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Does Magnesium Help PMS?
Unlike calcium, the benefits of magnesium in the management of premenstrual syndrome are not widely accepted. However, studies indicate that women with PMS also have low levels of magnesium. One way in which magnesium can provide relief for PMS symptoms is by enhancing the activities of calcium. But there is good evidence to indicate that magnesium does more than that. How else can magnesium supplementation reduce PMS symptoms and which PMS symptoms are relieved? Read on to find out.
Magnesium is an essential mineral in humans and it has close ties with calcium and phosphates.
This nutrient is present in every cell of the body where it is needed for the syntheses of genetic materials (DNA and RNA) as well as for the activation of ATP (adenosine triphosphate, the chief energy molecule of cells).
Magnesium is also important to nerve conduction as well as bone health and cardiovascular health.
Humans typically hold 24 g of magnesium in the bodies. Most of this magnesium is stored in the bones (60%) and skeletal muscles (20%).
Although magnesium deficiency is rare, studies show that only 1 in 3 Americans meet the recommended dietary intake for the essential mineral. Therefore, most of the population suffers from low levels of magnesium.
Unfortunately, chronic hypomagnesemia can also be as dangerous as magnesium deficiency because it increases the risks of chronic diseases such as osteoporosis, asthma and diabetes.
Health experts recommend magnesium supplementation for preventing hypomagnesemia and for lowering the risk of these chronic diseases.
In addition, studies show that magnesium supplementation lowers the risks of heart attack, pre-eclampsia and stroke. It is also proven to improve the symptoms of migraine, fibromyalgia and premenstrual syndrome.
Before discussing the relationship between magnesium and PMS, it is important to acknowledge the role of calcium in the management of PMS.
Calcium is the only natural supplement that is currently unanimously accepted to help with PMS.
Researchers have conclusively proven that calcium deficiency is one of the major causes of PMS and that calcium supplementation can help with the condition. And magnesium is important to the absorption and utilization of calcium.
Along with vitamin D, magnesium is required for most of the functions of calcium. For example, magnesium and vitamin D are needed for calcium to bind to bones.
In addition, magnesium is needed for the release of calcium from certain cells. Therefore, low magnesium levels keep calcium locked inside these cells and make the mineral unavailable. This blockage also inhibits the release of parathyroid hormone and leads to both hypocalcemia and hypoparathyroidism.
The negative effects of the inhibition of calcium release are mostly felt in the central nervous system.
There, hypocalcemia through hypomagnesemia reduces the electrical firing of neurons and also blocks the release of acetylcholine and glutamate, the chief excitatory neurotransmitter in the brain.
Therefore, low magnesium levels can trigger mood changes, irritability and depression by reducing neuronal activities in the brain.
In addition, research shows that the calcium-magnesium ratio fluctuates during the menstrual cycle.
Magnesium level is at its lowest during the luteal phase. This phase occurs just before the start of menstrual flow and is the period when women experience PMS symptoms.
Low magnesium level has been repeatedly linked to higher risk of PMS. One study even found that women with PMS have lower levels of magnesium in their red blood cells than women without PMS.
This observation is confirmed by comparing the symptoms of PMS with the signs of hypomagnesemia.
Some of the symptoms shared by both conditions include weakness, muscle cramps, irritability and depression.
Just as PMS is sometimes believed to be caused by the improper regulation of calcium in the body, PMS can also be described as a condition induced by hypomagnesemia.
To prove that low magnesium level is responsible for some of the symptoms of PMS, researchers gave magnesium supplements to women with PMS. In every study in which magnesium supplementation is used as a PMS treatment, certain symptoms of PMS were quickly and totally resolved.
From past studies, it has been shown that magnesium can provide relief for the following PMS symptoms: migraine headache, mood swings and fluid retention (presenting as weight gain, abdominal bloating, edematous swelling and breast tenderness).
Clearly, magnesium supplementation improved PMS symptoms by resolving hypomagnesemia.
