You can eat
- Small oily fish (sardines, anchovies, mackerel) and ground flaxseed or chia seeds: they provide omega-3, and eating more fish is associated with less period pain.
- Pulses (lentils, chickpeas, beans) and whole grains: they provide fibre that supports fullness and blood glucose stability in PCOS.
- Leafy greens and cruciferous vegetables (spinach, chard, broccoli, rocket): they provide folate, fibre and plant-based iron, which can be useful if your periods are heavy.
- Nuts and seeds (walnuts, almonds, pumpkin seeds): sources of magnesium, fibre and heart-healthy fats.
- Fresh seasonal whole fruit (berries, apples, oranges): provides polyphenols, water and fibre without causing sharp rises in blood glucose.
- Extra virgin olive oil: the main fat for cooking and dressing food, and a foundation of the Mediterranean dietary pattern.
- Plain, unsweetened fermented dairy products (natural yoghurt, kefir) or calcium-fortified plant-based alternatives: they provide calcium, which may help ease some premenstrual symptoms.
- Quality protein at every meal (eggs, tofu, poultry, white fish): helps maintain steady energy and avoid sudden hunger.
What to avoid
- Ultra-processed foods high in sugar and low-quality fats: they displace fruit, vegetables and fish, which are associated with less menstrual pain.
- Excess salt and ready-made foods: they encourage fluid retention and can worsen bloating in the days before your period.
- Alcoholic drinks: they impair sleep and may worsen premenstrual mood changes.
- Sugary soft drinks and packaged juices: they cause sharp fluctuations in blood glucose and insulin, which may be unhelpful if you have insulin resistance or PCOS.
- Fatty cured meats and processed meats: best kept occasional; they often contain a lot of salt and saturated fat and can make digestion feel heavier.
- Refined flour and pastries: they displace nutrient-rich foods and can worsen energy dips and spikes in appetite.
- Too much coffee and other stimulant drinks before your period: if you notice they affect you, they may increase irritability and insomnia.
- Commercial supplements to “balance hormones” without a prescription: they lack strong evidence and may interact with medical treatments.
Changes that help
Sweet cravings during the luteal phase
Biscuits or pastries → Wholemeal toast with peanut butter and banana, as it provides slowly released energy and magnesium without causing sharp drops in blood glucose
Premenstrual bloating and fluid retention
Too much table salt and salty snacks → Herbs, lemon and spices (oregano, turmeric), as they add flavour without sodium, which can worsen fluid retention
Evening meals on days with period pain
Fried foods, ready meals or fatty red meat → Courgette soup with a poached egg or grilled tofu, as this is a light meal that may be easier to digest when you are already uncomfortable
Carbohydrates with PCOS
Refined flour, white rice or soft drinks → Pulses, quinoa, oats and whole fruit, as their fibre helps moderate rises in blood glucose and insulin
Habits that help
- Aim for 7 to 8 hours of sleep on a regular schedule, as good rest supports insulin response.
- Combine strength and aerobic exercise: working muscles help reduce insulin resistance in PCOS.
- Apply local heat to the pelvic area when pain starts, as it relaxes the muscles and eases cramps.
- Take relaxing breaks when you feel stressed, as stress can amplify pain and premenstrual symptoms.
Hormones change throughout the cycle, along with appetite, energy, fluid retention and bowel habits. None of this is a flaw that needs to be corrected through restriction.
When there is also a diagnosis of polycystic ovary syndrome (PCOS) or endometriosis, conflicting messages and endless lists of foods to avoid can follow. We often see this in consultations: women who have cut out gluten, dairy and sugar all at once and are still just as tired and in pain.
Why do appetite and energy change during the menstrual cycle?
Many women notice that their relationship with food changes throughout the month. During the first half of the cycle (the follicular phase), oestrogen is dominant and appetite tends to remain more stable. After ovulation comes the luteal phase. Progesterone rises, and it is common to eat a little more. A systematic review published in Nutrition Reviews estimates an average increase of about 170 kcal per day compared with the follicular phase [3]. Resting energy expenditure may also rise slightly during this phase. According to a review published in PLOS One, the effect is small. In the most recent studies, it is no longer statistically significant [4]. See “Postnatal diet”.
That is why hunger and cravings for comforting foods often increase in the days before your period. This is not a lack of willpower; it is a physiological signal. In consultations, we teach you how to respond with complex carbohydrates (oats, potatoes, pulses), enough protein and healthy fats. We avoid severe restrictions that can lead to binge eating. If you are also hoping to become pregnant, you can read our guidance on nutrition for fertility.
How can nutrition help relieve premenstrual syndrome?
Premenstrual syndrome (PMS) includes physical and emotional symptoms—breast tenderness, irritability, abdominal distension and bloating—that appear during the luteal phase and ease when your period starts. The American College of Obstetricians and Gynecologists (ACOG) guideline on premenstrual disorders recommends regular exercise as a basic measure. It also recognises that calcium may help reduce symptoms [5].
