© Ascend Media S492 THE AMERICAN JOURNAL OF MANAGED CARE DECEMBER 2005

The biology of menstrually relatedsymptoms involves either direct orindirect interaction of the ovarian cycle with key hormones, neurotransmit-ters, or other substances.1 A menstruating woman may experience symptoms in the late luteal phase of her ovulatory cycle throughout her childbearing years. To pro-vide relief for women who suffer moderately or severely from any combination of these symptoms, it would seem prudent to seek a solution that works in tandem with female physiology to restore health-related quality of life and an overall sense of well-being with the fewest possible adverse effects. Symptoms related to the menstrual cycle may be limited to mild discomfort or extend to premenstrual syndrome (PMS) or to premenstrual dysphoric disorder (PMDD), which would include severe emotional and somatic impairment. Only limited research on alleviation of menstrual symptoms has been conducted to date on women meeting the diagnostic criteria published by th