A review of treatment of premenstrual syndrome & premenstrual dysphoric disorder

UCLA School of Medicine, Department of Obstetrics and Gynecology, Center for the Health Sciences, Los Angeles, CA 90095-1740, USA.
Psychoneuroendocrinology (Impact Factor: 4.94). 09/2003; 28 Suppl 3(3):39-53. DOI: 10.1016/S0306-4530(03)00096-9
Source: PubMed


Severe premenstrual syndrome (PMS) and, more recently, premenstrual dysphoric disorder (PMDD) have been studied extensively over the last 20 years. The defining criteria for diagnosis of the disorders according to the American College of Obstetricians and Gynecologists (ACOG) include at least one moderate to severe mood symptom and one physical symptom for the diagnosis of PMS and by DSM IV criteria a total of 5 symptoms with 1 severe mood symptom for the diagnosis of PMDD. There must be functional impairment attributed to the symptoms. The symptoms must be present for one to two weeks premenstrually with relief by day 4 of menses and should be documented prospectively for at least two cycles using a daily rating form. Nonpharmacologic management with some evidence for efficacy include cognitive behavioral relaxation therapy, aerobic exercise, as well as calcium, magnesium, vitamin B(6) L-tryptophan supplementation or a complex carbohydrate drink. Pharmacologic management with at least ten randomized controlled trials to support efficacy include selective serotonin reuptake inhibitors administered daily or premenstrually and serotonergic tricyclic antidepressants. Anxiolytics and potassium sparing diuretics have demonstrated mixed results in the literature. Hormonal therapy is geared towards producing anovulation. There is good clinical evidence for GnRH analogs with addback hormonal therapy, danocrine, and estradiol implants or patches with progestin to protect the endometrium. Oral contraceptive pills prevent ovulation and should be effective for the treatment of PMS/PMDD. However, limited evidence does not support efficacy for oral contraceptive agents containing progestins derived from 19-nortestosterone. The combination of the estrogen and progestin may produce symptoms similar to PMS, such as water retention and irritability. There is preliminary evidence that a new oral contraceptive pill containing low-dose estrogen and the progestin drospirenone, a spironolactone analog, instead of a 19-nortestosterone derivative can reduce symptoms of water retention and other side effects related to estrogen excess. The studies are in progress, however, preliminary evidence suggests that the drospirenone-containing pill called Yasmin may be effective the treatment of PMDD.

49 Reads
  • Source
    • "Interessant nok forverret behandling med Strattera symptomer både på depresjon og intensitet av suicidal atferd, mens det sykliske mønsteret forble uforandret. Behandling Flere dobbelt-blind-plasebokontrollerte studier har vist positiv effekt av medisiner som øker serotoninkonsentrasjonen i hjernen for å behandle PMDD (oppsummert i en oversiktsartikkel av Rapkin, 2003). Pasientens tilstand har blitt betydelig bedre etter behandling med Zoloft (Sertralin). "

    05/2015; 15(3). DOI:10.5617/suicidologi.2034
  • Source
    • "Until recently, the focus on single, usually pharmacologic therapy has dominated the treatment of PMS. But now clinical research suggests that combination of treatments including pharmacotherapies (like selective serotonin reuptake inhibitors (SSRIs), anxiolytic agents, gonadotropin-releasing hormone (GnRH) agonists, the diuretic spironolactone, non-steroidal anti-inflammatory drugs and combination oral contraceptives (OCs)), cognitive and behavioral therapies, aerobic exercises, homeopathic remedies, reflexology, light therapy, massage therapy, dietary and nutritional modifications have been used over the years to treat premenstrual symptoms are more beneficial than are single treatments [19-25]. Hence, the primary aim of this study was to assess the prevalence, impacts and medical managements of PMS on female students of College of Health Sciences students, Mekelle University. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Premenstrual syndrome (PMS) is used to describe physical, cognitive, affective, and behavioral symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolve quickly at or within a few days of the onset of menstruation. The primary aim of the study was to assess the prevalence, impacts and medical managements of PMS on female medical students of Mekelle University College of Health Science. A cross-sectional study was conducted among systematically selected female students of Mekelle University College of Health Science, Mekelle town, northern Ethiopia from March to April 2013. A structured and pretested self-administered questionnaire was employed for data collection. The collected data were analyzed using the Statistical Package for the Social Sciences, SPSS Inc., Chicago, IL (SPSS version 16). The criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR) were used to diagnose PMS.Result: From the total population size of 608; a sample size of 258 was drawn. Age of the study participants ranged from 18 to 25 years, with mean age of 20.86 +/- 1.913 years. Among the participants, 144(83.2%) have had at least one PM symptoms with their menstrual period. The prevalence of PMS according to DSM-IV was 37.0%. About 49(28.3%) reported frequent class missing, 17(9.8%) exam missing, 14(8.1%) low grade scoring and 3(1.7%) of them reported withdrawal from their learning associated with their PMS. Only 83(48.0%) participants sought medical treatment for their PMS. The treatment modalities used were pain killers, 63(36.4%), hot drinks like coffee and tea, 13(7.5%), and massage therapy and exercise, 7(4.0%). Binary logistic regression analysis revealed average length of one cycle of menstruation (COR = 0.20(0.070-0.569)) and academic performance impairment (AOR = 0.345(0.183-0.653)) were significantly associated with the diagnosis of PMS and use PMS treatments respectively. Our study revealed a high prevalence and negative impact of PMS on students of Mekelle University. Therefore, health education, appropriate medical treatment and counseling services, as part of the overall health service, should be availed and provided to affected women.
    BMC Women's Health 03/2014; 14(1):52. DOI:10.1186/1472-6874-14-52 · 1.50 Impact Factor
  • Source
    • "TMPs are cheap and will rarely deny treatment to patients due to lack of payment. This makes them the most likely to be consulted by the majority rural poor (Kaingu et al., 2011; Kazerooni et al., 2006; Rapkin, 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Reproductive dysfunction is a major health concern amongst the inhabitants of Tana River County. An ethno botanical study was conducted in Garsen, Itsowe and Ngao sub divisions of Tana River County to document the utilization of medicinal plants for the management of female reproductive ailments. The target population was practicing herbalists from Pokomo, Ormo and Giryama communities in the study area. Structured questionnaires and focussed group discussions were used to collect data. Forty eight plant species distributed in 40 genera and 29 families were documented as being important for the management of pregnancy related complications, menstrual disorders, infertility, fibroids and as contraceptives. The species most frequently cited by the herbalists were fourteen. Fifty two percent of the plant species were probably being mentioned for the first time as being useful in reproductive health management. In conclusion, Tana River has a pool of TMPs with a wealth of indigenous knowledge that needs to be exploited. The plants used to treat dysmenorrhea for example may be important analgesic agents that need further investigation while those with anti-fertility properties may contain steroidal phyto chemical compounds. Such species therefore need further investigation to establish their efficacy and mechanism of action.
    05/2013; 3(2). DOI:10.5667/tang.2013.0006
Show more

Similar Publications


49 Reads
Available from