Premenstrual Syndrome (PMS) - Treatment Overview
Bloating or breast tenderness
Spironolactone. Taken during the premenstrual phase,
this diuretic can relieve bloating and breast tenderness.
- Drospirenone, in the birth control pill called
YAZ or Yasmin, acts like spironolactone. It relieves bloating, breast
- Daily vitamin E (400 IU),
taken during the premenstrual phase, may help with breast tenderness.
Evening primrose oil
contains essential fatty acids that may offer mild relief of some PMS symptoms for some women.
For more information about complementary, alternative,
and supplement therapies for PMS, see the Other Treatment section of this
Other hormonal, sedative, or surgical treatments for severe PMS
The goal of hormonal and surgical treatments is to stop a
part of the hormonal (endocrine) system that is linked to premenstrual
symptoms. These treatments are not commonly used to treat PMS symptoms, either
because they are now known to be ineffective or because they have severe side
Birth control pills (estrogen-progestin) are
widely prescribed for PMS, but they do not always relieve PMS. 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 are known to be ineffective for treating 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 has been used in the past for PMS, but for
some women, it may make physical and emotional symptoms worse.
Danazol is a synthetic male hormone that can relieve breast pain by decreasing estrogen
production. It isn't often prescribed.
treatment with alprazolam is occasionally used for PMS-related anxiety.
It depresses the central nervous system, loses effectiveness over time, and can
be addictive. Because long-term use can be complicated by withdrawal and
life-threatening symptoms, this medicine is only recommended for a few days'
use when other treatments have been ineffective.
Gonadotropin-releasing hormone agonists (GnRH-a) are a
last-resort treatment for severe
PMDD symptoms. This medicine stops the monthly menstrual hormonal cycle and results in a condition similar to menopause.
- Surgery to
ovaries (oophorectomy) is a rarely used, controversial
treatment, because it irreversibly causes early
menopause. Menopause symptoms caused by surgery, such
as hot flashes, depression, and insomnia, are often more severe than those of
What to think about
No single therapy is effective
for all women. You and your health professional may have to try more than one
type of treatment before finding the right choice for you.