Materiały źródłowe

• #1 Treatment of premenstrual syndrome and premenstrual dysphoric disorder – UpToDate

  https://www.uptodate.com/contents/treatment-of-premenstrual-syndrome-and-premenstrual-dysphoric-disorder

  Treatment of premenstrual syndrome and premenstrual dysphoric disorder […] The management of PMS and PMDD will be reviewed here. […] The treatment goals for patients with premenstrual disorders are to relieve symptoms and improve functional impairment. A number of approaches, including lifestyle measures (exercise and relaxation techniques), cognitive behavioral therapy, and medications (selective serotonin reuptake inhibitors [SSRIs] and/or combined oral estrogen-progestin contraceptives (COCs) are effective for women with either PMS or PMDD.

• #2 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  The main intention to treat PMS is symptom relief and to reduce its effects on daily routine activities. Pharmacotherapy was always the first line of treatment for premenstrual syndrome, but recent research has suggested the superior benefits with combination therapy. […] Combination of pharmacotherapies (such as NSAIDs, SSRIs, anxiolytic agents, gonadotropin-releasing hormone (GnRH) agonists, spironolactone, oral contraceptive pills) with nonpharmacological treatments, mainly cognitive and behavioral therapies, exercises, massage therapy, light therapy along with dietary and nutritional modifications have been proven beneficial for the treatment of premenstrual symptoms. […] Lifestyle modifications include regular exercise, avoiding stressful events, and maintaining healthy sleeping habits, especially during the premenstrual period. Increased intake of complex carbohydrates increases the level of tryptophan, a serotonin precursor.

• #3 Premenstrual Syndrome and Premenstrual Dysphoric Disorder | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0801/p236.html

  Premenstrual disorders affect up to 12% of women. […] Physicians should tailor therapy to achieve the greatest functional improvement possible for their patients. Select serotonergic antidepressants are first-line treatments. They can be used continuously or only during the luteal phase. Oral contraceptives and calcium supplements may also be used. […] The Daily Record of Severity of Problems is a useful tool to help diagnose PMS and PMDD. […] Selective serotonin reuptake inhibitors may be used as first-line treatment for severe symptoms of PMS and PMDD. […] Oral contraceptives are effective for treatment of PMS and PMDD. […] Calcium supplementation of 1,000 to 1,200 mg per day may improve PMS symptoms. […] Cognitive behavior therapy may improve PMS and PMDD symptoms. […] Treatment of PMS and PMDD focuses on relieving physical and psychiatric symptoms. Many of the medications used address the body’s hormonal activity through suppression of ovulation, whereas others affect the concentration of neurotransmitters such as serotonin, norepinephrine, or dopamine in the brain.

• #4 Premenstrual syndrome: Learn More – Treatment for PMS – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279264/

  Some women who have premenstrual syndrome (PMS) have such bad symptoms on the days before their period that they cant go about their usual activities. But there are various ways to cope with and treat typical symptoms such as pain, breast tenderness and mood swings. […] Most women who get PMS dont have very severe symptoms, and they find ways to cope with them like getting enough rest and avoiding stress around the time leading up to their period. There is a lot of advice out there about how to deal with PMS, including: getting enough exercise and doing sports, using relaxation techniques and meditating, not smoking, drinking less alcohol and caffeine, and eating less salt. […] An analysis of several studies suggests that regularly doing sports can reduce the symptoms of PMS. […] Various medications are used for the treatment of PMS. But only very few of them have been approved for this purpose.

• #5 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  The management of PMS is often frustrating for both patients and physicians. Clinical outcomes can be expected to improve as a result of recent consensus on diagnostic criteria for PMS and PMDD, data from improved clinical trials, and the availability of evidence-based clinical guidelines. […] Initially, all patients with PMS should be offered nonpharmacologic therapy. Medication should be offered to patients with persistent symptoms of PMS and those who meet criteria for PMDD. […] Nonpharmacologic interventions for PMS include patient education, supportive therapy, and behavioral changes. Women who have been educated about the biologic basis and prevalence of PMS report an increased sense of control and relief of symptoms. […] Although not rigorously evaluated, supportive therapy may be responsible for the high placebo-response rates in clinical trials.

• #6 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  If PMS symptoms are severe and cause problems with work or personal relationships, you may have premenstrual dysphoric disorder (PMDD). PMDD is a severe type of PMS that affects a small percentage of women. Drugs called selective serotonin reuptake inhibitors (SSRIs) can help treat PMDD in some women. These drugs are used to treat depression. […] If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, your ob-gyn may recommend medication. […] For many women, regular aerobic exercise lessens PMS symptoms. It may reduce fatigue and depression. Aerobic exercise, which includes brisk walking, running, cycling, and swimming, increases your heart rate and lung function.

• #7 PMS (Premenstrual Syndrome) Guide to Managing Effectively | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/pms-premenstrual-syndrome

  Hormonal Contraceptives: Prescription medications like hormonal contraceptives prevent ovulation, potentially providing relief from PMS symptoms. […] You can alleviate or minimize premenstrual syndrome symptoms by changing your diet and beginning an exercise routine. […] Begin at least 30 minutes of brisk walking, cycling, swimming, or other aerobic activities most days of the week. Consistent exercise can enhance your overall well-being and mitigate fatigue and mood fluctuations. […] Studies suggest that calcium can alleviate symptoms such as fatigue, food cravings, and even depression associated with PMS. […] Some research indicates that magnesium may help alleviate PMS symptoms like headaches, stress, and anxiety. […] Certain studies have shown that Vitamin B6 can improve symptoms related to mild and moderate PMS.

