Calcium

Supplement 2: Calcium

What is it?

Calcium: Minerals are defined as chemical elements required as essential nutrients to maintain body functions¹.

Calcium can be found in a variety of foods, including:

• Dairy products, such as cheese, milk and yogurt

• Dark green leafy vegetables, such as broccoli and kale

• Fish with edible soft bones, such as sardines and canned salmon

• Calcium-fortified foods and beverages, such as soy products, cereal and fruit juices, and milk substitutes².

How does it work?

Calcium decreases with rising estrogen concentrations which leads to decrease in neurotransmitter synthesis and release, leading to decrease in serotonin levels, causing mood changes during PMS. The calcium effect on PMS is correlated to the production of serotonin and tryptophan metabolism. .

Calcium supplementation may act by resolving an underlying physiologic deficit, suppressing parathyroid hormone secretion, and, ultimately, reducing neuromuscular irritability and vascular reactivity. .

Recommended dose: ACOG recommends supplementation of 1.2 mg calcium daily to alleviate both physical and psychological PMS symptoms, especially reducing water retention and breast tenderness³.

What is the efficacy?

A double-blind randomized clinical trial was conducted to evaluate the effects of low dose calcium on severity of PMS.

Sixty-six female students diagnosed with PMS were involved in the experimental and control groups. The participants were randomly assigned into two groups to receive 500 mg of calcium daily or placebo for two months.

No significant differences were observed in the mean scores of PMS symptoms between calcium and placebo groups before the treatment (P=0.74). However, significant differences were noticed between the two intervention groups in the first (P=0.01) and second menstrual cycles (P=0.001) after the intervention.

Overall, the results of the present study suggest that treatment with calcium supplements is an effective method for reducing mood disorders during PMS⁴.

Side effects:

Short-term effects: Constipation, diarrhea, abdominal pain

Long-term effects: Kidney stones, Cardiovascular problems, colorectal neoplasms⁵.

References

1. Kaewrudee S, Kietpeerakool C, Pattanittum P, Lumbiganon P. Vitamin or mineral supplements for premenstrual syndrome. Cochrane Database Syst Rev. 2018 Jan 18;2018(1):CD012933. doi: 10.1002/14651858.CD012933.

2. National Institutes of Health, Office of Dietary Supplements. Calcium and Vitamin D: Important for Bone Health [Internet]. Bethesda (MD): National Institutes of Health; [cited 2025 Apr 23]. Available from: https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health

3. Oboza P, Ogarek N, Wójtowicz M, Rhaiem TB, Olszanecka-Glinianowicz M, Kocełak P. Relationships between premenstrual syndrome (PMS) and diet composition, dietary patterns and eating behaviors. Nutrients. 2024 Jun 17;16(12):1911. doi: 10.3390/nu16121911.

4. Shobeiri F, Ezzati Araste F, Ebrahimi R, Jenabi E, Nazari M. Effect of calcium on premenstrual syndrome: A double-blind randomized clinical trial. Obstet Gynecol Sci. 2017 Jan 15;60(1):100–5. doi: 10.5468/ogs.2017.60.1.100.

5. Li K, Wang X-F, Li D-Y, Chen Y-C, Zhao L-J, Liu X-G, Guo Y-F, Shen J, Lin X, Deng J, Zhou R. The good, the bad, and the ugly of calcium supplementation: a review of calcium intake on human health. Clin Interv Aging. 2018 Nov 28;13:2443–52. doi: 10.2147/CIA.S157523.