Premenstrual syndrome: how to alleviate the condition? How long does PMS last?

A woman's nervous state before menstruation has become an object of ridicule from men. Premenstrual syndrome (PMS) “spoils” the lives of both, often causing quarrels in couples and quarrels in the family. Therefore, men should also know what PMS is in girls.

Women who have experienced all the “delights” of PMS know for sure that this is not a series of whims, but a truly complex condition. However, only a few of them know how to cope with the manifestations of hormonal changes in the body. Modern medicine provides this opportunity: compliance with certain rules and use safe drugs will help you survive the premenstrual period without shock and depression.

PMS in women - transcript

What it is? PMS - special condition women a few days before menstrual bleeding, characterized by emotional instability, vegetative-vascular and metabolic abnormalities. The abbreviation “PMS” stands for premenstrual syndrome. To make it clear what premenstrual syndrome is, we will answer frequently asked questions:

• Premenstrual syndrome: are men right when they mock a woman’s condition?

This time the men are clearly wrong. Premenstrual syndrome is included in the WHO classification. This means that the global medical community recognizes this deviation.

• Do all women experience PMS?

Every second woman experiences premenstrual syndrome. Moreover, the incidence of PMS and the severity of its symptoms increases with age. So, before the age of 30, only 20% of women suffer from it, after 30 - every third, and after 40 years, PMS occurs in 55-75% of women.

• Why does premenstrual syndrome occur?

Doctors do not give a definite answer. Hormonal fluctuations before menstruation, as a cause of PMS, are not always justified. For some women, changes in the levels of the hormones progesterone and estrogen are not as significant. The theory about a temporary change in neuroregulation is closest to the truth.

• How many days before menstruation appear? PMS symptoms?

A woman's condition changes 2-10 days before the onset of menstrual bleeding. The duration of this period and the severity of its manifestations vary from person to person. However, everything painful sensations necessarily stop in the first days of menstruation.

• Do you just have to endure premenstrual syndrome?

Not at all necessary. To alleviate menstrual syndrome, several rules have been developed for daily routine and nutrition. Also, in case of severe manifestations, the gynecologist may prescribe some medications(they will be discussed below).

• Does PMS go away after childbirth?

In some women, premenstrual syndrome is initially absent and may appear after childbirth. For others, on the contrary, unpleasant symptoms disappear or improve (especially breast swelling and tenderness) after the baby is born.

Important! PMS and menstruation are always connected: painful symptoms disappear after bleeding occurs.

Most often, premenstrual syndrome occurs in smokers (the likelihood of PMS doubles!), and women with a weight index over 30 (divide your kg by your height squared in meters). The risk also increases after abortion and complicated childbirth, after gynecological operations. A genetically determined reaction of the body to physiological changes before menstruation. However, PMS is most often recorded in depressed (phlegmatic) and emotionally labile (choleric) women.

Characteristic symptoms of PMS

It is unlikely that there will be women with the same picture of PMS: there are about 150 signs premenstrual syndrome. However, in such a variety of characteristics, main groups can be distinguished. Symptoms of PMS in women:

• Deviations from the side nervous system and psyche

A woman’s mood can be described in one word - negative. She may cry over a trifle or for no reason at all. Ready to “tear to shreds”, the degree of aggression also little coincides with the offense inflicted. At best, a woman is depressed and experiences irritability, which she cannot always cope with.

• Hormonal changes

Due to increased progesterone levels for 1-2 weeks. Before menstruation, a woman’s mammary glands become noticeably enlarged and engorged. Many women this period A bra size larger than usual is required. The bursting pain in the chest can be so intense that normal walking causes discomfort.

Some women have veins protruding from the skin of their mammary glands. At the same time, swelling of the hands and face may occur, and swelling in the legs becomes more noticeable at the end of the day. An increase in temperature to 37.0-37.2ºС is often recorded. Often the stomach increases in size due to the accumulation of gases and constipation.

• Autonomic disorders

During PMS, pulsating pain often occurs. headache, radiating to the eye area. The attacks are similar to migraines, sometimes accompanied by nausea and vomiting, but the pressure remains normal.

PMS after 40 years, when hormonal changes aggravated by concomitant diseases, often provokes increases in blood pressure in the evenings (hypertensive crisis), tachycardia (rapid heartbeat), shortness of breath and pain in the heart.

Premenstrual syndrome can occur with a predominance of certain symptoms (edematous, cephalgic, crisis), but most often a mixed form is diagnosed. Almost every woman suffering from PMS experiences:

• constant thirst and increased sweating, acne;
• dizziness and staggering, especially in the morning, and fatigue;
• desire to eat salty or sweet, increased appetite;
• heaviness in the lower abdomen and spastic pain, radiating to the lower back most often due to prolonged inflammatory process in the genitals (thrush, chronic adnexitis etc.);
• goosebumps and, less commonly, numbness of the fingers and toes associated with vitamin deficiencies. B6 and magnesium;
• aversion to strong odors, even your own perfume.

