What treatments are available to cure premenstrual syndrome (PMS)?
Different treatments are aimed at different causes of premenstrual syndrome, and different approaches may relieve some symptoms but not others. Anti-inflammatory drugs are especially helpful for cramping, bowel symptoms, breast pain, and headaches. Diuretics (water pills) help with swelling and sometimes headaches. Antianxiety drugs and antidepressants (which usually also relieve anxiety) may help with mood, irritability, and concentration. For those women who also seek
contraception, contraceptives such as pills and patches (all of which inhibit ovulation) may be of value as they reduce the hormonal variability of the natural menstrual cycle. Indeed, the progestin drospirenone (Yasmin) has been associated with a further decrease in PMS/PMDD symptoms because of its unique action as a mild diuretic, although it is not yet specifically approved for this indication. Supplements help some women as well.
General measures include dietary changes, exercise, and emotional support from family and friends during the time of a woman's cycle. Avoidance of salt before the menstrual period, reduction of caffeine intake, elimination of smoking, alcohol and refined sugars have all been recommended and may help symptoms. Other dietary alterations that have been recommended include restricting the intake of animal fats, dairy products and calcium.
Women have been encouraged to increase their intake of complex carbohydrates (for example, pasta and rice), magnesium and zinc (minerals), vitamins A, E, and B6. While doses of vitamin B6 of 50mg once or twice daily can help relieve symptoms of premenstrual syndrome, excessive use of vitamin B6 is discouraged, since it can cause nervous system symptoms including tingling and numbness in the arms and legs, and even permanent nerve damage
If your symptoms are moderate to severe and interfere with your normal daily activities, then your doctor probably will prescribe medications aimed at relieving specific symptoms.For example, if you are troubled by bloating and weight gain, then your doctor may prescribe a diuretic to help your body eliminate the excess water. Oral contraceptives, especially birth control pills containing both estrogen and progestin, may be used to minimize the severity of cramps and the length of your period.
If you have symptoms of irritability, social withdrawal, angry outbursts or depression that interferes with your work or home responsibilities or your personal relationships, then your doctor may suggest that you try an antidepressant medication. These medications have proven to be effective in alleviating these types of symptoms. The most effective antidepressants for relieving PMS are selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac, Sarafem and others), sertraline hydrochloride (Zoloft) and clomipramine (Anafranil). Other antidepressants include nefazodone (Serzone) and venlafaxine (Effexor). These can be taken for two weeks prior to each period or can be taken every day.
For very severe symptoms, or when other medications fail, your doctor may prescribe a medication that causes the ovaries to stop producing estrogen so that ovulation stops. Danocrine (Danazol) is a synthetic androgen that suppresses the hormones in the brain that trigger ovulation. Gonadotropin-releasing hormone (GRNH) agonists, such as leuprolide (Lupron), create a temporary menopausal state by suppressing hormones in the brain that control the production of ovarian hormones and ovulation. These medications can be used only for short periods of time. They commonly lead to hot flashes and other symptoms of menopause. If therapy needs to continue for more than six months, you will also have to take estrogen to prevent bone loss. Whether your symptoms are mild or severe, it always helps to have your family's understanding and support while you are being treated for premenstrual syndrome. For this reason, your doctor will encourage you to speak frankly with family members about your symptoms and your premenstrual syndrome treatment.
Ability to cope with the extra burden of premenstrual hormone changes may be enhanced by a variety of non-medical means. Regular exercise may improve your self-esteem and provide you with a feeling of being more healthy. Similarly, relaxation by a variety of means and improving your diet may have a beneficial effect. There is no evidence that special diets for premenstrual syndrome have additional benefit. Theoretically, pyridoxine (Vitamin B6) and magnesium may be beneficial as they are known to play an essential part in the chemistry of the brain: controlled trials, however, have shown little scientific evidence of clinical benefit. Counselling may be assist some individuals to assess their problems in life and make a start on sorting them out.