• #8 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Finding ways to relax and reduce stress can help women who have PMS. Your ob-gyn might suggest relaxation therapy to help lessen PMS symptoms. Relaxation therapy may include breathing exercises, meditation, and yoga. […] Simple changes in your diet may help relieve the symptoms of PMS: Eat a diet rich in complex carbohydrates. A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. […] Taking 1,200 milligrams (mg) of calcium a day can help reduce the physical and mood symptoms that are part of PMS. Taking magnesium supplements may help reduce water retention („bloating”), breast tenderness, and mood symptoms. […] Drugs that prevent ovulation, such as hormonal birth control methods, may lessen physical symptoms. But not all may relieve the mood symptoms of PMS. It may be necessary to try more than one of these medications before finding one that works. Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain. […] Diuretics („water pills”) are drugs that help reduce fluid buildup. Your ob-gyn can prescribe a diuretic if water retention is a major symptom for you.

• #9 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article//953696-treatment

  Nonsteroidal anti-inflammatory drugs (NSAIDs) may have a role for the management of premenstrual pain and inflammation in the late luteal phase. […] Because of the difficulty of treating PMS and the variations in response to treatments experienced by patients, complementary and alternative strategies have been explored for patients with PMS. […] These include the following: Cognitive behavioral therapy, Group therapy, Relaxation response, Biofeedback, Guided imagery, Light therapy, Massage, Exercise, Yoga, Calcium supplementation, Accupuncture, Chiropractic therapy, Homeopathy and herbal medicines (Crocus sativus L (saffron), Vitex agnus castus (chasteberry)). […] ACOG recommends bilateral oophorectomy be considered only for adults with severe and refractory symptoms after thorough counseling about the associated risks.

• #10 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Finding ways to relax and reduce stress can help women who have PMS. Your ob-gyn might suggest relaxation therapy to help lessen PMS symptoms. Relaxation therapy may include breathing exercises, meditation, and yoga. […] Simple changes in your diet may help relieve the symptoms of PMS: Eat a diet rich in complex carbohydrates. A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. […] Taking 1,200 milligrams (mg) of calcium a day can help reduce the physical and mood symptoms that are part of PMS. Taking magnesium supplements may help reduce water retention („bloating”), breast tenderness, and mood symptoms. […] Drugs that prevent ovulation, such as hormonal birth control methods, may lessen physical symptoms. But not all may relieve the mood symptoms of PMS. It may be necessary to try more than one of these medications before finding one that works. Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain. […] Diuretics („water pills”) are drugs that help reduce fluid buildup. Your ob-gyn can prescribe a diuretic if water retention is a major symptom for you.

• #11 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  Dietary restrictions and exercise may also be useful in patients with PMS. Sodium restriction has been proposed to minimize bloating, fluid retention, and breast swelling and tenderness. Caffeine restriction is recommended because of the association between caffeine and premenstrual irritability and insomnia. […] Dietary supplements that have been evaluated in women with PMS include vitamins (A, E, and B6), calcium, magnesium, multivitamin/mineral supplements, and evening primrose oil. […] Nonpharmacologic measures should be monitored at least every three months. If symptoms are not adequately relieved, the addition of pharmacologic treatment should be considered. […] Because serotonin has been implicated in the pathogenesis of PMS and PMDD, various SSRIs have been tested in these disorders. The U.S. Food and Drug Administration (FDA) has labeled fluoxetine (Sarafem and sertraline [Zoloft]) for the treatment of PMDD.

• #12 Premenstrual syndrome: Learn More – Treatment for PMS – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279264/

  Some women who have very swollen and sore breasts use diuretics. […] GnRH analogues are used to treat severe PMS in rare cases. […] Some women take the hormone progesterone in the days leading up to their period even though it hasn’t been approved for the treatment of PMS. […] Research has produced weak evidence suggesting that calcium can relieve PMS symptoms when taken at a dose of between 1,000 and 1,200 mg a day. […] It’s still not clear whether cognitive behavioral therapy (CBT) can help women cope better with PMS.

• #13 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  Finding ways to relax and reduce stress can help women who have PMS. Your ob-gyn might suggest relaxation therapy to help lessen PMS symptoms. Relaxation therapy may include breathing exercises, meditation, and yoga. […] Simple changes in your diet may help relieve the symptoms of PMS: Eat a diet rich in complex carbohydrates. A complex carbohydrate-rich diet may reduce mood symptoms and food cravings. […] Taking 1,200 milligrams (mg) of calcium a day can help reduce the physical and mood symptoms that are part of PMS. Taking magnesium supplements may help reduce water retention („bloating”), breast tenderness, and mood symptoms. […] Drugs that prevent ovulation, such as hormonal birth control methods, may lessen physical symptoms. But not all may relieve the mood symptoms of PMS. It may be necessary to try more than one of these medications before finding one that works. Antidepressants can be helpful in treating PMS in some women. These drugs can help lessen mood symptoms. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain. […] Diuretics („water pills”) are drugs that help reduce fluid buildup. Your ob-gyn can prescribe a diuretic if water retention is a major symptom for you.

