Water retention before your period: How to stop the swelling

Monthly water retention can be uncomfortable and annoying. But simple lifestyle changes can usually relieve this common premenstrual symptom.

Premenstrual water retention is that bloated, heavy, full feeling that occurs a week or two before your period begins and goes away after your period starts. For most women, water retention before menstruation is just a monthly bother, but in some cases, it can be severe enough to interfere with daily activities. Luckily, there are other options besides spending five days in your "fat pants." Lifestyle changes, medications and natural remedies can help ease your bloated belly.

Water retention: The most common premenstrual symptom

That need-to-unbutton-your-pants feeling is perfectly normal. Up to 85 percent of women who menstruate have at least one premenstrual sign or symptom. And abdominal bloating, caused by water retention, is common.

Water retention is just one of more than 200 symptoms that have been linked to a woman's monthly menstrual cycle — a condition commonly known as premenstrual syndrome (PMS). Other common signs and symptoms of PMS include fatigue, breast tenderness, acne, headaches, food cravings, irritability and crying spells. These signs and symptoms typically begin between the ages of 25 and 35.

Why water retention happens

The exact cause of PMS — and its unwelcome symptoms — is unclear, but cyclic changes in hormones during this time of the month seem to play a major role. Here's a refresher on how your menstrual cycle works:

The average menstrual cycle lasts about 28 days. Day one is the first day of your period.
In the first half of your cycle, estrogen levels increase, signaling the lining of your womb (uterus) to thicken and grow. During the same time, hormones from your pituitary gland stimulate your ovaries to develop and release an egg.
About day 14, the egg is released and travels into one of your fallopian tubes. Then progesterone levels increase in preparation for pregnancy.
If the egg isn't fertilized, hormones decrease again and the thickened lining of the uterus is shed during your menstrual period. This occurs about day 28, and the whole cycle starts over again.

Chemical changes in the brain seem to interact with monthly hormonal changes and contribute to PMS symptoms. Serotonin is the brain chemical (neurotransmitter) most frequently blamed for PMS, but other chemicals also may come into play. In addition, stress and emotional problems seem to make PMS worse.

How to get your belly back

Most women can minimize — or prevent — premenstrual water retention and its resulting weight gain. Lifestyle changes usually do the trick, but medications and natural remedies can help, too.

Lifestyle changes
Taking extra-good care of yourself just before your period can help banish bloating. Plus, positive lifestyle changes provide other health benefits all month long.

Exercise. When PMS strikes, fight the urge to sit around in your sweats and watch chick flicks. Women who exercise generally report fewer PMS symptoms.
Skip the salt. Restricting sodium in the last few days before your period can reduce bloating, fluid retention, and breast swelling and tenderness. So put away your saltshaker. And pay attention to less-obvious sources of sodium, including condiments, such as soy sauce, and processed and prepared foods, such as canned vegetables, soups and deli meats.
Try smaller meals. Nibble on five or six small meals, instead of three big ones. Just make sure these smaller meals include plenty of fruits, vegetables and whole grains.

For most women, these lifestyle changes are the only treatment needed for water retention.

Medications
If you can't control premenstrual water retention with lifestyle changes alone, nonprescription and prescription medications can help:

Diuretics. The most effective medicine for water retention is usually a diuretic. Sometimes called water pills, these medications help rid your body of sodium and water by making your kidneys excrete more sodium in urine. They are available in over-the-counter formulations, such as pamabrom (Aquaban), or stronger prescription pills. But long-term use of these fluid reducers can cause electrolyte abnormalities or even kidney damage.
Over-the-counter PMS treatments. These medicines (Midol, Pamprin) usually contain some combination of mild diuretics, pain relievers, antihistamines and caffeine. So they can treat a range of PMS symptoms. However, if your main symptom is water retention, you may not need all of the active ingredients in these medications.
Over-the-counter pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve), may alleviate physical symptoms that occur with PMS. If you experience abdominal cramps along with bloating, acetaminophen (Tylenol, others) also may help.
Birth control pill (oral contraceptive). If you have severe water retention and cramping, your doctor may recommend a low-dose oral contraceptive. These medicines prevent ovulation, which can reduce the physical symptoms of PMS.

The best medication for you depends on a range of factors, including the severity of your symptoms and your desire to become pregnant.

Natural remedies
Countless vitamins, minerals and herbs have been touted as a cure for PMS symptoms. The following remedies have proved to reduce water retention in scientific studies:

Calcium. Studies show that taking 1,200 milligrams (mg) of calcium a day may reduce water retention, cramps and other physical symptoms of PMS.
Magnesium. A dose of 200 mg to 400 mg of magnesium each day has shown some benefit to alleviate bloating.
Natural diuretics. Some herbs — including dandelion, ginger and juniper — act as a natural diuretic because they make you urinate more. However, natural diuretics have only a modest effect, compared with conventional medications.

Primrose oil and gingko leaf extract also are commonly recommended for premenstrual water retention, but there is little evidence for their effectiveness.

When to talk to your doctor about water retention

Talk to your doctor if you're troubled by monthly water retention. He or she may suggest that you keep a symptom diary for a few months. This helps confirm that your symptoms are related to your menstrual cycle, rather than other causes of abdominal pain, including irritable bowel syndrome, celiac disease or other gastrointestinal problems.

Your doctor can also help determine the best treatment for you. Over-the-counter PMS medications and herbal remedies can interact with other medications you're taking and some can't be taken in high doses for extended periods. Work with your doctor to find a safe, effective way to put those fat pants back in the closet — and wear your favorite jeans all month long.