PMS Options

Posted: Oct. 1, 2005

How common is PMS? Estimates of the percentage of women affected by premenstrual syndrome (PMS) vary widely. According to the American College of Obstetricians and Gynecologists, up to 40 percent of menstruating women report some symptoms of PMS.

Most of these women have symptoms that are fairly mild and do not need treatment. Some women (perhaps 5 to 10 percent of menstruating women) have a more severe form of PMS.

What treatment is available for PMS?
Many treatments have been tried for easing the symptoms of PMS. However, no treatment has been found that works for everyone. A combination of lifestyle changes and other treatment may be needed.

If your PMS symptoms do not require medical help, a healthier lifestyle may help you feel better. Here are some suggestions:

• Adopt a healthier way of life. Exercise regularly, get enough sleep, choose healthy foods, don't smoke, and find ways to manage stress in your life.
• Try avoiding excess salt, sugary foods, caffeine, and alcohol, especially when you are having PMS symptoms.
• Be sure that you are getting enough vitamins and minerals. Take a multivitamin every day that includes 400 micrograms of folic acid. A calcium supplement with vitamin D can help keep bones strong and may help with PMS symptoms.
• In more severe cases, drugs such as diuretics, ibuprofen, birth control pills or antidepressants may be used. Although PMS does not seem to be related to abnormal hormone levels, some women respond to hormonal treatment. For example, one approach has been to use drugs such as birth control pills to stop ovulation from occurring. There is evidence that a brain chemical, serotonin, plays a role in severe forms of PMS. Antidepressants that alter serotonin in the body have been shown to help many women with severe PMS.

What is Premenstrual Dysphoric Disorder (PMDD)?
PMDD is a severe, disabling form of PMS. In PMDD, the main symptoms are mood disorders such as depression, anxiety, tension, and persistent anger or irritability. These severe symptoms lead to problems with relationships and carrying out normal activities.

Women with PMDD usually also have physical symptoms, such as headache, joint and muscle pain, lack of energy, bloating and breast tenderness. According to the American Psychiatric Association, a woman must have at least five of the typical symptoms to be diagnosed with PMDD. The symptoms must occur during the two weeks before her period and go away when bleeding begins.

Research has shown that antidepressants called selective serotonin reuptake inhibitors (SSRIs) can help many women with PMDD. The Food and Drug Administration has approved two such medications to date for treatment of PMDD – sertraline (Zoloft) and fluoxetine (Sarafem).

Source: National Women's Health Information Center of the U.S. Department of Health and Human Services

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