Premenstrual Syndrome (PMS) - Treatment Overview
Most women normally have
one or more troubling physical and emotional symptoms between the time they
ovulate and the first days of their
menstrual period. These are
called premenstrual symptoms. When premenstrual symptoms interfere with your
relationships or responsibilities, they are called
premenstrual syndrome (PMS) or
premenstrual dysphoric disorder (PMDD), a severe form
Although PMS cannot be cured, you do have a number of
lifestyle and medication choices that can reduce your symptoms and improve your
quality of life.
Basic PMS treatment
If you have PMS, keep a menstrual diary, make lifestyle changes,
and use home treatment measures. After a few
menstrual cycles, you should notice some improvement in symptoms. Whether or
not you then decide to add medication treatment, the following home treatment may help you:
- Take daily
calcium and vitamin B6 (50 mg to 100 mg). Both of these
nutrients affect the
endocrine system. Calcium may help relieve PMS
symptoms. Daily vitamin B6 may improve PMS depression and
- Reduce your
caffeine, refined sugar, and sodium intake, at least during the premenstrual
phase of your cycle. These substances are linked to emotional and physical PMS
symptoms, such as insomnia, tension and anxiety, food cravings, pain, and
- Get regular exercise.
Exercise helps reduce depression. Women often
report that exercise helps relieve tension, pain, and mood-related PMS
Reduce stress. While stress is not a cause of PMS, it
may make your symptoms worse. In turn, coping with stress can be more difficult
during the premenstrual period.
nonprescription medicines, such as
nonsteroidal anti-inflammatory drugs (NSAIDs), for
headache, joint or muscle pain, or cramps. 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.
See examples of menstrual symptom diaries or use this menstrual diary(What is a PDF document?).
Additional treatments for PMS
If you still have
moderate to severe symptoms after two or three cycles of healthy lifestyle and
home treatment measures, talk your health professional about further treatment
options. Consider the following for specific symptoms.
All physical and mood-related symptoms
selective serotonin reuptake inhibitor (SSRI) class of
antidepressants is often the first-choice medicine for moderate to severe
premenstrual symptoms, including aggression, depression, anxiety, and physical
symptoms. Most women gain relief by taking an SSRI either continuously or only
during their premenstrual days. If you try an SSRI but find it ineffective,
it's a good idea to try another type of SSRI before moving on to another class
of medicine. For more information, see:
PMS: Should I Try an SSRI Medicine for My Symptoms?
birth control pill with estrogen and drospirenone may help relieve symptoms in women with severe PMS or PMDD. This pill is sold as YAZ (very
low-estrogen) or Yasmin (low-estrogen).