A severe form of PMS is diagnosed when there are 5-12 severe symptoms.

Premenstrual syndrome can occur in the following scenarios:

• Compensation stage - signs of PMS are mild and disappear immediately upon the onset of menstruation. The course is stable, progression of symptoms over the years is not observed.
• Subcompensation stage - the severity of symptoms increases over the years, as a result, the woman’s ability to work is impaired for some time.
• Stage of decompensation - severe symptoms (hypertensive crises, fainting, etc.) disappear only after several days after the end of menstrual bleeding. Women experience panic attacks, suicidal thoughts are common. During PMS women They often show violence, especially towards their children (they beat them severely).

At severe symptoms Issuance of PMS is acceptable sick leave. However, severe premenstrual syndrome can be a reason for refusal when applying for a job. In European countries, during a divorce, if you ex-wife pronounced PMS is observed, children may be left with their father.

Premenstrual syndrome or pregnancy

The symptoms of premenstrual syndrome are very similar to those of pregnancy. Main question women - how to distinguish: PMS or pregnancy? It is almost impossible if you do not take a pregnancy test or wait a while for your period. However, some signs suggest pregnancy:

• Only during pregnancy is there a perversion of taste. In addition to cravings for salty or sweet foods, as with PMS, a pregnant woman refuses previously favorite foods and expresses strong desire use chalk and earth. An addiction may arise, for example, to lard, which the woman previously could not tolerate.
• Strong odors also cause a negative reaction in a pregnant woman. In addition, a pregnant woman may experience olfactory “hallucinations”: specific smell appears in the wrong place.
• Pain in the lower abdomen during pregnancy is less annoying, occurs periodically and is of a milder, nagging nature. Lower back pain appears only when there is a threat of miscarriage or in later stages of pregnancy.
• Mood swings can occur already in the first weeks of pregnancy, which coincides with PMS period. However, a pregnant woman expresses positive emotions as violently as anger. The premenstrual period is characterized by a negative emotional reaction.
• Fatigue occurs closer to 1 month. pregnancy (about 2 weeks missed period).
• PMS ends with the onset of menstruation. In this case, a complete uterine bleeding. Sometimes during pregnancy they also appear bloody issues on the days when menstruation is due. The difference between bleeding during pregnancy and menstruation is its spotting nature: only a few drops of blood are released, and the discharge is pink or brownish.
• Only during pregnancy, from the first weeks, frequent urination is often observed. This symptom is not typical for PMS.
• Nausea can be caused by premenstrual syndrome and occurs throughout the day. During pregnancy, nausea and vomiting occur a little later, at 4-5 weeks. and indicate early toxicosis.

Important! An hCG test will help diagnose pregnancy. Some tests are highly sensitive and can detect pregnancy within 4 days. before the expected menstruation begins. However, the optimal time for the test is considered to be the 2nd day of a missed period and the next week.

It is quite possible to reduce and, at best, completely get rid of premenstrual syndrome. If the symptoms are not too severe, the following recommendations will help cope with PMS without drug therapy:

• Adequate sleep of at least 8 hours. Walking and breathing exercises will help improve your sleep.
• Physical activity stimulates the synthesis of endorphins, which improve mood and calm the nervous system. During the premenstrual period, dancing, yoga and other relaxing practices (massage, bathing) are especially useful.
• Nutrition correction - giving up sweets and fatty foods, saturating the diet with fruits and vegetables. Coffee, alcohol, energy drinks and chocolate have an irritating effect on the nervous system. These foods should be excluded during the PMS period.
• Regular sex is a source of oxytocin (the hormone of happiness). In addition, the uterus relaxes and spastic pain disappears. Don't drown out the heightened sexual desire: nature itself tells you what the body needs.
• Hold your emotions. The best tactics for the premenstrual period - I'll think about it later. Of course, you shouldn’t ignore the serious negativity that coincides with PMS. But knowing that it is easy to “go too far” and say too much, it is better to postpone a serious conversation until later.
• You should not go shopping during the premenstrual period. There is a high probability of wasting money, which can subsequently develop into a family conflict.

In severe cases, a woman is prescribed drug therapy:

• PMS pain, what to do? - let's take No-shpa. However, you should not get carried away with this drug. Providing an antispasmodic effect, No-spa in large doses may increase menstrual bleeding. Gives a good analgesic effect NSAID drugs(Ibuprofen, Naproxen). It is worth remembering: Ibuprofen (Nurofen, Mig-400) is not recommended for women over 40 years old due to its negative effect on the heart.
• Pain in the chest and swelling are easily eliminated by taking diuretics (Veroshpiron 25 mg, Furosemide 40 mg).
• Multivitamins - will compensate for the lack of magnesium, calcium and vit. AT 6. An excellent tool for PMS, the drug Magne-B6 is used, taking it for 1 month. followed by a repeat course. Gives a good effect homeopathic remedy Mastodinone and saffron decoction.
• Relieving nervous system excitation - most often used herbal preparations(Novo-Passit, Persen). Mixed tinctures of valerian and motherwort will help reduce stress and improve sleep, take 15-25 drops. 2-3 times a day or only an hour before bedtime. In severe cases, the tranquilizer Afobazole is prescribed, which effectively eliminates anxiety. At the same time, the drug does not have a negative effect on the psyche; women can drive a car while taking it. It is advisable to take antidepressants (Fluoxetine, Zoloft, Paxil) and antipsychotics (Nootropil, Sonapax, Aminalon). Tranquilizers, antidepressants and antipsychotics are used only as prescribed by a doctor!
• Hormonal agents - to stabilize hormonal levels and level out PMS symptoms, oral contraceptives (Midiana, Yarina) are used, course - 3 months, followed by repetition. The progestational drug Drospirenone (Anabella, Angelique, Vidora) prevents engorgement of the glands and swelling.

