 Premenstrual syndrome, or PMS, is the term used to describe the symptoms that some women experience about seven to ten days before their menstrual periods start. A variety of symptoms have been associated with PMS, including headaches, backaches, weight gain, breast tenderness, water retention, food cravings, acne, and stomach upset. Other symptoms include emotional changes such as irritability, mood swings, anxiety, sadness, or reduced sex drive.Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve menstrual cramps when over-the-counter drugs don't work. Examples of prescription NSAIDs include ibuprofen (brand name Motrin), and naproxen (>Naprosyn). Prescription diuretics (water pills) such as >spironolactone (Aldactone) and >hydrochlorothiazide (HydroDiuril) relieve water retention due to PMS. These drugs work in the kidneys to remove the excess water from the body. Birth control pills can reduce physical and emotional symptoms of PMS in some women. They work by keeping hormone levels in the body more stable. But in other women, birth control pills are not effective and can make PMS symptoms worse. Antidepressants can help reduce symptoms of PMS. Examples include tricyclic antidepressants such as clomipramine (>Anafranil) and selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (>Paxil) and sertraline (>Zoloft). Recently, fluoxetine (>Sarafem) was approved for the treatment of Premenstrual Dysphoric Disorder (PMDD), a severe form of PMS. Doctors prescribe these medicines every day on a regular basis or only during certain parts of the menstrual cycle to treat depression, anxiety, and mood swings. There may be a link between an increased risk of suicide in children taking antidepressants. Be sure to talk with you or your child's doctor regarding the benefits and risks of these medications. Sources:
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Micromedex® Healthcare Series. Thomson Micromedex, 2006
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Ericksson, E., International Journal of Clinical Psychopharmacology 14S (1999).
Young, S.A. "Treatment of Premenstrual Dysphoric Disorder with Sertraline During the Luteal Phase: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial," Journal of Psychiatry 59 (1998).
Danforth's Obstetrics and Gynecology. Lippincott Williams & Wilkins, 1999.
Kistner's Gynecology & Women's Health. Mosby, Inc., 1999.
Sarafem Product Information. Warner Chilcott, July 2006.
Griffith's 5-Minute Clinical Consult. Lippincott Williams & Wilkins, 1999.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
This answer prepared 12/26/2000.
This information updated 2/7/2007.
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