Health Information

Medications for Premenstrual Syndrome (PMS)

The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

If your premenstrual syndrome (PMS) symptoms do not improve after two or three months of lifestyle changes, your doctor may recommend drug therapy. The following drugs may be used to treat PMS symptoms:

Prescription Medications

Oral Contraceptives

  • Combination of estrogen and progestin
  • Progestin only

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac, Sarafem)
  • Sertraline (Zoloft)

Benzodiazepines

  • Alprazolam (Xanax)
  • Lorazepam (Ativan)

Prescription Medications

Oral Contraceptives

Since hormonal contraceptives suppress ovulation, they may be able to provide PMS relief in many women. Depending on your medical history and risk factors, your doctor may prescribe combined oral contraceptive pills (which contain both estrogen and progestin) or a progestin-only contraceptive.

Possible side effects include:

  • Mood changes
  • Breast tenderness
  • Headaches
  • Unpredictable spotting (usually resolves after first 3 cycles)
Selective Serotonin Reuptake Inhibitors (SSRIs)

Common names include:

  • Citalopram (Celexa)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac, Sarafem)
  • Sertraline (Zoloft)

Serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin in the brain. These medicines are used in the treatment of premenstrual dysphoric disorder (PMDD), a more uncommon and severe form of PMS. The medicine can help relieve depression , irritability, and some of the physical symptoms. SSRIs may also offer benefit to women who have severe PMS, but are not diagnosed with PMDD.

SSRIs tend to work much faster in relieving depressive symptoms associated with PMS than the symptoms of major depression. This is why it is important for your doctor to correctly diagnose you. Depending on your condition, you may only need to take SSRIs during the two-week premenstrual period.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Sexual dysfunction
  • Weight gain
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (Young adults may be at a higher risk for this side effect.)
Benzodiazepines

Common names include:

  • Alprazolam (Xanax)
  • Lorazepam (Ativan)

Benzodiazepines may be helpful if you have severe premenstrual anxiety that is not relieved by SSRIs or other treatments. These drugs must be used carefully because they can cause dependency if used on a regular basis for three months or more. It may be best to use these drugs only a few days a month when symptoms are most severe.

Possible side effects include:

  • Drowsiness
  • Dizziness

Special Considerations

Whenever you are taking a prescription medicine, take the following precautions:

  • Take your medicine as directed. Do not change the amount or schedule.
  • Know what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking the medicine.
  • Plan ahead for refills if you need them.
  • Do not share your medicine with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

Revision Information

  • American College of Obstetricians and Gynecologists. Practice bulletin: premenstrual syndrome. ACOG. No. 15. April 2000.

  • Premenstrual syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated June 14, 2012. Accessed August 20, 2012.

  • Premenstrual syndrome (PMS). Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/premenstrual-syndrome-pms.html . Updated August 2010. Accessed August 20, 2012.

  • Premenstrual syndrome (PMS) fact sheet. Women's Health.gov website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.cfm . Updated May 18, 2010. Accessed August 20, 2012.