There is pms. Premenstrual syndrome or PMS in women - symptoms and treatment

We talk all the time about how embarrassed we are when we yell and get irritated with children, but if, for example, you are sick, then it is doubly difficult to maintain composure. Just imagine, you are sick with the flu, do you have children jumping on your head? Most likely, the partner understands that the flu is a serious illness, and will try to take care of the children. With PMS, the story is quite different. Premenstrual syndrome is usually perceived as a kind of "female hysteria", some kind of "women's stuff." "What are your days?" - a classic sexist argument in any conflict between a man and a woman. In fact, PMS is not nonsense or whims at all, but a serious disease that requires intervention and treatment. Yes - it is very difficult for a woman suffering from PMS to be understanding and calm, because she does not feel well. Psychiatrist Sergey Kistenev said on his blog why PMS is serious and what to do about it.

Modern ideas and tactics of conducting

Many women of reproductive age experience irritability, weakness, outbursts of aggression or depression about once a month. According to some reports, up to 40% of women experience certain inconveniences in the second phase of the cycle. Some of them have reconciled and consider it their "highlight", but most still feel significant discomfort. As you may have guessed, we will talk about PMS.

Premenstrual syndrome (PMS) is a real disorder that needs to be diagnosed and treated, and not hushed up and waiting for menopause as a relief.

Premenstrual syndrome is a complex psychoendocrine disorder that affects a woman's emotional and physical well-being. In a broad sense, PMS is a combination of emotional, behavioral and somatic disorders that begin in the luteal (prior to menstruation) phase of the menstrual cycle and end with the onset of menstruation. Quite unpleasantly, premenstrual dysphoric syndrome (PMSD) proceeds - a variant of the severe course of PMS, in which mood and behavior disorders can turn into aggression.

How do you know if you have PMS?

• First, if you've never thought about it, most likely not.
• Secondly, you can refer to the options for the course of PMS.

Clinical classification of PMS

Clinical classification according to the forms of premenstrual syndrome, which quite fully describes the possible variants of clinical manifestations, is given below.

Neuropsychic form (dysphoric)

The clinic is dominated by mood disorders, aggressiveness, irritability, depression, apathy, tearfulness.

edematous form

Characterized by the formation of edema, fluid retention, bloating, swelling of the mammary glands.

Cephalgic form

Patients complain of headaches, increased sensitivity to light and sound, depressed mood, headache, which is sometimes accompanied by nausea and vomiting.

crisis form

Reminds me of panic attacks. A woman may experience acute fear, which is accompanied by sweating, tachycardia, chest pain.

The frequency of occurrence of these forms depends on age, for example, at 16-20 years old and at 25-34 years old, as a rule, a neuropsychic (dysphoric) form occurs, and at 20-24 years old - an edematous form. There is no clear justification for such a distribution by age, but statistically the edematous form occurs more often in this age group: 20-24 years. Crisis and cephalgic forms are less common, their origin may be associated with stress.

If you have the symptoms described above, and they interfere with your activity in the days before your period, this is an occasion to consult a gynecologist.

I want to separately focus on premenstrual dysphoric syndrome (the most severe form of PMS). Often a woman writes off PMDS as a feature of her character. This is quite paradoxical, because objectively she suffers from this. I want to give the most reliable diagnostic criteria for PMDS, so that any woman who finds them in herself will realize that she needs to seek help.

Clinical criteria for PMDS according to DSM (Diagnostic and Statistical Manual of mental disorders):

(BUT) During the last year, in most menstrual cycles (at least three), five (or more) of the symptoms listed below are observed, with one of them from the first four; symptoms persist during the last week of the luteal phase, disappear a few days after the onset of menstruation, are absent within a week after menstruation:

• sadness, hopelessness, self-condemnation (belittling one's own value);
• tension, anxiety;
• pronounced lability of mood with intermittent bouts of tearfulness;
• constant irritability, anger, conflict;
• decreased interest in habitual activities, which may be associated with alienation from social ties;
• difficulty concentrating;
• fatigue, lack of energy, drowsiness;
• changes in appetite with overeating or a need for specific (sometimes inedible) foods;
• hypersomnia or insomnia (insomnia);
• subjective feeling of being overwhelmed or lacking control;
• somatic symptoms (tension or pain in the mammary glands, a feeling of swelling of the body or weight gain, headaches, joint and muscle pain).

(B) These symptoms prevent:

• professional activity,
• learning, as well as habitual social activity,
• interpersonal relationships.

(AT) The symptoms are not the result of another disorder, such as major depressive disorder, panic disorder, dysthymic disorder, or personality disorder (although they may overlap with any other disorder).

