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PMS Bloating and Weight Gain
by Dr. Daniel J. Heller
A week before your period you step onto the scale and ...Wham! You weigh four pounds more than you did a few days before. Or, the week before your cycle starts, your bra size increases and your breasts become painfully tender. Your rings don't fit, your ankles are swollen, your clothes are tight, your abdomen is bloated, your skin feels stretched out and there are bags under your eyes—do we need to mention that it makes you want to scream?
This, of course, is premenstrual bloating, a symptom of premenstrual syndrome for many women. Even women who don't suffer from PMS often note some degree of premenstrual edema or water retention. Many women feel that PMS bloating and weight gain are two of the most annoying premenstrual symptoms, because they don't come and go like cramps or irritability might; they effect how you look, so they can affect your confidence and how you feel about yourself; and they can affect how every part of your body feels.
Premenstrual bloating has been with us a very long time. PMS was not even recognized before the 1970s, and was not the subject of much medical research at all before the 1980s, but premenstrual bloating was the subject of medical research long before almost any other PMS symptom.
Unfortunately, doctors and laypeople alike often mistakenly believe PMS is imaginary. We have discussed this misunderstanding extensively elsewhere on this site, but it's worth mentioning again because weight gain is often suggested to be one of the most dubious of PMS symptoms. However, PMS bloating and weight gain are real, although the reason they occur is not completely understood. Women with PMS bloating retain water, and have increased fluid balance hormone levels, in the second half of their cycles.
You might think—and the marketing of over-the-counter PMS products might lead you to believe—that the logical approach to PMS water retention is to take a diuretic drug that causes you to urinate excess water (in other words, makes you pee). But this approach is far from ideal, for two good reasons. To start with, diuretics rob your body of precious minerals, as you excrete them along with the water you eliminate, but second because it's fundamentally preferable to treat both the symptoms and the cause of any health problem. Taking a diuretic drug for PMS is not treating the underlying hormonal imbalance that is believed to be the cause of PMS.
Specifically, most diuretics deplete the body of potassium and magnesium. Both are important nutrient minerals that actually help with bloating. You read that correctly: Diuretics rob your body of the very nutrients you need to fight bloating!
This is true for most diuretics, including those found in over-the-counter PMS medications. There are, however, prescription-strength potassium-sparing diuretics used for heart conditions that do not cause potassium loss, though they can still cause magnesium loss, and vegetable and fruit consumption must be limited when taking them. That doesn't sound very healthy to us!
Potassium is the natural counterbalance to sodium in the body, and it's easy to obtain from fruits and vegetables. The saltier the food you eat, the more potassium your body requires and the more PMS bloating you may be prone to experience. But diuretic drugs, which can deplete potassium reserves, can make your bloating even worse in the long run. Another way to think of this is that the more you take diuretics, the more you will need the diuretics.
The same is true for magnesium and premenstrual bloating: whereas taking magnesium supplements helps offset premenstrual water retention, diuretic drugs deplete your magnesium, making PMS bloating worse in the long run! And, unlike potassium, magnesium is difficult to get from your diet. Magnesium deficiency is surprisingly common, and is increasingly being associated with common and troublesome conditions such as prediabetes and heart disease.
You can overcome PMS bloating yourself, beginning with these five simple steps:
Drink plenty of water. It might seem counterintuitive to recommend hydration as a remedy for water retention, but if your cells and tissues are properly hydrated throughout the month you'll probably retain less water, and you may just feel better, too! As is the case with most holistic solutions, starting a day or two after the symptoms begin is too late. Adopting the healthy habit of 6–8 glasses of water per day, all month long, is ideal.
Cut back on salt. Excess salt—specifically, sodium chloride—causes you to retain water. You can balance that effect out by hydrating properly, and by loading up on fruits and veggies, though ideally you'd also cut way back on any snacks, meats, canned foods, and restaurant meals that are chock full of sodium, and minimize your use of the salt shaker as well. We'd rather not suggest a specific number of milligrams of sodium you can eat per day, since every woman is different. As a rule of thumb, though, one highly salted food (snack or meal) per day is more than enough.
Dietary Tip for Bloating. Dandelion Greens. This familiar and ubiquitous weed is an honored and time-tested herbal medicine and food, and its leaves are a gentle, yet effective diuretic that actually replenishes your potassium rather than depleting it. Dandelion greens may be an acquired taste, as some find them bitter. Traditionally harvested in early spring when the tender young shoots are first emerging and most tender, they can be steamed, boiled, or sautéed, and used much like spinach or other cooked leafy greens. If the leaves are small and tender, they can be used in salads. Like most vegetables, they are most nutritious when not overcooked.
Eat plenty of vegetables and fruits. Veggies and fruits are the ultimate health foods: they are a great source of fiber, antioxidants, and vitamins and minerals. They are also a great source of potassium—this is especially true for all fruits, not just bananas—and that will help balance out the salt in your diet.
Cut back on refined sugars. When you eat sweets, your pancreas releases insulin to control your blood sugar. Insulin can cause you to retain salt, which then leads to bloating. (Anyone who has ever tried a low-carb diet and lost several pounds in just a few days is familiar with this phenomenon. As your insulin level plummets, you lose water weight very quickly because your body excretes salt and water together.)
Take a holistic approach. We suggest you take these steps as part of an overall program that balances optimal nutritional supplementation and herbal PMS relief with a mind-body-spirit approach. While you may gain some benefit from addressing the symptom of premenstrual bloating in isolation, the best results come from recognizing how PMS affects you as a whole person, and taking that whole-person approach to optimal wellness.