The treatment of PMS depends on:
The severity and type of symptoms
How bothersome they are
For example, your symptoms may be mild. They may not interfere with your daily life or personal relationships. In this case, your doctor may suggest that you try one or more of the following lifestyle changes:
Exercise regularly, three to five times per week.
Do not skip meals. Follow a regular meal schedule to maintain a more stable blood sugar level.
Eat a balanced diet that is low in refined sugars.
Try to get a good night's sleep. Avoid staying up all night.
If you smoke, quit.
Cut down on caffeine, alcohol, red meat and salty foods.
Practice stress reduction techniques. Take a nice long bath. Or, try meditation or biofeedback.
Your doctor also may suggest taking supplements of vitamin B6, calcium or magnesium. Always follow the dosage recommended by your doctor. Do not take more than 100 milligrams per day of vitamin B6. Nerve damage has been associated with vitamin B6 at high doses.
If your symptoms are moderate to severe and interfere with your normal daily activities, your doctor probably will prescribe medications. These medications are aimed at relieving specific symptoms.
For example, if you are troubled by bloating and weight gain, your doctor may prescribe a diuretic. This will help your body eliminate the excess water. Oral contraceptives, especially those that contain both estrogen and progestin, may minimize the severity of cramps and the length of your period.
Your doctor may suggest that you try an antidepressant medication. This is likely if you have symptoms that interfere with your work or home responsibilities or your personal relationships. These symptoms may include irritability, social withdrawal, angry outbursts or depression.
The most effective antidepressants for relieving PMS are selective serotonin reuptake inhibitors (SSRIs). Examples of SSRIs include:
Fluoxetine (Prozac, Sarafem)
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.
Less commonly, your doctor may prescribe a medication that causes the ovaries to stop producing estrogen, so that ovulation stops. This is usually reserved for very severe symptoms, or when other medications fail. Danocrine (Danazol) is a synthetic androgen. It suppresses the hormones in the brain that trigger ovulation. Gonadotropin-releasing hormone (GRNH) agonists, such as leuprolide (Lupron), create a temporary menopausal state. They do this by suppressing hormones that control the production of ovarian hormones and ovulation.
These medications are generally used 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 PMS. Your doctor will encourage you to speak frankly with family members about your symptoms and your PMS treatment.