Premenstrual Syndrome (PMS) - Medications
Troubling physical and emotional symptoms
that occur between the time you
ovulate and the first days of your
menstrual period are called premenstrual symptoms.
When premenstrual symptoms interfere with your relationships or
responsibilities, they are called
premenstrual syndrome (PMS). When premenstrual
emotional symptoms or aggression are severe, they are called
premenstrual dysphoric disorder (PMDD).
If you have moderate to severe premenstrual symptoms that continue
despite home treatment and lifestyle changes, talk to your health professional
about using medicine. Most medicines for PMS affect some part of the
endocrine system, with the goal of blocking or
increasing a certain chemical process that may be causing symptoms. There is no
known medicine that can "cure" PMS.
The most commonly used medicines for PMS are
nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and selective serotonin
reuptake inhibitors (SSRIs) for mood-related symptoms. There is also a type of birth control pill, sold as YAZ and Yasmin, that may help relieve PMDD
PMS: Should I Try an SSRI Medicine for My Symptoms?
Pain relievers (nonsteroidal anti-inflammatory drugs [NSAIDs])
Naproxen, ibuprofen, or mefenamic acid. NSAIDs
relieve premenstrual and menstrual pain and reduce menstrual bleeding. They
inflammation, which is from increased
prostaglandin production during the premenstrual
period. NSAIDs work best when taken before and continued at regular dosage
intervals throughout the premenstrual pain period. For some women, this
continues into the first days of menstrual bleeding, to relieve painful cramps.
If you have regular cycles, start taking an NSAID 1 to 2 days before you expect
pain to start.
Selective serotonin reuptake inhibitors (SSRIs) to treat mood-related and physical symptoms
Diuretic to treat water retention and weight gain
Spironolactone. When taken
during the premenstrual weeks, this
diuretic may reduce bloating and breast tenderness by
blocking the body's use of the hormone aldosterone.
- Drospirenone, in the
birth control pill called Yasmin or YAZ, acts like a water pill (diuretic). It
relieves bloating and breast tenderness. This medicine may also help relieve symptoms of severe PMS or PMDD.
Benzodiazepine to treat anxiety
Alprazolam is only
recommended for a few days' use when other treatments have been ineffective. It
depresses the central nervous system, loses effectiveness over time, and can be
addictive. Long-term use can be complicated by withdrawal or life-threatening
- There is a
birth control pill with estrogen and drospirenone (sold as YAZ and Yasmin)
that may help relieve symptoms of severe PMS or PMDD. YAZ is very low-estrogen,
and Yasmin is low-estrogen.
- Other types of birth control pills
(estrogen-progestin) are widely prescribed for PMS, but birth control pills may not relieve PMS symptoms for everyone. Although
they may improve bloating, headache, abdominal pain, and breast tenderness for
some women, other women report that they have worse symptoms or they develop
mood problems. Birth control pills do not appear to help relieve
mood symptoms. Estrogen alone may offer some benefit for some women,
but when taken without progestin, it increases the risk of
uterine (endometrial) cancer.
Progestin (progesterone) has been used in the past for
PMS, but for some women, it may make physical and emotional symptoms