Therapeutic management of premenstrual syndrome.
BACKGROUND
Premenstrual syndrome (PMS) is among the most common health problems reported by reproductive-age women. Estimates indicate that up to 25% of women may warrant treatment for the distress or impaired functioning associated with the symptoms.


METHODS
The primary focus of this review is the clinical condition of PMS and randomized, placebo-controlled trials of PMS treatment. A literature search in PubMed was conducted for these topics. The most recent reports of specific treatments in controlled treatment studies and all meta-analyses were selected.


RESULTS
Reports consistently indicate that serotonergic antidepressants reduce PMS symptoms compared to a placebo. Hormonal treatments are the most widely prescribed medical treatment. Some oral contraceptives and gonadotropin-releasing hormone analogs have demonstrated efficacy, particularly for women who want contraception and PMS symptom control. Numerous non-pharmacologic treatments are utilized, but efficacy is reported only for calcium supplements, Vitex agnus castus (chasteberry), and cognitive-behavioral therapies. Further research to develop new therapies for the 40% of women with PMS who do not respond to the currently available treatments is needed.


CONCLUSIONS
There are treatments with demonstrated efficacy for PMS, and the majority of women can be helped.
Freeman
Ellen W
EW
Departments of Obstetrics/Gynecology and Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. freemane@mail.med.upenn.edu
D002136:Calcium, Dietary / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use*; D006801:Humans; D008517:Phytotherapy; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000628:therapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020950:Vitex
D002136:Calcium, Dietary; D003278:Contraceptives, Oral, Hormonal; D007987:Gonadotropin-Releasing Hormone; D017367:Selective Serotonin Reuptake Inhibitors