Clinical Features

  • This manifests as premenstrual discomfort in lower abdomen and back 7–10 days preceding menses. It gives a sensation of distension or pelvic engorgement. There is relief after flow begins.
  • It is accompanied by nervous irritability, depression, headache, listlessness, and discomfort in breasts.
  • Occasionally there is fluid retention.

A good history and physical examination are important for accurate diagnosis.


  • Reassurance
  • Mild tranquillizers: Phenobarbitone 30mg nocte OR diazepam 5mg nocte.
  • Norethisterone (progestin) 5mg BD orally days 19–26 of cycle for 3 cycles.