• #14 PMS (Premenstrual Syndrome) Guide to Managing Effectively | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/pms-premenstrual-syndrome

  Hormonal Contraceptives: Prescription medications like hormonal contraceptives prevent ovulation, potentially providing relief from PMS symptoms. […] You can alleviate or minimize premenstrual syndrome symptoms by changing your diet and beginning an exercise routine. […] Begin at least 30 minutes of brisk walking, cycling, swimming, or other aerobic activities most days of the week. Consistent exercise can enhance your overall well-being and mitigate fatigue and mood fluctuations. […] Studies suggest that calcium can alleviate symptoms such as fatigue, food cravings, and even depression associated with PMS. […] Some research indicates that magnesium may help alleviate PMS symptoms like headaches, stress, and anxiety. […] Certain studies have shown that Vitamin B6 can improve symptoms related to mild and moderate PMS.

• #15 Premenstrual syndrome (PMS)

  https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome

  Diuretics (water pills) may reduce symptoms of bloating and breast tenderness. […] Anti-anxiety medicine may help reduce feelings of anxiousness. […] Talk to your doctor before taking any supplement. […] Studies show that calcium can help reduce some PMS symptoms, such as fatigue, cravings, and depression. […] Vitamin B6 may help with PMS symptoms, including moodiness, irritability, forgetfulness, bloating, and anxiety. […] Some women report relief from their PMS symptoms with yoga or meditation. […] Researchers continue to search for new ways to treat PMS.

• #16 PMS (Premenstrual Syndrome) Guide to Managing Effectively | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/pms-premenstrual-syndrome

  Research suggests that Omega-3 and Omega-6 fatty acids may ease PMS symptoms. […] Various herbal remedies such as black cohosh, dried chasteberry, and evening primrose oil can help alleviate symptoms. […] PMS symptoms cannot be prevented but can be managed with medications and lifestyle modifications.

• #17 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  Cognitive-behavioral therapy (CBT) is an approach that emphasizes the correction of unsettled disruptive thoughts, behaviors, and emotions. CBT helps in the recognition of these behaviors and helps develop coping strategies to improve daily functioning. […] The fruit extract Vitex agnus-castus is the only herbal medicine that is proven to control PMS-associated mood swings and irritability. […] Recent studies of combined oral contraceptives comprising 0.02 mg of ethinyl estradiol and 3 mg of drospirenone (compound hormone pills for 24 days followed by hormone-inactive pills for the last four days) have demonstrated an improvement in PMDD symptoms. […] Selective serotonin receptor inhibitors (SSRIs) can be used as the first-line treatment of PMS with predominantly emotional symptoms.

• #18 Cognitive Behavioral Therapy for Premenstrual Syndromes: A Review of the Literature – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/posts/cognitive-behavioral-therapy-for-premenstrual-syndromes-a-review-of-the-literature/

  Significant numbers of reproductive-aged women experience premenstrual syndromes characterized by depressed mood, irritability, mood swings, anxiety or tension, sleep disruption, and other physical symptoms, including bloating and breast tenderness. […] In a recent paper published in the Archives of Women’s Mental Health, Lustyk and colleagues review the evidence in support of using Cognitive Behavioral Therapy (CBT) to treat premenstrual syndromes. […] CBT has been shown to be an effective treatment for mood and anxiety disorders and has been shown to help people cope better with physical symptoms, such as pain. […] Due to the limitations of existing research, the use of CBT as a treatment for premenstrual symptoms requires further study before drawing conclusions about its effectiveness as a treatment. […] CBT should also be evaluated as an adjunct therapy to medication and lifestyle modification.

• #19 Managing premenstrual syndrome (PMS) | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/

  Premenstrual syndrome (PMS) is the name given to a collection of physical and emotional symptoms that can occur in the two weeks before you have your period. […] The information here aims to help you better understand your health and your options for treatment and care. […] Treatment options, including: Psychological support and therapy, Complementary therapy, Medical treatment, Surgery. […] Speak with your healthcare professional if you would like further information about ways to change your lifestyle and about treatments that can help. […] Cognitive behavioural therapy (CBT) is known to help PMS symptoms and should be offered to you as a treatment option. […] There are several alternative or complementary therapies for PMS. Many women find these helpful, although there is little evidence to show that they are effective.

• #20 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article//953696-treatment

  Nonsteroidal anti-inflammatory drugs (NSAIDs) may have a role for the management of premenstrual pain and inflammation in the late luteal phase. […] Because of the difficulty of treating PMS and the variations in response to treatments experienced by patients, complementary and alternative strategies have been explored for patients with PMS. […] These include the following: Cognitive behavioral therapy, Group therapy, Relaxation response, Biofeedback, Guided imagery, Light therapy, Massage, Exercise, Yoga, Calcium supplementation, Accupuncture, Chiropractic therapy, Homeopathy and herbal medicines (Crocus sativus L (saffron), Vitex agnus castus (chasteberry)). […] ACOG recommends bilateral oophorectomy be considered only for adults with severe and refractory symptoms after thorough counseling about the associated risks.

