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Premenstrual syndrome — DRCOG MCQ

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ModerateGynaecologyPremenstrual syndromeDRCOG

A 29-year-old woman has cyclical irritability, low mood and breast tenderness in the week before menstruation, resolving within days of bleeding. Symptoms impair work but she has no persistent depression. What is the most appropriate management?

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Correct answer: D — Offer lifestyle measures and consider SSRI or combined hormonal contraception

PMS is suggested by recurrent luteal-phase symptoms that resolve with menstruation. Management includes symptom diaries, lifestyle measures and options such as SSRIs or combined hormonal contraception depending on preference and contraindications. Antipsychotics and antibiotics are not first-line. Severe refractory symptoms may need specialist care, not immediate hysterectomy from primary care.

Reference: RCOG Green-top Guideline No. 48; NICE CKS PMS