These studies also showed that magnesium was even more effective when combined with calcium, vitamin B6 and/or vitamin D.
But how can magnesium improve PMS symptoms? Discussed below are some of the health benefits of magnesium that contribute to the relief felt by women with PMS placed on magnesium supplements.
Magnesium is involved in energy production at the cellular level.
Unlike glucose and fatty acids, the body does not break down magnesium to make energy. Rather, the energy “currency” of cells, ATP, needs magnesium in order to be biologically active.
This means that the active energy molecule of cells is ATP-Mg. Therefore, low magnesium level will promote low energy states.
The importance of magnesium to cellular energy production is the reason why weakness, lethargy and fatigue are the symptoms of hypomagnesemia. Since these are also some of the symptoms of PMS, it is likely that low magnesium levels in women with PMS are also responsible for these symptoms.
By increasing magnesium intake, either with food or supplements, women experiencing PMS can restore their energy level and feel less fatigued.
Another way by which magnesium reduces fatigue is through its role as a muscle relaxant.
Hypomagnesemia is known to cause muscle weakness and muscle spasms. Muscle weakness can cause fatigue. Muscle spasms, on the other hand, can cause the cramps experienced during PMS.
Magnesium can reduce muscle spasms and cramps by acting as a muscle relaxant. To fulfil this function, magnesium closes the calcium channels feeding electrical charges into neurons around muscles. This results in less activity and less excitation of the muscles.
Therefore, besides reducing fatigue, magnesium can also help relax the muscles and eliminate PMS cramps.
Low magnesium levels can also affect the balance of hormones. For example, hypomagnesemia increases the level of aldosterone in the body.
Aldosterone is a corticosteroid hormone released from the adrenal gland. It is responsible for the balance of water and salt in the body.
A high aldosterone level promotes the conservation of sodium and the retention of water.
Unfortunately, the costs of aldosterone secretion include the loss of important minerals such as potassium and magnesium.
In addition, sodium retention also means fluid retention. Therefore, the hormonal imbalance triggered by low magnesium levels not only further reduces magnesium levels but also causes bloating, water weight gain, edema and breast tenderness.
It is no wonder then that magnesium supplementation in women with PMS reduces fluid retention.
Low magnesium levels also cause neurotransmitter imbalance in the brain. Studies show that without magnesium, the release of the neurotransmitters involved in mood is reduced.
Two of the neurotransmitters affected by hypomagnesemia are dopamine and glutamate.
The inhibition of such neurotransmitters is responsible for the anxiety, irritability, mood swings and depression felt by women while experiencing PMS.
Lastly, there is good evidence to suggest that low magnesium levels can promote inflammation. Women with PMS may experience inflammation as breast tenderness.
The link between magnesium and inflammation is not well understood. However, it has been shown that magnesium is involved in the metabolism of essential fatty acids. Essential fatty acids (especially omega-3 and omega-6 fatty acids) are central to the inflammatory process. A good balance is required between omega-3 fatty acids and omega-6 fatty acids to prevent inflammation.
Generally, omega-3 fatty acids have anti-inflammatory properties while omega-6 fatty acids are usually pro-inflammatory.
An optimal magnesium level can help establish and maintain the right balance of these fatty acids.
On the other hand, low magnesium level can disrupt the fatty acid balance and allow the dominance of pro-inflammatory fatty acids.
In a 1981 study published in The American Journal of Clinical Nutrition, a group of researchers investigated the claim that magnesium deficiency was a factor in the development of PMS.
Their investigation involved measuring serum and red blood cell levels of magnesium in women with PMS and comparing those values with the ones obtained from women without PMS.
The results of the study showed that magnesium levels were lower in women with PMS. In addition, the researchers saw that there was a greater difference in red blood cell magnesium levels in the 2 groups of women.