Dysphoria and fatigue in the premenstrual period may be associated with an exacerbation of a somatic disease (endocrine disorders, oncological pathology, systemic lupus erythematosus, anemia, endometriosis, various infections). The differential diagnosis in these cases is aided by (1) history data, as well as data from (2) laboratory tests and (3) physical examination.

The basis for the diagnosis is the cyclicity of symptoms. For a definitive diagnosis of PMDS, criteria A, B, and C (simultaneously) must be observed for two menstrual cycles.

Treatment or who to go to

Treatment of premenstrual syndrome is carried out by a gynecologist, but if the course becomes complicated and mood and behavior disorders appear, then a psychiatrist should be consulted.

Treatment methods:

• Non-drug method: Physical activity, normalization of the work regime, sex, rest.
• This method is effective only at the initial stage and you should not rely on it, if complaints do not go away within two cycles, it is better to visit a doctor immediately.
• Hormonal treatment: the gold standard for treating PMS, prescribed by a gynecologist.
• Oral contraceptive (OC) therapy is used to suppress ovulation.
• Antidepressants: this group of drugs is used if the symptoms of PMS have not been reduced during OC therapy for two complete cycles.
• The second option is if a woman does not want to use OK or there are contraindications for their use. For the correct appointment of antidepressants, you need to seek the advice of a psychiatrist.
• Other methods: tranquilizers, non-steroidal anti-inflammatory drugs, diuretics. They are used only symptomatically and cannot replace the main method of therapy!!!

Debunking the Myths

The development of PMS and PMDS is NOT affected by:

• Family status;
• Amount of children;
• Irregular sexual contacts;
• Early or late age of onset of menstruation;
• cycle length;
• Use of OCs or other hormonal methods of contraception (contraceptives may be a method of treating PMS and PMDS, but not provoke their occurrence).

In fact, the risk factors for developing PMS and PMDS are:

• stress,
• obesity (BMI over 30),
• diabetes,
• asthma,

• sexual infections.

Depression and anxiety (which is observed regardless of the phase of the cycle. There is an increase in symptoms before menstruation). COCs can exacerbate depressive symptoms, so at least a screening test for depression should be performed before prescribing. In the presence of depression, it is better to discuss the tactics of prescribing COCs with a psychiatrist.

In conclusion, I would like to say: dear women, be healthy. But if you suddenly find yourself in the condition described above, or one of your loved ones suffers from it or, perhaps, is unsuccessfully treated with folk remedies (mint, valerian, celery), you do not need to wait for a miracle and suffer, seek medical help.

Sources:

1 Usman S, Indusekhar R, and O'Brien S. Hormonal management of premenstrual syndrome. Best Pr. Res Clinic Obs. Gynaecol, 2008, 22: 251–60.

2 Vos T, Flaxman AD, Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990GÇô2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2163–2196

3 Yureneva S. V., Prilepskaya V. N., Ledina A. V. Premenstrual syndrome and premenstrual dysphoric disorder.

4 Guidelines for outpatient care in obstetrics and gynecology, 3rd, rev. V. N. Serov, G. T. Sukhikh, V. N. Prilepskaya, V. E. Radzinsky. M.: GEOTAR-Media, 2016: 895–907.

4 Schiller CE, Johnson SL, Abate AC, Schmidt PJ, and Rubinow DR. Reproductive Steroid Regulation of Mood and Behavior. Compr. Physiol., 2016 July, 6: 1135–1160.

5 Power RF, Mani SK, Codina J, Conneely OM, O'Malley BW. Dopaminergic and ligand-independent activation of steroid hormone receptors. Science, 1991, 254(5038): 1636–1639.

Doctors have always tried to determine the reasons why women feel unwell and irritable in the days immediately before monthly . In ancient times, this phenomenon was associated with various factors - both with the phases of the moon, and with the health of a woman, and with the characteristics of the area where she lived. However, the state before menstruation was a mystery to the Aesculapius. Only in the twentieth century, doctors were able to understand to some extent what was happening to the ladies.

Speaking of PMS - what it is, you should know how PMS is deciphered - this is what it means - a manifestation that is characteristic of women on the days before menstruation. PMS is a complex of symptoms that appear in women and girls a few days before the onset of menstruation.

What are the causes of such manifestations, and what does this syndrome mean, scientists are still investigating. Those who are interested in how PMS is translated should learn more about what manifestations are characteristic of this condition. Each transcript of what PMS is in girls contains a description of all the characteristic symptoms and manifestations.

After all, PMS in women is a whole complex of symptoms, both physical and mental - their scientists counted about 150. Approximately 75% of women experience premenstrual syndrome to varying degrees.

