The menstrual cycle is a healthy, but pro-inflammatory, physiological process [1]. It is, therefore, possible to reduce (pre)menstrual changes/ symptoms, through a range of anti-inflammatory approaches [2];

1. Taking anti-inflammatory medications such as Ibuprofen, or Naproxen, 2-4 days (400-1200mg per day) before you expect your period, will substantially reduce blood loss and cramping [3].

2. Taking high strength Omega 3 oils every day can also make a big difference [4].

3. Taking hormonal (contraceptive) medications, which typically alleviate all (pre)menstrual symptoms [5]. You may need to try a few different types before you find the one that works best for you- each person responds differently!

4. If you prefer not to take medications (and/ or dietary supplements), the good news is that menstrual health responds very well to some simple lifestyle changes.

By following these four steps, many people will notice a significant improvement in their health and wellbeing. Better still, even if these approaches do not completely prevent all of your symptoms, they will definitely help, and won't make things any worse, since they are all health-promoting interventions.

1. Diet- what you eat can affect your menstrual health considerably.
Please see this blog post for more information, and to see the clinical research behind these 8 general recommendations:

1. Eat lots of fresh fruit and vegetables
2. Eat lots of fibre (and drink water with it!)
3. Eat oily foods (mainly unsaturated fats)
4. Reduce meat and dairy products
5. Avoid sugary foods and drinks
6. Avoid caffeine
7. Avoid alcohol
8. Take nutritional supplements, if needed (e.g. Omega oils, calcium, iron, magnesium, vitamins, or zinc)

Note: An 'anti-inflammatory' diet is recommended for the management of several chronic health conditions, including those that are known to be triggered, or worsened, at certain points in the menstrual cycle.

2. Exercise- Don't panic! You do not have to run a marathon, or take up competitive sports (unless you want to?) What's most important is that you regularly spend time moving your body, developing your strength, and getting slightly out of breath. The key to success is finding an activity that you enjoy doing, perhaps with others, to provide the motivation to keep going.

The NHS recommends that adults spend [6];

- at least 2.5 hours of moderate aerobic activity such as cycling or fast walking every week, and

- strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).

Obviously, there are many reasons why moderate exercise is good for your health, but in terms of menstrual health it can improve self-esteem and low mood, and metabolic conditions such as PCOS (Polycystic Ovary Syndrome) or amenorrhea (a lack of regular periods).

3. Improve self-esteem- in a sexist (patriarchal) society it is very easy to develop negative feelings towards the menstrual cycle, or female body. The pressure we feel to hide our periods can make them appear disruptive to work, socialising, exercise, care for others, or other enjoyable activities. This can lower mood and self-esteem, and increase anxiety levels.

Getting to know and trust your body, especially the taboo bits (i.e. the vulva and vagina) can boost self-esteem. Making peace with your body can make a surprisingly big difference in improving menstrual health and well-being.

Happily, improving self-esteem is a relatively easy thing to do!

It involves noticing any negative internal thoughts, and analysing them to prove to yourself that they are not actually true, or reflective of who you really are (i.e. a human being of equal worth to all other human beings). Some people might benefit from the support of a professional counsellor, but a good (and cheap) starting point is this amazing booklet from the Oxford Cognitive Therapy Centre.

Learning more about the menstrual cycle, using a menstrual cup, and tracking changes over time, can also help boost self-esteem. For example, a menstrual cup encourages the user to get to know (and like!) their reproductive anatomy better, and to observe menstrual fluid up close. Cycle tracking helps you to know what is normal for you, and so feel more in control of health and well-being.

4. Reduce stress - Although we have become used to differentiating between ‘mental' and ‘physical' health, this is an artificial separation, especially when thinking about menstrual health.

For example, it is known that the menstrual cycle interacts with the HPA (Hypothalamic–Pituitary–Adrenal) axis, better known as the ‘stress axis’ [7]. If you experience an increase in stress, you will feel anxious- your ‘fight or flight’ response is triggered. This is what we have evolved to do, regardless of the fact that this response might have been triggered by healthy changes in the menstrual cycle, rather than a scary, dangerous, or otherwise stressful situation.

Interestingly, research shows that cyclical changes are strongly affected by external (stress) factors, as well as physiological changes [8]. For example, irritability, is nearly always in response to an experience of 'injustice'  or 'frustration' of some sort- e.g. shouting at the kids whilst trying to get them ready for school, if your partner does not equally share in this responsibility. In fact, being single, or having a supportive partner can significantly improve menstrual health, by simply reducing the sense of 'injustice' regarding personal responsibilities during the premenstrual/ menstrual phase [9]!

A top tip is to ask your partner to cook dinner, or to be in charge of childcare just before and/ or during your period...

Another is to set a regular sleep pattern- use an alarm for when you should start to get ready for bed, switch off any screen devices, and try and wake up at a similar time each day. This will help regulate your body clock, which is also involved in the stress/ inflammation responses and the menstrual cycle!

By tracking changes over time, and getting to know when you are likely to feel more anxious, or sensitive to stress,  you can feel more in control, and ‘resist’ those first fluttery feelings in the pit of your stomach.

Take note of any triggering experiences- this will help you to identify the cause(s) of your stress e.g. work, home, or finances etc. Relaxation techniques or mindfulness practice can help to calm your breathing, and body, to break out of a downward spiral of emotional distress.

Then talk to the people in your life about the triggers that contribute to stress. Perhaps they could help in some way e.g. provide childcare support, help you to manage debt, or simply allow you some more space (e.g. at certain times in your cycle)?

Page last reviewed and updated: Dec 2020