(Reuters Health) - The amount of foods containing sugars or other carbohydrates that a woman eats has nothing to do with the likelihood she will start experiencing premenstrual syndrome (PMS), researchers say.

“While there are dietary recommendations to alleviate symptoms, such as increasing complex carbohydrates or to reduce sugar intake, there has been very little research done on risk factors for developing PMS,” lead author Serena Houghton told Reuters Health in an email.

“Women with clinically significant PMS have symptoms that interfere with so many aspects of their life, like work, school and interactions with their friends and family, and being able to prevent this in the first place would be beneficial for a number of women,” said Houghton, a researcher at the University of Massachusetts Amherst.

Up to 20 percent of women experience physical and emotional symptoms leading up to and during the first few days of their periods each month, Houghton and her colleagues write in European Journal of Clinical Nutrition.

To see whether carbs or fiber in the diet in the years before PMS begins have any influence on the risk of developing it, the study team looked at data from a large long-term study of women. Participants included female nurses who were between 25 and 42 years old when the study began in 1989 and who answered yearly questionnaires about their diets and health.

When the researchers compared 1,234 women who were eventually diagnosed with PMS to 2,426 women who did not have the condition, they found no difference in risk of developing PMS during 14 years of follow-up based on daily intakes of total sugar, added sugars, natural sugars, sucrose, fructose or glucose.

“Overall, it does not appear that the amount of carbohydrates and types of carbohydrates are associated with a woman’s risk of developing PMS; but eating a healthy diet with complex carbs has other health benefits,” Houghton said.

Only one sugar, maltose, was linked to a 45 percent increased risk for PMS among women who ate a lot of it compared with those who ate the least. Researchers say that result needs further study to explain.

“Maltose tends to be consumed in small quantities from foods like cooked sweet potatoes, beer and other malted beverages, and processed foods,” Houghton said

In the same study population, alcohol, including beer, had very minimal risk, so having a 45 percent increase in risk was somewhat surprising, Houghton remarked.

The strengths of this study include that it followed a large group of premenopausal women over a significant period of time and there was a high response rate throughout, said Dr. Talitha Bruney, an obstetrician and gynecologist with Montefiore Medical Center in New York.

“The drawbacks include (that) all the evaluation and diagnoses were done by questionnaire format only, which can lead to its own lack of objectively,” Bruney, who was not involved in the study, told Reuters Health by email.

“However, the overall findings showed no significant association, which appears to be a similar finding when compared to other studies,” she added.

When a woman does develop PMS, Bruney said, treatment depends on the severity of symptoms, and often multiple options may have to be tailored to meet the needs of the patient.

“Mild symptoms can often be treated with exercise and relaxation,” she said.

It’s unclear whether diet modification and supplements improve symptoms when compared to placebo. But there may be some benefit from consuming a diet rich in complex carbohydrates, Bruney said.

“There is poor data supporting the efficacy of calcium, magnesium, vitamin B6 supplementation, and since there may be an associated risk of toxicity, it may be wise to refrain from recommending routine use,” she said.

Proven therapies include the use of drugs that prevent ovulation such as oral contraceptives pills and antidepressants such as selective serotonin receptor inhibitors, especially in patients with significant mood symptoms, Bruney noted.

“NSAIDs can help reduce pain and diuretics can relieve bloating symptoms,” she said.

SOURCE: go.nature.com/2GiEX5h European Journal of Clinical Nutrition, online January 29, 2018.