Premenstrual syndrome cannot be tolerated. The condition of PMS, especially in women with an unstable psyche and neurosis, can worsen over time, which ultimately will negatively affect the quality of life and ability to work.

It is also worth remembering that diseases of the genital area, endocrine disorders(including hypo- and hyperthyroidism) only aggravate the course of premenstrual syndrome. Their treatment, following recommendations for lifestyle changes and, if necessary, medications will help cope with even severe PMS.

Premenstrual syndrome (PMS) is a complex complex of somatic and mental disorders, which appear 2-14 days before menstruation and, as a rule, completely disappear after it begins. Thus, PMS develops in the second, luteal phase menstrual cycle. You can also find other names for this condition: premenstrual tension syndrome, cyclic syndrome, premenstrual illness.

PMS in one form or another occurs in 3 out of 4 menstruating women aged 15 to 49 years.

PMS appears especially often at the end of the 3rd and beginning of the 4th decade. Typically, PMS symptoms are characterized by periodicity: they are more pronounced in some months and may disappear in others.

Symptoms of premenstrual syndrome traditionally divided into two groups:

Emotional and behavioral: tension and anxiety; mood swings, irritability, fits of anger or crying; depressed mood, changes in appetite (from complete absence to a pronounced feeling of hunger), sleep disturbances (insomnia) and concentration, the desire to isolate oneself from others, increased sensitivity to sounds and smells.

General somatic: headache, feeling of fullness in the eyeballs, pain in the heart, general weakness, weight gain due to fluid retention, bloating, nausea, engorgement of the mammary glands, pain in the joints and muscles, numbness of the hands, loose stool or constipation.

Symptoms of PMS can appear in various combinations and are characterized by: varying intensity, in connection with which a distinction is made between mild (3–4 symptoms) and severe (5–12 manifestations) forms of PMS. Sometimes emotional and behavioral disorders of PMS make a woman unable to work; in such cases they talk about premenstrual dysphoria. According to another classification, compensated, subcompensated and decompensated stages of PMS are distinguished. In the first case, the disease does not progress, in the second, the severity of symptoms increases over the years, and in the third, after the cessation of menstruation. manifestations of PMS persist for longer and longer periods of time.

Depending on the prevalence of certain symptoms, PMS is divided into four forms: neuropsychic(emotional and behavioral symptoms predominate - see above), edematous(swelling of the face, legs, fingers, engorgement of the mammary glands comes to the fore), cephalgic(severe headache, nausea, vomiting, dizziness) and crisis(in the form of attacks, palpitations, a feeling of fear of death, increased blood pressure, numbness of the limbs). Dividing PMS into these forms allows you to choose the most effective treatment.

The exact causes of PMS are unknown, but factors that contribute to the development of this condition have been identified. Frank, who described this syndrome in 1931, believed that it was caused by excess estrogen. Later, it was suggested that progesterone decreases in the second phase of the menstrual cycle. There is no doubt that the manifestations of PMS depend on cyclical fluctuations of hormones. This is evidenced by the disappearance of the syndrome during pregnancy and menopause. Fluctuations in serotonin (a neurotransmitter) in the brain are responsible for changes in a person's mood. It is believed that an insufficient amount of it can contribute to the development of premenstrual depression, sleep disturbances, changes in appetite, general weakness. Proponents of the “water intoxication” theory point to changes in the renin-angiotensin-aldosterone system, which plays a role in important role during development hypertension. Many researchers consider primary neuro-hormonal disorders in the area of ​​two very important structures of the brain - the hypothalamus (considering PMS as a manifestation of hypothalamic syndrome) and the pituitary gland (the leading role is assigned to melanostimulating hormone and its interaction with endorphins).

Difficult births, abortions, stressful situations, infectious diseases, especially neuroinfections, overwork serve as trigger factors in the development of PMS. More often, this syndrome occurs in women with existing diseases. internal organs. It has been noticed that a lack of vitamins and microelements in food against the background of increased consumption of salty foods, coffee and alcohol also contributes to the development of PMS. The disease is more often observed in representatives of mental work. The hereditary nature of the disease can be traced.