As a rule, PMS in girls begins to appear about 2-10 days before the day when signs of menstruation appear. After the menstruation ends, the menstrual syndrome also completely disappears.

Why does PMS develop?

Until now, all the studies conducted have not made it possible to determine why premenstrual syndrome manifests itself? There are many theories that explain why this condition develops.

• The so-called "water intoxication" is a disturbed water-salt metabolism.
• Allergic nature - high sensitivity of the body to endogenous.
• Psychosomatic - the development of physiological symptoms due to the influence of mental factors.

The most complete and broadest to date is the hormonal theory, according to which PMS is explained by a strong hormonal fluctuation in the second phase of the cycle. After all, in order for the female body to function correctly, a normal hormonal balance is important:

• are able to improve well-being, both physical and mental, activate mental activity, increase vitality;
• progesterone provides a sedative effect, which can lead to a depressive state in the second phase;
• affect libido, increase efficiency and energy.

In the second phase of the cycle, the hormonal background of a woman changes. Consequently, the hormonal theory suggests that the body reacts inadequately to such a “storm”. Interestingly, premenstrual tension syndrome is inherited.

Since in the premenstrual period in the body there is endocrine instability , this leads to the manifestation of somatic and psychovegetative disorders. The main reason for this is the fluctuation of sex hormones during the monthly cycle and the reaction of the limbic parts of the brain to this.

• When the level increases estrogen and first increases, and then decreases the level progesterone , swelling, soreness of the mammary glands, dysfunctions of the heart and blood vessels, pressure surges, irritability are also noted in women.
• With increased secretion fluid is also retained in the body.
• When content increases , there are violations of a vegetative-vascular nature, digestive disorders - diarrhea, nausea, as well as headaches resembling.

Thus, modern physicians distinguish the following factors that determine the development of PMS:

• A decrease in the level, which leads to the manifestation of mental symptoms of premenstrual syndrome: with a decrease in this hormone, sadness and longing are noted.
• Deficiency leads to fluid retention, breast tenderness, mood changes.
• A lack of magnesium leads to the development of symptoms such as headache, desire to eat sweets.
• Smoking – women who smoke are twice as likely to suffer from PMS.
• - those with a body mass index greater than 30 are much more likely to experience the symptoms of this syndrome.
• Genetics - the tendency to PMS can be inherited.
• Difficult childbirth, abortion, gynecological operations.

The main symptoms of PMS in women

Speaking about what are the symptoms of PMS, how many days before menstruation in girls and women they appear, one should take into account the individual characteristics of each organism. The main signs of PMS before menstruation are divided into several different groups by doctors. There are such symptoms of premenstrual syndrome (in groups):

• neuro-psychic : depression, aggression, irritability and tearfulness.
• Exchange-endocrine : chills, swelling due to impaired water-salt metabolism, fever, discomfort in the mammary glands, bloating, blurred vision and memory.
• Vegetative-vascular : headache, pressure drops, nausea, vomiting, tachycardia,.

Speaking about what symptoms before menstruation appear in women, it should be noted that they can be conditionally divided into several forms. However, as a rule, they are combined. So, if pronounced psycho-vegetative disorders are noted, the pain threshold decreases, and the woman perceives pain very sharply - a week or a few days before menstruation.

What signs of menstruation for a week or a few days can be observed?

Neuropsychic form		Disturbances in the emotional and nervous spheres are manifested: panic attacks, causeless longing and depression may develop; anxiety, feeling of fear, depression; forgetfulness, impaired concentration, mood swings; insomnia, activation or decrease in libido; aggression, dizziness.
crisis form		There is tachycardia, pressure drops, pain in the heart; frequent urination before menstruation, panic. those who are characterized by this form, as a rule, have heart disease, kidney disease, and poor digestion.
Atypical manifestations		The temperature rises to subfebrile indicators; constantly worried about drowsiness, allergic manifestations, vomiting.
edematous form		Characterized by negative diuresis and fluid retention in the body. There are swelling of the limbs and face, itching of the skin, thirst, weight gain, pain in the lower back and joints, headache, decreased urination, and digestive problems.
Cephalgic form		Most show vegetative-vascular and neurological symptoms: migraine, cardialgia; nausea and vomiting; tachycardia; high sensitivity to smells and sounds. Approximately 75% of women have an increase in the vascular pattern, hyperostosis. With this form, as a rule, a family history includes hypertension, diseases of the digestive system, diseases of the heart and blood vessels.

Wikipedia and other sources indicate that every woman has PMS in her own way, and the symptoms may vary.