• #21 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  Cognitive-behavioral therapy (CBT) is an approach that emphasizes the correction of unsettled disruptive thoughts, behaviors, and emotions. CBT helps in the recognition of these behaviors and helps develop coping strategies to improve daily functioning. […] The fruit extract Vitex agnus-castus is the only herbal medicine that is proven to control PMS-associated mood swings and irritability. […] Recent studies of combined oral contraceptives comprising 0.02 mg of ethinyl estradiol and 3 mg of drospirenone (compound hormone pills for 24 days followed by hormone-inactive pills for the last four days) have demonstrated an improvement in PMDD symptoms. […] Selective serotonin receptor inhibitors (SSRIs) can be used as the first-line treatment of PMS with predominantly emotional symptoms.

• #22 Premenstrual syndrome (PMS) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

  When exercise and limiting salt intake aren’t enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS. […] These prescription medications stop ovulation, which may bring relief from PMS symptoms. […] Some women report relief of PMS symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John’s wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms. […] A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.

• #23 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/953696-treatment

  Medical care for premenstrual syndrome (PMS) is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. No single pharmacologic treatment is universally effective, and studies of all therapies have produced inconsistent results. […] At present, selective serotonin reuptake inhibitors (SSRIs) are commonly considered the most appropriate first-line therapy for premenstrual disorders, especially where psychological or behavioral symptoms are prominent. […] Although the literature supporting combined oral contraceptives (COCs) for PMS is mixed, it remains a reasonable option according to the American College of Obstetricians and Gynecologists (ACOG) and the International Society for Premenstrual Disorders (ISPMD). […] Gonadotropin-releasing hormone (GnRH) agonists can be employed for adults with severe, refractory PMS with or without add-back therapy to address hypoestrogenic adverse effects and concerns about bone health.

• #24 PMS and PMDD: Overview and Current Treatment Approaches

  https://www.uspharmacist.com/article/pms-and-pmdd-overview-and-current-treatment-approaches

  Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) can cause physical symptoms and psychological symptoms similar to those of depression, with PMDD being the most severe form of PMS. Treatment approaches range from lifestyle changes and self-care to behavioral therapies and prescription medications. […] Selective serotonin reuptake inhibitors are the gold standard for pharmacologic treatment of PMS and PMDD. […] Treatment plans for PMS and PMDD encompass nonpharmacologic and pharmacologic approaches used either together or separately. […] Pharmacologic treatment is suggested when lifestyle changes and other nonpharmacologic therapies no longer provide adequate symptom relief or if the patient prefers to initiate therapy with a prescription medication instead of nonpharmacologic measures.

• #25 Premenstrual syndrome (PMS) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

  For many women, lifestyle changes can help relieve PMS symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome. […] Commonly prescribed medications for premenstrual syndrome include: […] Selective serotonin reuptake inhibitors (SSRIs) which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others have been successful in reducing mood symptoms. selective serotonin reuptake inhibitors (SSRIs) are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD). […] Taken before or at the onset of your period, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

• #26 Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics

  Vitamin and mineral supplements – Although vitamin B6 (up to 100 mg/day) was initially thought to provide a small benefit for PMS symptoms, the majority of studies now suggest that it is no better than placebo. The most effective medications are described in the next section. […] Selective serotonin reuptake inhibitors (SSRIs) are a highly effective treatment for the symptoms of PMS and PMDD. The SSRIs include fluoxetine (Prozac and Sarafem), sertraline (Zoloft), citalopram (Celexa), and paroxetine (Paxil). Studies showed that SSRIs reduced the symptoms of PMDD significantly compared with placebo; between 60 and 75 percent of women with PMDD improve with an SSRI. It may not be necessary to take the medication every day. Taking the SSRI only during the second half of the menstrual cycle may be sufficient.

• #27 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/953696-treatment

  Medical care for premenstrual syndrome (PMS) is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. No single pharmacologic treatment is universally effective, and studies of all therapies have produced inconsistent results. […] At present, selective serotonin reuptake inhibitors (SSRIs) are commonly considered the most appropriate first-line therapy for premenstrual disorders, especially where psychological or behavioral symptoms are prominent. […] Although the literature supporting combined oral contraceptives (COCs) for PMS is mixed, it remains a reasonable option according to the American College of Obstetricians and Gynecologists (ACOG) and the International Society for Premenstrual Disorders (ISPMD). […] Gonadotropin-releasing hormone (GnRH) agonists can be employed for adults with severe, refractory PMS with or without add-back therapy to address hypoestrogenic adverse effects and concerns about bone health.

• #28 Premenstrual syndrome (PMS) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

  For many women, lifestyle changes can help relieve PMS symptoms. But depending on the severity of your symptoms, your doctor may prescribe one or more medications for premenstrual syndrome. […] Commonly prescribed medications for premenstrual syndrome include: […] Selective serotonin reuptake inhibitors (SSRIs) which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others have been successful in reducing mood symptoms. selective serotonin reuptake inhibitors (SSRIs) are the first line treatment for severe PMS or premenstrual dysphoric disorder (PMDD). […] Taken before or at the onset of your period, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.

