Premenstrual syndrome - what is it? PMS: symptoms, treatment. What is PMS and how can you alleviate the condition of a woman during premenstrual syndrome
If suddenly you find yourself craving a sandwich with butter, or burst into tears of tenderness at the sight small child, or you're craving 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 so, then 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 sets in, try to just 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 tissues and capable of causing depression),
- lower the level (of a substance released in the tissues of the brain and affecting the level of activity and mood).
For some women, PMS is calm, for others it is very violent, but the timing of symptoms is always predictable. This is what distinguishes premenstrual tension syndrome from other diseases. Changes in the emotional and physical state appear 7-10 days before menstruation, and disappear almost immediately after the onset of menstruation. These dates can be set if you keep a menstrual diary for several months, noting in it all the symptoms and the dates of the beginning and end of menstruation.
If symptoms persist throughout menstrual cycle, perhaps PMS is not their cause. In this case, you should consult a psychiatrist.
Causes of premenstrual syndrome
The appearance of premenstrual tension syndrome in some women and its absence in others is associated primarily with hormonal fluctuations during the menstrual cycle and individual reactions of the whole organism to them. Recently, however, scientists have begun to explore other possible reasons this condition (no definitive evidence yet):
Monthly cyclic fluctuations in the amount of certain substances (neurotransmitters) in the brain, which include endorphins that affect mood,
- Not good nutrition: such symptoms before menstrual syndrome like mood swings, fluid retention, breast tenderness, fatigue are associated with B6 deficiency, while headaches, dizziness, palpitations and chocolate cravings are caused by magnesium deficiency,
- hereditary factor. It has been proven that identical twins are much more likely to suffer PMS together than fraternal twins. Perhaps there is a genetic predisposition to PMS.
Symptoms of premenstrual syndrome
Physical symptoms:
Increased sensitivity or even soreness of the breast,
- breast augmentation,
- 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,
- intense thirst and frequent urination,
craving for food, especially salty or sweet, intolerance to alcohol,
- lethargy, fatigue or vice versa, energy,
- palpitations and flushing of the face,
- an increase in the number of acne.
Psychological symptoms:
Frequent mood swings
-, spleen, feeling of depression,
- constant tension and irritability,
- insomnia or prolonged sleep,
- distraction and forgetfulness.
Some women may experience more severe symptoms:
- panic
- thoughts of suicide
- aggressiveness, propensity to violence.
What can you do
Do physical exercise. Research has shown that regular exercise reduces the symptoms of PMS, perhaps? this is due to the release of endorphins or other substances in the brain that relieve stress and elevate mood.
Sleep 8-9 hours a day. Lack of sleep exacerbates anxiety and other negative emotions, increases irritability. If you suffer from insomnia, find a way to deal with it. Deep breathing and more simple ways relaxation before sleep is in many cases very effective. Before going to bed, take hot baths and drink a glass of warm milk.
Eat a diet that is low in fat and high in fiber. In PMS time Try to eat foods like 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 drops mood and strong heartbeat.
Do not eat a lot, limit sweets, it is better to take some fruit.
Maintain a constant level of insulin in the blood for this, eat a little about 6 times a day, this is better than eating a large portion once. Try to eat right.
Nutritionists recommend daily as food additives consume vitamin B6 (50-100 mg) and magnesium (250 mg). In addition, doctors prescribe calcium supplementation, 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 with PMS are more likely to get sick. Scientists believe that this is a consequence of the weakening of the 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 drugs are undesirable due to the fact that they are addictive. Newer antidepressants have been shown to be effective for PMS, but they must be taken under medical supervision.
For migraines associated with PMS, the doctor may prescribe special therapy aimed at preventing headache attacks. To relieve pain, most doctors prescribe non-steroidal anti-inflammatory drugs, such as.
With edema or other signs of fluid retention, diuretics are prescribed, which must be started 5-7 days before the onset of menstruation.
In some cases, a doctor may prescribe progesterone and other hormones for PMS.
Prevention of PMS
Any violation in the body, the causes of which are not clear, is difficult to prevent. To date the best way control of this situation is the ability to cope with it, not prevention.
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 of the menstrual cycle. You can 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.
Especially often PMS appears at the end of the 3rd, beginning of the 4th decade of years. 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 total absence to a pronounced feeling of hunger), sleep disturbances (insomnia) and concentration of attention, the desire to isolate themselves from others, increased sensitivity to sounds and smells.
General somatic: headache, a feeling of fullness in eyeballs, pain in the heart area, general weakness, weight gain due to fluid retention, bloating, nausea, breast engorgement, pain in the joints and muscles, numbness of the hands, liquid stool or constipation.
Symptoms of PMS can manifest in various combinations and are characterized by different intensity, in connection with which there are mild (3–4 symptoms) and severe (5–12 manifestations) form of PMS. Sometimes the emotional and behavioral disorders of PMS make a woman unable to work; in such cases one speaks of 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, the manifestations of PMS persist for an increasingly long time.
