Many of the same strategies used to treat PMS (premenstrual syndrome) may also be helpful in relieving symptoms of PMDD (premenstrual dysphoric disorder). The four main forms of treatment are:
Good nutrition. Many health experts recommend that women with PMDD limit their intake of salt, caffeine, refined sugar, and alcohol. Supplements, such as calcium, vitamin B6, vitamin E, and magnesium may be recommended. The effectiveness of any of these approaches hasn't been well established
Exercise. Regular aerobic exercise such as walking or swimming appears to improve premenstrual symptoms. It's unclear whether it can treat PMDD.
Medications. Several antidepressants may be used to treat PMDD. There are three drugs approved by the FDA for the treatment of PMDD: Sarafem, Paxil CR, and Zoloft. These antidepressants can relieve the symptoms of PMDD. Other antidepressants have also been effective in relieving symptoms of PMDD. These medicines can be taken continuously or intermittently, just during the 14-day premenstrual period. Taking them intermittently may decreases the side effects of these drugs.
Some over-the-counter pain relievers such as aspirin, ibuprofen (Motrin), and naproxen (Aleve) may help some symptoms such as headache, breast tenderness, backache, and cramping. Diuretics, or water pills, can help with fluid retention and bloating.
If anxiety is a component of the symptoms, an anti-anxiety drug may be recommended. Currently, none are approved to treat PMDD.
Hormones can be used to treat PMDD. Ovulation can be stopped either using medication or surgically (as a last resort). Medicines used to stop ovulation include birth control pills, Danazol, Zoladex, Synarel, and Lupron. The second hormonal approach to treat PMDD is the use of progesterone or estrogen to relieve symptoms. It's unclear whether this approach is effective.
Counseling. Therapy to help women with PMDD develop effective coping strategies may help some with PMDD. Relaxation therapy, meditation, reflexology, and yoga may also help, but these approaches have not been widely studied.
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