Premenstrual dysphoric disorder -- review looks at treatment effectiveness

I found that PMS tea, made from plants which have a diuretic effect, fixed my PMS. I could feel that my brain was swollen. This treatment has been known for decades in the natural health community. Of course, drug companies are not going to want to fund studies for such a low-cost solution. I'm not going to claim it can help every woman with this problem. I haven't made a scientific study. But it would certainly make sense to try it first.

http://www.eurekalert.org/pub_releases/2015-09/wkh-pdd090915.php

Public Release: 9-Sep-2015
Premenstrual dysphoric disorder -- review looks at treatment effectiveness
Wolters Kluwer Health

September 9, 2015 - Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome that causes major disruption in several areas of life for many women. Many treatment options have been proposed, but which are most effective? A comprehensive review of the evidence, including specific treatment guidelines, is presented in the September Journal of Psychiatric Practice, published by Wolters Kluwer.

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About three to eight percent of premenopausal women suffer from PMDD: a severe form of premenstrual syndrome with a combination of emotional and physical symptoms, causing significant impairment in home, work, and social life. Severe PMDD symptoms may also lead to suicidal thoughts--one study found that 15 percent of women with PMDD reported at least one suicide attempt.

In their review, Maharaj and Trevino identify a wide range of proposed PMDD treatments--classified as psychiatric, anovulatory, supplements, herbal, and non-pharmacologic. While the cause of PMDD is not entirely understood, one contributing factor seems to be negative effects of changing hormone levels on certain neurotransmitters, including serotonin.

This has been supported by studies showing a rapid response to selective serotonin reuptake inhibitors (SSRIs), a widely used class of antidepressant drugs. Based on the results of 31 randomized trials including nearly 4,400 women, SSRIs are considered the "first-line" treatment for PMDD. Although treatment with SSRIs may be continuous, semi-intermittent, or administered at the start of symptoms, further research is needed to determine which of these treatment schedules provide the best balance between effectiveness and side effects.

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Oral contraceptives containing drosperinone/ethinyl estradiol are an effective and recommended treatment option for women with PMDD who are also seeking contraception.

When these options fail, various anovulatory treatments--which decrease ovarian hormone production resulting in a state of medical menopause--are effective. However, because of potential side effects and high cost, these are considered "third-line" alternatives.

Various supplements and herbal-related treatments have been proposed as well, with some warranting further research. However, so far, only calcium supplementation has shown a consistent therapeutic benefit.

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