Depending on the predominance of certain symptoms, PMS is divided into four forms: neuropsychic(emotional and behavioral symptoms prevail - see above), edematous(swelling of the face, shins, fingers, engorgement of the mammary glands come to the fore), cephalgic(headache, nausea, vomiting, dizziness) and crisis(in the form of seizures, palpitations predominate, a feeling of fear of death, increased blood pressure, limb numbness). The division of 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 an excess of estrogen. Later, the opinion was expressed about the decrease in progesterone in the second phase of the menstrual cycle. There is no doubt that the manifestations of PMS depend on the cyclic fluctuations of hormones. This is evidenced by the disappearance of the syndrome during pregnancy and the onset of 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, and general weakness. Supporters of the theory of "water intoxication" point to changes in the renin-angiotensin-aldosterone system, which plays an important role in the development hypertension. Many researchers consider primary neuro-hormonal disorders in the region of two very important brain structures - the hypothalamus (considering PMS as a manifestation of the hypothalamic syndrome) and the pituitary gland (the leading role is assigned to the melanostimulating hormone and its interaction with endorphins).
Difficult childbirth, abortions, stressful situations, infectious diseases, especially neuroinfections, overwork are triggering factors in the development of PMS. More often this syndrome occurs in women with pre-existing diseases of the 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 contribute to the development of PMS. The disease is more often observed in representatives of mental labor. The hereditary nature of the disease is traced.
Diagnosis of premenstrual syndrome
The symptoms of PMS are numerous. Therefore, often patients turn to a therapist and a neuropathologist. The treatment appears to be successful. This is due to the fact that after menstruation, the symptoms of the disease disappear. Then comes the disappointment in connection with the resumption of symptoms. The cyclicity of manifestations suggests PMS and serves as a reason for referring the patient to a gynecologist. Many experts recognize the following criteria for diagnosing PMS: the cyclicity (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; the symptoms must interfere with the quality of daily life.
A gynecologist must perform vaginal and rectal examination small pelvis, carefully examines the patient's complaints, taking into account her lifestyle, previous diseases. Significant benefits can be provided by a patient diary (calendar), which marks the dates of the onset and disappearance of symptoms, as well as the dates of menstruation. If necessary, determine the concentration of hormones in the blood, and the content of progesterone is determined in both phases of the menstrual cycle. X-rays of the skull, sella turcica and cervical spine, electroencephalography, electrocardiography, mammography (in the first phase of the cycle), consultation of an ophthalmologist (the condition of the fundus), a neuropathologist, and in some cases a psychiatrist. Additional examinations help to exclude other gynecological diseases and choose the most rational therapy.
Treatment of premenstrual syndrome Start with a normal diet and lifestyle changes. To get rid of flatulence and a feeling of fullness in the stomach, it is necessary to eat food often and in small portions. Limiting salty foods reduces fluid retention. The most useful carbohydrates are found in fruits, vegetables and whole grains. Calcium needs are best covered by dairy products rather than supplements. Drinks containing alcohol and caffeine should not be consumed. Dieting is especially important during the second phase of the menstrual cycle. There is evidence of a significant reduction in the risk of PMS with the use of increased amount B vitamins, but only from food sources. Physical exercises, visits to the gym are necessary. Useful brisk walking fresh air, swimming, skiing, etc. Physical education and sports should take place regularly. Massage and yoga classes are shown, which will teach you to relax muscles, breathe deeply and correctly. You need to set aside enough time for sleep.
Oral contraceptives inhibit ovulation, stabilize the concentration of sex hormones in the blood, and thus relieve the symptoms of PMS. In connection with hyperestrogenism (estrogens contribute to fluid retention), the appointment of progestogens (a group of hormones derived from progesterone), for example, duphaston, utrogestan, is indicated, which are prescribed for 10 days from the 16th day of the menstrual cycle. 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 the retention of sodium and water in the body and prevents the effects caused by estrogen, such as weight gain, breast engorgement. Drospirenone is especially effective in 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. With cephalgic and other forms of PMS, it is justified to prescribe drugs that improve metabolic processes in the brain, for example, nootropil and aminalon.
Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, etc.) relieve symptoms such as breast engorgement, headache.
Of the diuretics, preference is given to veroshpiron (aldosterone antagonist), which is prescribed 4 days before the onset of symptoms (the date helps to determine the patient's diary), the reception is continued until menstruation.
This information is provided for informational purposes only and should not be used for self-treatment.
Remember that with manifestations of PMS cannot be tolerated, because they often worsen the quality of life and lead to disability. Lifestyle change and drug therapy effective in the treatment of this disease.
The nervous state of a woman before menstruation has become an object of ridicule from men. Premenstrual syndrome (PMS) “spoils” the lives of both, often being the cause of quarrels in a couple and quarrels in the family. Therefore, what is PMS in girls, men should also know.
Women who have experienced all the “charms” of PMS know for sure that this is not a series of whims, but a really difficult condition. However, only a few of them are able to cope with the manifestations of hormonal changes in the body. modern medicine makes it possible: the observance of certain rules and the use safe drugs will help to survive the premenstrual period without shocks 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 constitutes premenstrual syndrome, 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 world medical community recognizes this deviation.
- Does PMS happen to all women?
Every second woman faces premenstrual syndrome. Moreover, the incidence of PMS and the severity of its symptoms increases with age. So, up to 30 years, 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 cause of PMS are not always justified. In some women, changes in the levels of the hormones progesterone and estrogen are not as significant. Closest to the truth is the theory of a temporary change in neuroregulation.
