PREMENSTRUAL SYNDROME (PMS)
WHAT IS IT?
The cyclic recurrence of physical and/or psychological symptoms the days or weeks prior to the
menstrual period. The physical symptoms may include bloating, breast tenderness, backache,
headache, cramps, and/or swelling of the extremities. The emotional or affective symptoms may
include depression, irritability, anxiety, confusion, outbursts of anger, and/or social withdrawal.
The cause is not completely understood but most likely related to fluctuations in hormones,
biochemical mediators, and their interaction in the brain. Premenstrual symptoms are common
and it is estimated that up to 85% of menstruating women report one or more premenstrual
symptoms.
HOW DO I KNOW I HAVE IT?
There is no blood test that a doctor can do to diagnose PMS it is a clinical diagnosis. You may
want to keep a diary or log of your symptoms daily for at least 2 to 3 months.
TREATMENT
Treatment is varied and depends on the degree of symptoms and desire of the patient. It may
include nonpharmacologic approaches such as lifestyle modifications, complementary and
alternative therapies, and/or pharmacologic options with prescription medications.
NONPHARMACOLOGIC TREATMENT
Regular aerobic exercise
Stress management and supportive therapy (yoga, meditation)
Cognitive behavioral therapy
Dietary changes: Increase complex carbohydrates (whole grains, oats, wheat), reduce salt,
caffeine and alcohol, and increase in calcium and magnesium rich foods)
Nutritional Supplements: calcium 1200 mg/day, Magnesium 200-400 mg/day
Evening primrose oil 1500 mg/day (breast tenderness)
PHARMACOLOGIC TREATMENT
Anti-inflammatory Agents: Naproxen sodium 600 mg three times daily
Hormonal Contraception: Pills, Nuvaring, DepoProvera, Nexplanon
Diuretics: Aldactone 50-200 mg/day (fluid retention)
Selective serotonin reuptake inhibitors (SS-RIs): Prozac, Zoloft, Paxil, Lexapro, Celexa, Effexor
Anxiolytics: Xanax, Buspar