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Your Period Problems Are Not Caused by the Food You Eat


A woman with a fork enjoys her food

If you search “hormone balancing” online, you’ll find many lists about the foods you should and should not be eating. You’re certainly not alone if you’re left feeling a lot of guilt and confusion around food choices by being told that the food you eat is a direct result of your premenstrual syndrome (PMS) or other period concerns.


As a naturopathic doctor, many of my patients in their menstruating years typically express that they eat “bad” foods, especially before their period (luteal phase), and want guidance around nutrition. In some cases fear around food becomes a significant source of stress and it can seem easier to just skip meals rather than trying to find the “healthy” choices. Food cravings, especially premenstrually, end up feeling like a personal failing rather than a sign of hunger or just a simple want for a particular taste, texture, or comforting food. I understand how people get here. It is confusing, and we just want to feel better. However, it’s concerning when hormone-balancing efforts cause harm to your relationship with food.


Before going any further, I want you to know that your PMS symptoms are natural and are not your fault. But there are things you can do to support your cycle—without the food restrictions most of us are familiar with in diet culture. Let’s take a look at what’s actually going on with your hormones during your menstrual cycle, along with nutrition habits that are not restrictive and can more positively support you.


Cravings & Hunger? It Could be Your Cycle


It's just a phase

Many people notice increased hunger and cravings before their period1, and as a result, tend to eat more in the luteal phase (from ovulation to the next period) compared to the follicular phase (from the first day of the period to ovulation).2 There are many reasons why this could be the case, including changes in metabolism, cultural expectations, or the influence of other PMS symptoms (mood changes, for example). Some studies show increased resting metabolic rate (the energy you expend at rest) in the luteal compared to the follicular phase, which could explain increased hunger.3


Hormones naturally fluctuate

In another study, 24-hour energy expenditure (including resting metabolic rate, energy expended to eat, and energy expended for activities) was also higher in the luteal phase.4 While there is still a lot we don’t fully understand, it does seem that the normal fluctuation in hormones that occurs during the cycle influences metabolism and appetite. It is very common, and normal, to notice a change in appetite depending on where you are in your menstrual cycle. It isn’t a sign of your lack of willpower.

Hormone-Balancing Diets & Food Restriction Can Cause More (not less) Menstrual Issues


Attitude about food is more important than the actual food for managing PMS

The problem with willpower

The problem with “hormone balancing” diets is that they make people feel that the root cause of their menstrual issues is their “lack of willpower”, which tends to lead to unnecessary food restriction.


Food restriction is problematic

Food restriction in and of itself can contribute to period problems, like irregular or absent periods (hypothalamic amenorrhea), worse PMS, or worse period pain. One study found a connection between worse menstrual pain, and lower intake of protein, lower intake of omega-3 (specifically from fish), and skipping breakfast.5 6


Skipping breakfast is an eating pattern that I notice all of the time, and it can make it more difficult to get enough nutrition for the rest of the day. Carbohydrates are often vilified, but studies show that they are not associated with the development of PMS,7 and can actually help improve mood-related PMS.8 9


Food attitude and not the food itself is the issue

In a study of adolescents, researchers found higher levels of disordered eating behaviors, emotional eating, and uncontrolled eating behaviors in those with PMS compared to those without, but there was no difference in actual food intake between the two groups.10 This means that food attitude, and not the food itself, was the problem. Meeting nutrition needs, like eating regularly, and getting enough protein, carbs, calories, etc. is what is important when it comes to supporting hormone health. It isn’t fancy, and it isn’t a diet.


How Can Intuitive Eating Help Menstrual Issues and PMS?


A delicious veggie burger with cheese
Veggie burger photo courtesy @flareandflourish

Relax the rules

We often feel that we need to follow strict food rules to be healthy, but as we have seen, it might be counterproductive. This is where intuitive eating (IE) can be helpful.


What is intuitive eating?

IE is a weight-neutral, evidence-based practice of connecting to your body’s needs and using them to guide you, rather than a set of external rules, or expectations.11 It is associated with positive body image, self-esteem, and well-being,12 and negatively associated with disordered eating behaviors, perceived social/cultural pressure, and concerns about weight.13


Food is not to be feared

It is not always easy to tune out the voices that are feeding into food fear, but it is possible to feel more ease and self-compassion with the fluctuating nature of appetite, bodies, and the menstrual cycle.


