Royal College of Obstetricians says women should get therapy to help beat PMS

More than a million women who suffer from severe PMS should be offered free counselling, according to leading doctors.

They say cognitive behavioural therapy is more effective at controlling symptoms than antidepressants.

Pre-Menstrual Syndrome refers to a series of symptoms that occur just before the monthly period, including mood swings, breast pain and bloating.

Up to 40 per cent of women are affected, with one in 12 having it so severely that it interferes with their daily living.

Guidelines from the Royal College of Obstetricians published today urge doctors to routinely refer these women for cognitive behavioural therapy.

This is usually done with a psychiatrist or psychologist who helps patients talk through their problems and overcome them. 

The counselling sessions last between 30 and 60 minutes and are held once or twice a week for six months.

Research has found that CBT is just as a effective for PMS as fluoxetine, a commonly used antidepressant, and has no side-effects. 

Antidepressants can cause insomnia, weight gain and nausea, and patients can become addicted.

The guidelines also instruct GPs to tell women to exercise and to take vitamin B6, both of which have also been shown to alleviate symptoms.

Shaughn O’Brien, professor of obstetrics and gynaecology at Keele University and lead author of the guidelines, said: ‘PMS can be a serious condition which can dramatically impact on the quality of a woman’s life, affecting her personal and professional life, therefore it is essential that an integrated holistic approach to treatment is adopted.

‘While many women can be treated by their GP by adopting lifestyle changes, taking the contraceptive pill, SSRIs (antidepressants) or vitamin B6, some women will need more complex care provided by a team of GPs, gynaecologists, psychiatrists and dieticians.

‘In the most extreme cases, PMS can lead to self-harm and suicide. We hope that these guidelines go some way in raising awareness of the seriousness of the condition and available treatment options, not only in women but also among healthcare professionals.’

PMS is thought to be caused by changes in levels of oestrogen and progesterone, which occur during the monthly cycle. This may alter certain chemicals in the brain – such as serotonin, the happy hormone – leading to depression or mood swings.

Women are more likely to suffer from PMS if they are obese, inactive or eat too much salty food.

There are up to 100 different symptoms but the most common include feeling bloated, pain in the abdomen, headaches, backache, breast pain, insomnia and weight gain.