Premenstrual syndrome: current knowledge and management.

Premenstrual syndrome (PMS) has become a popular self-diagnosis. Faulty research has led to confusion about the diagnosis, epidemiologic features, causes and treatment of this disorder. There is no proof that the premenstrual period is a time of increased violence. An association between menstrually related mood disorders and other psychiatric illness is also unproven. Despite many theories no definitive cause of PMS has been established, and controlled studies of various treatments have failed to find a universally effective approach. Conservative measures involving support, diet and exercise seem to help in most cases. The use of alprazolam and mefenamic acid may help some women. Rectal or vaginal progesterone therapy has been proven ineffective and should not be used.