title: Recording and treatment of premenstrual syndrome in UK general practice: a retrospective cohort study.
abstract: OBJECTIVE
  To investigate the rate of recording of premenstrual syndrome diagnoses in UK primary care and describe pharmacological treatments initiated following a premenstrual syndrome (PMS) diagnosis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  UK primary care.
  
  
  METHODS
  Women registered with a practice contributing to The Health Improvement Network primary care database between 1995 and 2013.
  
  
  METHODS
  The primary outcome was the rate of first premenstrual syndrome records per 1000 person years, stratified by calendar year and age. The secondary outcome was the proportions of women with a premenstrual syndrome record prescribed a selective serotonin reuptake inhibitor, progestogen, oestrogen, combined oral contraceptive, progestin only contraceptive, gonadotrophin-releasing hormone, danazol and vitamin B6.
  
  
  RESULTS
  The rate of recording of premenstrual syndrome diagnoses decreased over calendar time from 8.43 in 1995 to 1.72 in 2013. Of the 38,614 women without treatment in the 6 months prior to diagnosis, 54% received a potentially premenstrual syndrome-related prescription on the day of their first PMS record while 77% received a prescription in the 24 months after. Between 1995 and 1999, the majority of women were prescribed progestogens (23%) or vitamin B6 (20%) on the day of their first PMS record; after 1999, these figures fell to 3% for progestogen and vitamin B6 with the majority of women instead being prescribed a selective serotonin reuptake inhibitor (28%) or combined oral contraceptive (17%).
  
  
  CONCLUSIONS
  Recording of premenstrual syndrome diagnoses in UK primary care has declined substantially over time and preferred prescription treatment has changed from progestogen to selective serotonin reuptake inhibitor and combined oral contraceptives.
authors.affiliation: Department of Primary care and Population Health, University College London, London, UK.
authors.forename: Cormac J
authors.initials: CJ
authors.lastname: Sammon
authors.affiliation: Department of Primary care and Population Health, University College London, London, UK.
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
authors.affiliation: Department of Primary care and Population Health, University College London, London, UK Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000453:epidemiology*; D011372:Progestins / Q000627:therapeutic use; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D006113:United Kingdom; D025101:Vitamin B 6 / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D011372:Progestins; D017367:Selective Serotonin Reuptake Inhibitors; D025101:Vitamin B 6
keywords: EPIDEMIOLOGY; REPRODUCTIVE MEDICINE; premenstrual