Premenstrual syndrome and self-medication with opioids.

We have described a patient in opioid substitution treatment using heroin to treat her premenstrual complaints. After a short review of the diagnosis and etiology of premenstrual syndrome or premenstrual dysphoric disorder, the relation between premenstrual syndrome/premenstrual dysphoric disorder and opioid receptors is discussed. In the case of the patient described, increasing the dose of methadone in the premenstrual period produced significant clinical improvement.