- How many days before menstruation do PMS symptoms appear?
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 is individual. However, all painful sensations necessarily stop in the first days of menstruation.
- Do you have to endure premenstrual syndrome?
Not at all necessary. To alleviate menstrual syndrome, several rules have been developed for the daily routine and nutrition. Also, in case of its pronounced 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. In others, on the contrary, unpleasant symptoms disappear or weaken (especially swelling and soreness of the breast) after the birth of the child.
Important! PMS and menstruation are always connected: painful symptoms disappear after the onset of bleeding.
Most often, premenstrual syndrome occurs in smokers (the probability of PMS is doubled!), women with a weight index over 30 (divide your kg by your height squared in meters). Also, the risk increases after abortion and complicated childbirth, after gynecological operations. A genetically determined reaction of the body to physiological changes before menses. However, PMS is most often recorded in depressive (phlegmatic) and emotionally labile (choleric) ladies.
Typical symptoms of PMS
It is unlikely that there will be women with the same picture of PMS: there are about 150 signs of premenstrual syndrome. However, in such a variety of characters, the main groups can be distinguished. Symptoms of PMS in women:
- Deviations from the nervous system and psyche
The mood of a woman can be called in one word - negative. She may cry for nothing or for no reason at all. Ready to “tear to shreds”, the degree of aggression also does not coincide much with the offense inflicted. At best, a woman is in depressed state and experiences irritability, which he cannot always cope with.
- Hormonal changes
Because of advanced level progesterone for 1-2 weeks. before menstruation, a woman noticeably increases and engorges the mammary glands. Many women on given period A bra size larger than normal is required. The bursting soreness in the chest can be so intense that ordinary walking causes discomfort.
In some ladies, veins protrude on the skin of the mammary glands. At the same time, swelling of the hands and face can be observed, and swelling on the legs at the end of the day becomes more noticeable. Often, an increase in temperature to 37.0-37.2ºС is recorded. Often the stomach increases in size due to the accumulation of gases and constipation.
- Autonomic disorders
During PMS, a throbbing headache often occurs, radiating to the eye area. Attacks are similar to migraines, sometimes accompanied by nausea and vomiting, but the pressure remains normal.
PMS after 40 years hormonal changes aggravated by concomitant diseases, often provokes rises in pressure in the evenings (hypertensive crisis), tachycardia (palpitations), 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 excessive 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, irradiation to the lower back is 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 vit. B6 and magnesium;
- rejection of strong odors, even your own perfume.
Severe PMS is diagnosed in the presence of pronounced 5-12 symptoms.
Premenstrual syndrome can proceed according to the following scenarios:
- Compensation stage - the signs of PMS are not very pronounced, they disappear immediately with the onset of menstruation. The course is stable, progression of symptoms over the years is not observed.
- Stage of subcompensation - 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 a few days after the end of menstrual bleeding. Women have panic attacks, suicidal thoughts are not uncommon. During PMS women they often show violence, especially towards their children (they beat them severely).
At severe symptoms PMS is allowed to issue a sick leave. However, severe premenstrual syndrome can be a reason for refusal when applying for a job. In European countries, upon divorce, if ex-wife pronounced PMS is observed, children can 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 some time for menstruation. However, according to some signs, pregnancy can be assumed:
- Only during pregnancy there is a perversion of taste. In addition to cravings for salty or sweet, as with PMS, a pregnant woman refuses her previously favorite food and expresses an acute desire to consume chalk, earth. There may be an addiction, for example, to fat, which the woman could not bear before.
- Pungent odors in a pregnant woman also cause a negative reaction. In addition, a pregnant woman may experience olfactory "hallucinations": a specific smell appears in the wrong place.
- The pain in the lower abdomen during the onset of pregnancy is less straining, occurs periodically and has a softer, pulling character. Lower back pain appears only when there is a threat of miscarriage or for more later dates pregnancy.
- Mood swings can occur as early as the first weeks of pregnancy, which coincides in time with PMS period. However, a pregnant woman expresses positive emotions as violently as anger. The premenstrual period is characterized by a negative emotional reaction.
- Rapid fatigue occurs closer to 1 month. pregnancy (approximately 2 weeks delay in menstruation).
- PMS ends with the onset of menstruation. At the same time, there is a complete uterine bleeding. Sometimes during pregnancy also appear bloody issues on the days when menstruation should occur. The difference between bleeding during pregnancy and menstruation is a smearing character: only a few drops of blood are released, and the discharge is pink or brownish.
- Only during pregnancy, frequent urination is often observed from the first weeks. For PMS, this symptom is not typical.
- Nausea can be triggered by premenstrual syndrome and is observed throughout the day. During pregnancy, nausea and vomiting occur a little later, for 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 onset of the expected menstruation. However, the optimal time for the test is the 2nd day of the delay in menstruation 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 help to cope with PMS without drug therapy:
- Full sleep for at least 8 hours. Walking and breathing exercises will help improve 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.
- Correction of nutrition - the rejection of sweet and fatty, the saturation of the diet with fruits and vegetables. Coffee, alcohol, energy drinks and chocolate irritate the nervous system. These products should be excluded for the period of PMS.
