From the Research
Selective serotonin reuptake inhibitors (SSRIs) are the most effective treatment for premenstrual syndrome (PMS), reducing overall self-rated symptoms significantly more than placebo, as shown in a 2013 study 1.
Treatment Options for PMS
Treatment options for PMS include both lifestyle modifications and medications.
- Lifestyle changes should be tried first, including regular exercise, stress reduction techniques, adequate sleep, and dietary adjustments such as reducing caffeine, salt, and alcohol while eating smaller, more frequent meals.
- Nutritional supplements that may help include calcium (1200 mg daily), magnesium (400 mg daily), and vitamin B6 (50-100 mg daily) 2.
Medication Options
For symptom management, over-the-counter pain relievers like ibuprofen (200-400 mg every 4-6 hours) or naproxen (220 mg every 8-12 hours) can reduce cramping and breast tenderness.
- If these measures are insufficient, hormonal treatments such as combined oral contraceptives can regulate hormonal fluctuations.
- For severe emotional symptoms, SSRIs like fluoxetine (20 mg daily) or sertraline (50-150 mg daily) may be prescribed, either continuously or just during the luteal phase (two weeks before menstruation) 1.
- Diuretics like spironolactone (25-100 mg daily) can help with bloating.
Individualized Approach
These treatments work by addressing the hormonal fluctuations and neurotransmitter changes that cause PMS symptoms, with different options targeting specific symptom clusters.
- A combination approach often works best, and treatment should be individualized based on symptom severity and personal health factors.
- It is essential to consider the potential side effects of SSRIs, such as nausea, asthenia, and decreased libido, and to weigh these against the benefits of treatment 1.