GynaecologyFree in the app
Premenstrual syndrome
Diary first, then a stepped plan.
Source: RCOG GTG 48| Diagnosis | Prospective symptom diary for 2 cycles. |
|---|---|
| First line | Exercise, CBT, vitamin B6; drospirenone pill; low-dose SSRI (luteal or continuous). |
| Second line | Transdermal oestradiol with progestogen protection; higher-dose SSRI. |
| Third line | GnRH analogue with add-back HRT. |
| Fourth line | Hysterectomy and BSO with HRT, after a GnRH trial. |
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.