Premenstrual syndrome (PMS) is defined as a recurrent, cyclical set of varying physical & behavioral symptoms that appear 7 to 14 days before menses & usually subside with onset. Depending on the symptoms & their severity, they usually interfere with some aspect of a woman's life. The effects of PMS range from minimal discomfort to severe, disruptive symptoms & can include nervousness, irritability, depression, & multiple somatic complaints.

Researchers believe that 70% to 90% of women experience PMS at some time during their childbearing years, usually between ages 25 & 45. According to the DSM-IV-TR, a more severe form of PMS is referred to as premenstrual dysphoric disorder (PMDD). PMDD includes the psychological manifestations of PMS.

reason of Premenstrual Syndrome

The list of biological theories offered to explain the cause of PMS is impressive. It includes such conditions as progesterone deficiency in the luteal phase of the menstrual cycle & vitamin deficiencies. Although there's no evidence that PMS is hormonally mediated, failure to identify a specific disorder with a specific mechanism suggests that PMS represents a variety of manifestations triggered by normal physiologic hormonal changes.

Hormone levels

Measuring hormone levels is of no help in understanding PMS because there are no differences between women who get PMS & those who don't.

Signs & symptoms of Premenstrual Syndrome

Clinical effects vary widely among patients & may include behavioral symptoms, somatic symptoms, or both. These symptoms include:

behavioral- mild to severe personality changes, mood changes, anxiety, nervousness, hostility, irritability, agitation, sleep disturbances (either insomnia or hypersomnia), fatigue, lethargy, & depression as well as overeating, food cravings, & increased appetite.
somatic - breast tenderness or swelling, abdominal tenderness or bloating, weight gain, joint pain, headache, edema, diarrhea or constipation, & exacerbations of skin problems (such as acne or rashes), respiratory problems (such as asthma), or neurologic problems (such as seizures).

Diagnosis of Premenstrual Syndrome includes:

The patient history shows typical symptoms related to the menstrual cycle. To help ensure an accurate history, the patient may be asked to record menstrual symptoms & body temperature on a calendar for 2 to 3 months prior to diagnosis. Estrogen & progesterone blood levels may be evaluated to help rule out hormonal imbalance. A psychological evaluation is also recommended to rule out or detect any underlying psychiatric disorders.

Premenstrual Syndrome treatment

Educating & reassuring patients that PMS is a real physiologic syndrome are important parts of treatment. Because treatment is predominantly symptomatic, each patient must learn to cope with her own individual set of symptoms. Treatment may include antidepressants, vitamins such as B6 (pyridoxine), hormonal contraceptives, selective serotonin reuptake inhibitors, prostaglandin inhibitors, diuretics, & nonsteroidal anti-inflammatory drugs.

Herbal remedies for PMS

Calcium carbonate intake to reduce craming & moodiness.
Kava Kava will treats anxiety & improves mood.
Buchu treats bloating & excess water weight.
Magnesium oxide to reduce headache, fuild retention & moodiness.

Special considerations

Inform the patient that self-help groups exist for women with PMS; if appropriate, help her contact such a group.
Obtain a complete patient history to help identify any emotional problems that may contribute to PMS. lf necessary, refer the patient for psychological counseling.
Suggest that the patient seek further medical consultation if symptoms are severe & interfere with her normal lifestyle.

back to Gynecological problems section

Online TV | English Girls Make Up | Learn English | Learn French | Learn German