Menstrual Health and Lifestyle Medicine

This chapter discusses prevention and treatment of common menstrual disorders including primary dysmenorrhea, premenstrual syndrome (PMS), and uterine fibroids utilizing a Lifestyle Medicine approach. Particular attention is given to several pillars of lifestyle medicine: nutrition, physical activity, sleep, stress, and cessation of alcohol and tobacco use. Low-fat, high-fiber plant-based diets are recommended to decrease excess circulating serum estrogen, which results in improvement of menstrual symptoms in both primary dysmenorrhea and PMS and is associated with reduced incidence of uterine fibroids. Physical activity is beneficial in treating dysmenorrhea and PMS and should be emphasized. Stress and sleep are linked to both dysmenorrhea and PMS. Stress management, relaxation techniques, and sleep optimization may play a role in management. Caffeine and alcohol should be limited in dysmenorrhea. However, no clear association between caffeine or alcohol use and PMS was found. Smokers develop worse symptoms of both dysmenorrhea and PMS and tobacco cessation should be strongly encouraged in both disorders. Although some vitamins may show promise, particularly in deficiency, the suggested role of vitamin supplementation is generally unclear with sparse data and limited studies.