by Scholten A

Medications for Premenstrual Syndrome (PMS)

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
If your premenstrual syndrome (PMS) symptoms do not improve after 2-3 months of lifestyle changes, your doctor may recommend drug therapy. The following drugs may be used to treat PMS symptoms:

Prescription Medications

  • Combination of estrogen and progestin
  • Progestin only
  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Alprazolam
  • Lorazepam

Prescription Medications

Oral Contraceptives
Since hormonal contraceptives suppress ovulation, they may be able to provide PMS relief in many women. Depending on your medical history and risk factors, your doctor may prescribe combined oral contraceptive pills (which contain both estrogen and progestin) or a progestin-only contraceptive.
Possible side effects include:
  • Mood changes
  • Breast tenderness
  • Headaches
  • Unpredictable spotting (usually resolves after first 3 cycles)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Common names include:
  • Citalopram
  • Fluvoxamine
  • Paroxetine
  • Fluoxetine
  • Sertraline
Serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin in the brain. These medication are used in the treatment of premenstrual dysphoric disorder (PMDD), a more uncommon and severe form of PMS. The medication can help relieve depression , irritability, and some of the physical symptoms. SSRIs may also offer benefit to women who have severe PMS, but are not diagnosed with PMDD.
SSRIs tend to work much faster in relieving depressive symptoms associated with PMS than the symptoms of major depression. This is why it is important for your doctor to correctly diagnose you. Depending on your condition, you may only need to take SSRIs during the 2-week premenstrual period.
Possible side effects include:
  • Nausea
  • Diarrhea
  • Insomnia
  • Sexual dysfunction
  • Weight gain
  • Risk of severe mood and behavior changes, including suicidal thoughts in some people (Young adults may be at a higher risk for this side effect.)
Common names include:
  • Alprazolam
  • Lorazepam
Benzodiazepines may be helpful if you have severe premenstrual anxiety that is not relieved by SSRIs or other treatments. These drugs must be used carefully because they can cause dependency if used on a regular basis for 3 months or more. It may be best to use these drugs only a few days a month when symptoms are most severe.
Possible side effects include:
  • Drowsiness
  • Lightheadedness

Special Considerations

It is important to take all of the antibiotics as prescribed, even when you are feeling well.
If you are taking medications, follow these general guidelines:
  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.


Premenstrual syndrome. EBSCO DynaMed Plus website. Available at: Updated June 9, 2016. Accessed October 4, 2016.
Premenstrual syndrome (PMS). Family Doctor—American Academy of Family Physicians website. Available at: Updated April 2014. Accessed August 18, 2016.
Premenstrual syndrome (PMS) fact sheet. Office on Women's Health website. Available at: Updated December 23, 2014. Accessed August 18, 2016.

Revision Information

  • Reviewer: Michael Woods, MD, FAAP
  • Review Date: 09/2016
  • Update Date: 08/18/2016

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