Therapy
Cognitive-behavioral therapies (CBTs) are proving to be very effective in reducing PMS symptoms and improving functioning. In one study of women who had undergone an intensive behavioral program, PMS symptoms were reduced by 75%, and well being and self esteem increased. Improvement was most significant in the first three months of treatment, but some benefits persisted.
Several cognitive-behavioral strategies are being investigated for PMS. Techniques include:
- Identifying sources of stress.
- Restructuring priorities.
- Reframing perception of menstruation as a positive experience.
- Defining and practicing methods for managing and reducing stress.
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The benefits of CBT are comparable to those in women taking antidepressants. There does not seem to be any advantage in combining both treatments. Either one is effective.
Identifying Sources of Stress
Step 1. The Daily Diary. Often women do not recognize that the decline in their mood and the premenstrual phase coincide. Keeping a diary can help. It is useful to start the process of stress reduction with an informal record of daily events and activities tracked by days of the menstrual cycle. While this exercise might itself seem stress producing, it need not be done in painstaking detail. A few words accompanying a time and date will usually be enough to serve as reminders of significant events or activities.
Negative experiences should be noted, such as the following:
- Those that put a strain on energy and time.
- Those that trigger anger or anxiety.
- Those that precipitate a negative physical response (such as a sour stomach or headache).
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