You do not need diuretics for bloating. It can help to reduce the salt in ultra-processed and ready-made foods. Fruit, vegetables and pulses provide potassium. You can meet your calcium needs through food: dairy products (up to three servings a day, preferably plain and unsweetened), calcium-fortified plant-based drinks, almonds or canned sardines with their bones. From age 25 onwards, EFSA sets 950 mg of calcium per day as the reference intake for adults. Each case should be assessed individually before considering a supplement. Spreading complex carbohydrates throughout the day helps prevent energy dips and sudden hunger.
What can nutrition do for painful periods or dysmenorrhoea?
Primary dysmenorrhoea is period pain without an underlying disease. It is mainly caused by excess prostaglandins. These inflammatory substances are produced by the endometrium and cause painful uterine contractions. Your doctor will prescribe pain treatment, usually painkillers, and nutrition can support it.
A systematic review of 38 observational studies published in Gynecologic and Obstetric Investigation found that eating more fruit, vegetables, fish and dairy products is associated with less menstrual pain [6]. These are association studies: they do not prove that diet relieves pain, but their findings point in the same direction as the Mediterranean dietary pattern we already recommend for overall health. Eating fish, especially oily fish, two or three times a week and reducing ultra-processed foods are simple changes with no risk. If heavy periods have caused iron deficiency, read our guide to iron-deficiency anaemia.
What role does nutrition play in polycystic ovary syndrome (PCOS)?
Polycystic ovary syndrome (PCOS) is an endocrine and metabolic condition. It can involve irregular cycles or no ovulation, alongside signs of excess androgens, such as increased hair growth or acne. Insulin resistance is very common. This means the body needs more insulin than usual to control blood sugar. A gynaecologist makes the diagnosis using standardised clinical, laboratory and ultrasound criteria.
The international evidence-based guideline for PCOS was published in 2023 by Monash University, ESHRE and ASRM. It places healthy habits—nutrition and physical activity—at the heart of care for all women with PCOS [1]. It does not recommend one type of diet over another. In consultations, we do not aim for aggressive restriction; we work towards an eating pattern you can maintain: pulses, whole grains, whole fruit and vegetables for fibre, protein at every meal and unsaturated fats. This approach aims to improve insulin response and metabolic health. Nutrition does not make PCOS go away or replace medication when it is needed.
How can nutrition help with endometriosis, and what are its limits?
Endometriosis is a chronic inflammatory disease in which tissue similar to the endometrium grows outside the uterus. It can cause pelvic pain, very painful periods and, often, digestive symptoms. A gynaecologist makes the diagnosis using imaging tests or, in some cases, surgery.
The European Society of Human Reproduction and Embryology (ESHRE) guideline on endometriosis concludes that the evidence does not support recommending any specific diet to reduce pain [2]. As general advice, it does recommend healthy habits and regular physical activity. We therefore do not promise that a diet will eliminate lesions or pain. In consultations, we work on the digestive symptoms experienced by many women with endometriosis.
Are supplements needed to “balance hormones”?
At Alimmenta, we do not sell supplements or believe in commercial combinations intended to indiscriminately “balance hormones”. Social media advertising often attributes unproven properties to various compounds. It also fails to mention that taking supplements without supervision may be ineffective, costly or interfere with other medicines.
Supplements can be useful in very specific clinical situations, such as a deficiency confirmed by a blood test. However, any supplement should complement a balanced diet, never replace it. Your doctor or dietitian-nutritionist will recommend one after assessing your individual situation.
Read the infographic text
I know lots of people who take supplements, don’t you use them at Alimmenta?
The difference is not between using supplements or rejecting them, but between supplementing by default and supplementing with judgement.
At Alimmenta we don’t sell supplements, and our work consists of showing each patient what they can achieve through diet, by reviewing this foundation.
- 1. FOUNDATION · The essentials: diet and habits
- 2. GOAL · symptoms · blood tests · body composition · performance · medical conditions
- 3. LIFE STAGE · adolescence · reproductive years · pregnancy · perimenopause · menopause · 60+
Some supplements can be useful in specific circumstances, but before recommending them we assess whether there is a real need, what evidence supports their use, what the right dose is, how long they should be taken and how their results will be checked.
So, once the patient’s diet has been reviewed, and depending on their blood tests and life stage, we assess whether supplementation is needed (points 2. and 3.).
What happens during a nutrition consultation for women’s health?
Our consultations avoid standard printed diets and unnecessary bans. We take a thorough, personalised approach:
- A complete dietary and clinical history: we review your schedule, digestion, recent test results, relationship with food and menstrual cycle.
- Symptom tracking across your cycle: we relate symptoms, appetite and tiredness to the different phases of your cycle so we can plan practical solutions.
- A gradual, realistic eating plan: we agree on changes that fit your working and family life, without leaving you hungry or asking you to obsessively count calories.
- Working with your healthcare team: we communicate with your gynaecologist or endocrinologist. If your symptoms cause anxiety or guilt, we can also involve our specialist psychology team.
