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Premenstrual syndrome - Treatment

Alternative Names

PMS

Treatment:

Exercise and diet changes can help relieve symptoms. It is also important to maintain a daily diary or log to record the type of symptoms you have, how severe they are, and how long they last. You should keep this "symptom diary" for at least 3 months. It will help your doctor make an accurate PMS diagnosis and recommend appropriate treatment.

Nutritional supplements may be recommended. Vitamin B6, calcium, and magnesium are commonly used.

Your doctor may recommend a low-salt diet and avoiding simple sugars, caffeine, and alcohol. Regular aerobic exercise throughout the month helps reduce the severity of PMS symptoms.

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.

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 receive treatment for specific symptoms related to PMS have significant relief.

Complications:

PMS symptoms may become severe enough to prevent women from maintaining normal function.

Women with depression may note increasing severity of symptoms during the second half of their cycle and may require associated medication adjustments. The suicide rate in women with depression is significantly higher during the latter 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 measures, or if symptoms occur that are severe enough to limit your ability to function.

  • Reviewed last on: 5/26/2008
  • Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lentz GM. Primary and Secondary Dysmenorrhea, Premenstrual Syndrome, and Premenstrual Dysphoric Disorder: Etiology, Diagnosis, Management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap. 36

Yonkers KA, O'Brien PM. Premenstrual syndrome. Lancet. 2008:371 (9619): 1200-10.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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