This CME has expired. The Spectrum of Menstrual Symptoms: Strategies for Counseling and Treatment CME Release date: October 2005 CME Expiration date for credit: October 31, 2007 CME Credit: 1 Faculty: Raquel Arias, MD, MPH Associated Professor of Obstetrics and Gynecology Keck School of Medicine University of Southern California Los Angeles, California Susan Wysocki, RNC, NP President National Association of Nurse Practitioners in Women's Health Washington, DC Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Dannemiller Memorial Educational Foundation and MedPro Medical Communications. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians. Designation of Credit: The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of one category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity. Statement of Need: Up to 90% of the reproductive-age women in the United States experience at least some premenstrual symptoms. These symptoms can range in severity from mild to actually disabling the woman for several days in most months. The development of diagnostic criteria for premenstrual dysphoric disorder (PMDD)-the most severe type of premenstrual symptoms-has enabled researchers to increase quality research in this important area of women's health. Many women can decrease their premenstrual symptoms by making lifestyle changes, such as avoiding certain foods, achieving a healthy weight, and increasing their physical activity. In addition, some over-the-counter products and pharmaceutical agents, often in off-label use, can help decrease the burden of symptoms during the luteal phase of a woman's cycle. Nurse practitioners, midwives, and all healthcare professionals counseling reproductive-age women need to be familiar with the benefits and risks of the various options available for women who experience bothersome premenstrual symptoms during most or all of their cycles. Intended Audience: This program has been developed for nurse practitioners and midwives who counsel women with premenstrual symptoms. Learning Objectives: Upon completion of this program, the participants should be able to: Discuss the prevalence of premenstrual symptoms and their impact on a woman's life. List the diagnostic criteria for premenstrual dysphoric disorder. Describe the different treatment options available for premenstrual symptoms, including benefits and risks. Explain the rationale for using oral contraceptives to reduce premenstrual symptoms, and discuss research findings for oral contraceptives containing progestins derived from 19-nortestosterone and from 17 -spirolactone (ie, drospirenone) in the treatment of these symptoms. DISCLOSURES: In accordance with the Accreditation Council for Continuing Medical Education (ACCME), the Dannemiller Memorial Educational Foundation requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest. Accordingly: Dr. Raquel Arias discloses that she is a consultant and/or member of an advisory board for Barr Laboratories, Berlex, Inc., Ortho-McNeil Pharmaceuticals, Inc., Organon USA, Inc., Novo Nordisk Pharmaceuticals, Inc., Pfizer Inc. and Wyeth Pharmaceuticals. Susan Wysocki discloses that she is a member of the Speakers Bureau and/or advisory board for Ortho-McNeil Pharmaceuticals, Inc., Berlex, Inc/., Wyeth Pharmaceuticals, 3M Corporation, Duramed Pharmaceuticals, inc., Novavax, Inc., Novo Nordisk Pharmaceuticals, Inc., Proctor & Gamble, Inc., Merck & Co., Inc., Solvey and FEI. To resolve identified conflicts of interest, the educational content was fully peer reviewed by a physician member of the Dannemiller Clinical Content Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based and commercially balanced. The Dannemiller Staff and MedPro Medical Communications staff that was involved in the development of this activity have no financial relationships with any commercial interest that are relevant to this activity. The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of the Dannemiller Memorial Educational Foundation, MedPro Medical Communications, or Berlex, Inc. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity. METHOD OF PARTICIPATION: This activity should take approximately one hour to complete. The participant should, in order, read the objectives, read the monograph, and take the link to the registration for credit and posttest evaluation form. The form provides each participant the opportunity to comment on the extent to which education objectives were met, the quality of the instruction process, the perception of enhances professional effectiveness, the perception of commercial bias and his or her views on future educational needs. To receive credit for this activity, follow the instructions provided on the evaluation form. The continuing medical education is valid through October 31, 2007. No credit will be given after this date. OFF LABEL DISCUSSION: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program. In the event you are unable to print the certificate, please submit the post-test and then email editor@dannemiller.com and a certificate will be mailed to you within two weeks.