Diagnosis of premenstrual syndrome

The symptoms of PMS are numerous. Therefore, patients often turn to a therapist and a neurologist. The treatment appears to be successful. This is explained by the fact that after menstruation the symptoms of the disease disappear. Then comes disappointment due to the resumption of symptoms. The cyclical nature of the manifestations suggests PMS and serves as a reason to refer the patient to a gynecologist. Many experts admit following criteria to diagnose PMS: cyclicality (recurrence) of symptoms that occur in the luteal (second) phase (2-14 days before menstruation) and their absence for at least 7 days of the follicular (first) phase; symptoms must interfere with quality of daily life.

The gynecologist must perform vaginal and rectal examination pelvis, carefully examines the patient’s complaints, taking into account her lifestyle and previous diseases. A patient diary (calendar), which records the dates of onset and disappearance of symptoms, as well as the dates of menstruation, can be of significant benefit. If necessary, the concentration of hormones in the blood is determined, and the content of progesterone is determined in both phases of the menstrual cycle. X-rays of the skull, sella turcica and cervical region spine, electroencephalography, electrocardiography, mammography (in the first phase of the cycle), consultation with an ophthalmologist (fundus condition), neurologist, and in some cases a psychiatrist. Additional examinations help exclude others gynecological diseases and choose the most rational therapy.

Treatment of premenstrual syndrome start with normalizing nutrition and changing lifestyle. To get rid of flatulence and a feeling of fullness in the stomach, you need to eat often and in small portions. Limiting salty foods reduces fluid retention. The most beneficial carbohydrates are found in fruits, vegetables and whole grains. It is better to cover the need for calcium through dairy products, but not food additives. Avoid drinking drinks containing alcohol and caffeine. Dieting is especially important in the second phase of the menstrual cycle. There is evidence of a significant reduction in the risk of PMS when consuming increased amounts of B vitamins, but only from food sources. Required physical exercise, visiting the gym. Fast walking in the fresh air, swimming, skiing, etc. are useful. physical culture and exercise should be done regularly. Massage and yoga classes are shown, which will teach you to relax your muscles and breathe deeply and correctly. You need to set aside enough time for sleep.

Oral contraceptives inhibit ovulation, stabilize the concentrations of sex hormones in the blood and, thus, alleviate the symptoms of PMS. In connection with hyperestrogenism (estrogens promote fluid retention), the administration of progestogens (a group of hormones derived from progesterone), for example, duphaston, utrozhestan, which are prescribed for 10 days from the 16th day of the menstrual cycle, is indicated. Recently, a new unique progestogen, drospirenone, which is a derivative of spirolactone (a diuretic), has been used to eliminate the symptoms of PMS. Therefore, it prevents sodium and water retention in the body and prevents estrogen-induced effects such as weight gain and breast engorgement. Drospirenone is especially effective for the edematous form of PMS.

Antidepressants (serotonin reuptake inhibitors) - fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft) and others - are very effective in eliminating emotional and behavioral disorders PMS and especially in cases of premenstrual dysphoria. These drugs can be prescribed two weeks before the onset of menstruation. For this purpose, tranquilizers (Rudotel) and antipsychotics (Sonapax) are also prescribed. For cephalgic and other forms of PMS, the prescription of drugs that improve metabolic processes in the brain, for example, nootropil and aminalon.

Nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, etc.) relieve symptoms such as breast engorgement and headache.

Of the diuretics, preference is given to veroshpiron (aldosterone antagonist), which is prescribed 4 days before the onset of symptoms (the patient’s diary helps determine the date), and continues until menstruation.

This information is provided for informational purposes only and should not be used for self-treatment.

Remember that manifestations of PMS cannot be tolerated, because they often worsen the quality of life and lead to loss of ability to work. Lifestyle changes and drug therapy are effective in treating this disease.

– a cyclically recurring symptom complex observed in the second half of the menstrual cycle (3-12 days before menstruation). It has an individual course and can be characterized by headache, severe irritability or depression, tearfulness, nausea, vomiting, skin itching, swelling, pain in the abdomen and in the heart area, palpitations, etc. Swelling is often observed, skin rashes, flatulence, painful engorgement of the mammary glands. In severe cases, neurosis may develop.

General information

Premenstrual syndrome, or PMS, are called vegetative-vascular, neuropsychic and metabolic-endocrine disorders that occur during the menstrual cycle (usually in the second phase). Synonyms for this condition found in the literature are the concepts of “premenstrual illness”, “premenstrual tension syndrome”, “cyclic illness”. Every second woman over the age of 30 is familiar with premenstrual syndrome firsthand; in women under 30, this condition occurs somewhat less frequently - in 20% of cases. In addition, manifestations of premenstrual syndrome are usually associated with emotionally unstable, thin, asthenic women who are more often engaged in intellectual activities.

