Most women have tender breasts, bloating, and muscle aches a few days before they start their menstrual periods. These are normal premenstrual symptoms. But when they get in the way of your work or daily life, they are called premenstrual syndrome, or PMS. PMS can affect your body as well as your mood. Sometimes it can make you change the way you act.
PMS symptoms can be mild or strong. If your symptoms are very bad, you may have premenstrual dysphoric disorder (PMDD). But PMDD is not as common.
SSRIs are a type of medicine that can restore the balance of certain brain chemicals called neurotransmitters. This may help relieve physical and emotional symptoms of PMS. SSRIs are also used to treat depression, anxiety, menopause hot flashes, and chronic pain.
SSRIs are often the first-choice medicine for treating severe PMS and PMDD symptoms, such as:
You can choose to take an SSRI every day or only on premenstrual days. If you have PMS symptoms that completely go away during your period, taking an SSRI only on premenstrual days is likely to work for you. But if you have symptoms such as depression or anxiety all the time, taking an SSRI every day may be a better choice.
There are several kinds of SSRIs for PMS. Each can affect your mood in a different way. One medicine may not be right for you, but another may work well. Most women feel better within a few days after they start taking the medicine, but it can take longer.
Your doctor may recommend treatment other than SSRIs if you have had a manic episode, if you have bipolar disorder or a seizure problem, or if you take another medicine that can't be used along with an SSRI.
Side effects of SSRIs are common but not serious. But some people stop taking the medicine because of side effects. Some of these side effects will go away after you take the medicine for several weeks. Side effects include:
If you are trying to get pregnant, talk with your doctor. Taking medicines for PMS in the early weeks of pregnancy could increase your chance of having a baby with birth defects.
FDA advisories. The U.S. Food and Drug Administration (FDA) has issued:
Your doctor may advise you to try an SSRI if:
|Try an SSRI for premenstrual symptoms||Try other treatment for PMS symptoms|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"When my PMS symptoms started to interfere with my job performance, I knew I had to treat them. The first SSRI I tried just didn't seem to help. But then my doctor prescribed a different one, and it started to work after about a week. What a relief!"
— Sarah, age 34
"I've had PMS since I was a teenager, so I've had many years to figure out what works for me. A few of my friends use an SSRI for their PMS problems, and it seems to work for them. For me, I've found that eating right and daily exercise keep me from getting keyed up and angry. I make sure I keep up with that, especially before my period, because if I don't, I'm a different person."
— Jonetta, age 29
"I didn't have PMS until my late 30s and was really thrown for a loop when I started feeling like I had no energy and having mood swings before my periods. It got to the point where my husband and kids didn't want to be around me for a week out of every month. Since I started taking an SSRI for the latter half of my menstrual cycle, I'm back to my usual self every month."
— Jane, age 38
"I thought I'd be able to try an SSRI for my PMS problems, but after talking to my doctor, I learned that it could make my epilepsy worse. So I've put more of my energy into improving my diet and getting plenty of exercise. It really does help."
— Diane, age 43
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to try an SSRI
Reasons to try other treatment
My PMS symptoms are affecting my daily life.
My symptoms aren't that bad.
I've made changes to my diet and lifestyle, and they are not working.
I'd like to try making diet and lifestyle changes first.
I'd like to try an SSRI even though I know there are side effects.
I don't want to have to deal with side effects.
I'm not trying to get pregnant.
I want to get pregnant.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking an SSRI
Trying other treatment
1. Are SSRI medicines safe to take if you are trying to get pregnant?
2. Do you need to take SSRI medicine every day to ease PMS symptoms?
3. Can you relieve symptoms of PMS on your own?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Kirtly Jones, MD - Obstetrics and Gynecology|