Positive Health Online

Abstract

DICKERSON and co-workers, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29406, USA, macfarll@musc.edu, review (36 references) the premenstrual syndrome. Abstract: Premenstrual syndrome is a common cyclical disorder among young and middle-aged women. It is characterized by emotional and physical symptoms that occur during the luteinizing phase of the menstrual cycle. Although the aetiology remains uncertain, research suggests that altered regulation of neurohormones and neurotransmitters is involved. Many symptoms can occur, including depression, mood lability, abdominal pain, breast tenderness, headache, and fatigue. Women with mild symptoms should be instructed about lifestyle changes such as healthy diet, sodium and caffeine restriction, exercise, and stress reduction. Supportive strategies such as the use of a symptom diary may be helpful. In women with moderate symptoms, treatment includes both medication and lifestyle changes. Dietary supplements such as calcium and evening primrose oil may offer modest benefit. Antidepressants of the selective serotonin uptake inhibitor class are the most effective pharmacological intervention at this time. Prostaglandin inhibitors and diuretics may offer some relief. Only weak evidence supports the use of gonadotropin-releasing hormone agonists, androgenic hormones, oestrogen, progesterone, or other psychotropics, and their use is limited by side effects.

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References

Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. American Family Physician 67 (8): 1743-1752, Apr 2003.