Chihal H J
J Reprod Med. 1987 Jun;32(6):449-52.
Women with mild to moderate premenstrual syndrome (PMS) should have their symptoms controlled with conservative therapy, including diet, exercise, education and nutritional supplementation. Those patients with moderate to severe PMS whose condition cannot be controlled in this conservative fashion should undergo pharmacologic trials. Recent studies of progesterone supplementation showed no improvement when it was compared to placebo; the one exception was the use of oral micronized progesterone one therapy at a level of 300 mg/day, but the study remains to be repeated by other investigators. The most logical therapy at present is suppression of ovulation with a short-term trial of danazol, perhaps followed by long-term suppression with estrogen implants or depomedroxyprogesterone acetate. Surgical ovariectomy is warranted in a very small number of cases. Prostaglandin inhibitors are effective for the physical complaints that may be associated with PMS. Some antihypertensive agents, such as clonidine and verapamil, which are also antimania drugs, may have a place in the treatment of PMS.
患有轻至中度经前综合征（PMS）的女性，其症状应通过保守治疗来控制，包括饮食、运动、教育及营养补充。那些患有中至重度PMS且病情无法通过这种保守方式控制的患者，应进行药物试验。近期关于补充孕酮的研究表明，与安慰剂相比并无改善；唯一的例外是每天使用300毫克剂量的口服微粒化孕酮单一疗法，但该研究仍有待其他研究者重复验证。目前最合理的治疗方法是短期试用达那唑抑制排卵，之后或许可采用雌激素植入物或醋酸甲羟孕酮进行长期抑制。极少数情况下才需要进行手术卵巢切除术。前列腺素抑制剂对可能与PMS相关的身体不适有效。一些抗高血压药物，如可乐定和维拉帕米，它们也是抗躁狂药物，在PMS的治疗中可能有一席之地。