Scientists, after conducting a series of studies, determined the frequency of manifestations of symptoms of premenstrual syndrome:

In addition, PMS can significantly aggravate the course of other diseases:

• anemia ;
• thyroid diseases;
• migraine ;
• chronic fatigue syndrome;
• diseases of the female genital area of ​​an inflammatory nature.

What conditions and diseases can masquerade as PMS?

To know how many days menstruation begins, every woman must have a calendar or a special notebook and write down the date of the beginning of menstruation, how long menstruation lasts, and also the day of ovulation (for this, it is enough to measure basal temperature). It is also worth noting the manifestation of symptoms before menstruation and well-being during ovulation.

If a woman keeps such records for several cycles, this helps her to establish how often the signs of PMS appear. Also, the diary will help determine if there is a delay in menstruation, etc.

To establish the diagnosis of PMS, the doctor determines the presence of at least 4 signs of the following:

• , insomnia ;
• deterioration of attention and memory;
• increased appetite, loss of appetite;
• severe fatigue, weakness;
• chest pain;
• swelling;
• pain in the joints or muscles;
• exacerbation of chronic diseases.

You can also diagnose this condition if at least one of the following signs is noted:

• conflict, tearfulness, nervousness and irritability, sudden mood swings in women;
• groundless anxiety, fear, tension;
• feeling of melancholy without reason, depression;
• depressive state;
• aggressiveness.

To determine the severity of PMS, it is important to consider the number of manifestations, their severity and duration:

• Mild form - manifests itself from 1 to 4 symptoms, if these are 1-2 signs, then they are significantly pronounced.
• Severe form - manifests itself from 2 to 12 signs, if these are 2-5 symptoms, then they are significantly pronounced. Sometimes they can lead to the fact that a woman becomes disabled a day or a few days before menstruation.

The cyclicity of manifestations is the main feature that distinguishes premenstrual syndrome from other diseases. That is, this condition is premenstrual syndrome when it begins before menstruation (from 2 to 10 days) and completely disappears after menstruation. But if the psychovegetative symptoms disappear, then physical sensations sometimes turn into painful periods or migraines in the first days of the cycle.

If a woman feels relatively good in the first phase of the cycle, then this is PMS, and not an exacerbation of chronic diseases - depression, neurosis, fibrocystic.

If soreness is noted only immediately before menstruation and during menstruation, and is combined with blood secretions in the middle of the cycle, then this indicates that, most likely, a gynecological disease develops in the body -, and etc.

To establish the form of PMS, hormones are examined: estradiol , prolactin , progesterone .

Additional research methods may also be prescribed, depending on which complaints prevail:

• If you are concerned about very severe headaches, dizziness, fainting, blurred vision, it is necessary to conduct a CT scan or MRI to rule out organic brain diseases.
• With the predominance of neuropsychic symptoms, an EEG is performed to rule out an epileptic syndrome.
• If edema is of concern, the amount of urine per day changes, tests are carried out to diagnose the kidneys.
• In case of significant breast engorgement, an ultrasound of the mammary glands should be performed.

Women who suffer from PMS are examined not only by a gynecologist, but also by other specialists: neurologists, psychiatrists, nephrologists, endocrinologists, cardiologists, and therapists.

How to understand - PMS or pregnancy?

Since some symptoms during pregnancy are very similar to those of PMS, it is important to consider the differences by which these conditions can be distinguished.

After the conception has occurred, the growth of the hormone occurs in the female body progesterone . As a result, a woman can confuse pregnancy with PMS when they begin to appear: breast tenderness and swelling, vomiting, nausea, mood swings, lower back pain, irritability.

Often, going to one or another thematic forum, you can see the reasoning of women about how to distinguish PMS from pregnancy before delay. Of course, if menstruation began on time, then the issue is removed by itself. However, even pregnant women sometimes have discharge during the days. When should you have your period. There are differences in discharge before menstruation and during pregnancy - in pregnant women, they are usually more scarce. But still, in order to verify the presence or absence of pregnancy, it is worth doing a test or conducting tests in honey. institution.

Below is a comparison of the most common signs during pregnancy and PMS.

Symptom	During pregnancy	For premenstrual syndrome
Chest pain	Occurs during pregnancy	Disappears with the onset of menstruation
Appetite	Taste preferences change, sense of smell sharpens, habitual smells irritate	May crave sweet, salty, sensitivity to odors, possibly increased appetite
Backache	Anxiety in the last trimester	Possible lower back pain
Fatigue	Appears about a month after conception.	Possible both after ovulation and a few days before menstruation
Pain in the lower abdomen	Intermittent, mild pain	Manifested individually
Emotional condition	Mood changes frequently	Irritability, tearfulness appear
Frequent urination	May be	Not
Toxicosis	Begins to develop approximately 4-5 weeks after conception	May have nausea, vomiting

Since the symptoms of these conditions are actually similar, and in some cases even pregnancy during menstruation is possible (at least, this is the impression a woman gets if there is a discharge), it is important to act correctly.

