Therapeutic management of premenstrual syndrome

Expert Opin Pharmacother. 2010 Dec;11(17):2879-89. doi: 10.1517/14656566.2010.509344. Epub 2010 Aug 5.


Importance of the field: Premenstrual syndrome (PMS) is among the most common health problems reported by reproductive-age women. Estimates indicate that up to 25% of women may warrant treatment for the distress or impaired functioning associated with the symptoms.

Areas covered in this review: The primary focus of this review is the clinical condition of PMS and randomized, placebo-controlled trials of PMS treatment. A literature search in PubMed was conducted for these topics. The most recent reports of specific treatments in controlled treatment studies and all meta-analyses were selected.

What the reader will gain: Reports consistently indicate that serotonergic antidepressants reduce PMS symptoms compared to a placebo. Hormonal treatments are the most widely prescribed medical treatment. Some oral contraceptives and gonadotropin-releasing hormone analogs have demonstrated efficacy, particularly for women who want contraception and PMS symptom control. Numerous non-pharmacologic treatments are utilized, but efficacy is reported only for calcium supplements, Vitex agnus castus (chasteberry), and cognitive-behavioral therapies. Further research to develop new therapies for the 40% of women with PMS who do not respond to the currently available treatments is needed.

Take home message: There are treatments with demonstrated efficacy for PMS, and the majority of women can be helped.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Calcium, Dietary / therapeutic use
  • Cognitive Behavioral Therapy
  • Contraceptives, Oral, Hormonal / therapeutic use*
  • Dietary Supplements
  • Female
  • Gonadotropin-Releasing Hormone / therapeutic use*
  • Humans
  • Phytotherapy
  • Premenstrual Syndrome / drug therapy*
  • Premenstrual Syndrome / therapy
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Vitex


  • Calcium, Dietary
  • Contraceptives, Oral, Hormonal
  • Serotonin Uptake Inhibitors
  • Gonadotropin-Releasing Hormone