Premenstrual syndrome (PMS)

• Overview
   
• Symptoms
   
• Diagnosis & Treatment
• Prevention
   
• Further information

Diagnosis

Your GP can only make a diagnosis of PMS based on the description of your symptoms.^1,2

That's why it's best to keep a diary over three periods so that you can show your GP if symptoms are related to your periods, and not other problems.¹

Use the online diary provided by the National Association for Premenstrual Syndrome.¹ (See Prevention) ¹

Treatment

Headaches, lower back pain and stomach pain¹

Over-the-counter painkillers will help you cope with pain.^1,2

Your GP may prescribe mefenamic acid, a prescription anti-inflammatory drug, which may reduce pain, but can cause side effects, such as nausea.²

Migraines

If you think your migraines are associated with your menstrual cycle, talk to your GP about drugs available to treat them, including stronger painkillers.⁴

You may be offered the contraceptive pill or hormone replacement therapy, where treatment will focus on stabilising your oestrogen levels.⁴ Some people are offered beta-blockers, anti-epilepsy drugs, which are thought to stabilise activity in the brain.⁴

Again, with migraine, it's good to keep a diary to help you recognise any other triggers that may cause migraines apart from your menstrual cycle.⁴ (See Prevention)

PMDD

If you have this extreme form of PMS, your GP may prescribe anti-depressant medicines called selective serotonin reuptake inhibitors (SSRIs).¹

Fluoxetine is one anti-depressant that appears to improve the physical and behavioural symptoms, but does cause side effects, such as nausea, tiredness, vomiting, diarrhoea or constipation and difficulty sleeping.²

Bloating, breast tenderness and mood

A diuretic (water tablet) called spironolactone, may ease bloating and breast tenderness as well as improve mood.²

Anti-anxiety drugs called alprazolam or buspirone may also help relieve severe anxiety symptoms, although they carry potential side effects which you need to ask your GP about.²

General symptoms

An exotic fruit extract called Agnus castus has been proved to be very effective in treatingmost PMS symptoms - irritability, mood alteration, anger, headache, and breast fullness, but not bloating.³

A study looking into its effectiveness was published in the British Medical Journal (BMJ) in 2001.³ It found that over half the women, who took part, had significant improvement in their symptoms.¹ Treatment was also found to be safe and generally free of side effects.³

You may need to take it for at least one year to see improvements and you should stop taking it if you become pregnant.³

Vitamin B6 has also been found to be effective in easing symptoms over a period of two to six months.²

There still needs to be more evidence to prove that calcium supplements and Evening Primrose Oil, one of the most popular self-help remedies, ease symptoms.²

Some women take magnesium supplements but there is no evidence to suggest it eases symptoms.²

There needs to be more research into how effective the oral contraceptive pill and hormone treatments with progesterone are in easing symptoms.^1,2 However, there is limited evidence to say that they do improve some mood and physical symptoms.^1,2

However, both treatments have potential side effects, including excessive bleeding, abdominal pain, nausea, headache, breast discomfort and irregular periods.² In fact, progesterone may induce PMS symptoms in some women.²