Causes of premenstrual syndrome

The course of the crisis form of premenstrual syndrome is manifested by sympatho-adrenal crises, characterized by attacks of rising blood pressure, tachycardia, heart pain without abnormalities on the ECG, and panic. The end of a crisis is usually accompanied by copious urination. Often attacks are provoked by stress and overwork. The crisis form of premenstrual syndrome can develop from untreated cephalgic, neuropsychic or edematous forms and usually manifests itself after 40 years. The background for the crisis form of premenstrual syndrome is diseases of the heart, blood vessels, kidneys, and digestive tract.

To cyclical manifestations atypical forms premenstrual syndrome include: increased body temperature (in the second phase of the cycle up to 37.5 ° C), hypersomnia (drowsiness), ophthalmoplegic migraine (headaches with oculomotor disturbances), allergic reactions (ulcerative stomatitis and ulcerative gingivitis, asthmatic syndrome, indomitable vomiting, iridocyclitis, Quincke's edema, etc.).

When determining the severity of premenstrual syndrome, they proceed from the number of symptomatic manifestations, highlighting mild and severe form premenstrual syndrome. Light form premenstrual syndrome manifests itself 3-4 characteristic symptoms appearing 2-10 days before the onset of menstruation, or the presence of 1-2 significantly pronounced symptoms. In severe forms of premenstrual syndrome, the number of symptoms increases to 5-12; they appear 3-14 days before the onset of menstruation. Moreover, all of them or several symptoms are significantly expressed.

In addition, an indicator of a severe form of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. Decreased ability to work is usually observed in the neuropsychic form of premenstrual syndrome.

It is customary to distinguish three stages in the development of premenstrual syndrome:

1. compensation stage - symptoms appear in the second phase of the menstrual cycle and disappear with the onset of menstruation; the course of premenstrual syndrome does not progress over the years
2. subcompensation stage - the number of symptoms increases, their severity worsens, manifestations of PMS accompany the entire menstruation; Premenstrual syndrome becomes more severe with age
3. stage of decompensation early start and late cessation of symptoms of premenstrual syndrome with minor “bright” intervals, severe PMS.

Diagnosis of premenstrual syndrome

Main diagnostic criterion premenstrual syndrome is cyclical, the periodic nature of complaints arising on the eve of menstruation and their disappearance after menstruation.

The diagnosis of premenstrual syndrome can be made based on the following signs:

• State of aggression or depression.
• Emotional imbalance: mood swings, tearfulness, irritability, conflict.
• Bad mood, feeling of melancholy and hopelessness.
• State of anxiety and fear.
• Decreased emotional tone and interest in current events.
• Increased fatigue and weakness.
• Decreased attention, memory impairment.
• Changes in appetite and taste preferences, signs of bulimia, weight gain.
• Insomnia or drowsiness.
• Painful tension in the mammary glands, swelling
• Headaches, muscle or joint pain.
• Worsening of the course of chronic extragenital pathology.

The manifestation of five of the above signs with the obligatory presence of at least one of the first four allows us to speak with confidence about premenstrual syndrome. An important part of the diagnosis is the patient’s keeping a self-observation diary, in which she should note all disturbances in her well-being over the course of 2-3 cycles.

A study of hormones (estradiol, progesterone and prolactin) in the blood allows us to determine the form of premenstrual syndrome. It is known that the edematous form is accompanied by a decrease in progesterone levels in the second half of the menstrual cycle. Cephalgic, neuropsychic and crisis forms of premenstrual syndrome are characterized by an increase in the level of prolactin in the blood. Purpose additional methods diagnosis is dictated by the form of premenstrual syndrome and leading complaints.

Pronounced manifestation cerebral symptoms(headaches, fainting, dizziness) is an indication for an MRI or CT scan of the brain to exclude focal lesions. EEG results are indicative for neuropsychic, edematous, cephalgic and crisis forms of the premenstrual cycle. In the diagnosis of the edematous form of premenstrual syndrome, an important role is played by measuring daily diuresis, recording the amount of fluid drunk, and conducting tests to study the excretory function of the kidneys (for example, Zimnitsky's test, Rehberg's test). In case of painful engorgement of the mammary glands, an ultrasound of the mammary glands or mammography is necessary to exclude organic pathology.

An examination of women suffering from one or another form of premenstrual syndrome is carried out with the participation of doctors of various specialties: neurologist, therapist, cardiologist, endocrinologist, psychiatrist, etc. Prescribed symptomatic treatment, as a rule, leads to an improvement in well-being in the second half of the menstrual cycle.

Treatment of premenstrual syndrome

In the treatment of premenstrual syndrome, medications and non-drug methods. Non-drug therapy includes psychotherapeutic treatment, adherence to work regime and good rest, physical therapy, physiotherapy. An important point is to maintain a balanced diet with sufficient amounts of plant and animal protein, plant fiber, and vitamins. In the second half of the menstrual cycle, you should limit the consumption of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, and alcoholic beverages.

Drug treatment is prescribed by a medical specialist, taking into account the leading manifestations of premenstrual syndrome. Since neuropsychic manifestations are expressed in all forms of premenstrual syndrome, almost all patients are advised to take sedative (sedative) drugs several days before the expected onset of symptoms. Symptomatic treatment premenstrual syndrome involves the use of painkillers, diuretics, antiallergic drugs.