When it comes to periods and nutrition, people are concerned about the following: eating too much, even though they are hungry; eating the “bad” salty or sweet foods they crave; and that what they are eating is causing their problems.


All foods fit into intuitive eating

Conversely, intuitive eating teaches the following:

  • Connect with hunger and fullness cues and honor them instead of following strict food rules;

  • Accept that all foods fit and there are no “good” or “bad” foods

  • Give yourself unconditional permission to eat

  • Be aware that there is no perfect diet

  • What you eat sometimes does not make or break your health

  • Enjoying the taste of something is a worthy reason to eat it.


It's OK

What this means for your luteal phase is that:


It's OK to eat more food when you are hungry.


It's OK to eat the treat that you are craving (in fact, avoiding it often intensifies the craving).


It's OK if your eating looks a bit different during the luteal phase compared to other times of the month.


Your Menstrual Issues Aren’t Your Fault


While there are ways that nutrition can support a better period experience, it isn’t your fault for having PMS, PMDD, PCOS, endometriosis, etc. Intuitive eating can help alleviate some guilt and pressure people feel around food choices, especially if their cycle influences their appetite.


If you are struggling with period problems or a difficult relationship with food, it is important to speak to a healthcare provider to discuss what recommendations might make the most sense for you as an individual.


Your relationship with food, the symptoms you experience, your ability to make nutrition changes, your digestive health, and other diagnoses, all influence nutrition recommendations and you deserve to have a conversation that is detailed & nuanced with a healthcare provider.


 

References:

  1. Gorczyca AM et al. Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. Eur J Nutr. 2016 Apr;55(3):1181-8.

  2. Michaela M et al. Dietary energy intake across the menstrual cycle: a narrative review, Nutrition Reviews, Volume 81, Issue 7, July 2023, Pages 869–886.

  3. Benton MJ et al. Effect of menstrual cycle on resting metabolism: A systematic review and meta-analysis. PLoS One. 2020 Jul 13;15(7):e0236025.

  4. Howe, J. C. et al. Energy expenditure by indirect calorimetry in premenopausal women: variation within one menstrual cycle. The Journal of Nutritional Biochemistry, Volume 4, Issue 5,1993,Pages 268-273

  5. Naraoka Y et al. Severity of Menstrual Pain Is Associated with Nutritional Intake and Lifestyle Habits. Healthcare (Basel). 2023 Apr 30;11(9):1289.

  6. Fujiwara T. et al Skipping breakfast adversely affects menstrual disorders in young college students, International Journal of Food Sciences and Nutrition, 2009. 60:sup6, 23-31

  7. Houghton SC et al. Carbohydrate and fiber intake and the risk of premenstrual syndrome. Eur J Clin Nutr. 2018 Jun;72(6):861-870.

  8. Sayegh R et al. The effect of a carbohydrate-rich beverage on mood, appetite, and cognitive function in women with premenstrual syndrome. Obstet Gynecol. 1995 Oct;86(4 Pt 1):520-8.

  9. Esmaeilpour M et al. Diets enriched with whole grains reduce premenstrual syndrome scores in nurses: an open-label parallel randomized controlled trial. Br J Nutr. 2019 May;121(9):992-1001.

  10. Isgin-Atici, Kubra et al. Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters! Journal of Pediatric Endocrinology and Metabolism, vol. 31, no. 11, 2018, pp. 1231-1239.

  11. Tribole, E. et al. Intuitive eating, 4th edition: a revolutionary anti-diet approach. St. Martin’s Press, 2020.

  12. Linardon, J et al. Intuitive eating and its psychological correlates: A meta-analysis. Int J Eat Disord. 2021; 54: 1073– 1098.

  13. Johanna U. et al. Intuitive eating and its association with psychosocial health in adults: A cross-sectional study in a representative Canadian sample. Appetite, Volume 168, 2022.

  14. Houghton SC et al. Carbohydrate and fiber intake and the risk of premenstrual syndrome. Eur J Clin Nutr. 2018 Jun;72(6):861-870.








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