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Home Formulary 7.0 Contraception, Gynaecology and Urinary Tract Disorders 7.1.6 Premenstrual tension syndrome

7.1.6 Premenstrual tension syndrome

ChoiceDrugDosage
1st choice No drug treatmentsee prescribing notes
2nd choiceNew generation COC e.g. Gedarel® 30/150 (desogestrel 150 micrograms, ethinylestradiol 30 micrograms) (3 x 21 pack)
- consider for moderate premenstrual syndrome

See section 7.3.1
(off label use if used solely to treat PMS)

Fluoxetine 20mg capsules; liquid 20mg/5ml (for severe premenstrual syndrome) Dose [unlicensed use]:
20mg daily from days 14 - 28 for 3 months, then reassess benefit before continuing

Prescribing Notes

  • For more information refer to CKS guidance on premenstrual syndrome.
  • Hormonal manipulation may be useful, e.g. a new generation combined oral contraceptive, in some circumstances.
  • The COC can be used cyclically or continuously for premenstrual syndrome.
  • Fluoxetine is no longer licensed for the treatment of premenstrual tension but there is some evidence to support its use; informed consent should be obtained and documented.

 

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