Certain nutrients may play a role in how severe premenstrual symptoms feel — and this study from Iran explored which dietary factors are linked to worse or better PMS outcomes. While the study focused on PMS rather than PMDD specifically, the findings about diet and premenstrual symptoms may be relevant to anyone dealing with cyclical symptom patterns.
Researchers surveyed 252 women with PMS about their dietary intake and eating behaviors. Nearly half reported severe PMS symptoms. The study found that higher sodium (salt) intake was linked to worse psychological and physical symptoms, while higher magnesium intake was associated with fewer psychological symptoms like mood changes and irritability. Interestingly, higher vitamin D and vitamin C intake were also linked to more severe psychological symptoms, which contradicts some earlier research suggesting these vitamins might help.
The authors suggest that magnesium may help because it supports brain chemicals involved in mood regulation, such as serotonin and GABA. High sodium may worsen symptoms through fluid retention, contributing to bloating and breast tenderness. The unexpected findings around vitamins D and C may reflect the complexity of how these nutrients interact with hormones and stress pathways — excessive amounts may not always be beneficial.
Women with signs of disordered eating tended to report more severe PMS, though this trend was not strong enough to be statistically confirmed. Because this was a snapshot-in-time study relying on self-reported diet records, it cannot prove that any nutrient directly causes symptom changes. Still, it adds to growing evidence that dietary choices — particularly magnesium-rich foods and limiting salt — could be worth considering as part of a broader approach to managing premenstrual symptoms. Any dietary changes should be discussed with a healthcare provider.
Key findings
- 49.4% of participants reported severe PMS, 21.9% moderate, and 28.7% mild according to the PSST
- Higher sodium intake was significantly positively associated with both psychological (p=0.003, OR=1.000, 95% CI=[1.000, 1.001]) and physical PMS symptoms (p=0.003)
- Magnesium intake showed a significant negative (protective) association with psychological PMS symptoms (p=0.009, OR=0.992, 95% CI=[0.987, 0.998])
- Vitamin D intake was significantly positively associated with both psychological (p=0.006, OR=1.406, 95% CI=[1.105, 1.788]) and physical symptoms (p=0.044, OR=1.298, 95% CI=[1.007, 1.674])
- Vitamin C intake was significantly positively associated with psychological PMS symptoms (p=0.036, OR=1.006, 95% CI=[1.000, 1.012])
- Individuals with eating disorders showed higher rates of severe PMS symptoms across all domains (e.g., 18.6% severe psychological symptoms vs. lower rates in those without eating disorders), but differences were not statistically significant (p>0.05)
Methods, briefly
Cross-sectional study of N=252 women with PMS (237 valid responses for analysis) referred to healthcare centers in Qazvin, Iran, conducted 2022–2023 via online questionnaires. PMS assessed using the Premenstrual Symptoms Screening Tool (PSST), dietary intake via 3-day dietary recall analyzed with Nutritionist-4 software, and eating attitudes via the Eating Attitudes Test-26 (EAT-26). Statistical analysis included ANOVA, chi-square tests, Kaiser-Meyer-Olkin test for sampling adequacy, and multivariable linear regression. Mean age was 32.41 ± 10.18 years; 59.9% single, 50% students.
Limitations to keep in mind
- Cross-sectional design prevents causal inference
- 3-day dietary recall is subject to recall bias and may lead to underreporting or overreporting of food consumption
- Online data collection may result in less precise responses
- Sample size was smaller than the calculated requirement of 560 participants (only 252 met criteria)
- Full range of dietary components was not evaluated
- The sample was predominantly highly educated (95.7% had higher education) and half were students, limiting generalizability
- Self-report measures for all outcomes including PMS symptoms and eating attitudes
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