Diuretics: For premenstrual fluid retention and bloating we will use potassium sparing diuretic spirolactone (aldactone) at doses of 25mg to 50 mg a day used two weeks prior to menses. This is only used when other methods fail.

Breast Tenderness: For severe breast tenderness that doesn't respond to nutritional therapy the use of bromocritpine 1.25 mg to 5 mg a day alleviates breast engorgement which can be 30 to 40% size increase.

Depression: For severe mood related disorders selective serotonin uptake inhibitor (SSRI) is used. At our clinic we most commonly use Sarafem (fluoxetine) 20 mg a day given 7 days prior to menses and stopping 2 days into menses. We have found that after approximately 3 months of nutritional and lifestyle changes these medications are not required.

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