title: ISPMD consensus on the management of premenstrual disorders.
abstract: The second consensus meeting of the International Society for Premenstrual Disorders (ISPMD) took place in London during March 2011. The primary goal was to evaluate the published evidence and consider the expert opinions of the ISPMD members to reach a consensus on advice for the management of premenstrual disorders. Gynaecologists, psychiatrists, psychologists and pharmacologists each formally presented the evidence within their area of expertise; this was followed by an in-depth discussion leading to consensus recommendations. This article provides a comprehensive review of the outcomes from the meeting. The group discussed and agreed that careful diagnosis based on the recommendations and classification derived from the first ISPMD consensus conference is essential and should underlie the appropriate management strategy. Options for the management of premenstrual disorders fall under two broad categories, (a) those influencing central nervous activity, particularly the modulation of the neurotransmitter serotonin and (b) those that suppress ovulation. Psychotropic medication, such as selective serotonin reuptake inhibitors, probably acts by dampening the influence of sex steroids on the brain. Oral contraceptives, gonadotropin-releasing hormone agonists, danazol and estradiol all most likely function by ovulation suppression. The role of oophorectomy was also considered in this respect. Alternative therapies are also addressed, with, e.g. cognitive behavioural therapy, calcium supplements and Vitex agnus castus warranting further exploration.
authors.affiliation: Institute for Science and Technology in Medicine, Keele University, Stoke on Trent, UK. t.nevatte@keele.ac.uk
authors.forename: Tracy
authors.initials: T
authors.lastname: Nevatte
authors.forename: Patrick Michael Shaughn
authors.initials: PM
authors.lastname: O'Brien
authors.forename: Torbjorn
authors.initials: T
authors.lastname: Bäckström
authors.forename: Candace
authors.initials: C
authors.lastname: Brown
authors.forename: Lorraine
authors.initials: L
authors.lastname: Dennerstein
authors.forename: Jean
authors.initials: J
authors.lastname: Endicott
authors.forename: C Neill
authors.initials: CN
authors.lastname: Epperson
authors.forename: Elias
authors.initials: E
authors.lastname: Eriksson
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Uriel
authors.initials: U
authors.lastname: Halbreich
authors.forename: Khalid
authors.initials: K
authors.lastname: Ismail
authors.forename: Nicholas
authors.initials: N
authors.lastname: Panay
authors.forename: Teri
authors.initials: T
authors.lastname: Pearlstein
authors.forename: Andrea
authors.initials: A
authors.lastname: Rapkin
authors.forename: Robert
authors.initials: R
authors.lastname: Reid
authors.forename: David
authors.initials: D
authors.lastname: Rubinow
authors.forename: Peter
authors.initials: P
authors.lastname: Schmidt
authors.forename: Meir
authors.initials: M
authors.lastname: Steiner
authors.forename: John
authors.initials: J
authors.lastname: Studd
authors.forename: Inger
authors.initials: I
authors.lastname: Sundström-Poromaa
authors.forename: Kimberly
authors.initials: K
authors.lastname: Yonkers
mesh_terms: D005260:Female; D006126:Group Processes; D006801:Humans; D011293:Premenstrual Syndrome / Q000145:classification / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology