What is the first-line treatment for premenstrual syndrome (PMS)?

Premenstrual syndrome (PMS) is a condition characterized by emotional, psychological, and physical symptoms that occur in the luteal phase of the menstrual cycle and resolve shortly after the onset of menstruation. Among the various treatment options, selective serotonin reuptake inhibitors (SSRIs) have been found to be particularly effective and are considered a first-line treatment for managing the symptoms of PMS.

SSRIs work by increasing the levels of serotonin in the brain, which can alleviate mood-related symptoms, such as irritability, anxiety, and depression that often accompany PMS. Clinical studies have indicated that SSRIs not only help improve mood symptoms but can also have a positive effect on physical symptoms associated with PMS, making them a versatile choice for treatment.

The other options available have their roles in the management of premenstrual symptoms but are not considered first-line treatments. Oral contraceptives may help in regulating hormonal fluctuations that contribute to PMS but are typically used when birth control is also a goal. Alprazolam, a benzodiazepine, may be used to address acute anxiety symptoms but is not a first-line treatment for PMS as it does not specifically target the underlying mood and physical symptoms associated with the syndrome. Gonadotropin-releasing hormone agonists