ABSTRACT
Psychological and somatic disturbances are part of the normal physiology of the menstrual cycle: the majority of women (95 per cent) will experience some mild premenstrual symptoms (PMS), with only a small percentage (5 per cent) being totally symptom free. Symptoms essentially occur in the 2 weeks prior to menstruation and resolve by the end of menstruation. The nature of the symptoms is less important than the timing, and keeping a diary of symptoms is necessary for supporting the diagnosis and is useful in distinguishing primary PMS from secondary. The International Society for Premenstrual Disorders defined looser criteria for the diagnosis of core PMS, which takes into account the wide variety of symptoms experienced by patients. Treatment depends on the severity of symptoms and begins for patients with mild problems with general advice, simple analgesia, counselling, education, exercise, and reassurance. Selective serotonin reuptake inhibitors have proven value in the treatment of PMS, although they are not licensed for this indication.
