PMS: How can my premenstrual syndrome be treated?

Int Clin Psychopharmacol. 2000 Nov;15 Suppl 3:S5-17.

Diagnosis and treatment of premenstrual dysphoric disorder: an update.

Steiner M,Born L.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Women's Health Concerns Clinic and Father Sean O'Sullivan Research Centre, Hamilton, Ontario, Canada. mst@fhs.csu. Mcmaster.ca Premenstrual dysphoric disorder (PMDD) appears in the appendix of the DSM-IV under the heading 'depressive disorder not otherwise specified'. Yet, recently, a group of experts reached a consensus that PMis a distinct clinical entity with characteristic symptoms of irritability, anger, internal tension, dysphoria, and mood lability. PMis the more severe form of premenstrual symptomatology, whereas premenstrual syndrome (PMS) is milder and more prevalent and both must be differentiated from premenstrual magnification/exacerbation of an underlying major psychiatric disorder or a medical condition. Accurate assessment and diagnosis of significant premenstrual symptomatology is paramount and can be influenced by subjective perception, retrospective versus prospective reporting, and cultural context. The serotonergic system, which is in a close reciprocal relationship with the gonadal hormones, has been identified as the most plausible target for intervention. Results from randomized placebo-controlled trials in women with PMhave clearly demonstrated that serotonin reuptake inhibitors (SSRIs), with daily or intermittent dosing, have excellent efficacy and minimal adverse effects and should be considered first-line treatment. Luteal phase only SSRI administration may offer an attractive treatment option for a disorder that is itself intermittent. Hormonal interventions, in particular the suppression of ovulation will eliminate premenstrual symptomatology; however, the benefits-risk ratio of these approaches should be carefully evaluated with the patient.

Please click on the required question.

• Premenstrual Syndrome - PMS What is The Premenstrual Syndrome (PMS)
• 2 How prevalent is PMS?
• 3 How can we tell if I have PMS?
• 4 How can my PMS be evaluated?
• 5 How can cyclical breast pain (mastalgia) be treated?
• 6 How can my PMS be treated?
• 7 What is the place of progestogens and progesterone in the management of PMS?
• 8 Could suppressing my menstrual cycle reduce my PMS problems?
• 9  Could a diuretic help my PMS?
• 10 Is there a place for anti-depressants or anxiolytic drugs in the management of PMS?
• 11 Is there a place for removing my ovaries in the management of PMS?
• 12 What can be done about my decreased libido (sex drive)
• 12A What is the place of Viagra (sildenafil citrate) in sexual dysfunction in women?
• 13 How is PMS treatment monitored?
• 14 How long should PMS treatment be taken?
• 15 What is the chronic fatigue syndrome?
• 16 What is seasonal affective disorder (SAD)
• 17 Where can I obtain more information?
• 18 Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

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