Raise your hand if you rely on a cup (or more!) of coffee to wake yourself up in the morning or for a quick afternoon pick-me-up. Now raise your hand if that sweet, sweet caffeine hit becomes mission-critical while you're battling period fatigue in the lead up to your cycle, when getting through the day becomes even more of a slog than normal. No judgments, no shame, but here's some news you definitely aren't going to like: Your daily coffee is probably making your PMS worse.
With studies showing that 85 percent of Americans drink at least one caffeinated beverage per day — and that's without mentioning that caffeine can also be found in some teas, sodas, chocolate, and even medications — it's highly likely that you do enjoy caffeine in some form each day. Per the U.S. Food and Drug Administration (FDA), most healthy adults can safely consume 400 milligrams a day (roughly four or five cups of coffee) without any serious, negative effects, so the average coffee drinker is well within those markers.
That said, it's not necessarily doing your menstrual cycle any favors, as two OB-GYNs tell Scary Mommy. Guidelines by the American College of Obstetricians and Gynecologists (ACOG) recommend avoiding caffeine altogether to relieve PMS symptoms and breast tenderness, and a 2014 study published in the Journal of Taibah University Medical Sciences found that drinking coffee during your period is linked to longer, heavier periods and other menstrual irregularities.
Before you panic, however, it's worth diving into exactly how and why caffeine might impact your PMS and period symptoms — and whether or not you should reduce or cut out caffeine altogether.
How does caffeine affect your body?
Caffeine is a stimulant drug that increases the production of adrenaline in the body (aka the fight or flight hormone), which increases your heart rate and gets your blood pumping. "Since caffeine is a stimulant, it can increase the activity in your brain and nervous system," says Dr. Monica Grover, OB-GYN and Chief Medical Officer at VSPOT. "It can increase energy metabolism throughout the brain; however, it can also have the effect of decreasing blood flow to the brain. Caffeine can activate noradrenaline neurons (aka stress hormones that are in charge of elevating your blood pressure and heart rate) and increase dopamine levels," which ignites the brain's reward system and gives you that "feel-good" vibe. "Caffeine can also aid in learning, memory, performance, and coordination," says Grover. A rise in these hormone levels causes your blood vessels to restrict, leading to tension in your body.
And while plenty of people consume caffeine in all its forms with little to no ill effects, Dr. Jane Van Dis, OB-GYN, medical advisor for Flex notes that "some people experience rapid heartbeats and increased blood pressure due to caffeine's effects on the cardiovascular system. The digestive system can also experience a reduction in appetite and heartburn for some."
How can caffeine affect your period?
Research has shown mixed results between caffeine and period symptoms, despite the ACOG guidelines. In fact, a 2016 study published in the American Journal of Clinical Nutrition found that the impacts of caffeine on PMS symptoms are limited, and that high caffeine intake was not linked to breast tenderness, irritability, or fatigue. A 1999 study by the American Journal of Epidemiology found that women who drink caffeinated beverages during menstruation tend to have shortened periods, not longer ones, as the 2014 study found.
If the research has you confused, it's likely because people have different levels of sensitivity and reactions to caffeine, and period-havers experience varying degrees of menstrual symptoms in their cycles. "The studies linking caffeine and PMS symptoms are not very well established," says Grover. "What we know is that many women feel intense fatigue due to the luteal phase of their cycles, and as a result, there may be an increase in caffeine intake to help stay alert. However, caffeine has the effect of constricting blood vessels, and this can lead to more painful cramps, shorter periods (which can lead to prolonged time for conception), as well exacerbation of bloating, fatigue, anxiety, and mood changes, particularly once caffeine wears off. It can also lead to breast tenderness and an increased risk of fibrocystic breast disease due to raising stress hormones which trigger inflammation."
Factors such as "age, body weight, and tolerance all affect how we metabolize caffeine, which in turn changes how caffeine can impact your menstrual cycle," adds Grover. "When it comes to drinking coffee during your period or PMS, experts recommend limiting caffeine intake, but the exact amount you can have will depend on how your body processes caffeine. It may make PMS symptoms worse, although the conclusivity of this data is yet to be determined."
How much caffeine should you have leading up to your period?
If you feel like caffeine might exacerbate your period symptoms, cutting back is never a bad idea — particularly in the week before and during your period. "Regardless if on or off your period, 400mg is the maximum recommended amount of caffeine intake per day, including beverages, food, and supplements," says Van Dis. "Too much of any substance can have adverse effects, but again, there's insufficient evidence to show that caffeine helps or hurt PMS symptoms. Too much caffeine can definitely hurt, though, and cause side effects like a post-caffeine headache."
Grover recommends reducing to "less than 400mg of caffeine per day at least 4-6 days prior to the onset of your menses, as this will help to reduce an inflammation reaction in making uterine cramping and flow worse. I would suggest black tea, matcha green tea, or a kombucha. They all make great substitutes. Herbal teas can also be very soothing with pain or bloating as well as diminishing any types of mood changes or headaches."
Dr. Monica Grover, OB-GYN and Chief Medical Officer at VSPOT
Dr. Jane Van Dis, OB-GYN, medical advisor for Flex