Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Medications used to treat the different symptoms of PMS
Diuretics are medications that increase urine
production, thereby eliminating excess fluid and relieving
weight gain, bloating, swelling, and a full feeling.
Ammonium chloride, caffeine, and pamabrom are mild
diuretics that are ingredients in nonprescription OTC
products such as Diurex PMS, Lurline PMS, Midol PMS,
Pamprin Multisymptom, and Premesyn PMS. Spironolactone
(Aldactone) is a prescription diuretic that has been used
to treat premenstrual swelling of the hands, feet, or face.
Nonsteroidal anti-inflammatory medications (NSAIDs)
are commonly used for menstrual cramps,
pelvic discomfort. NSAIDs are available as both prescription and
non-prescription products. Examples of NSAIDs include ibuprofen
(Advil, Motrin), naproxen (Aleve, Anaprox), ketoprofen
(Orudis), and mefenamic acid (Ponstel).
Oral contraceptive pills (OCPs) are sometimes prescribed by doctors to decrease fluctuations in ovarian hormone levels. While older studies failed to provide evidence that OCPs can consistently provide relief for symptoms of PMS, the newer
birth control pills, with their improved hormonal formulations, seem to be more beneficial.
Ovarian suppressors such as danazol (Danocrine) have
been prescribed by doctors to suppress ovarian hormone
production. Danocrine cannot be used over long periods
because of side effects.
Gonadotropin-releasing hormone (GnRH) analogs, which
cause the complete suppression of ovarian function, have
been found to help some women with PMS. These GnRH
analogs are not prescribed long term (more than 6 months)
because of their adverse effects on bone density and an
increased risk of bone thinning (osteoporosis).
Antidepressants are prescribed by doctors to treat the
mood disturbances related to PMS. Antidepressants appear to
work by increasing brain chemical (serotonin and others)
levels that are affected by the ovarian hormones.
Fluoxetine (Prozac) and paroxetine (Paxil) are examples of
antidepressant medications that have been found to be
effective in treating the mood changes associated with PMS.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 9/14/2011