- Regular sex is a source of oxytocin (the hormone of happiness). In addition, the uterus relaxes, spastic pains disappear. Don't drown out the high sexual desire: nature itself suggests what the body needs.
- Hold on to your emotions. The best tactic for the premenstrual period - I'll think about it later. Of course, you should not ignore the serious negative that coincided 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 in the future can develop into a family conflict.
In severe cases, a woman is prescribed drug therapy:
- Pain with PMS, what to do? - let's say No-shpy. However, you should not get carried away with this drug. Having an antispasmodic effect, No-shpa in large doses may increase menstrual bleeding. Good analgesic effect NSAID preparations(Ibuprofen, Naproxen). It is worth remembering: Ibuprofen (Nurofen, Mig-400) is not recommended for women over 40 due to negative impact on the heart.
- Soreness in the chest and swelling - easily eliminated by taking diuretics (Veroshpiron 25 mg, Furosemide 40 mg).
- Multivitamins - will compensate for the lack of magnesium, calcium and vit. AT 6. Excellent tool with PMS is the drug Magne-B6, the reception lasts 1 month. followed by a repeat course. good effect gives homeopathic remedy Mastodinon and saffron decoction.
- Removal of excitation of the nervous system - most often used herbal preparations(Novo-Passit, Persen). Mixed tinctures of valerian and motherwort will help reduce stress and improve sleep, take 15-25 caps. 2-3 times a day or only an hour before bedtime. In severe cases, a tranquilizer Afobazol is prescribed, which effectively eliminates the state of 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 on prescription!
- Hormonal agents - for stabilization hormonal level and leveling the symptoms of PMS, oral contraceptives (Midiana, Yarina) are used, the course is 3 months, followed by repetition. Prevents engorgement of the glands and swelling of the progestogen drug Drospirenone (Anabella, Angelik, Vidora).
Premenstrual syndrome is not to be tolerated. The condition with PMS, especially in women with an unstable psyche and neurosis, may worsen over time, which ultimately will negatively affect the quality of life and working capacity.
It is also worth remembering that diseases of the genital area, endocrine disorders(including hypo- and hyperthyroidism) only exacerbate the course of premenstrual syndrome. Their treatment, adherence to recommendations for lifestyle changes and, if necessary, medicines help to cope even with severe PMS.
Premenstrual syndrome (PMS) (also called premenstrual tension, cyclical or premenstrual sickness) is a complex of physical and mental symptoms that are cyclical in nature and occur a few days before the onset of menstruation. This specific condition is caused by the pathological course of the second phase of the menstrual cycle, which is characteristic of most women.
It was found that the risk of developing PMS increases over the years. According to statistics, urban women are more susceptible to this disease than rural ones. About ninety percent of women reproductive age observe in themselves some changes in the body that occur before the approach of menstruation, usually seven to ten days before it begins. In some women, these manifestations of symptoms are mild and do not affect everyday life (mild form PMS), respectively, do not require treatment, but in others (such as about 3-8%), the symptoms appear in a severe form that requires mandatory medical intervention. The fact that the manifestation of certain symptoms is cyclical makes it possible to distinguish PMS from other diseases.
Changes of an emotional and physical nature in the state of a woman before menstruation pass almost immediately after they begin. If symptoms are observed throughout the entire menstrual cycle, you should consult a doctor, since the cause of this condition may not be PMS at all, but more serious illness. In this case, a consultation with a psychiatrist is recommended.
Causes of premenstrual syndrome.
More recently, premenstrual syndrome was considered a disorder. psychological nature, until it was proven that it is based on a change in the level of hormones in the body. The presence or absence of premenstrual tension syndrome in women is due to fluctuations in the hormonal background during the menstrual cycle and various reactions on them the body of each of the fair sex.
The most common causes of PMS are:
- Violation water-salt metabolism.
- hereditary predisposition.
- Frequent stressful and conflict situations in the family (in most cases, PMS develops in women of a certain mental make-up: overly irritable, thin, taking care of their health too much).
- Hormonal failures, namely, a violation of the level of the hormones estrogen and progesterone in the second phase of the menstrual cycle (the level of estrogen increases with a lack of function corpus luteum with a decrease in the level of progesterone, which affects the nervous and emotional state of a woman).
- Increased secretion of the hormone prolactin, against which changes occur in the mammary glands.
- Various diseases of the thyroid gland.
- Inadequate nutrition: lack of vitamin B6, as well as zinc, magnesium, calcium.
- Cyclical fluctuations in the level of certain substances (neurotransmitters) in the brain (particularly endorphins) that affect mood.
As mentioned earlier, with the onset of menstruation, the symptoms of PMS completely disappear or significantly decrease. There are several main forms of PMS that have pronounced symptoms:
- Psychovegetative form in which PMS manifests itself in the form of forgetfulness, excessive irritability, conflict, resentment, often tearfulness, there is also weakness, fatigue, drowsiness or insomnia, constipation, numbness of the hands, decreased sexual desire, unpredictable outbursts of anger or depression, sensitivity to smells, flatulence. It has been noted that most often in young women of reproductive age, premenstrual tension syndrome is expressed in the form of bouts of depression, and in adolescents in transitional age aggressiveness prevails.