• #29 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/953696-treatment

  Nonsteroidal anti-inflammatory drugs (NSAIDs) may have a role for the management of premenstrual pain and inflammation in the late luteal phase. […] Because of the difficulty of treating PMS and the variations in response to treatments experienced by patients, complementary and alternative strategies have been explored for patients with PMS. […] These techniques and therapies may be considered as adjuncts to medical treatment or as alternatives to pharmacologic management. […] ACOG recommends bilateral oophorectomy be considered only for adults with severe and refractory symptoms after thorough counseling about the associated risks. […] Despite a lack of evidence to indicate that dietary changes can definitively affect PMS symptoms, healthy lifestyle recommendations can benefit the patient overall and provide a sense of self-efficacy and control.

• #30 Premenstrual syndrome (PMS) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/diagnosis-treatment/drc-20376787

  When exercise and limiting salt intake aren’t enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS. […] These prescription medications stop ovulation, which may bring relief from PMS symptoms. […] Some women report relief of PMS symptoms with the use of herbs, such as ginkgo, ginger, chasteberry (Vitex agnus), evening primrose oil and St. John’s wort. However, few scientific studies have found that any herbs are effective for relief of PMS symptoms. […] A practitioner of acupuncture inserts sterilized stainless steel needles into the skin at specific points on the body. Some women experience symptom relief after acupuncture treatment.

• #31 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  Spironolactone (Aldactone), an aldosterone antagonist structurally similar to steroid hormones, is the only diuretic that has been shown to effectively relieve PMS symptoms such as breast tenderness and fluid retention. […] Danazol is an androgenic agent that inhibits gonadotropin release, thereby improving mastalgia. Continuous danazol therapy may also relieve other PMS symptoms. […] Although oral contraceptive pills (OCPs) are widely prescribed for the management of PMS, they have not been shown to be consistently effective.

• #32 PMS & PMDD – MGH Center for Women’s Mental Health

  https://womensmentalhealth.org/specialty-clinics/pms-and-pmdd/

  Hormonal treatments of PMS and PMDD are based on the principle that suppression of ovulation eliminates premenstrual symptomatology. […] Women who have tried all of the above treatments and still suffer from severe PMDD symptoms may consider surgery. […] After the diagnosis of PMS or PMDD has been made through exclusion of other medical and psychiatric conditions, as well as by prospective daily ratings of symptoms, treatment can be initiated. For all women, simple lifestyle changes in diet, exercise and stress management are encouraged. […] For patients with severe symptoms of PMS or with a diagnosis of PMDD, SSRIs are the first-line treatment.

• #33 Premenstrual syndrome: Learn More – Treatment for PMS – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279264/

  Hormonal medications are often used to try to relieve typical PMS-related symptoms. […] The most common way to influence the menstrual cycle using hormones is by taking hormonal contraceptives, such as birth control pills. […] Two studies have provided weak evidence that a contraceptive pill containing two particular hormones the progestin drospirenone and a low-dose estrogen can help women with PMS. […] If premenstrual dysphoric disorder (PMDD) is clearly affecting a woman’s mental health leading to things like depression, anxiety and feelings of despair antidepressants may be an option. […] Various painkillers are used in the treatment of PMS, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (the drug in medications like Aspirin) and ibuprofen.

• #34 Premenstrual Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560698/

  Cognitive-behavioral therapy (CBT) is an approach that emphasizes the correction of unsettled disruptive thoughts, behaviors, and emotions. CBT helps in the recognition of these behaviors and helps develop coping strategies to improve daily functioning. […] The fruit extract Vitex agnus-castus is the only herbal medicine that is proven to control PMS-associated mood swings and irritability. […] Recent studies of combined oral contraceptives comprising 0.02 mg of ethinyl estradiol and 3 mg of drospirenone (compound hormone pills for 24 days followed by hormone-inactive pills for the last four days) have demonstrated an improvement in PMDD symptoms. […] Selective serotonin receptor inhibitors (SSRIs) can be used as the first-line treatment of PMS with predominantly emotional symptoms.

• #35 Managing premenstrual syndrome (PMS) | RCOG

  https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/

  Two types of antidepressant medications have been shown to help PMS symptoms, namely selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs). […] Some women find using the combined oral contraceptive pill helps with PMS symptoms. […] Using estrogen hormone patches or gel can improve the physical and psychological symptoms of PMS. […] GnRH analogues may be recommended if you have severe PMS symptoms and when other treatments have not worked or are not suitable. […] Your healthcare professional will only suggest surgical treatment if you have severe symptoms and all other treatments have not helped. […] Treatment, information and support are available to enable you to manage your symptoms.

• #36 Patient education: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/premenstrual-syndrome-pms-and-premenstrual-dysphoric-disorder-pmdd-beyond-the-basics

  Gonadotropin-releasing hormone (GnRH) agonists (eg, leuprolide acetate or goserelin acetate) are a type of medication that causes the ovaries to temporarily stop making estrogen and progesterone. This causes a temporary menopause and improves the physical symptoms (eg, bloating) and emotional symptoms caused by PMS and PMDD. However, the medication results in extremely low estrogen levels, which causes severe hot flashes and bone loss over time. Therefore, in addition to the GnRH agonist, women are treated with low doses of estrogen and progesterone to stop hot flashes and to prevent bone loss. This is termed estrogen and progestogen addback. Although GnRH agonist treatment is very effective, it requires an injection once every one to three months. This treatment is only used if other simpler treatments do not work.

