Syndrome (PMS)
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- What is PMS?
- Symptoms of PMS
- Causes of PMS
- Prevention of PMS
- Risk factors for PMS
- Complications of PMS
- When to see a doctor about PMS
- Diagnosis of PMS
- Conventional treatment of PMS
- Alternative/complementary treatment of PMS
- Living with PMS
- Caring for someone with PMS
Conventional treatment of pre-menstrual syndrome (PMS)
The conventional (western) medical approach to treating PMS is through the following.
Hormone therapy
These are used to regulate hormones by preventing ovulation and prevent or ease PMS symptoms:
- Contraceptive pill - this contains both eostrogen and progesterone in specific amounts. There are many variations of the Pill, with different amounts of each of the hormones eostrogen and progesterone. Today, most doctors prescribe a particular contraceptive pill called Yasmin with a special combination of hormones (drosperinone/ethinyl estradiol), as research has shown it can greatly assist in reducing the symptoms of PMS by suppressing ovulation, reducing fluid retention and countering the effects of testosterone. The other commonly prescribed contraceptive pill is YAZ, which is very low in eostrogen (lower than Yasmin)
- Danazol - this medication reduces the output of both follicle-stimulating hormone (FSH) and luteinising hormone (LH) and eostrogen, so it stops the menstrual cycle, which may help with some women's PMS symptoms. If the menstrual cycle is ceased, then PMDD symptoms are also not going to occur. While Danazol is effective at reducing symptoms of PMS, it is only prescribed as a medication of extreme last resort, when other options are not viable, as it has really severe side effects (acne, cramps, depression, flushing, increased HDL ("bad") cholesterol levels, increased male characteristics, reduced breast size, weight gain) and also cannot be prescribed for longer than six months
- GnRH agonists - Gonadotropin releasing hormone agonists (GnRH) are a type of medication that suppresses ovulation by stopping the production of estrogen and progesterone. The GnRH agonists are effective at reducing symptoms of PMS, but they are only prescribed as a medication of last resort, when other options are not viable, as they have severe menopause-like side effects (in particular, hot flushes and night sweating) and they also cannot be prescribed for longer than six months
- Bromocriptine - this drug selectively targets one of the abnormal hormones (prolactin), but is not used very much these days as its side effects can cause a worsening and further imbalance of the hormones
These drugs all have side effects and they just treat the symptoms and not the actual cause of the PMS, so they do not really provide a major benefit for PMS long-term, which is the reason why many doctors these days are more inclined to suggest an alternative/complementary approach to treating PMS and only suggest medication as a last resort.
The contraceptive pill for example, should not be taken by women who smoke, who have had any type of blood clots or who have had any type of oestrogen-dominant female cancers. The other medications also have their own set of side effects and the risks should be discussed with your doctor.
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Medications
The following medications are prescribed, either on their own or in a combination advised by your doctor, depending on symptoms:
- Fluid retention relief - to relieve symptoms associated with
bloating in the breasts, abdomen and the whole body
- Diuretics - both over-the-counter and prescription are used to relieve the fluid retention and breast tenderness symptoms associated with PMS by blocking the function of the hormone aldosterone. Examples are: Aldactone(not to be taken at night as they can cause disrupted sleep when they wake you with the need to urinate often)
- Prostaglandin inhibitors - to
relieve inflammation
- COX-2 Inhibitors - these medications are used to relieve menstrual cramping and premenstrual symptoms. Examples are: Celebrex (other Cox-2 inhibitors have been taken off the market due to significant side effects, including heart attack, stroke and possible death)
- Analgesics - to
relieve pain and/or inflammation
- Naproxen, ibuprofen, or mefenamic acid - these are non-steroidal anti-inflammatory medications which relieve premenstrual pain and reduce menstrual pain and bleeding. They work to reduce inflammation by reducing prostaglandin production. Examples are: Advil, Naprogesic, Nurofen, Ponstan
- Anti-depressants - these are recommended to be used just in the two weeks prior to menstruation, during PMS (or sometimes all month for some women) to reduce symptoms associated with depression. Today, there are a number of anti-depressant medications which are specifically tailored to be used for PMS
- Benzodiazepines - are only recommended to be used for a few days prior to menstruation for anxiety symptoms, when other treatments have been ineffective. These medications depress the central nervous system, but they lose their effectiveness over time and can be very addictive. Examples are: Xanax
- SSRIs - these medications work by helping the brain retain more serotonin, the neurotransmitter responsible for regulating mood and which may be low in women with PMS. These medications help to relieve depression, anxiety, irritability, aggression, and many physical symptoms of PMS. Examples are: Prozac, Sarafem, Paxil, Zoloft, Luvox, Celex
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< 8: diagnosis 10: alternative treatment > Last reviewed: 15 August 2008 || Last updated: 9 January 2010
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NOTE: Mega doses of any type of vitamin, mineral, amino acid or herbal supplement cannot cure illnesses and in fact can be very dangerous and produce toxic side effects and interfere with medicine you are taking. Always ensure you consult your doctor before taking any type of complementary supplements.
Disclaimer: This guide is not intended to be used for diagnostic or prescriptive purposes. For any treatment or diagnosis of illness, please see your doctor.
