***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Premenstrual syndrome ( PMS ) symptoms can reduce quality of life and impair daily functioning . This study examined the effects of Korean h and acupuncture therapy ( HAT ) and h and moxibustion therapy ( HMT ) on symptom severity in Korean women with PMS . This quasi-experimental pilot study based on the khi , yin , yang , and the five elements theory used a nonequivalent control group pretest — posttest design . Experimental groups received 10 sessions of either HAT or HMT treatment . Outcome measures included menstrual symptom severity as measured with the Menstrual Symptom Severity List and skin temperature change measured with Digital Infrared Thermographic Imaging . Both experimental groups had significantly reduced overall PMS symptom severity scores following therapy as compared to women in the control group .  The HMT but not the HAT group showed improved flow of khi and balanced skin temperature in symmetric body areas . HAT and HMT may be effective strategies for women to reduce PMS symptoms Clinical trials have demonstrated that serotonin reuptake inhibitors ( SRIs ) and the extract of Vitex agnus castus are effective for the treatment of  premenstrual dysphoric disorder  ( PMDD ) . However , to the best of our knowledge , there has been no study comparing the efficacy of the SRIs with Vitex agnus castus ( AC ) extract . Therefore , the aim of the present study was to compare the efficacy of fluoxetine , a selective serotonin reuptake inhibitor ( SSRI ) , with that of the AC extract , a natural choice . After a period of 2 screening months to screen the patients for suitability , 41 patients with PMDD according to DSM‐IV were recruited into the study . The patients were r and omized to fluoxetine or AC for 2 months of single‐blind , rater‐ blinded and prospect i ve treatment period . The outcome measures included the Penn daily symptom report ( DSR ) , the Hamilton depression rating scale ( HAM‐D ) , and the clinical global impression‐severity of illness ( CGI‐SI ) and ‐improvement ( CGI‐I ) scales . At endpoint , using the clinical criterion for improvement , a similar percentage of patients responded to fluoxetine ( 68.4 % , n = 13 ) and AC ( 57.9 % , n = 11 ) . There was no statistically significant difference between the groups with respect to the rate of responders . This preliminary study suggests that patients with PMDD respond well to treatment with both fluoxetine and AC . However , fluoxetine was more effective for psychological symptoms while the extract diminished the physical symptoms . Copyright © 2002 John Wiley & Sons , Premenstrual syndrome ( PMS ) refers to a set of emotional and physiologic symptoms occurring during the last week of the premenstrual phase and diminishing by the end of menstruation [ 1 ] . Hypericum perforatum ( St John 's wort ) is a traditional herbal remedy that has been found to be effective at alleviating the symptoms of mild – moderate depression in those experiencing PMS [ 2–4 ] . The aim of the present study was to investigate the efficacy of H. perforatum in the treatment of PMS . In total , 170 women with PMS ( for at least 6 months ) who were referred to Zeinabieh Hospital , Shiraz University of Medical Sciences , Shiraz , Iran , were included in the present prospect i ve , r and omized , double-blind , placebo-controlled study . Women with current major psychiatric disorders , recent history of serious health problems , use of psychotropic medication , concomitant treatment for PMS ( e.g. vitamins and supplements ) , current or planned pregnancy , current lactation , lack of appropriate contraception , irregular menstrual cycles , and those using oral contraceptives were excluded from the study . The American College of Obstetrics and Gynecology st and ard diagnostic criteria [ 1 ] were used to define PMS . Ethics approval was provided by the Institutional Review Board and the Ethics Committee of Shiraz University of Medical Sciences , and all participants gave written informed consent . The participants were r and omly divided into 2 groups : those receiving H. perforatum ( 2 680-μg hypericin tablets per day [ n=85 ] ) and those receiving placebo ( 2 cellulose tablets per day [ n=85 ] ) for 8 weeks ( 2 menstrual cycles ) . Anxiety ( mood swings , anxiety , or nervous tension/irritability ) , hydration ( breast tenderness , swelling of extremities , or weight gain ) , depression ( depression , crying , forgetfulness , or insomnia ) , and craving ( increased appetite , headache , or fatigue ) were evaluated daily on scale of 1 ( not at all ) to 6 ( extreme ) . The 28-item General Health Question naire was used to evaluate the psychologic status of participants , all