Nonpharmacologic therapy

A. Relaxation therapy and cognitive behavioral therapy have shown some benefit. Behavioral measures include keeping a symptom diary, getting adequate rest and exercise, and making dietary changes.

B. Sleep disturbances, ranging from insomnia to excessive sleep, are common. A structured sleep schedule with consistent sleep and wake times is recommended. Sodium restriction may minimize bloating, fluid retention, and breast swelling and tenderness. Caffeine restriction and aerobic exercise often reduce symptoms.

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