Clinical Roundup: How Do You Treat Premenstrual Syndrome in Your Practice? (original) (raw)
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Premenstrual syndrome. Evidence-based treatment in family practice
Canadian family physician Médecin de famille canadien, 2002
To evaluate the strength of evidence for treatments for premenstrual syndrome (PMS) and to derive a set of practical guidelines for managing PMS in family practice. An advanced MEDLINE search was conducted from January 1990 to December 2001. The Cochrane Library and personal contacts were also used. Quality of evidence in studies ranged from level I to level III, depending on the intervention. Good scientific evidence shows that calcium carbonate (1200 mg/d) and selective serotonin reuptake inhibitors are effective treatments for PMS. The most commonly used therapies (including vitamin B6, evening primrose oil, and oral contraceptives) are based on inconclusive evidence. Other treatments for which there is inconclusive evidence include aerobic exercise, stress reduction, cognitive therapy, spironolactone, magnesium, nonsteroidal anti-inflammatory drugs, various hormonal regimens, and a complex carbohydrate-rich diet. Although evidence for them is inconclusive, it is reasonable to re...
American Journal of Obstetrics and Gynecology, 2001
and CISCOM (to December 1988) were searched. In addition, leading investigators in the field and manufacturers of herbal preparations were contacted. The reference lists of all the retrieved papers were examined for additional publications. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) that had been published in a peer-reviewed journal were included. Specific interventions included in the review The interventions investigated were: herbal medicine, homeopathy, dietary supplementation, relaxation, massage, reflexology, chiropractic and biofeedback. The herbal medicines included extracts from the chaste tree, ginkgo biloba, and the essential oil of the evening primrose flower. The dietary supplements included calcium, magnesium, vitamin B6, vitamin E, a carbohydrate drink, and a nutritional multi-supplement containing large amounts of magnesium, vitamin B6 and other essential micro-nutrients. Participants included in the review Women with symptoms of PMS. While it is reported that 30 to 80% of women experience symptoms consistent with PMS, the authors state that the prevalence of PMS is around 2.5% of women of reproductive age when strict diagnostic criteria are applied. However, in 6 of the 27 studies, the authors reported that the diagnosis of PMS was unchecked. Outcomes assessed in the review A range of outcomes were assessed. Some of the trials included in the review used standard questionnaires such as the Menstrual Distress Questionnaire (MDQ) and the Menstrual Symptom Questionnaire (MSQ). The scales assessed a range of constituent symptoms including anger, anxiety, arousal, breast pain, carbohydrate cravings, depression, fluid retention and memory. Performance against these scales was used as an outcome measure. In addition, some studies used other outcome measures such as visual analogue scales, subjective ratings by the patients and patient diaries. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the reviewers performed the selection. Assessment of study quality A quantitative assessment of methodological quality was not carried out, but the authors commented on the rigour of the individual studies in the tables presented. These comments related to patient recruitment, trial design, and statistical analysis methods. Data pertinent to the validity of the included studies were extracted by the first author and checked by the second author. Any discrepancies were resolved through discussion.
Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder
Annals of Pharmacotherapy, 2008
U p to 90% of women of childbearing age report experiencing premenstrual symptoms at some point in their lives. A smaller subset (up to 20%) report severe symptoms of premenstrual syndrome (PMS) that warrant treatment, and 3-8% are diagnosed as having a severe form known as premenstrual dysphoric disorder (PMDD). 1-3 This comprehensive review discusses the prevalence, etiology, symptomatology, and treatment of PMS/PMDD.
An integrative medicine approach to premenstrual syndrome
American Journal of Obstetrics and Gynecology, 2003
Complementary and alternative medicine (CAM) approaches are widely used by women with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This article provides a comprehensive review of the medical literature on clinical applications of CAM for these conditions. The information was collected via a Medline review dating back to 1966 and subsequent selected review of bibliographies from these articles for non-Medline referenced but relevant clinical studies. For many of the therapies discussed, there is a lack of conclusive evidence either confirming or refuting efficacy. For other therapies, including certain herbal and nutritional approaches, the use of exercise, and the use of mind-body approaches, there is substantial evidence of efficacy. This review will be relevant to the practicing clinician seeking to become aware of and to understand the relevance of the complementary/alternative therapies being used by his/her patients for PMS and PMDD.
The Assessment of the Symptoms of Premenstrual Syndrome and their Response to Therapy
British Journal of Psychiatry, 1981
SummaryThe symptoms of premenstrual syndrome should be rated daily, or at frequent intervals throughout the menstrual cycle. Self-rating is usually most feasible and separate rating of differing symptom groups is important, as symptoms differ in their response to therapy. Daily scores should be analysed to assess periodicity, either by subdividing the cycle into phases or by using the least mean square method of fitting sine waves. Standardized scores enable data to be compared across cycles. In a clinical trial it is important to include an untreated cycle to assess whether the subject has premenstrual syndrome and as a baseline with which to compare treated cycles. Allowance should be made for a carry-over effect and for high placebo response. One solution is to use a change-over design balanced for carry-over effects. The criteria used to define a patient should be stated.
Pre Menstrual Syndrome: Different Approaches of Management
2014
Pre-Menstrual Syndrome (PMS) is defined as the recurrence of psychological and physical symptoms in the luteal phase, which remit in the follicular phase of the menstrual cycle. Symptoms of which fall in three domains: Emotional, Physical and Behavioural, eg: depression, irritability, tension, crying, abdominal cramps, fatigue, bloating, food cravings, poor concentration, social withdrawal etc. Premenstrual symptoms can be managed if diagnosed at right time with suitable pharmacological and non pharmacological treatment. Therefore it is suggested that life style modification & counselling are essential. If neglected, may even be life threatening in patients with severe symptoms can be occur. Non-pharmacologic interventions for PMS include patient education, supportive therapy, and behavioural changes. Behavioural measures include keeping a symptom diary, getting adequate rest and exercise, and making dietary changes. Dietary supplements in women with PMS should include vitamins (A, ...
Gynecological Management of Premenstrual Symptoms
Current Pain and Headache Reports, 2010
The vast majority of menstruating women experience uncomfortable symptoms during the premenstrual phase of their menstrual cycles. Although many women do not require specific treatment of their symptoms, approximately 20% to 50% report moderate to severe premenstrual symptoms and about 5% meet the diagnostic criteria for premenstrual dysphoric disorder, the most severe manifestation of premenstrual symptoms. While the etiology of premenstrual symptoms remains unclear, several theories have implicated sex steroids and neurotransmitters in the development and manifestation of symptoms. Further complicating the delineation of etiology is that premenstrual symptoms can be somatic, psychological, or behavioral, as well as a combination of all three. Developing successful interventions for premenstrual symptoms has thus been challenging, with interventions focused on a particular aspect of premenstrual symptomatology. Treatments for premenstrual symptoms include lifestyle changes, cognitive behavioral therapies, and pharmacologic agents including ovulation suppression regimens, antidepressant medications, and anxiolytics.
Gaceta médica de Caracas, 2022
The objective was to review and analyze narratively the etiology, pathophysiology, and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder. For that purpose, Latin-American and international references were reviewed on different web pages. Publications from 1995 to April 2022 were reviewed. Premenstrual syndrome and premenstrual dysphoric disorders are of theories diseases in medicine and are found among menstruating women of all ages. Symptoms of PMS vary from mild to severe enough to interfere with daily personal and occupational life. This review analyses the possible etiologies, the pathophysiological mechanism, and how to make its diagnosis of premenstrual syndrome and premenstrual dysphoric disorders.