Leading place in drug treatment premenstrual syndrome has a specific hormone therapy progesterone analogue drugs. It should be remembered that the treatment of premenstrual syndrome is a long process, sometimes continuing throughout the entire reproductive period, requiring internal discipline from the woman and strict compliance with all doctor’s instructions.

If you suddenly find yourself craving a sandwich with butter, or burst into tears of emotion at the sight of... small child, or you're itching to buy a pair of earrings that you're unlikely to wear, stop for a moment and ask yourself if you're about to get your period. If soon, your unusual behavior may be caused by premenstrual syndrome or premenstrual tension syndrome (PMS). This is a specific condition that precedes menstruation and, to one degree or another, is characteristic of most women. When PMS hits, just try to calm down and control your actions. When your period starts, you will return to your normal state.

Premenstrual tension syndrome is associated with regular fluctuations in the level of hormones in the blood.

Previously, premenstrual syndrome was considered as psychological illness, until researchers proved that this condition is organic in nature, due to changes in the level of hormones in the body.

Increase the production of aldosterone, which causes a lot of changes in the body,
- increase the level of monoamine oxidase (a substance released in brain tissue that can cause depression),
- lower the level of (a substance released in the brain tissue that affects activity levels and mood).

For some women, PMS passes calmly, for others it is very violent, but the time of onset of symptoms is always predictable. This is what makes it possible to distinguish premenstrual tension syndrome from other diseases. Changes in emotional and physical condition appear 7-10 days before menstruation, and disappear almost immediately after the start of menstruation. These dates can be established by keeping a menstrual diary for several months, noting in it all the symptoms and dates of the beginning and end of menstruation.
If symptoms persist throughout your menstrual cycle, PMS may not be the cause. In this case, you should contact a psychiatrist.

Causes of premenstrual syndrome

The appearance of premenstrual tension syndrome in some women and its absence in others is associated primarily with fluctuations hormonal levels during the menstrual cycle and the individual reactions of the whole body to them. However, recently scientists have begun to investigate other possible causes of this condition (there is no definitive evidence yet):

Monthly cyclical fluctuations in the amount of certain substances (neurotransmitters) in the brain, which include endorphins, which affect mood,
- poor nutrition: symptoms of premenstrual syndrome such as mood swings, fluid retention in the body, increased breast sensitivity, fatigue are associated with B6 deficiency, while headaches, dizziness, palpitations and cravings for chocolate are caused by magnesium deficiency,
- hereditary factor. It has been proven that identical twins are much more likely to suffer from PMS together than fraternal twins. There may be a genetic predisposition to PMS.

Symptoms of premenstrual syndrome

Physical symptoms:

Increased sensitivity or even tenderness of the breasts,
- breast enlargement,
- fluid retention in the body, leading to swelling of the legs and arms and weight gain of about 2 kg,
- headaches, especially migraines,
- nausea, vomiting and dizziness,
- and joints and specific back pain,
- in some cases constipation, diarrhea,
- extreme thirst and frequent urination,
- cravings for food, especially salty or sweet foods, intolerance to alcohol,
- lethargy, fatigue or vice versa, energy,
- palpitations and flushing of the face,
- increase in the number of acne.

Psychological symptoms:

Frequent mood changes
- , blues, feeling of depression,
- constant tension and irritability,
- insomnia or prolonged sleep,
- absent-mindedness and forgetfulness.
Some women may experience more severe symptoms:
- panic
- thoughts of suicide
- aggressiveness, tendency to violence.

What can you do

Exercise. Study Shows Regular Exercise Reduces PMS Symptoms, Perhaps? this is due to the release of endorphins or other substances in the brain that relieve stress and improve mood.

Sleep 8-9 hours a day. Lack of sleep aggravates anxiety and other negative emotions, and increases irritability. If you suffer from insomnia, find a way to combat it. Deep breathing and others simple ways Relaxation before bed turns out to be very effective in many cases. Before going to bed, take a hot bath and drink a glass of warm milk.

Eat a diet that is low in fat and high in fiber. In PMS time Try to consume foods such as coffee, cheese and chocolate as little as possible. They have been linked to migraines and a host of other PMS symptoms, such as anxiety states, frequent changes mood and palpitations.

Don't eat a lot, limit sweets, it's better to take some fruit.

Maintain a constant level of insulin in the blood by eating small meals about 6 times a day, this is better than eating a large portion once. Try to eat healthy.

Nutritionists recommend taking vitamin B6 (50-100 mg) and magnesium (250 mg) daily in the form of food supplements. In addition, doctors prescribe additional calcium intake, which, together with magnesium, eliminates PMS symptoms and protects against osteoporosis, and iron (to fight anemia).

Many women say that primrose oil (a substance rich in important fatty acids). Check with your doctor about the dosage for you.

Stay away from crowds, don't go outside if the weather is bad, and get plenty of vitamin C (antioxidant and stimulant). immune system). Women suffering from PMS get sick more often. Scientists believe that this is a consequence of a weakened immune system before the onset of menstruation, which makes the body vulnerable to viral, bacterial and fungal infections.

