We have seen in previous chapters that the current management of severe premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) includes hormonal, alternative, and non-medication therapies as well as ovarian suppression (see Chapters 14, 15, and 17). Limited evidence supports the effectiveness of some of these treatment strategies, particularly the complementary and so-called ʼnatural remedies’; in addition, potential side effects and risks involving long-term use of hormone treatments may limit their use.