Premenstrual syndrome (PMS)

Alternative names:

PMS; premenstrual dysphoria; premenstrual tension

Treatment:

Self-care methods include exercise and dietary measures mentioned previously under the "Prevention" category. It is also important to maintain a daily diary or log to record the type, severity , and duration of symptoms. A "symptom diary" should be kept for a minimum of 3 months in order to correlate symptoms with the menstrual cycle. The diary will greatly assist the health care provider not only in the accurate diagnosis of PMS, but also with the proposed treatment methods.

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

Prostaglandin inhibitors (aspirin, ibuprofen, other NSAIDS) may be prescribed for women with significant pain, including headache, backache, menstrual cramping and breast tenderness. Diuretics may be prescribed for women found to have significant weight gain due to fluid retention.

Psychiatric medications and or therapy may be used for women who exhibit a moderate-to-severe degree of anxiety, irritability, or depression.

Hormonal therapy may include a trial on oral contraceptives which may either decrease or increase PMS symptoms. The use of progesterone vaginal suppositories during the second half of the menstrual cycle is still controversial.

Expectations (prognosis):

After adequate diagnosis and symptom-specific treatment has been initiated, most women with PMS obtain 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 incidence of suicide in women with depression is significantly higher during the latter half of the menstrual cycle.

Calling your health care provider:

Call for an appointment with your health care provider if PMS does not resolve to self treatment measures, or if symptoms occur that are severe enough to limit functional ability.