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Quick Reference Guide for Clinicians
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Managing Premenstrual Symptoms

(Published June 2008)

Using This Guide

It is estimated that 75–85% of menstruating women experience some uncomfortable symptoms during the premenstrual phase of their cycles.1 Many women experience premenstrual symptoms that do not require specific treatment. In contrast, the symptoms of premenstrual disorders interfere with normal functioning and have a significant negative effect on a woman’s quality of life.

Despite increasing attention and awareness of premenstrual disorders, they are notoriously underrecognized. Many women delay seeking treatment and thus go undiagnosed for years. Yet the degree and prevalence of disability of premenstrual disorders equal that associated with many widely recognized conditions.2 Overall, women with premenstrual disorders represent a largely uncared-for group for whom the evidence for conventional therapy is sparse and controversial.3 Treatment options vary and produce overall response rates of less than 60%.2

The key to effective management of premenstrual disorders is time, patience, and knowledge of various treatments that have proven to be effective. This Quick Reference Guide for Clinicians® has been designed to help health care providers to recognize premenstrual disorders and apply evidence-based management strategies. Also provided are clinical management alternatives and patient education information and resources.

The practical steps outlined here will equip clinicians with the tools necessary to accurately and appropriately diagnose, treat, and counsel women dealing with premenstrual disorders. The information provided in this guide will help providers to reduce patients’ uncertainty regarding treatment options and to be more effective in offering positive treatment strategies for women presenting with these symptoms.


  1. Mishell DR Jr. Premenstrual disorders: epidemiology and disease burden. Am J Manag Care. 2005;11(16 Suppl):S473–479.
  2. Halbreich U, Borenstein J, Pearlstein T, Kahn LS. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology. 2003;28(Suppl 3):1–23.
  3. Domoney CL, Vashisht A, Studd JW. Premenstrual syndrome and the use of alternative therapies. Ann N Y Acad Sci. 2003;997:330–340.