What can a doctor do?

Since the causes of the disease are not fully understood, the treatment of PMS focuses on alleviating its symptoms:

For anxiety, insomnia, and other psychological symptoms, a doctor may prescribe tranquilizers or sedatives. However long-term use These medications are undesirable because they are addictive. Newer antidepressants have shown to be effective for PMS, but they must be taken under medical supervision.

For migraines associated with PMS, your doctor may prescribe special therapy aimed at preventing headache attacks. To relieve pain, most doctors prescribe non-steroidal anti-inflammatory drugs such as.

For swelling or other signs of fluid retention, diuretics are prescribed, which must be started 5-7 days before the start of menstruation.

In some cases, the doctor may prescribe progesterones and other hormones for PMS.

Prevention of PMS

Any disorder in the body, the causes of which are not clear, is difficult to prevent. At the moment the best way Control of a given situation is the ability to cope with it, not prevention.

Premenstrual syndrome (PMS) is the physical and emotional symptoms observed in women 1-2 weeks before menstruation. Symptoms different women often differ and stop when menstruation begins. Common symptoms are acne, breast tenderness, bloating, fatigue, anxiety, and mood changes. Symptoms often last for six days. Symptoms may change over time. During pregnancy or after menopause, symptoms disappear. The diagnosis of PMS requires the presence of a consistent pattern of emotional and physical symptoms between the period after ovulation and before the onset of menstruation, and the severity of these symptoms must be sufficient to interfere with the woman's normal functioning of daily life. Emotional symptoms should be absent at the beginning of the menstrual cycle. For diagnosis, keeping a diary of symptoms for several months can be used. Before making a diagnosis, other diseases that can cause similar symptoms should be excluded. The cause of PMS is unknown. Some symptoms may worsen if the diet contains high amounts of salt, or. It is believed that the basis of the PMS mechanism is a change hormonal levels. If symptoms are mild, women are advised to reduce their intake of salt, caffeine and stress levels, as well as increase physical activity. In some cases, taking supplements and may be helpful. WITH physical symptoms Anti-inflammatory drugs such as help fight. For more severe symptoms may be used contraception or . Up to 80% of women report having some symptoms before their period begins. In 20-30% of women, these symptoms qualify as PMS. (PMDD) is a more severe form of PMS with more pronounced psychological symptoms. PMDD affects three to eight percent of premenopausal women. In addition to the usual drugs used for PMS, classes of drugs can be used for PMDD. selective inhibitors serotonin reuptake.

Signs and symptoms

More than 200 cases have been associated with PMS various symptoms. Common emotional and nonspecific symptoms include stress, anxiety, difficulty falling asleep (insomnia), headache, fatigue, mood swings, increased emotional sensitivity and changes in libido. Physical symptoms associated with the menstrual cycle include bloating, lower back pain, abdominal cramps, constipation or diarrhea, swollen or tender breasts, cyclic acne, joint or muscle pain, and binge eating. Exact symptoms and their intensity is different for all women. One woman in different cycles Symptoms may vary and change over time. Most women with PMS experience only a few of the following: possible symptoms, and the onset of symptoms is relatively predictable.

Causes

Although PMS has been associated with the luteal phase, the exact causes of the syndrome are not clear, but it is clear that several factors may be involved in the pathogenesis. One important factor is hormonal changes during the menstrual cycle; these changes are more pronounced in some women than others. Chemical changes in the brain, stress and emotional problems such as depression do not cause PMS, but can make it worse. Low intake and minerals, high sodium intake and/or may worsen symptoms such as water retention and bloating. PMS is more common in women between 20 and 40 years of age; in women who have at least one child; in women with a family history of depression; and in women with a history of illness postpartum depression or mood disorder.

Diagnosis

Does not exist laboratory methods testing or unique physical examination methods to confirm the diagnosis of PMS. The three main signs of PSM include:

A woman's chief complaint is one or more emotional symptoms associated with PMS (most often irritability, tension or a feeling of unhappiness). If physical symptoms alone (bloating or abdominal pain) are present, PMS cannot be diagnosed.

Symptoms begin predictably during the luteal (premenstrual) phase and decrease or disappear predictably immediately before or during menstruation, and do not appear until before ovulation.

Symptoms must be severe enough to impair or interfere with everyday life women.

