Do you suffer from PMS?

Research shows a low-fat, vegetarian diet may provide relief.

PMS -- premenstrual syndrome -just the thought of it makes women who suffer from it want to cringe.

While the symptoms, and their severity, may vary from woman to woman, they are at best a discomfort and at worst, debilitating.

So, is PMS just part of being a woman? No. In fact, research suggests that a low-fat, vegetarian diet may provide significant relief. A recent study demonstrating this was published in the February issue of the journal Obstetrics & Gynecology. It was conducted by the Physicians Committee for Responsible Medicine (PCRM) in conjunction with the Department of Obstetrics and Gynecology at Georgetown University Medical Center, both located in Washington, D.C.

About the study
For two menstrual cycles, 33 women followed a low-fat, vegetarian diet consisting of grains, vegetables, soy, legumes and fruits; the diet was free of animal products, added oils, fried foods, avocados, olives, nuts, nut butters and seeds. About 10 percent of the diets calories came from fat. For two additional menstrual cycles, the women followed their customary diets and took a supplemental placebo pill. During both phases of the study, the researchers assessed dietary intake, serum sex-hormone binding globulin concentration (sex-hormone binding globulin is a protein in the blood which, the authors explain, binds to and inactivates estrogen in the bloodstream until it is needed), body weight, pain duration and intensity of PMS symptoms.

They found that, in women with dysmenorrhea (painful menstruation) a low-fat vegetarian diet was associated with a significant increase in mean serum sex-hormone binding globulin concentration and reductions in mean body weight and body-mass index. This type of diet also yields reductions in menstrual pain duration, pain intensity and duration of premenstrual symptoms.

Why would a low-fat, vegetarian diet ease PMS?
The authors of this study believe that a major cause of PMS symptoms are chemicals called prostaglandins, which are made from traces of fat stored in cell membranes. Sex hormones, such as estrogen, increase prostaglandin production. Going into the study they hypothesized that if women reduced their fat consumption, they'd also decrease their estrogen levels, which would in turn reduce cell growth and prostaglandin production. Given the positive results, their hypothesis appears to have proved correct.

It's also important to note that the vegetarian diets likely provided a significant source of omega-3 fatty acids, which is not true of the average American diet. The authors note that "omega-3 fatty acids are precursors of PGs [prostaglandins], which have anti-inflammatory actions." Diets high in low-end vegetable seed oils (standard American diet loaded with overprocessed foods), on the other hand, are richer in omega-6 fatty acids, which break down into inflammatory prostaglandins. Previous research has shown a link between a higher ratio of omega-3 fatty acid to omega-6 fatty acid intake with reduced menstrual pain.

Neal Barnard, MD, PCRM president and one of the study's authors, also notes that the high-fiber content of the diet was an important factor. "Fiber in the intestinal tract carries away waste estrogens that have come from the bloodstream through the liver, down the bile duct and into the intestinal tract. Without fiber, estrogens are reabsorbed into the bloodstream."

Vegetarianism vs. menopause
When asked if he thought that a vegetarian diet would be of benefit to women going through menopause, Barnard said he believed it would. "Menopausal symptoms can be thought of as estrogen 'withdrawal.' If a woman's estrogen level is lower throughout life, she'll have less of a change at menopause and less dramatic symptoms."

P.S. People who choose to follow this diet for a long period of time should be sure they are getting adequate vitamin B12.

REFERENCES
Avery-Grant, Anika, R.D. The Vegetarian Female. Garden City Park, NY: Avery Publishing Group, 1999.

Barnard, Neal D. MD. "Diet and Sex-Hormone Binding Globulin, Dysmenorrhea, and Premenstrual Symptoms," Obstetrics & Gynecology 95(2):245-250, 2000.

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By Patricia Andersen-Parrado

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