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Premenstrual Syndrome (PMS) - Medications

If you have moderate to severe premenstrual symptoms even after you've tried home treatment and lifestyle changes, talk to your doctor about using medicine. Be safe with medicines. Read and follow all instructions on the label.

The most commonly used medicines for PMS are:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain.
  • Selective serotonin reuptake inhibitors (SSRIs) for mood-related symptoms.
  • Hormonal birth control, which may help relieve premenstrual dysphoric disorder (PMDD).
PMS: Should I Try an SSRI Medicine for My Symptoms?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • NSAIDs such as ibuprofen and naproxen relieve premenstrual pain and cramps and reduce menstrual bleeding. Try to start taking an NSAID 1 or 2 days before you expect pain to start. NSAIDs work best when taken before and at regular intervals throughout the premenstrual pain period.

Selective serotonin reuptake inhibitors (SSRIs)

  • SSRIs such as citalopram, fluoxetine, and paroxetine may help relieve physical and emotional symptoms of PMS. They are effective either when taken during the premenstrual weeks only or when taken continuously.
PMS: Should I Try an SSRI Medicine for My Symptoms?

Hormonal birth control

  • A low-estrogen birth control pill such as YAZ or Yasmin may help relieve symptoms of severe PMS or PMDD.
  • Other types of birth control pills (estrogen-progestin) are widely prescribed for PMS. They may improve bloating, headache, belly pain, and breast tenderness in some women. But other women may have worse symptoms or develop mood problems.
  • Estrogen alone may offer some benefit for some women. But when estrogen is taken without progestin, it increases the risk of uterine (endometrial) cancer.
  • Progestin (progesterone) has been used in the past for PMS. But for some women, it may make physical and emotional symptoms worse.

For more information about birth control pills and progestin, see the topic Birth Control.

Diuretics

  • Spironolactone is a water pill (diuretic). It may reduce bloating and breast tenderness if taken during the premenstrual weeks.
  • Drospirenone, which is in the certain low-estrogen birth control pills, acts like a diuretic to relieve bloating and breast tenderness. This medicine may also help relieve symptoms of severe PMS or PMDD.
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