Treating premenstrual syndrome (PMS)

Treatments forpremenstrual syndrome (PMS)may help you manage your symptoms so they don't interfere with your daily life.

If your PMS is mild or moderate, you may want to make changes to your diet and lifestyle before resorting to medical treatment.

This is because many of the medical treatments can have side effects that may be worse than your PMS symptoms.

Lifestyle changes

Diet

The following tips can help you maintain a healthy, balanced diet, and may alsohelp control the symptoms of PMS:

  • eat smaller meals more frequently to help reduce bloating
  • avoid eating salty foods to limit bloating and fluid retention
  • drink plenty of water to avoid Dehydration being dehydrated can make headaches and tiredness worse
  • eat lots of complex carbohydrates, which can be found in foods such as fruit, vegetables and wholegrains
  • eat calcium-rich foods such as cheese and milk to improve the physical and psychological symptoms of PMSif you can't eat dairy products, try calcium-fortified soya alternatives
  • eat plenty of fruit and vegetables, which are rich in vitamins and minerals and may ease your PMS symptoms aim to eat at least five portions a day
  • avoid caffeine and alcohol, which can affect your mood and energy levels

Examples of activities include walking, swimming and cycling.

Exercise improves your overall health and can help alleviate depression and tiredness.

Stretching and breathing exercises, such as yoga and pilates , can help you sleep better and reduce yourstress levels.

Some women may find these helpful foreasing their symptoms.

For example, supplements of calcium , vitamin D , magnesium and agnus castus (a herb known as chasteberry) may reduce some symptoms of PMS.

However, many complementary therapies and supplements have either not been tested or haven't been proven to be effective.

Always see your GP before taking any supplements, as taking them alongside certain medications orin excessive amounts can be harmful.

If you decide to take a complementary treatment, take one at a time so you know it works for you.Go back to your GP if your symptoms don't change after three months, as they may recommendanother treatment.

Psychological therapy

If you have psychological symptoms, such as feeling depressed or emotional, it may help to talk to a health professional.

Cognitive behavioural therapy (CBT) is the term for a group of therapies designed to help solve problems such as anxiety and depression. A cognitive behavioural therapist can help you learn new ways of managing some of your symptoms.

However, there's no single treatment that works for everyone.

A wide range of treatmentsis available. You may have to try several before you find one that suits you. Your choice of treatment will be based on your symptoms and how severe they are, and the possible side effects of the medication.

If you're prescribed treatment for PMS,you may be asked to record any changes to your symptoms so you know how effective it is for you. If the treatment doesn't ease your symptoms, you may be prescribed an alternative.

Medical treatments for PMS include:

  • painkillers
  • acombined oral contraceptive pill
  • oestrogen-only patches and implants
  • selective serotonin reuptake inhibitors (SSRIs)
  • gonadotrophin-releasing hormone (GnRH) analogues

These are described in more detail below.

Painkillers

Painkilling medication, including paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) ,can relieve some of the painful PMS symptomssuch as:

  • stomach cramps
  • headaches
  • muscle pain and joint pain

These medications are available over the counter without a prescription, so makesure you read the manufacturer's instructions before taking them. Children under the age of 16 shouldn't take aspirin and people with asthma shouldn'ttake ibuprofen .

Oral contraceptive pills

As well as preventing pregnancy,the combined contraceptive pill may help improve symptoms of PMS in some women by preventing ovulation (when an egg is released from your ovaries).

In particular, newer types of contraceptive pill containing certain versions of the hormone progestogen, such as the Yasmin pill, have been shown to be effectivefor treating some PMS symptoms, and may even be effective for improving symptoms of PMDD.

However, contraceptive pills don't help all women and they can have side effects similar to the symptoms of PMS, such as breast pain or a depressed mood.

Oestrogen-only patches and implants

Like combined contraceptive pills, oestrogen-only patchesand implants may help improve some symptoms of PMS by preventing ovulation. However, they're usually only used to treat PMS under the guidance of a gynaecologist.

Unless you've had a hysterectomy (removal of your womb), oestrogen patches and implantsalso need to be combined with a low dose of the hormone progestogen.

This isto reducethe risk of thickening of thewomb lining (endometrial hyperplasia), which can develop into womb cancer . This may be in the form of progestogen tablets ora progestogen-releasing intrauterine system (IUS) .

Side effects of using an oestrogen patch can include skin irritation, itching and soreness, andtheadditional progestogen dose can have side effects similar to the symptoms of PMS.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) may be the most effective treatment if you have severe PMS or PMDD.

SSRIs, such asfluoxetine and sertraline, are antidepressants that can be taken daily to relieve tiredness, food cravings and sleep problems, and combat depression.

However,SSRIs alsomay have negative side effects thatcould outweigh their benefits, such as:

  • nausea
  • insomnia
  • headache
  • loss of libido (less interest in sex)

Gonadotrophin-releasing hormone (GnRH)analogues

Gonadotrophin-releasing hormone (GnRH) analogues are synthetic hormones that create a temporary menopause and stop your periods by blocking the production of oestrogen and progesterone. They're taken as an injection.

GnRH analogues should only be used in women with severe PMS when all other treatments have failed. They often have side effects such as:

  • hot flushes
  • vaginal dryness
  • loss of libido
  • osteoporosis (thinning of the bones)

They should only be taken alone for up to six months.

IfGnRH analoguesare used for longer than this, you'll be advised to take hormone replacement therapy (HRT) to reduce menopausal complications such as osteoporosis.


Content supplied by the NHS Website

Medically Reviewed by a doctor on 28 Nov 2016