• #37 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article/953696-treatment

  Medical care for premenstrual syndrome (PMS) is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. No single pharmacologic treatment is universally effective, and studies of all therapies have produced inconsistent results. […] At present, selective serotonin reuptake inhibitors (SSRIs) are commonly considered the most appropriate first-line therapy for premenstrual disorders, especially where psychological or behavioral symptoms are prominent. […] Although the literature supporting combined oral contraceptives (COCs) for PMS is mixed, it remains a reasonable option according to the American College of Obstetricians and Gynecologists (ACOG) and the International Society for Premenstrual Disorders (ISPMD). […] Gonadotropin-releasing hormone (GnRH) agonists can be employed for adults with severe, refractory PMS with or without add-back therapy to address hypoestrogenic adverse effects and concerns about bone health.

• #38 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article//953696-treatment

  Medical care for premenstrual syndrome (PMS) is primarily pharmacologic and behavioral, with an emphasis on relief of symptoms. No single pharmacologic treatment is universally effective, and studies of all therapies have produced inconsistent results. […] At present, selective serotonin reuptake inhibitors (SSRIs) are commonly considered the most appropriate first-line therapy for premenstrual disorders, especially where psychological or behavioral symptoms are prominent. […] Although the literature supporting combined oral contraceptives (COCs) for PMS is mixed, it remains a reasonable option according to the American College of Obstetricians and Gynecologists (ACOG) and the International Society for Premenstrual Disorders (ISPMD). […] Gonadotropin-releasing hormone (GnRH) agonists can be employed for adults with severe, refractory PMS with or without add-back therapy to address hypoestrogenic adverse effects and concerns about bone health.

• #39 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science

  https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358

  Oophorectomy alone removes PMS, but estrogen replacement is needed after surgery. […] Prevention of ovulation by performing hysterectomy with bilateral salpingo-oophorectomy is highly successful in the treatment of severe PMS. […] With the management of PMS, the quality of life can be improved. The first step in PMS management is to create awareness, to make women self-screen, adopt lifestyle changes, apply nutrition suggestions and use stress coping methods. If these methods are insufficient, CBT and CAT in the second step are applied. If PMS continues to affect daily life negatively; hormonal, non-hormonal and symptomatic treatment in the third step; oophorectomy or laparoscopic hysterectomy + bilateral salpingo-oopherectomy in the fourth step are applied.

• #40 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science

  https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358

  Oophorectomy alone removes PMS, but estrogen replacement is needed after surgery. […] Prevention of ovulation by performing hysterectomy with bilateral salpingo-oophorectomy is highly successful in the treatment of severe PMS. […] With the management of PMS, the quality of life can be improved. The first step in PMS management is to create awareness, to make women self-screen, adopt lifestyle changes, apply nutrition suggestions and use stress coping methods. If these methods are insufficient, CBT and CAT in the second step are applied. If PMS continues to affect daily life negatively; hormonal, non-hormonal and symptomatic treatment in the third step; oophorectomy or laparoscopic hysterectomy + bilateral salpingo-oopherectomy in the fourth step are applied.

• #41 Premenstrual Syndrome (PMS, PMT) | Symptoms and Treatment

  https://patient.info/womens-health/periods-and-period-problems/premenstrual-syndrome

  In theory, preventing ovulation should help PMS. […] Oestrogen given via a patch or gel has been shown to improve symptoms by suppressing egg production. […] Other methods of suppressing ovulation include medicines called gonadotrophin-releasing hormone analogues. […] Surgery to remove the womb and both ovaries (hysterectomy and bilateral salpingo-oophorectomy) also prevents ovulation and will cure PMS, although is a drastic option.

• #42 Premenstrual Syndrome (PMS) | ACOG

  https://www.acog.org/womens-health/faqs/premenstrual-syndrome

  If PMS symptoms are severe and cause problems with work or personal relationships, you may have premenstrual dysphoric disorder (PMDD). PMDD is a severe type of PMS that affects a small percentage of women. Drugs called selective serotonin reuptake inhibitors (SSRIs) can help treat PMDD in some women. These drugs are used to treat depression. […] If your symptoms are mild to moderate, they often can be relieved by changes in lifestyle or diet. If your PMS symptoms begin to interfere with your life, you may decide to seek medical treatment. Treatment will depend on how severe your symptoms are. In more severe cases, your ob-gyn may recommend medication. […] For many women, regular aerobic exercise lessens PMS symptoms. It may reduce fatigue and depression. Aerobic exercise, which includes brisk walking, running, cycling, and swimming, increases your heart rate and lung function.

