Q. What can I do to treat PMS?
A. Research has found that as many as 85 percent of menstruating women report one or more premenstrual symptoms (PMS); however, only 5 percent to 10 percent of women report significant impairment in their lifestyles from PMS. To formally be diagnosed with PMS, a patient must report one or more of the following symptoms during the five days before menses in three consecutive cycles: depression, angry outbursts, irritability, anxiety, confusion and social withdrawal, breast tenderness, abdominal bloating, headache and swelling of extremities.
Treatment options for PMS are often tailored to a patient’s symptoms. Supportive therapy is one option. Aerobic exercise and dietary supplementation (of calcium, magnesium and vitamin E) have also been shown to be beneficial. Oral contraceptives are excellent for physical symptoms, but not emotional ones. Selective Serotonin Reuptake Inhibitors (SSRIs) are the initial drugs of choice for severe PMS; Fluoxetine is the most studied drug in this class, but sertraline, paroxitine, clomipramine, fluvoxamine, and nefazodone have also been efficacious. Patients with severe symptoms who don’t respond to other medications and therapies are sometimes given gonadotropin-releasing hormone agonist. Removal of both ovaries and both fallopian tubes – called a bilateral salpingo-oophorectomy – is also an option in severe cases.
S. Craig Tidwell, M.D.
Obstetrics and Gynecology
Associates in Obstetrics and Gynecology
1105 Burleyson Road
Dalton, GA 30720
Ph. (706) 278-4640