Objective. To comparatively study the efficiency and acceptability of phyto-and hormone therapy in the treatment of women with moderate and severe PMS. Material and methods. The study included 243 patients aged 16–49 years with moderate or severe PMS; 121 women were treated with dry Vitex agnus castus fruit extract (4 mg); 122 women received an oral contracep-tivecontaining 20 mg of ethinyl estradiol and 3 mg of drospirenone in a 24/4 regimen. The severity of PMS and the efficiency of treatment were evaluated by analyzing the questionnaires, PMS diaries, and visual analog scale, which had been filled out by the patients. Result. The evaluation of the impact of therapy on the course of PMS showed that the phytopreparation was more highly effective against the metabolic and endocrine manifestations of PMS, to a greater extent the dietary behavior of patients, and mastalgia. There were more pronounced psychoemotional changes during hormone treatment. Conclusion. Phytopreparation containing 4 mg of dry extract Vitex agnus castus was effective in treating women with moderate or severe PMS. The proportion of women who have improved after 6 cycles of treatment, calculated on the basis of the self-assessment scale of the questionnaire, was 66.1%. This is comparable to the effectiveness of a hormonal combined contraceptive preparation containing 20 μg of ethinyl estradiol and 3 mg of drospirenone 24/4 in the treatment of PMS (the proportion of women – 71.3%, p < 0.05). © 2018, Bionika Media Ltd.. All rights reserved.