Guideline, 2013

What do experts agree is the best way to treat PMS and PMDD?

A group of international experts agreed that treatment should start with careful diagnosis, and that the main options work either by calming brain serotonin activity or by stopping ovulation, with some other approaches worth more study.

Moderate study design Not a patient study; a panel of gynaecologists, psychiatrists, psychologists and pharmacologists (ISPMD experts).

What they did

This was not a new study but a consensus guideline. Experts in gynaecology, psychiatry, psychology and pharmacology from the International Society for Premenstrual Disorders (ISPMD) met in London in March 2011, reviewed published evidence, and discussed it to agree recommendations for managing premenstrual disorders.

What they found

The group agreed that careful diagnosis should guide treatment. Treatments fall into two broad groups: those that act on the brain and serotonin, such as SSRIs, and those that suppress ovulation, such as oral contraceptives, GnRH agonists, danazol and estradiol, or in some cases removal of the ovaries (oophorectomy). Alternative approaches, including cognitive behavioural therapy, calcium supplements and Vitex agnus castus, were seen as worth further research.

What it means for you

This gives a broad roadmap of accepted and promising treatment options for PMS and PMDD, but it is an expert opinion summary of existing evidence rather than a new trial, so it does not give fresh data on how well any single treatment works.

2011

Year of the consensus meeting

2nd

Consensus meeting number for ISPMD

About the study

Original title: ISPMD consensus on the management of premenstrual disorders
Authors: Nevatte T, O'Brien PM, Bäckström T et al.
Journal: Archives of women's mental health
Year: 2013
Study design: Guideline
What was tested: Review of SSRIs, oral contraceptives, GnRH agonists, danazol, estradiol, oophorectomy, CBT, calcium, Vitex agnus castus.
Open access: Yes
Read the paper: doi.org/10.1007/s00737-013-0346-y

Topics

Premenstrual syndrome (PMS)SSRIs and antidepressants Oral contraceptives and drospirenone GnRH agonists and ovarian suppression Cognitive behavioral therapy Calcium Vitex agnus-castus (chasteberry)Surgical menopause

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