• #43 Premenstrual Dysphoric Disorder (PMDD): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9132-premenstrual-dysphoric-disorder-pmdd

  People with premenstrual dysphoric disorder (PMDD) have PMS symptoms (bloating, headaches and breast tenderness) in the weeks before their period. […] Hormonal birth control and antidepressants can relieve symptoms. […] Your healthcare provider may recommend one or more of these treatments to help manage PMDD: Antidepressants called SSRIs (selective serotonin reuptake inhibitors) to help manage your brains serotonin levels. […] Hormonal birth control pills that have drospirenone and ethinyl estradiol. […] Dietary changes such as cutting back on certain foods and caffeine. […] Over-the-counter pain medicines to ease cramps (dysmenorrhea), headaches, breast tenderness and other physical symptoms. […] Regular exercise to improve mood. […] Stress management tools, such as deep breathing exercises and meditation.

• #44 Premenstrual dysphoric disorder (PMDD)

  https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd

  PMDD causes severe irritability, depression, or anxiety in the week or two before your period starts. […] You may need medicine or other treatment to help with your symptoms. […] Treatments for PMDD include: Antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs change serotonin levels in the brain. […] The Food and Drug Administration (FDA) approved three SSRIs to treat PMDD: Sertraline, Fluoxetine, Paroxetine HCI. […] Birth control pills. The FDA has approved a birth control pill containing drospirenone and ethinyl estradiol, to treat PMDD. […] Over-the-counter pain relievers may help relieve physical symptoms, such as cramps, joint pain, headaches, backaches, and breast tenderness. […] Stress management, such as relaxation techniques and spending time on activities you enjoy.

• #45 Premenstrual Syndrome (PMS): Causes, Symptoms, and Treatment

  https://www.healthline.com/health/premenstrual-syndrome

  PMS is the changes in mood, emotions, physical health, and behavior that can occur between ovulation and the start of your period. […] Below, well cover the symptoms of PMS in detail, plus offer some tips on getting support and relief from your symptoms. […] If you have symptoms of PMDD, your doctor may recommend working with a therapist or psychiatrist, especially if you experience co-occurring mental health symptoms related to depression, trauma, or stress. […] Other treatments and coping strategies that may help include: daily exercise, limiting caffeine, practicing new methods of coping with stress, drospirenone and ethinyl estradiol tablet (Yaz), the only birth control pill approved by the Food and Drug Administration (FDA) for PMDD symptoms, antidepressant or anti-anxiety medication, including selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

• #46 Medications Used to Treat Premenstrual Dysphoric Disorder (PMDD) – BuzzRx

  https://www.buzzrx.com/blog/medications-used-to-treat-premenstrual-dysphoric-disorder-pmdd

  Approximately 80% of menstruating women experience PMS (premenstrual syndrome), a constellation of physical and psychological symptoms that occur during the luteal phase of the menstrual cycle (just after the ovary releases the egg and before the menstrual period starts). […] Patients with PMDD experience severe, disabling symptoms that affect their ability to work and function on a daily basis. […] Fortunately, effective treatment options are available for premenstrual dysphoric disorder. […] The first line of treatment for premenstrual dysphoric disorder (PMDD) is an antidepressant medication. […] Hormonal therapies consisting of GnRH agonists (histrelin, goserelin, leuprolide) may be effective for some women with depressed moods due to PMDD. […] Diuretics can be used to relieve the bloating and water retention that frequently accompany PMS.

• #47 PMS (premenstrual syndrome)

  https://www.nhs.uk/conditions/pre-menstrual-syndrome/

  There are things you can try to help ease your PMS (premenstrual syndrome) symptoms. […] A GP can advise you on treatments that can help. […] If you have PMS (premenstrual syndrome), a GP may recommend other treatments as well as making lifestyle changes. […] These may include: hormonal medicine, such as the combined contraceptive pill, cognitive behavioural therapy, antidepressants. […] Complementary therapies and dietary supplements may help with PMS, but there’s not much evidence that they work. […] Check with a GP or pharmacist if you’re also taking medicines before starting to take regular supplements.

• #48 Premenstrual Syndrome Treatment & Management: Medical Care, Surgical Care, Diet

  https://emedicine.medscape.com/article//953696-treatment

  Despite a lack of evidence to indicate that dietary changes can definitively affect PMS symptoms, healthy lifestyle recommendations can benefit the patient overall and provide a sense of self-efficacy and control. […] Exercise may benefit patients with PMS with both direct symptom improvement as well as overall stress reduction. […] PMS symptoms are often difficult to control. Some symptoms may respond well to treatment, whereas others remain refractory. It is important for patients to monitor their PMS symptoms over time, as this may help patients refine their pharmacologic treatments, incorporate additional holistic strategies, and fine-tune the interventions that have been most effective for their disease process.

• #49 Premenstrual Syndrome (PMS, PMT) | Symptoms and Treatment

  https://patient.info/womens-health/periods-and-period-problems/premenstrual-syndrome

  Premenstrual syndrome (PMS) can cause various symptoms before periods. Various treatment options are available. […] The diagnosis of PMS is based on your symptoms. […] The following may help: It may help you to understand what is happening. This may relieve some of the anxiety about symptoms. […] Many treatments for PMS have been tried over the years. There are very few that have been proven to work. Treatments for PMS may take a while to work fully. […] Various herbal products, vitamins and minerals are sold for the treatment of PMS. […] CBT is a talking treatment (psychological treatment), during which, ways to find more adaptive ways of coping with premenstrual symptoms are explored. […] An SSRI medicine (for example, fluoxetine or citalopram) may be prescribed to treat more severe PMS.

