TREATMENT STRATEGIES FOR PREMENSTRUAL-SYNDROME

Premenstrual syndrome (PMS) refers to a group of menstrually related d isorders. Premenstrual symptoms sufficient to impair daily activity an d relationships are estimated to occur in tip to 40 percent of women o f reproductive age, with 5 percent of these women having severe impair ment. Although no single causative factor has been identified PMS is r elated to ovulatory cycles and resolves at menopause. A specific diagn ostic test for PMS does not exist. Treatment is based on the symptoms. Oral contraceptive agents, diuretics and antidepressants have been us ed successfully to relieve symptoms. Cognitive therapy may help the pa tient develop appropriate ways to cope with the obstacles, frustration s and discomforts of daily life. Although dietary deficiencies may be difficult to demonstrate, nutritional supplementation may result in si gnificant improvement. Various treatments, including progesterone supp lementation, vitamin B-6 in high doses, alprazolam and gonadotropin-re leasing hormone agonists, are generally not recommended. A comprehensi ve treatment plan that encourages a healthy lifestyle may relieve symp toms in most women.