- edematous form of PMS, characterized most often by engorgement and soreness of the mammary glands, as well as swelling of the fingers, face, legs, slight weight gain, itchy skin, acne, muscle pain, weakness, sweating, bloating.
- Cephalgic form of PMS, with this form, the main symptoms of manifestation are headaches, dizziness, fainting, increased irritability, nausea and vomiting. I note that headaches in this form can be paroxysmal, accompanied by swelling and redness of the face.
- "Crisis" form, in which symptoms of the so-called "panic attacks" are observed - an increase in blood pressure, increased heart rate, attacks of compression behind the sternum, the presence of fear of death. Mostly similar condition worries women with this form of PMS in evening time or at night. Basically, this form is observed in women in the premenopausal period (aged 45-47 years). In most cases, patients with a crisis form of PMS have diseases gastrointestinal tract, kidney and cardiovascular system.
- Atypical form of PMS accompanied by an increase in body temperature up to 38 ° C with migraine attacks on the days of menstruation, ulcerative gingivitis and stomatitis, asthma attacks before and during menstruation.
- The combination of several forms of PMS at once (mixed). As a rule, there is a combination of psychovegetative and edematous forms.
- The mild form is characterized by the manifestation of three to four symptoms, one or two of which prevail.
- The severe form is expressed in the simultaneous manifestation of five to twelve symptoms, in which two to five symptoms are most pronounced.
Stages of premenstrual syndrome.
There are three stages of PMS:
- compensated, in which the severity of the symptoms of the disease is insignificant, with the onset of menstruation, the symptoms disappear, while the disease does not develop with age;
- subcompensated, which has pronounced symptoms that affect the woman's ability to work, and over the years, the manifestations of PMS only get worse;
- decompensated stage, expressed in a severe manifestation of symptoms that persist for several days after the end of menstruation.
Since the symptoms of the manifestation of premenstrual syndrome are quite extensive, some women confuse it with other diseases, often seeking help from the wrong specialists (therapist, neurologist, psychiatrist). Only a thorough examination can reveal the cause of the disease.
Diagnosis of premenstrual syndrome.
To make a diagnosis, the doctor examines the patient's history and listens to existing complaints. The cyclicity of attacks of the disease is the first sign of PMS.
To diagnose the disease, blood tests for hormones made in both phases of the menstrual cycle (prolactin, estradiol, progesterone) are examined. Depending on the form of PMS hormonal characteristics patients are different. For example, with the edematous form of PMS, there is a decrease in the level of progesterone in the second phase of the cycle, with neuropsychic, cephalgic and crisis forms, the level of prolactin in the blood increases.
After that, taking into account the form and complaints of the patients, additional studies are carried out (mammography, MRI, blood pressure control, electroencephalography, measurements of daily diuresis, etc.) with the involvement of other specialists (endocrinologist, neuropathologist, therapist, psychiatrist).
For the most accurate diagnosis of the disease, as well as to identify the dynamics of the treatment, experts recommend that all patients with PMS every day write down their complaints in detail in a kind of diary.
Treatment of premenstrual syndrome.
Treatment is carried out in a complex, regardless of the form of the disease.
To eliminate psycho-emotional manifestations, psychotropic and sedatives: sedatives Seduxen, Rudotel and antidepressants Tsipramin, Koaksil. These drugs are recommended to be taken for two months in both phases of the menstrual cycle.
To normalize the levels of sex hormones, hormonal preparations are prescribed:
- gestagens (Utrozhestan and Duphaston) during the second phase of the menstrual cycle;
- monophasic combined oral contraceptives (Zhanin, Logest, Yarina and others), which are well tolerated by patients, are suitable for all women of reproductive age in the absence of contraindications;
- androgen derivatives (Danazol) if present severe pain in the mammary glands;
- women in the premenopausal period are prescribed aGnRH (gonadotropin-releasing hormone agonists) - Zoladex, Buserelin, which block the functioning of the ovaries, excluding ovulation, thereby eliminating the symptoms of PMS.
Symptomatic therapy is carried out in the form additional treatment carried out to the main, in order to quickly eliminate the symptoms of PMS: non-steroidal anti-inflammatory drugs (Indomethacin, Diclofenac) and antihistamines (allergic reactions) - Tavegil, Suprastin.
Often prescribed for the treatment of premenstrual syndrome homeopathic preparations, in particular Mastodinon and Remens are vegetable not hormonal agents, the effect of which extends directly to the cause of PMS. In particular, they normalize the imbalance of hormones, reducing the manifestations of a psychological disease (irritability, anxiety and fear, tearfulness). Mastodinone is often recommended for the edematous form of the disease, including chest pain. It is prescribed for taking thirty drops twice a day, which are diluted with water, for three months. If the drug is in the form of tablets, then one tablet twice a day. The drug Remens is also taken for three months, ten drops, or one tablet three times a day. Both drugs have practically no contraindications: oversensitivity to the components of drugs, age restrictions - up to 12 years, pregnancy and lactation.
If the cause of the development of PMS was a lack of B vitamins and magnesium, then vitamins of this group (Magne B6), as well as calcium for the prevention of osteoporosis and iron in the fight against anemia, are prescribed.
The course of treatment averages from three to six months, depending on the severity of the disease.