• #50 Premenstrual Syndrome (PMS): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24288-pms-premenstrual-syndrome

  Symptoms usually show up around ovulation, when levels of estrogen and progesterone increase. […] There are many treatment options for PMS. Some people may need to try several different treatments until they find one that relieves their symptoms. […] You can usually manage mild symptoms with over-the-counter (OTC) medications. More severe symptoms may require a prescription from a provider. Options include: […] You can modify your lifestyle to help relieve pain and combat the mood-related symptoms of PMS. […] You cant prevent premenstrual syndrome, but you can manage symptoms with lifestyle changes, medications or a combination of both. […] Often, you can manage your symptoms with medications and lifestyle changes. If nothing youre doing is making a big enough difference, see your provider to get treatments that can help.

• #51 Current Approaches in Premenstrual Syndrome Management – Bezmialem Science

  https://bezmialemscience.org/articles/current-approaches-in-premenstrual-syndrome-management/doi/bas.galenos.2018.2358

  Premenstrual syndrome (PMS) is a health problem that occurs with physical and psychological symptoms presenting about five days before menstruation, end within a few days after the onset of menstruation. […] PMS management is carried out gradually by multidisciplinary team that adopted an integrative holistic approach in the direction of individualized plan. The first step includes creating awareness about PMS, teaching to women self-screening, lifestyle changes, regulation of diet, methods of coping with stress. […] If the problem continues, there is pharmacological treatment in the third step. Finally, surgical treatment is applied in the fourth step. […] It is recommended that PMS Management be carried out gradually by a multidisciplinary team that has adopted an integrated holistic approach. At the same time, an individualized management plan should be applied because the number, type and severity of premenstrual symptoms vary from person to person.

• #52 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  The management of PMS is often frustrating for both patients and physicians. Clinical outcomes can be expected to improve as a result of recent consensus on diagnostic criteria for PMS and PMDD, data from improved clinical trials, and the availability of evidence-based clinical guidelines. […] Initially, all patients with PMS should be offered nonpharmacologic therapy. Medication should be offered to patients with persistent symptoms of PMS and those who meet criteria for PMDD. […] Nonpharmacologic interventions for PMS include patient education, supportive therapy, and behavioral changes. Women who have been educated about the biologic basis and prevalence of PMS report an increased sense of control and relief of symptoms. […] Although not rigorously evaluated, supportive therapy may be responsible for the high placebo-response rates in clinical trials.

• #53 Premenstrual syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001505.htm

  Keep a daily diary or log for at least 3 months. Record the: […] This record will help you and your health care provider find the best treatment. […] A healthy lifestyle is the first step to managing PMS. For many women, lifestyle approaches are often enough to control symptoms. To manage PMS: […] Your provider may suggest that you take nutritional supplements. Vitamin B6, calcium, and magnesium are commonly used. Tryptophan, which is found in dairy products, may also be helpful. […] Get regular aerobic exercise throughout the month. This helps in reducing the severity of PMS symptoms. Exercise more often and harder during the weeks when you have PMS. […] In severe cases, some medicines used to treat depression may be helpful. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are often tried first. These have been shown to be very helpful. You may also want to seek the advice of a counselor or therapist. […] Other medicines that you may use include: […] Diuretics, which may help with severe fluid retention, which causes bloating, breast tenderness, and weight gain.

• #54 Premenstrual Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2003/0415/p1743.html

  The management of PMS is often frustrating for both patients and physicians. Clinical outcomes can be expected to improve as a result of recent consensus on diagnostic criteria for PMS and PMDD, data from improved clinical trials, and the availability of evidence-based clinical guidelines. […] Initially, all patients with PMS should be offered nonpharmacologic therapy. Medication should be offered to patients with persistent symptoms of PMS and those who meet criteria for PMDD. […] Nonpharmacologic interventions for PMS include patient education, supportive therapy, and behavioral changes. Women who have been educated about the biologic basis and prevalence of PMS report an increased sense of control and relief of symptoms. […] Although not rigorously evaluated, supportive therapy may be responsible for the high placebo-response rates in clinical trials.

• #55 Exploring Premenstrual Syndrome: Causes, Symptoms and Treatment

  https://mydoctor.kaiserpermanente.org/mas/news/exploring-premenstrual-syndrome-causes-symptoms-and-treatment-2430363

  Oftentimes, people don’t take premenstrual syndrome (PMS) seriously. […] As a board-certified ob-gyn, I know that PMS is real and can affect a woman’s quality of life. […] I want women and their loved ones to know premenstrual disorders are real and that there are ways to cope. […] Many women with mild to moderate symptoms of PMS can treat their symptoms with over-the-counter medications and lifestyle changes. […] Though many women may not feel like exercising when they are feeling symptoms of PMS or PMDD, exercise really can help ease tension and improve mood. […] Other lifestyle ways to handle PMS or PMDD include trying psychological counseling. Cognitive behavior therapy can be useful to learn self-help strategies for coping with PMS or PMDD symptoms. […] Studies have shown calcium can help reduce PMS and PMDD symptoms.

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