Premenstrual Syndrome - Highlights

Highlights

Paroxetine (Paxil) Drug Warnings

Premenstrual dysphoric disorder (PMDD) is severe depression and anxiety associated with premenstrual syndrome (PMS). PMDD is often treated with antidepressants, including paroxetine (Paxil):·

• In 2006, the FDA warned that paroxetine increases the risk of suicidal behavior, especially in young adults.
• Women with PMDD who are planning on becoming pregnant should be aware that paroxetine can cause birth defects if taken early in pregnancy.

Birth Control Pills for PMS

• Yaz, an estradiol/drospirenone oral contraceptive, was approved by the FDA in 2006. The FDA is considering approving it for treatment of PMDD. Clinical trials indicate that Yaz helps relieve mood symptoms associated with PMDD.
• Lybrel, a levonorgestrel/estradiol oral contraceptive, is under review by the FDA. If approved, it will be the first birth control pill to eliminate periods (and PMS). Lybrel is taken on a continuous basis with no pill-free days.

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Migraine and PMS

Migraine headaches may worsen PMS symptoms, according to a small study in the journal Headache. Researchers found that women who experience migraine headaches are more sensitive to PMS symptoms such as bloating, abdominal cramping, irritability, and depression.

Breast Pain Research

The breast cancer drug toremifene (Fareston) may help relieve premenstrual-associated breast pain, suggests a small study in the British Journal of Obstetrics and Gynecology. Toremifene blocks the effects of estrogen.

Lifestyle Approaches for Managing PMS

Simple lifestyle approaches may help control PMS symptoms. Women should keep a menstrual cycle diary to track their periods so they know when to modify their diet and get extra sleep. Here are some lifestyle tips for managing PMS:

• Exercise regularly
• Limit salt, alcohol, and caffeine
• Get enough sleep
• Practice stress reduction and relaxation techniques

Review Date: 07/11/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.