When Do I Need Medicine for PMS?

Medically Reviewed by Nivin Todd, MD on November 23, 2022
3 min read

Some women notice changes in their mood or the way that their bodies feel every month right before they get their periods. They may get acne, feel bloated, have tender breasts, cry more often, have angry outbursts, or feel depressed.

If you have these symptoms every month at the same time, and they go away as soon as your period starts, you have premenstrual syndrome (PMS).

If it’s mild, you may feel better if you exercise more often or avoid certain foods that can make you feel worse (like salt and caffeine). But if these symptoms feel dreadful month after month and they prevent you from normal daily tasks, it might help to go see your doctor.

After they give you an exam and hears about your symptoms, your doctor may suggest that you keep a calendar and return for treatment options, take an over-the-counter medicine, or they may prescribe something else. Every woman is different, so a drug that works for others might not be right for you.

Your doctor has several different types of medicine for you to consider. Knowing your medical history and symptoms, they can determine which is best to help your PMS.

Nonsteroidal anti-inflammatory drugs are painkillers that can also reduce inflammation (swelling). You can buy them over-the-counter, or your doctor may prescribe a stronger dosage of these drugs.

Common over-the-counter NSAIDs include aspirin, ibuprofen, and naproxen. They can reduce the pain of cramps and other aches. If you take them before your period starts, you may be able to prevent some PMS symptoms from happening.

If you retain water when you have PMS, you may gain a little weight and feel very bloated at that time of the month. Your doctor might prescribe a diuretic, which is medicine that helps you shed the extra water weight through natural means (by peeing more often).

If you need to take this type of drug, your doctor will likely ask you to cut back on the salt in your diet, because too much salt makes you retain water. Be sure to tell your doctor if you are taking any other medications, especially NSAIDs. Taking NSAIDs and diuretics at the same time can damage your kidneys.

There’s a connection between PMS and depression: Roughly half of women who go to their doctor for PMS also have it, as well as anxiety. PMS often causes mood problems, including depression during the time of the month that PMS symptoms appear, even among women who don’t have it at other times.

If your doctor thinks that your depression needs to be treated, they may prescribe you an antidepressant. There are many antidepressants, and people respond differently to them, so your doctor may have you try one or two prescriptions before they find one that’s right for you.

You may have success with selective serotonin reuptake inhibitors (SSRIs), including:

These have been shown to have help depression caused by PMS, but they don’t work for everyone. If you try an SSRI antidepressant and it does help, it’s unlikely you’ll notice quickly. It can take 3 to 4 weeks before you see any benefits.

The pill can do more than just keep you from getting pregnant. Many women with PMS have fewer unpleasant symptoms when they take birth control pills.

Why? The answer is likely because of how your body responds to birth control pills. When you take them, you don’t ovulate (release an egg from your ovary each month). Doctors think that not ovulating is probably the reason for the milder PMS symptoms.

Taking the pill also is more likely to improve your cramps, headaches, or other body aches, and help with the way PMS affects your moods, as well.