Vitamin D Deficiency & Premenstrual Symptoms

A woman holds pain medicine in her hand while holding her abdomen.

Scientists have found that women with lower vitamin D levels tend to have more severe premenstrual symptoms, and vitamin D supplementation may alleviate some symptoms in those with vitamin D deficiency.

In the week leading up to their periods, over 90% of women and girls of reproductive age report getting some premenstrual symptoms, including headaches, bloating, mood changes, and more (1). Approximately 20-40% of women and girls have symptoms severe enough to qualify as premenstrual syndrome (PMS) (2-4). Severe debilitating symptoms occur in approximately 5% of all women and girls (3).

In recent years, there has been some research into how vitamin D levels interact with premenstrual symptoms. Scientists have found that women with lower vitamin D levels tend to have more severe symptoms, and vitamin D supplementation may alleviate some premenstrual symptoms in those with vitamin D deficiency (4).

This article describes common premenstrual symptoms, explores how vitamin D works in the body — focusing on how it may impact those symptoms, and covers practical advice for vitamin D testing and supplementation. 

Common Premenstrual Symptoms

Premenstrual symptoms affect women and girls in the days leading up to their menstrual periods. These symptoms can be physical, emotional, and behavioral, and their intensity and occurrence can vary greatly from person to person. Below are the most common symptoms associated with PMS.

Physical Symptoms

  1. Bloating and water retention: Many women experience swelling or puffiness in the abdomen, hands, or feet due to fluid retention.

  2. Breast tenderness: Breasts may feel swollen, sensitive, or painful.

  3. Cramps: Abdominal or pelvic cramping can occur before and during the menstrual period.

  4. Headaches or migraines: Fluctuations in hormones can trigger headaches or exacerbate migraines.

  5. Joint or muscle pain: Some women report aching in the joints or muscles.

  6. Fatigue: Increased tiredness or sleep issues are common.

  7. Weight gain: Temporary weight gain due to fluid retention is possible.

  8. Acne flare-ups: Hormonal changes can lead to worsening of skin conditions.

  9. Digestive issues: This can include constipation or diarrhea.

Emotional & Behavioral Symptoms

  1. Mood swings: Rapid changes in mood, such as feeling suddenly sad or tearful, are common.

  2. Irritability or anger: Feelings of irritability or even anger can increase.

  3. Depression or feelings of despair: Some may feel a sense of hopelessness or deep sadness.

  4. Anxiety: Increased anxiety or tension can occur.

  5. Concentration difficulties: Problems with focus and attention are not uncommon.

  6. Social withdrawal: A desire to avoid social interactions and activities.

Changes in Behavior or Appetite

  1. Food cravings: Particularly for sweet or salty foods.

  2. Change in libido: Some may experience a decrease or increase in sexual desire.

  3. Sleep disturbances: This can include insomnia or, conversely, sleeping more than usual.

Vitamin D - An Overview

Vitamin D is often referred to as the "sunshine vitamin" because our body synthesizes ~80% of our vitamin D in our skin, and we require UVB light from sunshine to do so. Vitamin D is crucial for the absorption of calcium, for immune function, and for bone health (4). Research suggests that vitamin D also plays a role in regulating mood and mitigating inflammation as well as neurotransmitter synthesis (5-9).

To learn more about vitamin D, including foods high in vitamin D, see: Top Sources of Vitamin D + Kid Friendly Recipes - Dr. Green Mom 

How Does Vitamin D Affect Premenstrual Symptoms?

The biological mechanisms by which vitamin D influences premenstrual symptoms are still under investigation, but several theories have been proposed:

  1. Calcium Regulation: Vitamin D helps regulate calcium levels in the body, which is crucial for normal neurotransmission and muscle contraction. Fluctuations in calcium levels have been associated with mood disorders and physical symptoms like cramps, which are common symptoms in the week leading up to menstruation (5).

  2. Anti-inflammatory Properties: Vitamin D has anti-inflammatory effects that may reduce the inflammation associated with premenstrual symptoms (6,7).

