In 1931, when the American gynecologist Dr. Katharina Dalton systematically brought the symptoms later described as premenstrual syndrome into clinical discourse, it marked a turning point: for the first time, cycle-related symptoms were taken seriously not as a "nervous condition," but as a legitimate subject of research. Today, we benefit from this pioneering work, as it has opened the door to evidence-based strategies that significantly reduce pain, mood swings, and performance drops – all through practical steps.

Dysmenorrhea refers to cramp-like pain around menstruation. It primarily arises due to prostaglandins, signaling molecules that stimulate the uterus to stronger contractions. PMS encompasses a spectrum of physical and emotional symptoms in the late luteal phasethe days before bleeding when progesterone drops, ranging from water retention to mood lows. Relevant terms: visceral fatfat tissue around internal organs, metabolically active, endorphinsbody's own "feel-good" peptides with pain-relieving effects, omega-3 fatty acidsinflammation-modulating fatty acids from fish, algae, flax. The goal: to dampen inflammation activity, increase pain thresholds, stabilize blood sugar, and calm the stress nerve HPA axisstress regulation system of hypothalamus–pituitary–adrenal gland. Small adjustments can have disproportionate effects: diet, exercise, mindfulness, and targeted micronutrients.

Regular physical activity significantly lowers the risk and intensity of menstrual pain – probably because endorphins increase and inflammatory signaling pathways are dampened; observational data have associated "regular exercise" with lower dysmenorrhea ^[1]. Conversely, prolonged sitting correlates with more frequent and stronger symptoms, including higher pain intensity ^[2]. Tobacco and alcohol act as a double booster for discomfort: simultaneous consumption significantly increases the dysmenorrhea risk, while exercise serves as a protective factor ^[1]. Nutrition has a dual effect: omega-3 fatty acids reduce pain in various inflammatory contexts – including dysmenorrhea – and lower the need for painkillers ^[3]. Calcium, in turn, can alleviate PMS symptoms like negative mood, cravings, and pain ^{[4] [5] [6]}. Skipping meals destabilizes blood sugar and triggers stronger mood swings; data also show associations between snacking/meal-skipping and cycle disturbances, especially in PCOS ^[7]. The key insight: lifestyle factors amplify or mitigate the same biological pathway – inflammation and pain signaling – and thus serve as highly effective levers for high performance throughout the cycle.

Several lines of evidence outline a consistent picture. First: lifestyle clusters. A large cross-sectional analysis from the Taiwan Biobank with 8,567 women showed that concurrent smoking and alcohol consumption increases the dysmenorrhea risk more than either alone, while regular physical activity has a protective effect ^[1]. For daily life, this means: habits add up – both negatively and positively. Second: inflammation modulation via fatty acids. A meta-analysis of 17 randomized studies found that omega-3 supplementation over 3–4 months reduces pain and lowers the need for NSAIDs; the inclusion areas also encompassed dysmenorrhea ^[3]. Relevance: those with cyclical pain often only benefit after several weeks – consistency is key. Third: nutrient therapy for PMS. Several randomized, placebo-controlled studies demonstrated that 1,000–1,200 mg of calcium per day significantly reduces total PMS scores, negative affect, water retention, cravings, and pain in the luteal phase ^{[4] [6]}; another double-blind study confirmed improvements in fatigue, appetite, and mood ^[5]. Additionally, a narrative review suggests that herbal remedies like ginger with anti-inflammatory and analgesic properties can alleviate menstrual pain, although more research is needed for hormonal fine-tuning ^[8]. Finally, recent data indicate that prolonged sitting – regardless of exercise – correlates with stronger symptoms ^[2]. Mechanistically, this aligns: less inflammation, more stable neurotransmission, better pain inhibition.

- Incorporate omega-3 daily: 2–3 portions of fatty fish per week or 1–2 g of EPA/DHA from algae/fish oil; simultaneously avoid trans fats (hydrogenated fats, highly processed snacks). Effects will manifest after 4–12 weeks through reduced need for painkillers and lower cramping intensity ^[3].
- Start a short but consistent yoga/mindfulness practice: 10–20 minutes of asanas, breathing exercises, or yoga nidra 4–5 days per week. Aim: to calm stress pathways, raise pain threshold, and support hormonal balance ^[9].
- Harness plant power: ginger 500–1,000 mg/day (dried extract) in the days before and during menstruation; chaste tree according to product label. Both address inflammation/pain; consider individual tolerance and interactions ^[8].
- Secure calcium: 1,000–1,200 mg/day through diet (e.g., yogurt, cheese, calcium-rich mineral waters, fortified plant milk) or supplements, especially in the luteal phase. Expected effects: less negative mood, cravings, water retention, and pain ^{[4] [6] [5]}.
- Move smart: 2x/week moderate-high interval sessions (e.g., 20–30 minutes cycling/ergometer) plus daily activity. Effect: noticeably less pain after 8 weeks ^[10]; actively interrupt sitting times to decrease symptom severity ^[2].
- Avoid amplifiers: reduce alcohol and nicotine, ideally eliminate – the combination significantly increases the risk of severe cramps; regular exercise counters this ^[1].
- Eat regularly: 3–4 balanced meals stabilize blood sugar and reduce mood swings; meal-skipping and frequent snacking are associated with cycle disturbances, especially in PCOS ^[7].

The next few years are expected to clarify which combinations of omega-3, calcium, exercise, and mindfulness are optimal for different symptom profiles – and how plant-based compounds like ginger should be dosed more precisely. Studies linking sitting behavior, microbiome, and inflammation with cyclical pain are also anticipated, allowing for personalized routines.