Most women have tender breasts, bloating, and muscle aches a few days before they start their menstrual periods. These are normal premenstrual symptoms. But when they get in the way of your work or daily life, they are called premenstrual syndrome, or PMS. PMS can affect your body as well as your mood. Sometimes it can make you change the way you act.

PMS symptoms can be mild or strong. If your symptoms are very bad, you may have premenstrual dysphoric disorder (PMDD). But PMDD is not as common.

SSRIs are a type of medicine that can restore the balance of certain brain chemicals called neurotransmitters. This may help relieve physical and emotional symptoms of PMS. SSRIs are also used to treat depression, anxiety, menopause hot flashes, and chronic pain.

SSRIs are often the first-choice medicine for treating severe PMS and PMDD symptoms, such as:

• Depression.
• Anxiety.
• Irritability.
• Anger.
• Mood swings.
• Breast tenderness and bloating.
• Headaches, joint pain, and muscle pain.

You can choose to take an SSRI every day or only on premenstrual days. If you have PMS symptoms that completely go away during your period, taking an SSRI only on premenstrual days is likely to work for you. But if you have symptoms such as depression or anxiety all the time, taking an SSRI every day may be a better choice.

There are several kinds of SSRIs for PMS. Each can affect your mood in a different way. One medicine may not be right for you, but another may work well. Most women feel better within a few days after they start taking the medicine, but it can take longer.

Your doctor may recommend treatment other than SSRIs if you have had a manic episode, if you have bipolar disorder or a seizure problem, or if you take another medicine that can't be used along with an SSRI.

Side effects of SSRIs are common but not serious. But some people stop taking the medicine because of side effects. Some of these side effects will go away after you take the medicine for several weeks. Side effects include:

• Nausea, appetite changes, and weight loss.
• Headache.
• Tiredness and trouble sleeping.
• Nervousness.
• Lack of sexual desire, arousal, or orgasm.
• Dizziness.
• Tremors.
• Dry mouth.
• Rash (rare).
• Weight gain (rare), with long-term use.

If you are trying to get pregnant, talk with your doctor. Taking medicines for PMS in the early weeks of pregnancy could increase your chance of having a baby with birth defects.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:

• An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, people taking antidepressants should be watched for warning signs of suicide, such as saying they're going to hurt themselves, talking or writing about death, or giving away their things. This is especially important at the beginning of treatment or when doses are changed.
• A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

Your doctor may advise you to try an SSRI if:

• Your PMS symptoms are getting in the way of your work or daily life.
• You have another health problem, such as depression, anxiety, or chronic pain, that could be helped with SSRI treatment.