Read the infographic text
Faced with information overload: less marketing and more science
BMI · fasting · calcium · metabolism · cortisol · inflammation · anxiety · protein · hydration · magnesium · iron · detox · miracle diets · shakes · fat burners · hormone treatments · collagen
the essentials review by Alimmenta
Nutrition built on 3 pillars
- 1. FOUNDATION · The essentials: diet and habits
- 2. GOAL · symptoms · blood tests · body composition · performance · medical conditions
- 3. LIFE STAGE · adolescence · reproductive years · pregnancy · perimenopause · menopause · 60+
“It’s not about doing more, but about doing what makes sense for you right now.”
Women’s needs change throughout life. If you are approaching perimenopause or menopause, read our guide to nutrition and menopause. During pregnancy, see our pregnancy diet guide. If you are breastfeeding, read about what to eat while breastfeeding. For recurrent vaginal infections, see our guide to vulvovaginal candidiasis. See “Recurrent cystitis”.
If pain, bloating or an irregular cycle affects your day-to-day life, Alimmenta’s team of dietitians specialising in women’s health can help you find an eating plan tailored to you. We offer in-person consultations in Barcelona and online.
Every woman has her own rhythms, schedule and experience. The right plan is one that fits your life.
Your first step this week
A balanced plate at every meal
Include vegetables, a source of quality protein and complex carbohydrates to help keep your energy steady and avoid blood glucose spikes
Oily fish every week
Include small oily fish two or three times a week; eating more fish is associated with less menstrual pain
Track your cycle and symptoms
Use a calendar or app to note how your pain, digestion and appetite change throughout the month so you can anticipate your needs
When to see a doctor
When to see a doctor
Nutrition can help ease menstrual and digestive symptoms and, in PCOS, support healthy habits, which are central to care. We cannot diagnose gynaecological conditions or replace hormonal, drug or surgical treatments. These are matters for gynaecology, endocrinology and your GP.
Arrange a medical appointment without waiting to change your diet if you notice any of these signs:
- You bleed between periods or after sex, or need to change a pad or tampon every hour for several hours [7]
- You have gone more than three months without a period and are not pregnant [1]
- You have had very infrequent periods for years and have not received any treatment [1]
- Hair growth, acne or hair loss has increased quickly over a short time [1]
- You have developed dark, velvety patches on your neck or underarms, or feel very thirsty or extremely tired [1]
- You feel very low or have marked anxiety [1]
If any of these apply, make an appointment with your GP this week; they can refer you to gynaecology or endocrinology if needed. Going years without a period requires medical assessment, even if you are not trying to become pregnant.
Most menstrual symptoms do not reach this point. Knowing when to seek advice is part of looking after yourself.
Tell us what your cycle is like
At the first visit we talk about your cycle, your symptoms and what you eat. Within a week you have your plan. We also look at what your doctor has told you so that everything fits together.
Keep reading
Nutrition before pregnancy: how to support fertility
You want to try for a baby and advice reaches you from every direction about what to eat,…
Nutrition during menopause: what to eat and what to avoid
Hot flushes, a changing waistline despite eating no more, and concern about your bones arrive together, and what…
PCOS: food, insulin resistance and daily habits
You have PCOS and hear conflicting advice about carbohydrates, weight and exercise. Which changes are worth making without…
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PCOS and menstrual health dietitian in Barcelona
Nutrition for polycystic ovary syndrome, irregular cycles, absent periods and period pain, in Barcelona and online.
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Sources
- Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2023;38(9):1655-1679. doi:10.1093/humrep/dead156
- Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009. doi:10.1093/hropen/hoac009
- Tucker JAL, McCarthy SF, Bornath DPD, et al. The effect of the menstrual cycle on energy intake: a systematic review and meta-analysis. Nutr Rev. 2025;83(3):e866-e876. doi:10.1093/nutrit/nuae093
- Benton MJ, Hutchins AM, Dawes JJ. Effect of menstrual cycle on resting metabolism: a systematic review and meta-analysis. PLoS One. 2020;15(7):e0236025. doi:10.1371/journal.pone.0236025
- American College of Obstetricians and Gynecologists (ACOG). Management of premenstrual disorders: ACOG Clinical Practice Guideline No. 7. Obstet Gynecol. 2023;142(6):1516-1533. doi:10.1097/AOG.0000000000005426
- Bajalan Z, Alimoradi Z, Moafi F. Nutrition as a potential factor of primary dysmenorrhea: a systematic review of observational studies. Gynecol Obstet Invest. 2019;84(3):209-224. doi:10.1159/000495408
- National Institute for Health and Care Excellence (NICE). Suspected cancer: recognition and referral. NICE guideline NG12. 2015, updated 2026. Available at: https://www.nice.org.uk/guidance/ng12
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PCOS and menstrual health dietitian in BarcelonaNutrition for polycystic ovary syndrome, irregular cycles, absent periods and period pain, in Barcelona and online.
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