What is the treatment for premenstrual syndrome (PMS)?

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Fluctuating progesterone levels during premenstrual syndrome or PMS cause your hormones and your mood to yo-yo. Attack Plan: Take 100 mg of vitamin B6 a day.

  • Studies show that B6 reduces irritability and depression.
  • Unsalted nuts are a good natural source of vitamin B6. Try cashews, hazelnuts and peanuts.
  • For the best results, take this supplement as part of your daily routine.
  • Don’t double up on the dosage; doing so can have an adverse effect.

Other ways to help with symptoms of PMS is to get enough fiber and magnesium, which help to control cramping, diarrhea, bloating and fluid retention.

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To reduce premenstrual syndrome (PMS) induced breast tenderness you can try avoiding smoking and caffeine. Other measures include warm compresses, nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen and a supportive bra to provide symptomatic relief.

Ms. Vandana  R. Sheth
Nutrition & Dietetics Specialist
  • Cut back on your salt intake (this will help reduce bloating and fluid build up)
  • Limit your caffeine
  • Avoid excess sugar and foods with sugar alcohol.
  • Limit alcohol intake
  • Enjoy whole grains, fresh fruits, vegetables
  • Stay active

If home remedies don't help in relieving your premenstrual syndrome (PMS) symptoms, your doctor may recommend the following treatments:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to ease cramps and breast tenderness.
  • Birth control pills may be prescribed to relieve your symptoms by stopping ovulation and regulating your hormone level.
  • Natural progesterone therapy may help some women. Consult with your primary healthcare practitioner about this.
  • A medroxyprogesterone acetate (Depo-Provera) injection can be used to temporarily stop ovulation and menstruation in really severe cases.
  • Antidepressants can be used to help some severe emotional symptoms of PMS.

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Here are some things you can do to ease premenstrual syndrome (PMS) symptoms:

Exercise 30 minutes every day—all month long. This can help prevent and treat PMS symptoms. It's also good for your total health.

Eat healthy. Pay extra attention to these things before your period:

  • Limit salt. You may feel better and have less swelling.
  • Eat smaller meals, more often. This can help with food cravings.
  • Stay away from caffeine and alcohol. This may help ease aches, pains and mood swings.
  • Get enough calcium. Drink low-fat milk. Eat yogurt and broccoli. Drink soymilk with calcium.
  • Take a multivitamin.

Get enough sleep. Get at least 8 hours a night.

Lower your stress. Take time for yourself. Do things that make you feel happy and calm.

Take medicine for pain and discomfort. Try acetaminophen (like Tylenol) or ibuprofen (like Advil). You can also try medicines especially for PMS. These often combine pain medicine with something to help with bloating. Talk to your doctor or pharmacist.

Call or go to the doctor or clinic if:

  • PMS symptoms are very bad and nothing helps
  • PMS symptoms get in the way of normal life: work, family life, friendships or school

Many things have been tried to ease the symptoms of PMS. No treatment works for every woman, so you may need to try different ones to see what works. If your PMS is not so bad that you need to see a doctor, some lifestyle changes may help you feel better. Below are some lifestyle changes that may help ease your symptoms.

  • Take a multivitamin every day that includes 400 micrograms of folic acid. A calcium supplement with vitamin D can help keep bones strong and may help ease some PMS symptoms.
  • Exercise regularly.
  • Eat healthy foods, including fruits, vegetables and whole grains.
  • Avoid salt, sugary foods, caffeine and alcohol, especially when you are having PMS symptoms.
  • Get enough sleep. Try to get 8 hours of sleep each night.
  • Find healthy ways to cope with stress. Talk to your friends, exercise or write in a journal.
  • Don't smoke.
  • Over-the-counter pain relievers such as ibuprofen, aspirin, or naproxen may help ease cramps, headaches, backaches and breast tenderness.

In more severe cases of PMS, prescription medicines may be used to ease symptoms. One approach has been to use drugs such as birth control pills to stop ovulation from occurring, although not necessarily in the typical dosing format. It may be necessary to try different prescriptions to find one that eases symptoms. Women have reported fewer PMS symptoms, such as cramps and headaches, as well as lighter periods when using hormone-based contraception.

This information is based on source information from the National Women's Health Information Center.

Dr. John Preston, PsyD
Psychology Specialist

Premenstrual dysphoric disorder (PMDD) affects 5 percent of women in the USA. This is considered to be a biologically based mood disorder. It is unique among mood disorders: it has an abrupt onset (symptoms come on within several hours), it typically last for a discrete period of time (for some women it lasts only a day…for others 6 days, but generally the same number of days each month), it has an equally abrupt end, with symptoms going away within hours. It is also the only mood disorder that can be treated with antidepressants and symptom relief can occur within hours (all other mood disorders, if treated with antidepressants, require 2-6 weeks of treatment before there is significant reduction in symptoms).

This disorder is felt to be set in motion by changes in female sex hormones resulting in an abrupt decrease in serotonin in the brain. Symptoms include depression, irritability and/or anxiety. Treatments include:

  1. Enhancing quality of sleep by avoiding use of caffeine and alcohol during this period of time.
  2. Exercise (exercise increased brain levels of serotonin): the exercise must be aerobic (intensity enough to cause some huffing and puffing) however the intensity can be in keeping with one’s level of fitness; e.g., brisk walking for those who are not as fit or jogging/running for those who are more fit).
  3. Increasing calcium intake to 1200 mg a day (the amount found in 4 Tums tablets).
  4. Antidepressants: the ones that are effective must impact serotonin (includes most antidepressants, except Wellbutrin), taken only for the period of time when symptoms are present. It is not clear whether or not over-the-counter antidepressants (SAMe and St. John’s wort) are effective in treating PMDD.

It is important to note that this disorder can cause significant emotional suffering, treatments are effective, and the mood changes are not due to psychological problems; it is a biologically based mood disorder.

How do you treat PMS? Swallowing 500 milligrams of calcium supplements with vitamin D (400 IUs or milligrams) twice a day may help, especially for those not getting enough milk or dairy products. Some complementary therapies may work, although the jury is still out with respect to formal studies evaluating these. These strategies include using ginkgo biloba (gingko leaf extract) or Vitex agnus-castus (chasteberry) and eating carbohydrates. (yes, that was in one study.) Nonsteroidal anti-inflammatory drugs, nicknamed NSAIDs (pronounced en-seds) for short, may help; examples include ibuprofen (Motrin, Advil) and naproxen (Aleve). Birth control pills, which regulate hormone levels, may also help, especially ones with every-three-month periods. Selective serotonin reuptake inhibitors such as fluoxetine (brand name Prozac) may also be recommended for severe PMS. For those who don’t want to take a pill every day, Prozac comes in once-a-week form.

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Although premenstrual syndrome cannot be prevented, what you eat may tame some of the symptoms with your diet. Try these strategies:

  • Cut down on salt intake to decrease bloating or water retention. Eat less than 2,300 milligrams (about one teaspoon of salt) daily.
  • Drink water and other liquids. However, go easy on the coffee. Caffeine can heighten irritability.
  • Add calcium-rich foods such as low-fat dairy or dark leafy greens to your daily menus. Some research indicates calcium may help reduce fluid retention and regulate mood-related brain chemicals. In any case, calcium is essential for lifelong bone health and most women don't get enough of it in their daily diet.
  • Being active can help relieve stress and regulate mood, too. Try walking, biking or jogging on most days of the week.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.