  3. Neurotransmitter Synthesis: Vitamin D affects the synthesis of serotonin, a neurotransmitter that regulates mood, appetite, and sleep — all of which can be disrupted during the premenstrual period (8,9).

To learn more about vitamin D, including foods high in vitamin D, see: Top Sources of Vitamin D + Kid Friendly Recipes - Dr. Green Mom

Practical Advice: Vitamin D Testing & Supplementation

Given the potential benefits, women and girls experiencing uncomfortable premenstrual symptoms may wish to consider evaluating their vitamin D levels and discussing supplementation with a healthcare provider.

According to the National Institutes of Health Office of Dietary Supplements, preteens, teens, and adults should get a minimum of 600 IU (15 mcg) of vitamin D per day and may supplement with up to 4000 IU (100 mcg) of vitamin D per day (10).

Higher doses may be required to correct a deficiency. For example, in one study teen girls received 50,000 IU (1250 mcg) every two weeks for four months to correct their vitamin D deficiency (7). However, doses of this size should be monitored by a healthcare professional.

Vitamin D3 is the more active form of vitamin D and, we believe, is most effective for raising serum vitamin D levels in comparison to vitamin D2 (11). For more information about vitamin D3 supplementation — and why it may be better to give it in conjunction with vitamin K2 — see: Better Together: Vitamins D3 & K2


The relationship between vitamin D levels and premenstrual symptoms highlights the importance of micronutrients in our overall health and well-being. For women and girls experiencing unwanted premenstrual symptoms, checking vitamin D levels could be a worthwhile step towards finding relief.


  1. Winer, S. A., Rapkin, A. J. (2006). Premenstrual disorders: prevalence, etiology and impact. Journal of Reproductive Medicine; 51(4 Suppl):339-347.

  2. Dean, B. B., Borenstein, J. E., Knight, K., & Yonkers, K. (2006). Evaluating the criteria used for identification of PMS. Journal of women's health (2002), 15(5), 546–555.

  3. Kwan, I., & Onwude, J. L. (2015). Premenstrual syndrome. BMJ clinical evidence, 2015, 0806.

  4. Abdi F, Ozgoli G, Rahnemaie FS. A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstet Gynecol Sci. 2019 Mar;62(2):73-86. doi: 10.5468/ogs.2019.62.2.73. Epub 2019 Feb 25. Erratum in: Obstet Gynecol Sci. 2020 Mar;63(2):213. PMID: 30918875; PMCID: PMC6422848.

  5. Thys-Jacobs, S., McMahon, D., & Bilezikian, J. P. (2007). Cyclical changes in calcium metabolism across the menstrual cycle in women with premenstrual dysphoric disorder. Journal of Clinical Endocrinology & Metabolism, 92(8), 2952-2959.

  6. Bertone-Johnson, E. R., Hankinson, S. E., Bendich, A., Johnson, S. R., Willett, W. C., & Manson, J. E. (2005). Calcium and vitamin D intake and risk of incident premenstrual syndrome. Archives of Internal Medicine, 165(12), 1246-1252.

  7. Heidari, H., Amani, R., Feizi, A., Askari, G., Kohan, S., & Tavasoli, P. (2019). Vitamin D Supplementation for Premenstrual Syndrome-Related inflammation and antioxidant markers in students with vitamin D deficient: a randomized clinical trial. Scientific reports, 9(1), 14939.

  8. Patrick, R. P., & Ames, B. N. (2015). Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 29(6), 2207–2222.

  9. Murphy, P. K., & Wagner, C. L. (2008). Vitamin D and mood disorders among women: An integrative review. Journal of Midwifery & Women’s Health, 53(5), 440-446.

  10. Vitamin D fact sheet for health professionals. NIH Office of Dietary Supplements. Accessed April 17, 2024.

  11. Tripkovic, L., Lambert, H., Hart, K., Smith, C. P., Bucca, G., Penson, S., Chope, G., Hyppönen, E., Berry, J., Vieth, R., & Lanham-New, S. (2012). Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis. The American journal of clinical nutrition, 95(6), 1357–1364.

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