Self-treatment of premenstrual syndrome.
To speed up the healing process, as well as quick rehabilitation, it is necessary to lead a certain lifestyle:
- Proper nutrition - limit the consumption of coffee, salt, cheese, chocolate, fats (they provoke the occurrence of such manifestations of PMS as migraine), include fish, rice, sour-milk products, legumes, vegetables, fruits, greens in the diet. To maintain the level of insulin in the blood, it is recommended to eat at least five to six times a day in small portions.
- Playing sports - two to three times a week, which helps to increase the level of endorphins that improve mood. However, you should not abuse the loads, since their excessive amount only exacerbates the symptoms of PMS.
- It is necessary to monitor your emotional state, try not to be nervous, avoid stressful situations Get enough sleep (at least eight to nine hours of good sleep).
- As aid it is recommended to use herbal medicine: tincture of motherwort or valerian thirty drops three times a day, warm chamomile tea, green tea with mint.
- It is recommended to take as much vitamin C as possible. It has been proven that women with PMS get sick more often, this is due to the weakening of the immune system before menstruation, which makes it vulnerable to viral and bacterial infections.
The lack of timely treatment threatens the transition of the disease to a decompensated stage, characterized by severe depressive disorders, complications of a cardiovascular nature (high blood pressure, palpitations, pain in the heart). In addition, the number of asymptomatic days between cycles decreases over time.
PMS prevention.
- systematic reception oral contraceptives in the absence of contraindications;
- healthy lifestyle;
- regular sex life;
- exclusion of stressful situations.
Doctors have long puzzled over the causes of women's malaise before menstruation. Some healers associated it with the phases of the moon, others with the area in which the woman lives.
The condition of the girl before menstruation remained a mystery for a long time. Only in the twentieth century the veil of secrecy was slightly opened.
PMS is a mix of 150 different physical and mental symptoms. To one degree or another, about 75% of women experience manifestations of premenstrual syndrome.
How long does PMS last for girls? Unpleasant symptoms begin to appear 2-10 days before the onset of menstruation, and disappear with the advent of the "red" days of the calendar.
- Crime chronicle. PMS is not only shattered nerves and broken plates. Most traffic accidents, crimes, thefts committed by women occurred between the 21st and 28th days of the menstrual cycle.
- Shopping therapy. According to research, a few days before menstruation, women are most susceptible to the temptation to buy as much as possible.
- PMS symptoms are more prone to women engaged in mental work and residents of large cities.
- The term PMS was first used by Robert Frank, an obstetrician-gynecologist from England.
Why does premenstrual syndrome occur?
Numerous studies do not allow to identify the exact causes of premenstrual syndrome. There are many theories of its occurrence: “water intoxication” (violation of water-salt metabolism), allergic nature (increased sensitivity to endogenous), psychosomatic, hormonal, etc.
But the most complete is the hormonal theory, which explains the symptoms of PMS by fluctuations in the level of sex hormones in the 2nd phase of the menstrual cycle. For the normal, harmonious functioning of a woman's body, the balance of sex hormones is very important:
- - they improve physical and mental well-being, increase tone, creativity, speed of assimilation of information, learning abilities
- progesterone - renders sedative effect, which may give rise to depressive symptoms in phase 2 of the cycle
- androgens - affect libido, increase energy, performance
During the second phase of the menstrual cycle, a woman's hormonal levels change. According to this theory, the cause of PMS lies in the “inadequate” reaction of the body, including the brain regions responsible for behavior and emotions, to cyclic changes in hormonal levels, which is often inherited.
Since the days before menstruation are endocrine unstable, many women experience psychovegetative and somatic disorders. In this case, the decisive role is played not so much by the level of hormones (which can be normal), but by fluctuations in the content of sex hormones during the menstrual cycle and how the limbic parts of the brain responsible for behavior and emotions react to these changes:
- an increase in estrogen and first an increase, and then a decrease in progesterone- hence the retention of fluids, swelling, engorgement and soreness of the mammary glands, cardiovascular disorders, irritability, aggression, tearfulness
- hypersecretion - also leads to fluid retention, sodium in the body
- excess prostaglandins- , digestive disorders, migraine-like headaches
The most likely factors affecting the development of the syndrome, on which the opinions of physicians do not differ:
- Decreased serotonin levels- this is the so-called "hormone of joy", can be the cause of the development mental signs premenstrual syndrome, since a decrease in its level causes sadness, tearfulness, melancholy and depression.
- Vitamin B6 deficiency- Symptoms such as fatigue, fluid retention in the body, mood changes, and breast hypersensitivity indicate a lack of this vitamin.
- Magnesium deficiency – Magnesium deficiency can cause dizziness, headaches, cravings for chocolate.
- Smoking. smoking women twice as likely to have premenstrual syndrome.
- Overweight . Women with a body mass index over 30 are three times more likely to suffer from PMS symptoms.
- genetic factor- it is possible that the features of the course of premenstrual syndrome are inherited.
- , complicated childbirth, stress, surgical interventions, infections, gynecological pathologies.
The main symptoms and manifestations of premenstrual syndrome
Groups of symptoms in PMS:
- Neuropsychiatric disorders: aggression, depression, irritability, tearfulness.
