You can reduce stress and eat better, boost your exercise regime, caffeine, and take a dietary supplement, and still be racked with It's not fair, but that's the nature of PMS. With nearly two hundred symptoms, and frequently inconsistent symptom patterns month to month, just when you think you've gotten your PMS control, the symptoms suddenly shift and leave you miserable.

A Tough Choice

Self-care and lifestyle modifications are the recommended first course of action, but they're not foolproof. The biggest advantage in choosing to modify your lifestyle for PMS-related reasons is that it can be both curative and preventive: a better diet, more exercise, and less stress not only help reduce PMS symptoms but may prevent them from recurring. However, the downside is that the full effects of positive lifestyle changes can take months to develop, and changing your lifestyle is a difficult course of action in general, especially maintaining your new diet or your new commitment to exercise. Lifestyle changes may not relieve all of your physical symptoms either. What do you do in the meantime?

Medications, on the other hand, promise immediate relief, without all of the wait-and-see baggage of lifestyle changes. Or your doctor prescribes a pill that magically eliminates all your symptoms. Except that this doesn't — and probably can't — happen. For one, scientific understanding of PMS is not developed enough for a magic pill, over-the-counter or otherwise. Second, in many cases, medications relieve the symptoms without addressing the underlying causes, like stress, that predispose you to PMS.

When self-care doesn't fully relieve your symptoms, however, medications are a powerful tool in your PMS arsenal. Even women who are adamant about avoiding medications may find themselves backed into a corner when they find their mood swings are out control or their headaches confine them to bed. Women with mild PMS can treat their symptoms — bloating, achiness, breast tenderness — with some over-the-counter medications. Women with more severe symptoms may find a lot of benefit from taking prescription diuretics, antianxiety medications, or SSRIs, but given their potential side effects, these drugs are not for everyone.