Premenstrual syndrome and dysphoric disorder

Women with PMS and PMDD who begin medical therapy should be monitored at least every 3 months for efficacy of the treatment. The need for treatment continuation should be reviewed regularly. Suicidality should be discussed both initially and at every follow-up visit.

For patients in whom symptoms are resistant to first- and second-line treatment, and for whom childbearing is complete, medical or surgical oophorectomy can be discussed, with adjustments and re-evaluation of diagnosis as needed.