- Vegetovascular disorders: changes in blood pressure, headache, vomiting, nausea, dizziness, tachycardia,.
- Metabolic and endocrine disorders: swelling, fever, chills, breast engorgement, itching, flatulence, shortness of breath, thirst, memory loss,.
PMS in women can be conditionally divided into several forms, but their symptoms usually do not appear in isolation, but are combined. In the presence of psycho-vegetative manifestations, especially depression, in women, the pain threshold and they are more sensitive to pain.
neuropsychic |
crisis form |
Atypical manifestations of PMS |
Violations in the nervous and emotional spheres:
|
Most women have diseases of the cardiovascular system, kidneys, and gastrointestinal tract. |
|
edematous form |
Cephalgic form |
|
There is a negative diuresis with fluid retention. |
Leading mainly neurological and vegetative-vascular manifestations:
The family history of women with this form is aggravated by hypertension, cardiovascular diseases, and gastrointestinal diseases. |
PMS is different for every woman, and the symptoms vary greatly. According to the results of some studies, women with PMS have the following frequency of manifestation of one or another sign of PMS:
| Symptom | frequency % |
Hormonal theory of PMS |
| irritability | 94 | |
| soreness of the mammary glands | 87 | |
| bloating | 75 | |
| tearfulness | 69 | |
|
56 | |
|
50 | |
|
44 | |
|
37 | |
|
19 | |
| vomit | 12 | |
| constipation | 6 | |
| back pain | 3 |
Premenstrual syndrome can aggravate the course of other diseases:
- Anemia (see)
- (cm. )
- Thyroid diseases
- chronic fatigue syndrome
- Bronchial asthma
- allergic reactions
- Inflammatory diseases of the female genital organs
Diagnosis: what can masquerade as manifestations of PMS?
Since dates and dates are easily forgotten, in order to make it easier for yourself, you should keep a calendar or diary where you write down the start and end dates of menstruation, ovulation ( basal body temperature), weight, symptoms that bother. Keeping such a diary for 2-3 cycles will greatly simplify the diagnosis and allow you to trace the frequency of PMS symptoms.
The severity of premenstrual syndrome is determined by the number, duration and intensity of symptoms:
- Mild: 3-4 symptoms, or 1-2 if severe
- Severe form: 5-12 symptoms or 2-5, but very pronounced, and also regardless of the duration and their number, if they lead to disability (usually neuropsychic form)
The main feature that distinguishes premenstrual syndrome from other diseases or conditions is cyclicity. That is, a deterioration in well-being occurs a few days before menstruation (from 2 to 10) and completely disappears with their arrival. However, unlike psycho-vegetative, physical discomfort in the first days of the next cycle can intensify and smoothly turn into disorders such as menstrual migraine.
- If a woman feels relatively well in the 1st phase of the cycle, then this is premenstrual syndrome, and not chronic illness- neurosis, depression,
- If the pain appears only immediately before and during menstruation, especially when combined with - this is most likely not PMS, but other gynecological diseases -, chronic endometritis, dysmenorrhea (painful menstruation) and others.
To establish the form of the syndrome, hormone studies are carried out: prolactin, estradiol and progesterone. The doctor may also prescribe additional diagnostic methods, depending on the prevailing complaints:
- With severe headaches, dizziness, decreased vision and fainting, it is prescribed CT scan or MRI to rule out organic brain disease.
- With an abundance of neuropsychiatric diseases, an EEG is indicated to exclude the epileptic syndrome.
- With severe edema, changes in the daily amount of urine (diuresis), tests are performed to diagnose the kidneys (see).
- With severe and painful engorgement of the mammary glands, it is necessary to conduct an ultrasound of the mammary glands and mammography to exclude organic pathology.
Conducts a survey of women suffering from PMS, not only a gynecologist, but also involved: psychiatrists, neurologists, endocrinologists, nephrologists, cardiologists and therapists.
Premenstrual syndrome or pregnancy?
Some symptoms of PMS are similar to those of pregnancy (see). After conception, the content of the hormone progesterone in a woman’s body increases, which also happens during PMS, so the following symptoms are identical:
- fast fatiguability
- swelling and soreness of the breast
- nausea, vomiting
- irritability, mood swings
- lower back pain
How to distinguish pregnancy from PMS? Comparison of the most common symptoms of premenstrual syndrome and pregnancy:
| Symptoms | Pregnancy | Premenstrual syndrome |
|
accompanies the entire pregnancy | Pain goes away with menstruation |
|
the attitude to food changes, you want inedible, salty beer, something that a woman usually does not like, the sense of smell is greatly aggravated, ordinary smells can be very annoying | can crave sweet and savory, sensitivity to odors |
|
only late | may have back pain |
|
starts 4-5 weeks after conception | can appear both immediately after ovulation, and 2-5 days before menstruation |
| mild, short-term pain | individually in each case | |
|
frequent mood swings, tearfulness | irritability |
|
Maybe | No |
|
from 4-5 weeks after conception | possible nausea, vomiting |
The signs of both conditions are very similar, so it’s not easy to understand what exactly happens in a woman’s body and distinguish pregnancy from PMS:
- The easiest way to find out what caused poor health is to wait for the onset of menstruation.
