Premenstrual Syndrome - Therapy

Highlights	Risk Factors	Other Treatments
Introduction	Complications	Medications
Symptoms	Treatment	Resources
Diagnosis	Lifestyle Changes	References
Causes	Therapy

Therapy

Cognitive-behavioral therapies (CBTs) are proving to be very effective in reducing PMS symptoms and improving functioning. In one study of women who had undergone an intensive behavioral program, PMS symptoms were reduced by 75%, and well being and self esteem increased. Improvement was most significant in the first three months of treatment, but some benefits persisted.

text continues below

Several cognitive-behavioral strategies are being investigated for PMS. Techniques include:

Identifying sources of stress.
Restructuring priorities.
Reframing perception of menstruation as a positive experience.
Defining and practicing methods for managing and reducing stress.

The benefits of CBT are comparable to those in women taking antidepressants. There does not seem to be any advantage in combining both treatments. Either one is effective.

Identifying Sources of Stress

Step 1. The Daily Diary. Often women do not recognize that the decline in their mood and the premenstrual phase coincide. Keeping a diary can help. It is useful to start the process of stress reduction with an informal record of daily events and activities tracked by days of the menstrual cycle. While this exercise might itself seem stress producing, it need not be done in painstaking detail. A few words accompanying a time and date will usually be enough to serve as reminders of significant events or activities.

Negative experiences should be noted, such as the following:

Those that put a strain on energy and time.
Those that trigger anger or anxiety.
Those that precipitate a negative physical response (such as a sour stomach or headache).

Positive experiences should also be noted, including the following:

Those that are mentally or physically refreshing.
Those that produce a sense of accomplishment.

Step 2. Questioning the Sources of Stress. After reviewing the diary, women should try to identify two or three events or activities that have been significantly upsetting or overwhelming during the premenstrual phase. Priorities and goals should then be carefully examined. Women should ask themselves the following questions:

Do the stressful activities meet my own goals or someone else's?
Have I taken on tasks that I can reasonably accomplish?
Which tasks are in my control and which ones aren't, specifically during the premenstrual phase?

Restructuring Priorities

The next step is to attempt to shift the balance from stress-producing to stress-reducing activities. While eliminating stress completely is not practical, there may be ways to reduce its impact. In most cases, small daily decisions for improvement can accumulate and work to reconstruct a stressed existence into a pleasant and productive one.