The symptoms of premenstrual syndrome usually occur just before the menstrual cycle begins and usually improves once menstruation has begun.  For many women the symptoms of PMS are both physical and emotional resulting in weight gain, breast tenderness, fluid retention, compulsive behavior, headaches and a host of other complaints.

Treatment for premenstrual syndrome should never be undertaken at home without first getting a definitive diagnosis from your primary care physician.  This is because the symptoms of premenstrual syndrome can often mimic symptoms from other underlying medical conditions which, if left untreated, can have dire results.  For this reason it is important that women receive a definitive diagnosis from their doctor before attempting any treatment protocols.

The American College of Obstetricians and Gynecologists have issued practice guidelines for physicians to guide them in the diagnosis and treatment of premenstrual syndrome.  The American College of Obstetricians and Gynecologists recommend lifestyle changes such as aerobic exercise, a complex carbohydrate diet or nutritional supplements such as magnesium, vitamin E. and calcium to help relieve the symptoms of premenstrual syndrome.  In a recent large controlled clinical trial researchers believe that they demonstrated the beneficial effects of calcium supplements for women who suffer from premenstrual syndrome.

Several other preliminary studies suggest that vitamin E., magnesium and manganese may also be valuable in relieving premenstrual syndrome symptoms but additional clinical trials are needed to further evaluate their role.  Others have found relief with use of alternative treatments such as natural progesterone, Primrose oil and vitamin B6.  There is lack of clinical evidence for effectiveness but it has been suggested for treatment.  The American College of Obstetricians and Gynecologists have suggested controlled clinical trials are needed to assess the effectiveness and safety of these alternative medications.

Unfortunately, these clinical trials are expensive and often funded by pharmaceutical companies who have nothing to gain by proving that alternative treatments purchased at the health food store will be just as effective, if not more so, than the medications that they produce.

Prescription medication treatments which are tried are selective serotonin reuptake inhibitors, such as Prozac and Lexapro commonly used as antidepressants.  These have been shown to be effective and may be useful for individuals who have severe premenstrual syndrome.  Others have tried gonadotropin releasing hormone which presents a population and has been shown to be useful in severe symptoms, but the long-term side effects of using the meditation is unknown.

Doctors also use oral contraceptives for the treatment of PMS but currently there is no clinical data to support the effectiveness of this medication.  Oral contraceptives can be considered if the PMS symptoms are mostly physical but are not effective if mood symptoms are the primary symptom.  To help in the reduction of fluid retention physicians are able to prescribe spironolactone, which is the only diuretic it is been shown to be beneficial.

Because of the variety of treatment approaches that can be used developing treatment protocols for individual patients can be a challenge.  It is important for patients to work with their physicians by documenting the results of treatment protocols and sharing those results at their physician appointments.  Do not add any alternative medications to treatment protocols which are initiated by your doctor without discussing them first.  Even though natural supplements are available over the counter they also come with side effects and drug interactions which may interfere with the medications you are already taking.

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