7.1.6 Premenstrual tension syndrome
|1st choice||No drug treatment, see prescribing notes below|
|2nd choice||New 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|
- 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.