What medications can help for premenstrual syndrome treatment?
There are a number of prescription medicines used to treat PMS, including:
Anti-inflammatories: These drugs prevent the body from producing prostaglandins, which have been suggested as a cause of premenstrual syndrome. Reducing the amount of prostaglandins in the body may eliminate many of the inflammatory symptoms of premenstrual syndrome such as menstrual cramps, breast pain, headache, swelling, and
other discomforts. Several types of anti-inflammatory agents are used for premenstrual syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended initially, and there are several that may be purchased without a prescription. COX-2 inhibitors are a new type of NSAID that must be obtained with a prescription. These are longer-acting than most NSAIDs and have less risk of causing stomach discomfort or ulcers.
Hormones: Hormones such as nafarelin (Synarel) and leuprolide (Lupron) prevent your body from releasing eggs and undergoing a menstrual cycle. Therefore, if you take these medications, you will not ovulate and will not menstruate. This treatment eliminates premenstrual syndrome symptoms in more than half of all women receiving it. These hormones are like birth control pills in that they suppress the menstrual cycle, but the cycle returns when they are stopped. However, women taking the birth control pill still bleed every month. Women on this therapy have no periods at all. However, most contraceptive pills and patches can be used in a continuous fashion to reduce or eliminate withdrawal bleeding.
Selective serotonin-reuptake inhibitors (SSRIs): This class of antidepressants affects the availability of the neurotransmitter serotonin. The SSRIs fluoxetine (Prozac) and sertraline (Zoloft) have been shown in scientific studies to help reduce depression, irritability, and anxiety in premenstrual syndrome. Physical symptoms are usually helped too. Other SSRIs are also being studied for their effects on premenstrual syndrome. SSRIs can cause the side effects of drowsiness, nausea, and jitteriness in a small percentage of women. Women who begin SSRI therapy must decrease dosages very slowly to avoid possible side effects should they decide to stop the therapy. About 60 percent of women with severe premenstrual syndrome experience significant relief from SSRIs. Many take them throughout their menstrual cycle, but some have success using them just during the premenstrual phase.
Danazol (Danocrine) is another hormonal agent that blocks the production and the effects of certain female hormones. Danazol is a modified male sex hormone, which was shown to significantly decrease breast pain in clinical studies. However, it was not effective in treating other symptoms. Because danazol may increase certain fat levels in the blood, it is not recommended if you have high cholesterol levels. Because of the profound adverse side effect profile of danazol, its use continues to decrease.
Anti-anxiety drugs: Benzodiazepines are drugs that decrease anxiety by depressing the central nervous system. Alprazolam (Xanax) is a member of this class. It can be effective in treating the anxiety associated with premenstrual syndrome. You may feel drowsy if you take this type of medicine. Benzodiazepines can be addictive.
Antidepressants: Fluoxetine (Sarafem, also known as Prozac), sertraline (Zoloft), and paroxetine (Paxil) are medicines that help the body increase the activity of serotonin, a brain chemical that has been shown to be low in some women with premenstrual syndrome (and in those with PMDD). Clinical trials show that SSRIs effectively treat mood symptoms such as depression, anxiety, and anger. However, other symptoms of premenstrual syndrome, such as tiredness and decreased sexual drive, may not improve or may become worse on these drugs.
Birth control pills: These may help relieve the physical symptoms of premenstrual syndrome in some women, but the results are variable. Because birth control pills contain high levels of an estrogen-like hormone and progesterone -like hormone, they actually may cause premenstrual symptoms in some women. Women who experience premenstrual syndrome while on the pill should consider using another method of birth control.
Diuretics: Diuretics (commonly called water pills) are drugs that help the body to shed excess water through the kidneys. These medicines significantly help reduce the weight gain, breast swelling, and bloating associated with premenstrual syndrome. Metolazone (Mykrox, Zaroxolyn) and spironolactone (Aldactone) are 2 commonly used diuretics.
Progesterone: Many studies have been done using progesterone treatment for premenstrual syndrome. The majority of these studies have concluded that progesterone does not improve premenstrual syndrome symptoms.