is a set of symptoms associated with the menstruation cycle. They can include physical changes, such as fatigue, and emotional changes, like irritability. It typically starts 1-2 weeks before menstruation (period). The symptoms generally go away once menstruation begins. For a small number of women, PMS can become severe enough to interfere with daily function. Women may experience extreme fatigue,
anxiety. Severe PMS may also last longer than typical PMS.
A team of researchers conducted a review of numerous past studies of severe PMS treatment. Their goal was to find the effectiveness of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). The review found that this type of drug was effective in reducing severe PMS symptoms.
involved 40 previous studies. All of the studies were
randomized control trials. Results from this type of study are considered to be the most reliable. These trials investigated the ability of an SSRI to reduce PMS symptoms when compared to a
placebo. A review of all the data found that the SSRIs were better than the placebo at reducing:
- Overall intensity of symptoms
- Behavioral symptoms (eg, mood changes, irritability)
- Physical symptoms (eg, fatigue, cramping)
- Functional symptoms (eg, problems in social and work life)
There were some side effects associated with SSRIs. The groups that received the medication did report higher rates of nausea,
insomnia, headache, and decreased libido.
Severe PMS interferes significantly with daily activities. Pain, troublesome mood changes, and overwhelming fatigue make it difficult to get through the day. Fortunately, SSRIs seem to be effective at relieving these symptoms for many women. Since these medications all require a prescription and are not without side effects, speak to your doctor about how best to manage your severe PMS symptoms.
American Congress of Obstetricians and Gynecologists
Brown J, O'Brien PMS, Marjoribanks J, Wyatt K. Selective serotonin reuptake inhibitors for premenstrual syndrome.
Cochrane Database of Systematic Reviews.
2002, Issue 3. Art. No.: CD001396. DOI: 10.1002/14651858.CD001396.
Last reviewed April 2009 by Richard Glickman-Simon, MD
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