of whom completed the question naire prospect ively during the intervention cycles and reported any adverse effects . Statistical analyses were performed using SPSS version 15.0 ( SPSS , Chicago , IL , USA ) . The χ or Fisher exact test was applied for comparison between frequencies . Paired and independent sample t tests were used to compare means within and between groups , respectively . All tests were 2-sided and the level of significance was set at Pb0.05 . There were no significant differences in baseline characteristics between the groups ( Table 1 ) . Those receiving H. perforatum had significantly lower PMS scores compared with baseline ( Pb0.001 ) and the control group ( Pb0.001 ) . The biggest improvements in score occurred for crying ( 71 % ) and depression ( 52 % ) in the study group . More participants from the study group than the control group dropped out because of adverse events ( P=0.02 ) , although there were no significant differences in adverse events caused by the 2 preparations . H. perforatum seems to reduce premenstrual symptoms at 8 weeks of treatment , consistent with previous studies [ 2–4 ] . In their pilot study , Stevinson and Ernst [ 2 ] observed that daily intake of H. perforatum was associated with a 51 % reduction in symptom ratings — consistent with the 40 % reduction in the present study . Canning et al. [ 3 ] reported thatH. perforatumwasmore effective than placebo in the treatment of PMS . By measuring levels of serum sex hormones and inflammatory cytokines , they also excluded inflammatory or hormone regulation as a possible mechanism of action [ 3 ] . Consistent with the present results , Hicks et al. [ 4 ] observed that PMS mood symptoms ( anxiety and depression ) improved more than did other symptoms . The present study provides further evidence that H. perforatum— which is cheap and commonly available — is a well-tolerated and effective drug for the treatment ofwomenwithmoderate – severe PMS OBJECTIVE To determine the efficacy of fluoxetine ( 10 mg ) , alprazolam , propanolol and pyridoxine in the treatment of severe premenstrual syndrome ( PMS ) . METHOD One-hundred and twenty women were divided into four groups of 30 patients . Patients were su bmi tted to a r and omized , double-blind , placebo-controlled treatment and were given 3 months of placebo and 3 months of active drug . The active drug was pyridoxine ( 300 mg/day ) in group 1 ; alprazolam ( 0.75 mg/day ) in group 2 ; fluoxetine ( 10 mg/day ) in group 3 ; and propanolol ( 20 mg/day and 40 mg during the menstrual period ) in group 4 . RESULTS Fluoxetine in 10-mg doses obtained a mean reduction of 65.4 % in symptoms , followed by propanolol ( 58.7 % ) , alprazolam ( 55.6 % ) , pyridoxine ( 45.3 % ) and placebo ( 39.4 - 46.1 % ) . CONCLUSION Fluoxetine in 10-mg doses presented the best results for treating premenstrual syndrome Objective Although its etiology is unknown , it has been hypothesized that premenstrual syndrome ( FMS ) is linked to a deficiency of central serotoninergic activity . In the present study , we evaluated the effect of fluoxetine , a specific serotonin uptake inhibitor , on PMS symptoms . Methods Following extensive screening , including several psychological inventories , eight women with severe persistent PMS participated in a 6-month double-blind , placebo-controlled , crossover study which included three months each of daily fluoxetine 20 mg or placebo , administered in a r and omized order . Symptoms were evaluated using the Calendar of Premenstrual Experiences and other psychometric measures . Results Compared with placebo , treatment with fluoxetine was associated with an improvement in PMS symptoms as judged by highly significant decreases in behavioral ( P < .005 ) , physical ( P < .05 ) , and total ( P < .005 ) Calendar of Premenstrual Experiences scores ; Beck Depression Inventory scores ( P < .005 ) ; Profile of Mood States subscales scores including depression ( P < .005 ) , tension ( P < .005 ) , and anger ( P < .01 ) ; and State-Trait Anxiety Inventory scores . The use of fluoxetine was associated with a greater mean reduction in behavioral ( 75 % ) than in physical scores ( 40 % ) , with a mean decrease in total Calendar of Premenstrual Experiences scores of 62 % , which rendered these scores similar to follicular phase values . Thus , the luteal phase symptomatology of PMS was effectively abolished . At this dose , no significant side effects or complications were noted during treatment . Conclusion Fluoxetine appears to be a highly effective , well-tolerated treatment for the psychological and physical symptoms accompanying severe PMS Abstract More than 60 % of the women in both groups suffered from premenstrual syndrome ( PMS ) symptoms , such as anxiety , mastalgia , insomnia , nausea and gastrointestinal disorders , whereas a smaller number of women suffered from phobic disorders , premenstrual headaches and migraines . There were three women from the first group and seven women from the second group who continued the medication treatment with progestins , whereas one woman from the first group and nine women from the second group continued to take fluoxetine . In the first group , nine women stopped having PMS symptoms after two AP treatments , eight women stopped having them after three treatments and one woman stopped having them after four treatments . In four women from the first group and 16 women from the second group , PMS symptoms appeared during the following period ( cycle ) or continued even after four treatments , so the medication was continued . In the first group , one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6 . There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group ( P<0.001 ) , whereas their reduction was irrelevant in the placebo AP group ( P>0.05 ) . The success rate of AP in treating PMS symptoms was 77.8 % , whereas it was 5.9 % . in the placebo group . The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions . The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment CONTEXT Premenstrual syndrome is believed to affect 30 % to 80 % of women . Studies in various cultures have used a variety of method ologies to determine prevalence , symptom profile , and effectiveness of available treatments . This study was design ed to provide information on incidence of PMS and therapies used based on a national probability sample of US women . METHOD In 1996 a national probability sample ( N = 1052 ) of women aged 21 to 64 years was surveyed by telephone using r and om digit dial methods . The survey included demographic information , questions concerning respondent knowledge of premenstrual syndrome , incidence rates of common premenstrual syndrome symptoms , and any remedies that were used to control the symptoms . RESULTS Forty-one percent of the women responded " yes " to the question , " Do you suffer from premenstrual syndrome ? " An additional 17 % indicated that they experienced symptoms prior to their menstrual cycle that are commonly associated with premenstrual syndrome ( e.g. , pain , bloating , feeling more emotional , weight gain , food cravings ) , though without associating these symptoms with premenstrual syndrome explicity . The most frequently noted severe symptom was that of " [ feeling ] more emotional . " Of those reporting premenstrual syndrome symptoms , approximately 42 % took either prescription or over-the-counter medications to relieve them . Eighty percent of the women taking any type of medication relied on over-the-counter medications . Prescription drug use for premenstrual syndrome symptoms focused on medications to control pain ; hormone supplements were the second most frequently prescribed rugs . Fewer than 3 % of the respondents used prescription medications . Respondents were asked to indicate whether they had used a complementary medical therapy to control symptoms . Exercise was used most frequently ( 18 % ) , and acupuncture was the least frequently used . Although only a small percentage of women used complementary therapies , for most of these therapies a near-perfect concordance was found between usage and belief in efficacy . CONCLUSIONS Women were aware of symptoms related to premenstrual syndrome more frequently than they recognized a formalized medical syndrome . Less than half of the women reporting symptoms had taken either over-the-counter or prescription drugs . Those who tried complementary therapies generally found them to be effective OBJECTIVES To investigate the efficacy and safety of VAC BNO 1095 extract in Chinese women suffering from moderate to severe premenstrual syndrome ( PMS ) . METHODS Prospect 
    Output:
    
Experimental groups with Acupuncture and herbal medicine treatment ( all herbal medicine except Cirsium japonicum ) had significantly improved results regarding PMS/PMDD .
Conclusions Limited evidence supports the efficacy of alternative medicinal interventions such as acupuncture and herbal medicine in controlling premenstrual syndrome and premenstrual dysphoric disorder .
Acupuncture and herbal medicine treatments for premenstrual syndrome and premenstrual dysphoric disorder showed a 50 % or better reduction of symptoms compared to the initial state .
In both acupuncture and herbal medical interventions , there have been no serious adverse events reported , proving the safety of the interventions while most of the interventions provided over 50 % relief of symptoms associated with PMS/PMDD .