--- title: How do psychiatrists and gynecologists in Japan diagnose and treat PMS and PMDD? description: They use different approaches. Psychiatrists mainly prescribe SSRIs and Kampo medicines, while gynecologists use a mix including birth control pills. Most don url: https://niyora.com/research/papers/practical-diagnosis-and-treatment-of-premenstrual-syndrome-and-premenstrual-2024/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - How do psychiatrists and gynecologists in Japan diagnose and treat PMS and PMDD? Survey study, 2024 # How do psychiatrists and gynecologists in Japan diagnose and treat PMS and PMDD? They use different approaches. Psychiatrists mainly prescribe SSRIs and Kampo medicines, while gynecologists use a mix including birth control pills. Most don't use evidence-based diagnostic methods like symptom diaries. Early or limited evidence 262 psychiatrists and 409 gynecologists in Japan ## What they did Web-based survey conducted December 2021 to February 2022 of 262 psychiatrists and 409 gynecologists in Japan about their approach to diagnosing and treating PMS and PMDD. ## What they found Overall, 79.8% of psychiatrists and 97.3% of gynecologists reported being involved in PMS and PMDD diagnosis and treatment. Most psychiatrists (91.1%) prescribed SSRI or SNRI medications continuously, with 73.3% also prescribing Kampo medicines and only 2.8% prescribing birth control pills. Gynecologists most commonly used SSRI continuous (32.8%), Kampo medicines (42.1%), and luteal phase SSRI dosing (20.6%). Only 9.7% of psychiatrists maintained a two-cycle symptom diary. ## What it means for you In Japan, doctors tend to choose treatments based on their specialty rather than best available evidence. Most do not systematically track symptoms before diagnosing, which could lead to misdiagnosis. These findings are specific to Japan and may not apply to other countries. 262 psychiatrists surveyed 91.1% psychiatrists prescribing SSRI/SNRI continuously 9.7% psychiatrists using two-cycle symptom diary ## About the study Original title Practical diagnosis and treatment of premenstrual syndrome and premenstrual dysphoric disorder by psychiatrists and obstetricians/gynecologists in Japan Authors Yoshimi K, Inoue F, Odai T et al. Journal PCN reports : psychiatry and clinical neurosciences Year 2024 Study design Survey study What was tested None - survey of clinical practice Open access Yes Read the paper [doi.org/10.1002/pcn5.234](https://doi.org/10.1002/pcn5.234) Original abstract Aim: To investigate and compare the diagnoses and treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) from the perspectives of psychiatrists and obstetricians/gynecologists (OB/GYNs) in Japan. Methods: Between December 2021 and February 2022, a web-based survey was conducted among the members of the Japanese Association of Neuro-Psychiatric Clinics. Data from 262 psychiatrists who responded to the aforementioned survey were compared with data from 409 OB/GYNs from a survey conducted in 2021 among members of the Japanese Society of Obstetrics and Gynecology. Results: Overall, 79.8% of psychiatrists and 97.3% of OB/GYNs were involved in practicing PMS/PMDD diagnosis and treatment. Most psychiatrists believed that PMS should be treated by OB/GYNs (74.4%) and PMDD by psychiatrists (75.6%). Only vague medical interviews were conducted by 86.6% of psychiatrists, and only 9.7% maintained a two-cycle symptom diary. Psychiatrists mostly prescribed selective serotonin/serotonin and noradrenaline reuptake inhibitor (SSRI/SNRI) continuous dosing (91.1%), followed by Kampo medicines, especially Kamishoyosan (73.3%); only 2.8% chose oral contraceptive pills, unlike OB/GYNs, while SSRI continuous (32.8%) and luteal phase dosing (20.6%) and Kampo medicine (42.1%) were the most common first-line treatments. Lifestyle guidance was prescribed by 63.6% of psychiatrists, followed by cognitive behavioral therapy (13.8%) and the symptom diary observation method (11.1%), which were similar to OB/GYNs' choices. Conclusions: Many Japanese psychiatrists and OB/GYNs do not base PMS/PMDD diagnoses on prospective monitoring methods using specific diagnostic criteria and therefore do not provide evidence-based treatment. Moreover, a tendency of being biased toward treatments in which the department specialized was observed. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/)[Cognitive behavioral therapy](https://niyora.com/research/topics/treatment-cbt/)[Other herbal medicine](https://niyora.com/research/topics/treatment-herbal-other/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Review, 2015 What do we know about PMS and PMDD and how are they treated? Survey study, 2026 What are the causes, diagnosis, and treatments for PMS and PMDD? Review, 2016 How common are PMS and PMDD, and what are the best treatments? Study, 2022 What are the symptoms, causes, and treatments of PMS and PMDD? Review, 2024 What are the most effective treatments for PMDD? Review, 2018 What are the most effective treatments for premenstrual syndrome and PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