J Korean Med Assoc.  2005 Jul;48(7):672-678. 10.5124/jkma.2005.48.7.672.

Medical Treatment of Premenstrual Syndrome

• Kim T

• KMID: 2183597
• DOI: http://doi.org/10.5124/jkma.2005.48.7.672

Abstract

The premenstrual syndrome is a common sense one: the cyclic appearance of one or more of a large constellation of symptoms just prior to menses, occuring to such a degree that lifestyle or work is affected, followed by a period of time entirely free of symptoms. Symptoms are believed to the result from interaction between central neurotransmitters and normal menstrual hormonal changes. Pharmacologic management to support efficacy includes 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 available towards producing anovulation. There is a good clinical evidence for GnRH agonist with addback hormonal therapy. Oral contraceptive pills prevent ovulation and should be effective for the treatment of PMS. Treatment usually begins with lifestyle changes, over-thecounter medications. Physicians should be aware of the risks from many alternative therapies commonly touted in the popular press.

Keyword

Premenstrual syndrome; Treatment

MeSH Terms

Anovulation
Anti-Anxiety Agents
Antidepressive Agents, Tricyclic
Complementary Therapies
Diuretics, Potassium Sparing
Female
Gonadotropin-Releasing Hormone
Life Style
Neurotransmitter Agents
Ovulation
Premenstrual Syndrome*
Serotonin Uptake Inhibitors
Anti-Anxiety Agents
Antidepressive Agents, Tricyclic
Diuretics, Potassium Sparing
Gonadotropin-Releasing Hormone
Neurotransmitter Agents
Serotonin Uptake Inhibitors

Reference

1. Speroff L, Fritz M, et al. Clinical Gynecologic Endocrinology and Infertility. 2004. 7th ed. Philadelpia: Lippincott Williams & Wilkins;531–539.

2. Yen S, Jaffe R, et al. Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management. 2004. 5th ed. Philadelpia: WB Saunders;583–585.

4. Freeman EW, Kroll R, Rapkin A, Pearlstein T, Brown C. PMS/PMDD Research Group. Evaluation of a unique oral contraceptive in the treatment of premenstrual dysphoric disorder. J Womens Health Gend Based Med. 2001. 10:561–569.

5. Pearlstein TB, Stone AB. Long-term fluoxetine treatment of late luteal phase dysphoric disorder. J Clin Psychiatry. 1994. 55:332–335.

6. Domoney CL, Vashisht A, Studd JWW. Premenstrual syndrome and the use of alternative therapies. Ann N Y Acad Sci. 2003. 997:330–340.

7. Halbreich U. The diagnosis of premenstrual syndromes and premenstrual dysphoric disorder: clinical procedures and research perspectives. Gynecol Endocrinol. 2004. 19:320–334.

8. Rapkin A. A review of treatment of premenstrual syndrome and premenstrual dysphoric disorder. Psychoneuroendocrinology. 2003. 28:39–53.