There is no cure for premenstrual syndrome (PMS) but there are treatments that can help you manage your symptoms so they do not interfere with your daily life.
However, if your PMS is mild or moderate, you may want to make changes to your diet and lifestyle before resorting to medical treatment. This is because many of the medical treatments can have side effects that may be worse than your PMS symptoms.
Lifestyle changes
Diet
The following tips can help you to maintain a healthy, balanced daily diet:
- Eat smaller meals more frequently to help reduce bloating.
- Avoid eating salty foods to limit bloating and fluid retention.
- Drink plenty of water to avoid dehydration – being dehydrated can make headaches and tiredness worse.
- Eat lots of complex carbohydrates, which can be found in foods such as fruit, vegetables and wholegrains.
- Eat calcium-rich foods, such as cheese and milk, to improve physical and psychological symptoms of PMS. If you can't eat dairy products, try calcium-fortified soya alternatives.
- Avoid caffeine and alcohol, which can affect your mood and energy levels.
- Eat plenty of fruit and vegetables, which are rich in vitamins and minerals, and may ease your PMS symptoms. Aim to eat at least five portions a day.
Read more information about healthy eating.
Exercise
If possible, aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity every week. Examples of activities include walking, swimming and cycling. Exercise improves your overall health and can help to alleviate depression and tiredness.
Stretching and breathing exercises, such as yoga and pilates, can help you sleep better and reduce your stress levels.
Read more about health and fitness and how to manage stress.
Complementary medicines
There are many non-prescribed alternative treatments and supplements for PMS, and many women find them helpful in easing their symptoms. However, there is little research to back up their effectiveness. Most of the existing studies have shown mixed results.
Examples of complementary therapies that may reduce some symptoms of PMT are vitamins and minerals such as magnesium, vitamin B6 and vitamin E.
Always see your GP before taking any complementary medicine or supplement. If you decide to take a complementary treatment, take one at a time so you know if it works for you. If your symptoms don't change after three months, go back to your GP, who may recommend another treatment.
Psychological therapy
If you have psychological symptoms, such as feeling depressed or emotional, it may help to talk to a health professional. Cognitive behavioural therapy (CBT) is the term for a group of therapies that are designed to help solve problems such as anxiety and depression. A cognitive behavioural therapist can help you learn new ways of managing some of your symptoms.
Read more about cognitive behavioural therapy.
Medical treatment
If your PMS is severe or you have premenstrual dysphoric disorder (PMDD), you may wish to try a medical treatment. However, there is no single treatment that works for everyone.
A wide range of treatments are available. You may have to try several before you find one that suits you. Your choice of treatment will be based on your symptoms and how severe they are, and the possible side effects of the medication.
If your GP prescribes you a treatment for PMS, they may ask you to record any changes to your symptoms so that you both know how effective it is for you. If the treatment doesn't ease your symptoms, your GP may prescribe an alternative.
Medical treatments for PMS include:
These are described in more detail below.
Non-steroidal anti-inflammatory drugs (NSAIDs)
You can take NSAIDs, such as ibuprofen and aspirin, to ease stomach cramps and sore breasts. They may also relieve headaches, muscle pain and joint pain, but they can make fluid retention worse.
Children under the age of 16 shouldn't take aspirin. If you have asthma, do not take ibuprofen.
Contraceptives
As well as preventing pregnancy, some types of contraception can be prescribed to regulate symptoms of PMS. They often work by stopping ovulation (when an egg is released from your ovaries) or stabilising hormone levels, which can help to control mood swings. These include:
However, not all these forms of contraception work for all women with PMS, and they can have side effects. The side effects can be similar to the symptoms of PMS and may include, for example, fluid retention and irritability.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) may be the most effective treatment if you have severe PMS or PMDD. SSRIs, such as fluoxetine and sertraline, are antidepressants that can be taken daily to relieve tiredness, food cravings, sleep problems and combating depression.
However, like oral contraceptives, SSRIs may have negative side effects that may outweigh their benefits, such as nausea, insomnia, headache and loss of libido (less interest in sex).
Gonadotrophin-releasing hormone analogues
Gonadotrophin-releasing hormone (GnRH) analogues are synthetic hormones that create a temporary menopause and stop your periods by blocking the production of oestrogen and progesterone. They are taken as an injection and work in a similar way to gonadotrophin-releasing hormone (which is a natural female hormone).
GnRH analogues should only be used in women with severe PMS when all other treatments have failed. They often have side effects, such as hot flushes, vaginal dryness and loss of libido.
Drug names include goserelin, nafarelin and leuprorelin.
