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The gut-PMS connection: gut-smart tips to manage symptoms naturally

2 June 2025

By The Gut Health Doctor Team

Dr Megan Rossi in a lab looking through a microscope

Ever wondered whether your gut health influences premenstrual syndrome (PMS)? If you experience periods and find yourself feeling irritable, bloated or just not quite yourself in the days leading up to them, you’re far from alone. Up to half of women report some form of PMS, with more than 150 symptoms linked to it – from mood swings and anxiety to bloating, headaches and disrupted sleep.

Despite being incredibly common, the emotional and physical toll of PMS is often underestimated, misunderstood and overlooked. It can affect confidence, impact relationships, and interfere with daily life, sometimes without much awareness or appreciation from others. The good news? While there’s no magic fix, there may be more within your control than you think.

Emerging research suggests that what you eat – and how it supports your gut – could influence everything from mood to cramps. Let’s explore what the science says about the gut-PMS connection and if smarter nutrition might be part of the solution…

How your gut is involved in PMS

You might not associate your gut with your hormones or menstrual cycle, but they’re more connected than you think.

1. The period poop phenomenon

If you’ve ever had to rush to the loo around your period, it’s not a coincidence. This common experience is often caused by prostaglandins: hormone-like chemicals your body produces before and during your period to help shed the uterine lining. These also stimulate smooth muscle contractions in your gut, speeding up transit time and leading to diarrhoea. These same prostaglandins are responsible for period pain too, which is why anti-inflammatory painkillers like ibuprofen help – they can block prostaglandin activity.

2. The gut-hormone axis

Your gut bacteria play an important role in regulating neurotransmitters like serotonin, and hormones like estrogen, which not only impact PMS, but can also influence the sensitivity of the hundreds of millions of nerves throughout your body. This essentially means your body, gut included, can experience a heightened sense of pain when things are out of balance – like in PMS.

3. The gut-mood axis

It won’t come as any surprise to you that PMS is strongly linked to mood shifts, and the inflammation connected to both PMS and poor gut health may further exacerbate mental health changes, such as anxiety and low mood.

The science behind these connections is further supported by research, which demonstrates that PMS (and its severity) are associated with unique microbiome profiles.

Six small changes that could help ease PMS

Feeling more in control each month doesn’t necessarily mean a major diet overhaul. In fact, small wins are often the most sustainable. While no diet can completely cure PMS, research suggests certain eating patterns and foods may help reduce symptoms.

1. Add in more anti-inflammatory foods

A Mediterranean-style diet – rich in extra virgin olive oil, vegetables, legumes, nuts, and fish — has been linked to fewer PMS symptoms. A 2024 study found that women who regularly ate carotenoid-rich plant foods (colourful fruit and vegetables) were around 40% less likely to experience painful periods than those who didn’t. Another study linked low fruit intake to greater period pain, with women eating less than two pieces a day being three times more likely to suffer. Other findings also suggest that daily consumption of good-quality extra-virgin olive oil may help alleviate period pain.

2. Try prebiotic fibre

This feeds your gut microbes and supports a more resilient gut-brain axis. Options include garlic, onions, mixed beans, leeks and more. But as we’ll touch on below, it’s best to start slow and train your gut over several months to make the most of these fibres – and given there stimulatory effect on the gut, if you struggle with period poops, it’s best to reduce down during the first few days before, and first day or two after, your periods start.

Picture of two people exercising and staying active

3. Move your body regularly

Exercise, particularly moderate-intensity exercise, has been shown to lower inflammation and boost mood. In fact, a 2020 meta-analysis, which summarises all the studies on a single topic, confirmed that moderate-intensity exercise reduces both the severity and duration of PMS symptoms. Although moving your body can be the last thing you feel like doing when PMS strikes, taking 15 minutes out for some lower-intensity exercise like yoga or a walk can also help reduce PMS severity in the moment.

4. Explore mindfulness

A recent study found that women who used a mindfulness app for eight weeks experienced significant improvements in both emotional and physical PMS symptoms. Don’t underestimate the power of the gut:brain axis in hormone regulation.

