Keep a daily diary or log for at least 3 months. Record the type of symptoms you have, how severe they are, and how long they last. This symptom diary will help you and your health care provider find the best treatment.
A healthy lifestyle is the first step to managing PMS. For many women, lifestyle approaches are often enough to control symptoms.
- Drink plenty of fluids (water or juice, not soft drinks, alcohol, or other beverages with caffeine) to help reduce bloating, fluid retention, and other symptoms.
- Eat frequent, small meals. Do not go more than 3 hours between snacks. Avoid overeating.
- Eat a balanced diet with extra whole grains, vegetables, and fruit, and limited or no salt and sugar.
- Your health care provider may recommend that you take nutritional supplements. Vitamin B6, calcium, and magnesium are commonly used. Tryptophan, which is found in dairy products, may also be helpful.
- Get regular aerobic exercise throughout the month to help reduce the severity of PMS symptoms. Exercise more often and harder during the weeks when you have PMS.
- Try changing your nighttime sleep habits before taking drugs for insomnia.
Aspirin, ibuprofen, and other NSAIDs may be prescribed for headache, backache, menstrual cramping, and breast tenderness.
Birth control pills may decrease or increase PMS symptoms.
In severe cases, medicines to treat depression may be helpful. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are often tried first, and have been shown to be very helpful. You may also want to seek the advice of a counselor or therapist.
Other medicines that you may use include:
- Anti-anxiety drugs for severe anxiety
- Diuretics (may help with severe fluid retention, which causes bloating, breast tenderness, and weight gain)