Approach to Premenstrual Syndrome and Premenstrual Dysphoric Disorder from the Perspective of Family Medicine

This review aims to present a summary of the current information on the diagnosis, etiology, epidemiology, risk factors, both pharmacological and non-pharmacological treatments in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), which are common in primary health care and affect women of reproductive age both in terms of quality of life and social aspects. PMS and PMDD are characterised by physical, behavioural and psychological symptoms that occur during the luteal phase of the menstrual cycle and decrease with menstruation. Both entities affect millions of women at reproductive age as the prevalence of PMS is given as 12-98% while PMDD affects 2-5%. The management of PMS involves a multifaceted approach. Non-pharmacological agents include lifestyle changes, cognitive behavioural therapy, dietary support, education, exercise, calcium and vitamin B6, herbal therapies and acupuncture treatment. Pharmacological treatment options include selective serotonin reuptake inhibitors, combined oral contraceptives and GnRH analogues. The last treatment option is surgery.In conclusion, defining, diagnosing and managing premenstrual disorders (PMDs) is important both for primary care and other levels of care. Therefore increase in research on PMS and PMDD will raise awareness in the approach of family physicians working in primary health care institutions to patients presenting with premenstrual syndrome and premenstrual dysphoric disorder.