Therefore, they recommended that doctors should measure red blood cell magnesium levels along with serum magnesium levels when diagnosing magnesium deficiency as a cause of PMS.
A 1994 study published in the journal, Biological Psychiatry, took the investigation of magnesium levels a step further by measuring magnesium levels in mononuclear blood cells along with plasma and red blood cell magnesium levels.
For the study, the researchers recruited 26 women with PMS and 19 healthy women as controls.
By repeatedly measuring the 3 types of magnesium levels, the researchers found that women with PMS also have lower mononuclear blood cell magnesium levels along with lower red blood cell magnesium levels than the women who were free of PMS.
In addition, the researchers found that lower magnesium levels in women with PMS were not confined to the luteal phase of the menstrual cycle.
This study shows that magnesium deficiency is an underlying causative factor for PMS rather than a simple cyclic change during the luteal phase of the monthly cycle. Therefore, magnesium supplementation for women with PMS should not be restricted to the luteal phase.
In a 1991 study published in the journal, Obstetrics and Gynecology, a group of researchers determined whether oral magnesium supplementation can improve mood changes caused by PMS.
For the double-blind, randomized study, the researchers recruited 32 women with PMS and then took baseline measurements of their PMS symptoms for 2 months.
Thereafter, the women were given either placebo or magnesium (360 mg of elemental magnesium presented as magnesium pyrrolidone carboxylic acid) 3 times daily during their menstrual cycles for the next 2 months. Blood samples were drawn before, during and after the treatments.
The results of the study showed that magnesium supplementation raised the level of the mineral in lymphocytes and polymorphonuclear cells.
In addition, the women who took magnesium reported improvements in “cluster pain” and “negative moods”.
Another 1991 study published in the journal, Headache, followed the same methodology as the study described above and also used 360 mg/day of magnesium to determine the effect of magnesium supplementation on PMS-related migraine headache.
The researchers recruited 20 women with menstrual migraine and randomly assigned each of them to either placebo or magnesium pyrrolidone carboxylic acid from the 15th day of their menstrual cycles to the beginning of menstrual flow for 2 months.
After the second month, the results showed that both the placebo group and magnesium group reported improvements in their migraine headaches. However, the magnesium group had significantly lower pain scores.
The researchers believed that magnesium deficiency lowered the threshold of migraine pain.
Therefore, they concluded that magnesium supplements should be given to women with PMS in order to prevent menstrual migraine.
A 1998 study published in the Journal of Women’s Health explored another benefit of magnesium supplementation for women with PMS. In this study, the researchers determined whether magnesium supplements can be used to reduce fluid retention in PMS.
For this double-blind, placebo-controlled, crossover study, the researchers used magnesium oxide and recruited 38 women.
For the first 2 months of the study, each participant took either placebo or 200 mg of elemental magnesium (magnesium oxide supplement).
During this period, they were asked to continually rate the severity of the following PMS symptoms: anxiety, craving, depression, hydration and other symptoms.
The results showed that there was no difference between the two groups in the first month of the study. However, there were significant differences during the second month. The women in the magnesium group reported reductions in water weight gain, swelling of limbs, abdominal bloating and breast tenderness.
The researchers, therefore, concluded that a daily supplementation with 200 mg of magnesium can help reduce PMS symptoms involving fluid retention.
A 2000 study published in the Journal of Women’s Health and Gender-Based Medicine found that the combination of magnesium and vitamin B6 can provide better improvements in PMS symptoms than either of the supplements.
The researchers recruited 44 women with PMS and assigned each one to one of these 4 treatments:
The women recorded changes in their symptoms during one menstrual cycle.
The results of the study showed that the combination of vitamin B6 and magnesium produced a noticeable synergistic effect that lead to improvements in anxiety-related (anxiety, mood swings, irritability and nervous tension) PMS symptoms.
The researchers noted that magnesium oxide was not the best magnesium supplement to take because its absorption was poor and at least one month was needed to produce significant increase in magnesium levels.
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