Often meets soft form PMS. More severe symptoms will indicate PMDD. PMS, unlike PMDD, is not listed in the Diagnostic and Statistical Manual, fourth edition. mental illness(DSM-IV). To diagnose PMDD, a doctor must ask a woman to keep a record of her symptoms for at least two menstrual cycles. This will help determine whether symptoms are limited to the premenstrual period, are predictable, and interfere with normal functioning women. A number of standardized tools have been developed to describe PMS, including the PMS calendar, perspective recording of the impact and severity of menstruation, and visual analog scales. Diagnosis must exclude other disorders that may be associated with the observed symptoms. A number of disorders tend to get worse during menstruation, which can lead to misdiagnosis of PMS. These disorders include anemia, hypothyroidism, disorders eating behavior and drug addiction. The key difference between these diseases and PMS is that they are observed not only in the luteal phase of the cycle. In the period before menstruation, diseases and symptoms such as depression or other affective disorders, migraines, epilepsy, fatigue, irritable bowel syndrome, asthma, and allergies may worsen. Diagnosis should exclude problems associated with other aspects of female reproductive system including dysmenorrhea (pain during menstruation rather than before it), endometriosis, perimenopause, and side effects oral contraceptives. National Institute mental health conducted a study in which he compared the intensity of symptoms observed from days 5 to 10 of the cycle with symptoms observed six days before the onset of menstruation. To be diagnosed with PMS, the intensity of symptoms must increase by at least 30% in the 6 days before menstruation. This pattern should be observed according to at least for two consecutive cycles.

Control

Various technologies have been used to treat PMS. Women with mild form PMS is recommended to reduce salt and caffeine intake, reduce stress levels and increase levels physical activity. In some cases, calcium and vitamin D supplements may be helpful. Anti-inflammatory drugs such as naproxen may be used to control physical symptoms. At severe symptoms Contraception may be used. Diuretics may be used to combat fluid retention. Some studies have demonstrated the effectiveness of spironolactone.

Antidepressants

For severe PMS, SSRIs such as and may be used. Women with PMS may only use these medications on days when symptoms are expected to occur. Although effective in some cases, intermittent therapy may be generally less effective than long-term treatment. Common side effects of SSRIs include nausea and weakness.

Hormonal agents

For PMS, medications are often used hormonal contraception; A combination of an oral contraceptive and a contraceptive patch is often used. For some women, this class of drugs can trigger symptoms associated with PMS, while for others it can reduce the physical manifestations of the syndrome. Hormonal drugs do not alleviate emotional symptoms Progesterone is very often used for PMS, but there is insufficient evidence to support this use. At severe form Gonadotropin-releasing hormone antagonists can be used in PMS, but such drugs themselves have significant side effects.

Alternative medicine

Forecast

PMS is generally a stable diagnosis. Women susceptible to PMS experience the same symptoms with the same intensity at the end of each cycle for many years. Treatment of specific symptoms is usually effective. Even without treatment, there is a reduction in symptoms during premenopausal age. However, women who suffer from PMS or PMDD are more likely to experience menopausal symptoms such as hot flashes.

Prevalence

Up to 80% of women of childbearing age report some symptoms in the days before their period. In 20-30% of women, these symptoms qualify as PMS, and in 3-8% - as a severe form of PMS.

Story

Initially, PMS was considered a fictitious disease, and women who had symptoms were told that “the cause was in their head.” It was believed that a woman's reproductive organs had complete control over her. Women were warned against wasting energy needed for the functioning of the uterus and ovaries. In the 19th century, it became obvious that this view did not correspond to reality: young girls in America worked in factories for long and difficult hours; Newspapers in the 19th century were literally full of reports of magical remedies for getting rid of “tyranny.” natural processes menstrual cycle. In 1873, Edward Clarke published a book that big influence for a generation, entitled "Sex in Education". Clarke concluded that female workers suffered less than schoolgirls because they “taxed their brains less.” Presumably, women engaged in manual labor have stronger and more developed bodies, and a more “normally designed” reproductive system. Feminists would later take a position contrary to Clark's view that women should not leave the home, demonstrating that women could function in the world outside the home. Formal medical description premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD) was realized 70 years ago in a paper presented at the New York Academy of Medicine by Robert T. Frankl entitled " Hormonal reasons premenstrual tension." The term "premenstrual syndrome" was first used in an article published in 1953 by Dalton and Greene in " Medical journal Great Britain". PMS has since become firmly entrenched in popular culture, but little research has been done on PMS as a medical diagnosis. Women are believed to be partly responsible for the medicalization of PMS. By legitimizing the disorder, women contribute to the idea of ​​PMS as a disease. It is also suggested that the hype around PMS and PMDD is influenced by organizations and people who may benefit from it, such as feminists, psychologists, doctors and scientists.

Alternative theories

Most proponents of PMS as a social concept believe that PMS and PMDD have little in common: PMDD is caused by chemical processes occurring in the brain, and cause of PMS– hypochondria. Most studies of PMS and PMDD draw data exclusively from women's reports. According to sociologist Carol Tavris, in the West, women find themselves in such a situation that they are aware of the disorder in advance and expect to experience its symptoms. Anthropologist Emily Martin states that PMS is a cultural phenomenon that continues to increase in the presence of positive feedback and thus represents a social concept that contributes to or serves as an aid to women's learned helplessness. convenient excuse. Tavrit argues that PMS serves as an explanation for anger or sadness in women. The decision to call PMDD a disease has been criticized as inappropriate medicalization. In both cases, we are talking about emotional aspects rather than normal physical symptoms.