- If the calendar is already late, you should take a pregnancy test. A pharmacy test will give reliable results only with a delay in menstruation. It is sensitive to the pregnancy hormone (hCG) excreted in the urine. If you do not have enough patience and nerves to wait, you can take a blood test for hCG. It shows almost one hundred percent result on the tenth day after conception.
- The best option to find out what is bothering you - PMS syndrome or pregnancy - is to visit a gynecologist. The doctor will assess the condition of the uterus and, if pregnancy is suspected, will prescribe an ultrasound.
When to See a Doctor
If the manifestations of premenstrual syndrome significantly reduce the quality of life, affect the ability to work and have a pronounced character, treatment is indispensable. After a thorough examination, the doctor will prescribe drug therapy and will give the necessary recommendations to alleviate the course of the syndrome.
How can a doctor help?
In most cases, treatment is symptomatic. Depending on the form, course and symptoms of premenstrual syndrome, a woman needs:
- Psychotherapy - mood swings, irritability, depression, from which both a woman and loved ones suffer, are corrected by methods of stabilizing behavioral techniques and psycho-emotional relaxation, .
- For headaches, pain in the lower back and abdomen, non-steroidal anti-inflammatory drugs are prescribed for temporary relief pain syndrome(, Nimesulide, Ketanov, see).
- Diuretics for excretion excess fluid from the body with edema (see).
- Hormone therapy is prescribed for insufficiency of the second phase of the cycle, only after tests functional diagnostics, based on the results of the identified changes. Apply gestagens - Medroxyprogesterone acetate from 16 to 25 days of the cycle.
- are prescribed for a variety of neuropsychic symptoms (insomnia, nervousness, aggressiveness, anxiety, panic attacks, depression): Amitriptyline, Rudotel, Tazepam, Sonapax, Sertraline, Zoloft, Prozac, etc. in the 2nd phase of the cycle after 2 days from the onset of symptoms.
- With crisis and cephalgic forms, it is possible to prescribe Parlodel in the 2nd phase of the cycle, or if prolactin is elevated, then in a continuous mode, it has a normalizing effect on the central nervous system.
- With cephalgic and edematous forms, antiprostaglandin drugs are recommended (Indomethacin, Naprosin) in the second phase of the menstrual cycle.
- Since women often have elevated levels of histamine and serotonin with PMS, the doctor may prescribe 2nd generation antihistamines (see) 2 days before the expected worsening of the condition at night before the 2nd day of menstruation.
- To improve blood circulation in the central nervous system, it is possible to use Grandaxin, Nootropil, Aminolone for 2-3 weeks.
- In the crisis, cephalgic and neuropsychic form, drugs are indicated that normalize neurotransmitter metabolism in the central nervous system- Peritol, Difenin, the doctor prescribes the drug for a period of 3-6 months.
- Homeopathic preparations Remens or Mastodinone.
What can you do?
- Full sleep
Try to sleep as much as your body has time to fully rest, usually 8-10 hours (see. Lack of sleep leads to irritability, anxiety and aggression, negatively affects the immune system. If you suffer from insomnia, try walking before bed, breathing technology.
- aromatherapy
In the absence of allergies, compositions of specially selected aromatic oils are a good weapon against PMS symptoms. Geranium, rose and will help normalize the cycle. Lavender and basil effectively fight spasms. Juniper and bergamot are uplifting. Baths with aromatic oils start taking two weeks before your period.
Hiking, running, Pilates, body flex, yoga, dancing are a great way to treat symptoms of premenstrual syndrome in women. Regular exercise increases endorphin levels, which can help fight depression and insomnia, as well as reduce the severity of physical symptoms.
- Take vitamin B6 and magnesium two weeks before your period
Magne B6, Magnerot, as well as vitamins E and A - this will make it much more effective to deal with such manifestations of PMS as: heart palpitations, heart pain, fatigue, insomnia, anxiety and irritability.
- Nutrition
Eat more fruits and vegetables, high-fiber foods, and include calcium-rich foods in your diet. Temporarily limit the use of coffee, chocolate, cola, as caffeine increases mood swings, irritability, anxiety. The daily diet should include 10% fat, 15% protein and 75% carbohydrates. Fat intake should be reduced, as well as beef, some types of which contain artificial estrogens. Useful herbal teas, freshly squeezed juices, especially carrot and lemon. It is better not to drink alcohol, it depletes reserves mineral salts and vitamins of group B, disrupts the metabolism of carbohydrates, reduces the ability of the liver to utilize hormones.
- Relaxation practices
Avoid stress, try not to overwork and maintain a positive mood and thinking, relaxation practices help with this - yoga, meditation.
- Regular sex
It helps fight insomnia, stress and bad mood, increase the level of endorphins, strengthen the immune system. At this time, many women increase their sexual appetite - why not surprise your partner and try something new?
- medicinal plants
They can also help alleviate the symptoms of premenstrual syndrome: Vitex - relieves heaviness and pain in the mammary glands, Primrose (evening primrose) - from headaches and swelling, - an excellent antidepressant, normalizes libido, improves well-being and reduces fatigue.
Balanced diet, adequate exercise stress, vitamin supplements, healthy sleep, regular sex, a positive attitude towards life will help alleviate the psychological and physical manifestations of premenstrual syndrome.
