Treatment:

A healthy lifestyle is the first step to managing PMS. For many women with mild symptoms, lifestyle approaches are enough to control symptoms.

• Drink plenty of fluids (water or juice, not soft drinks or other beverages with caffeine) to help reduce bloating, fluid retention, and other symptoms.
• Eat frequent, small meals. Leave no more than 3 hours between snacks, and avoid overeating.
• Your health care provider may recommend that you take nutritional supplements. Vitamin B6, calcium, and magnesium are commonly used. Tryptophan, which is found in dairy products, may also be helpful.
• Your doctor may recommend that you eat a low-salt diet and avoid simple sugars, caffeine, and alcohol.
• Get regular aerobic exercise throughout the month to help reduce the severity of PMS symptoms.
• Try changing your nighttime sleep habits before taking drugs for insomnia. (See also: Sleeping difficulty)

Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed if you have significant pain, including headache, backache, menstrual cramping, and breast tenderness.

Birth control pills may decrease or increase PMS symptoms.

In severe cases, antidepressants may be helpful.

• The first options are usually antidepressants known as selective serotonin-reuptake inhibitors (SSRIs).
• Cognitive behavioral therapy may be an alternative to antidepressants.
• Light therapy may decrease the need for antidepressant medications.

Patients who have severe anxiety are sometimes given anti-anxiety drugs.

Diuretics may help women with severe fluid retention, which causes bloating, breast tenderness, and weight gain.

Bromocriptine, danazol, and tamoxifen are drugs that are occasionally used for relieving breast pain.

Expectations (prognosis):

Most women who are treated for PMS symptoms get significant relief.

Complications:

PMS symptoms may become severe enough to prevent women from functioning normally.

Women with depression may have more severe symptoms during the second half of their cycle and may need to have their medication adjusted. The suicide rate in women with depression is much higher during the second half of the menstrual cycle.

See also premenstrual dysphoric disorder (PMDD).

Calling your health care provider:

Call for an appointment with your health care provider if:

• PMS does not go away with self-treatment
• Your symptoms are so severe that they limit your ability to function