large studies confirm that taking extra calcium can significantly improve how you feel:
Emotional Relief: It helps calm symptoms such as depression, sadness, and mood swings. Physical Relief: It reduces physical discomforts like fatigue and bloating.
Oestrogen acts as the body's manager for calcium, and when oestrogen levels naturally drop before your period, this disrupts the body's ability to regulate calcium. It causes the flow of calcium in and out of your nerve cells to become dysregulated, disrupting the smooth signalling of mood regulating chemicals and directly causing PMDD symptoms like anxiety and irritability.
Use a calcium tool (https://theros.org.uk/information-and-support/bone-health/nutrition-for-bones/ calcium/calcium-rich-food-chooser/) to gauge how much calcium you are having at the moment. Aim for a consistent daily intake of 1000-1200mg calcium, ideally sourced from whole foods to prevent the cyclical dip in serum calcium associated with mood symptoms. Some people may benefit from a small, split-dose calcium supplement to support their symptoms, but consult your healthcare provider first.
Calcium works in a critical partnership with other key nutrients: Vitamin D is essential for ensuring calcium is properly absorbed from the gut into the bloodstream; Magnesium helps regulate this balance, working as a cofactor to activate Vitamin D and promoting nerve relaxation to reduce anxiety and cramps; and finally, Vitamin K2 acts as a safety guard by directing calcium toward the bones and actively away from the arteries, mitigating the cardiovascular risks sometimes linked to supplementation. Therefore, addressing PMDD symptoms requires not just consuming enough calcium, but also ensuring adequate intake of D, Magnesium, and K2 for optimal absorption, regulation, and safety.
Some food suggestions to increase your calcium intake:
• Make seeded crackers with flaxseed, mixed seeds, water and salt - delicious with hummus, cheese or avocado
• Snack on edamame beans sprinkled with sea salt and chilli flakes
• Have Greek yoghurt as part of your high protein breakfast or instead of a sugary snack
• Stir fry kale, and dress with olive oil, lemon juice and sesame seeds - serve alongside your favourite curry or a piece of salmon. Omega-3 Omega-3 Fatty Acids are highly anti-inflammatory and therefore can be helpful to minimise PMDD symptoms like anxiety, depression, and poor concentration. The active form is EPA, which excels at reducing inflammation and stabilising mood.
• Why EPA? Plant sources like flaxseeds contain ALA, but the body's conversion to active EPA is highly inefficient (often less than 5%).
◦ Prioritize Oily Fish: Consume salmon, sardines, or mackerel 2–3 times per week for EPA.
◦ Plant Boost: Use walnuts, ground flaxseeds, or chia seeds as secondary support, but not as the sole source.
• Supplement Note: If you do not eat fish regularly, discuss a high-EPA fish oil supplement with your healthcare provider
Saffron
Saffron has been shown to be an effective herbal intervention, with clinical trials demonstrating that a 30mg daily dose (during the luteal phase) can significantly ease PMDD mood symptoms like irritability and anxiety.
Vitamin B6
Vitamin B6 is critical for supporting PMDD mood symptoms because it is needed for the creation of serotonin, the brain's key mood-stabilising chemical. Ensuring adequate B6 supports the body's ability to produce serotonin, which is often dysregulated during the luteal phase-the second half of your cycle. Clinical evidence shows B6 can significantly reduce emotional symptoms like anxiety and irritability.
• B6 is readily found in foods such as chickpeas, chickpeas, salmon, potatoes, and bananas. e.g: a coconut chicken and chickpea curry
• Safety Note: Seek individual advice on supplements as long term daily use exceeding safe amounts can lead to nerve damage.
Nutrition is a powerful foundational tool you can actively use every day to take charge of your PMDD. By focusing on whole foods, stabilising your blood sugar, and ensuring adequate levels of key nutrients like calcium and B6, you are building a powerful base for mood stabilisation and inflammation control. Before starting any new supplement, especially if you are already taking medication, always speak with your doctor or a registered dietitian. Your healthcare team can help you integrate these nutritional strategies safely and effectively into a comprehensive, personalised treatment plan
Written By Dr Rebecca Hiscutt