Many promote the use of certain vitamins and minerals for the treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), but controlled studies supporting the use of nutritional supplements are sparse.
Oral contraceptives are commonly prescribed for the treatment of premenstrual symptoms and premenstrual dysphoric disorder (PMDD); however, the evidence supporting the use of oral contraceptives in this setting is limited. While most studies have shown that oral contraceptives are not effective for the treatment of premenstrual symptoms, there is preliminary evidence that a new oral contraceptive pill, Yaz, which contains low-dose estrogen and a novel progestin called drospirenone, may alleviate the symptoms of PMDD.
In this review, guidelines for the treatment of PMDD are provided.
About 3-5% of women of reproductive age suffer from premenstrual dysphoric disorder (PMDD), where they experience depressive symptoms, anxiety or irritability during the last one to two weeks (the premenstrual phase) of their menstrual cycle. In addition, many women who suffer from depression, including those who have been effectively treated with an antidepressant, report worsening of their depressive symptoms during the premenstrual phase of the menstrual cycle. Although this may be a consequence of sensitivity to fluctuating hormone levels, little is known about the efficacy of hormonal interventions, including oral contraceptives (OCPs), in the treatment of premenstrual worsening of depressive symptoms.
During the period before menstruation, many women report experiencing psychological and physical symptoms collectively referred to as premenstrual syndrome (PMS). The fruits, leaves and flowers of Vitex agnus castus (the Chaste Tree) have traditionally been used to relieve these symptoms. While the mode of action is not clear, the effects of the plant seem to mimic those of the corpus luteum, stimulating the production of lutenizing hormone, thereby increasing progesterone production. Schellenberg and colleagues recently studied the effects of agnus castus fruit in women with premenstrual syndrome.
During the two weeks prior to the onset of a menstrual period, many women experience physical symptoms, such as bloating, breast tenderness, headache, and muscle aches. A small proportion of women also note a change in their mood and complain of irritability, mood swings, depressed mood, or feeling tense. If these symptoms interfere with a woman's ability to function, she may have premenstrual dysphoric disorder (PMDD).
Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate some of the physical symptoms of PMS.