A photo of one of the mug cakes, in a white ramekin, topped with fresh berries and yoghurt

5. Satisfy cravings smarter

If you crave chocolate in the luteal phase (approx day 15-28, after ovulation and before your period), you’re not alone. Hormonal shifts impact serotonin, which often drives us to comfort foods. Rather than fighting it, try upgrading your sweet snack. These banana mug muffins include gut-loving complex carbohydrates and high-fibre ingredients to satisfy both your sweet cravings and your nutritional needs.

6. Get on top of thrush

Vaginal thrush is incredibly common, affecting 75% of women in their life time. The challenge with thrush, as you may have experienced firsthand, is the high risk of recurrence. What’s more, thrush has been shown to worsen PMS. While there is no evidence for the anti-candida diet – in fact, it could do more harm than good – there was a placebo-controlled study (aka RCT) showing that a specific formulation of probiotics can reduce your risk of relapse by close to three times compared to placebo.

What to avoid before your period

When it comes to PMS and gut symptoms, some foods and drinks might be best minimised in the days leading up to your period.

1. Caffeine and alcohol

Both are known to stimulate the gut and may worsen diarrhoea or discomfort. If you’re sensitive to either, try cutting back 2–3 days before your period starts.

2. Spicy and fatty foods

These can also play havoc with your gut transit time, leading to looser stools and bloating. While you don’t need to ditch them forever, try switching to lighter meals just before and during your period.

3. Large meals

Eating smaller, more frequent meals (five or six instead of three large ones) can reduce the ‘dumping’ effect on your gut and help with nutrient absorption.

4. High-FODMAP foods

If you’re prone to bloating or loose stools, temporarily cutting back on high-FODMAP foods — such as garlic, onions, apples, and beans — for a few days before your period may help. But remember to add this back in so you’re getting enough of the diversity that your microbes love.

Spotting the red flags: when PMS might be something more

Most people experience some changes around their cycle, but if symptoms feel overwhelming or affect your quality of life, it could signify something more complex. Conditions that may require medical diagnosis and support include:

Premenstrual dysphoric disorder (PMDD) – a severe form of PMS with significant emotional and physical symptoms
Endometriosis – where tissue similar to the womb lining grows elsewhere, often causing severe pain, heavy bleeding and pain during/ after sex
Polycystic ovary syndrome (PCOS) – which can affect hormones, periods, skin, hair growth and weight
Fibroids or adenomyosis – linked to heavy or more painful periods

If you’re dealing with extreme mood shifts, prolonged pain, irregular bleeding or worsening symptoms, it’s important to speak with a healthcare professional. A GP (ask for one that specialises in women’s health, if possible) or gynaecologist (although we appreciate waiting lists can be extensive) can help identify what’s happening and develop tailored treatment options. You deserve the right support, so please don’t suffer in silence.

Illustration of a woman picking out a grain out of a tapestry of different types of plants to show plant diversity

Takeaway

PMS is common, but that doesn’t mean it should be dismissed. While there is no one-size-fits-all solution, research indicates that dietary and lifestyle changes, particularly those that promote gut health, can significantly impact the management of monthly symptoms. From adding more plants to cutting back on gut stimulants before your period, small shifts can lead to big wins over time.

Of course, if you’re experiencing severe or worsening symptoms, it’s always worth speaking to a healthcare professional to rule out underlying conditions and explore personalised support.

If you want personalised support related to women’s health, speak to your GP or reach out to one of our specialist dietitians at The Gut Health Clinic. If you’re concerned about your blood pressure or want personalised support, speak to your GP or reach out to one of our specialist dietitians at The Gut Health Clinic.

Illustration of gut with micro bacteria and a quiz sheet

Is your gut healthy?

Take our quick quiz to give you helpful insight into the current state of your gut health. By assessing your symptoms, family history, immunity, mood and other lifestyle factors, you can be informed on the most effective areas to kickstart your own gut health transformation.

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The gut-PMS connection: gut-smart tips to manage symptoms naturally