It is best to wait until the menstruation begins. If a woman notes that she already has a delay, it is imperative to conduct a pregnancy test that reliably determines pregnancy after a delay. Those who want to immediately verify whether there was a conception can take (pregnancy hormone). Such a test already on the tenth day after conception accurately determines pregnancy.

It is most correct in such a situation to visit a gynecologist who will help you figure out what a woman really has - PMS or pregnancy through examination, ultrasound. Sometimes the question also arises, how to distinguish pregnancy from - in this case, you also need to consult a doctor or do a test.

When should you contact a specialist?

If pain, irritability, increased tearfulness in women, the causes of which are associated with PMS, significantly reduce the quality of life and are very pronounced, you should consult a doctor and carry out the treatment prescribed by him. Also, the doctor can give effective recommendations on how to alleviate certain unpleasant manifestations.

As a rule, symptomatic therapy is prescribed for such manifestations. How to treat PMS, and whether it is worth prescribing any drugs for treatment, the specialist determines, taking into account the form, symptoms, and course of premenstrual syndrome. The following treatments may be prescribed:

• With mood swings, depression, irritability, psychotherapy sessions, a relaxation technique, and a sedative are prescribed.
• If you are concerned about pain in the abdomen, lower back, headaches, it is recommended to take non-steroidal anti-inflammatory drugs to relieve pain (pills, and etc.).
• Also prescribe drugs for the treatment of premenstrual syndrome - diuretics in order to remove excess fluid and eliminate edema.
• Hormonal treatment is prescribed if there is an insufficiency of the second phase of the cycle, after carrying out tests of functional diagnostics, guided by the results of the changes that have been identified. Appoint gestagens — medroxyprogesterone acetate , they need to be taken from the 16th to the 25th day of the menstrual cycle.
• Tranquilizers and antidepressants are prescribed to women who develop numerous neuropsychic symptoms before menstruation: aggressiveness, nervousness, panic attacks, insomnia, etc. In such cases, appoint,. The drugs should be drunk in the second phase of the cycle, two days after the onset of symptoms.
• If a crisis or cephalgic form is diagnosed, it may be prescribed in the second phase of the monthly cycle. If prolactin is elevated, then Parlodel should be taken continuously.
• If a woman develops edematous or cephalgic forms, antiprostaglandin drugs are prescribed (,.
• Also, the doctor may prescribe homeopathic remedies, as well as vitamin and mineral complexes - for example, vitamins for depression for women.

How to alleviate the condition yourself?

If a woman is worried about PMS (sometimes erroneously called "postmenstrual syndrome"), then she should use some recommendations to alleviate the condition.

Have a good rest

You need to sleep as much time as the body needs for proper rest. As a rule, it is 8-10 hours. Many women who write to any thematic forum note that it was the normalization of sleep that made it possible to reduce the severity of unpleasant symptoms. With a lack of sleep, anxiety, irritability, aggressiveness can develop, worsens. For those who have insomnia, small evening walks can help.

aromatherapy

Provided that a woman does not suffer from allergies, aromatherapy can be practiced by choosing a special composition of aroma oils. It is recommended to use oil of lavender, basil, sage, geranium, rose, juniper, bergamot. It is worth starting to take baths with aromatic oils two weeks before menstruation.

Physical exercise

Any reasonable load has a positive effect on the body - running, dancing, yoga, body flex, etc. If you train fully and regularly, the content of endorphins . And this allows you to overcome depression and insomnia, reduce the severity of physical symptoms.

Vitamins and minerals

To reduce the severity of symptoms, magnesium should be taken two weeks before menstruation and. It is also recommended to drink and. This will help reduce the severity of a number of symptoms: palpitations, insomnia, anxiety, fatigue, irritability.

Nutrition

It is important to include in the diet as many vegetables and fruits as possible, as well as foods containing calcium and fiber. It is worth reducing the amount of coffee, cola, chocolate consumed, as caffeine provokes anxiety and mood swings. It is important to reduce the amount of fat in the diet.

It is also not recommended to eat beef, which may contain artificial estrogens. You should drink herbal teas, lemon and carrot juices. It is better to exclude or limit alcohol, since under its influence the reserves of minerals and vitamins are depleted, and the liver utilizes hormones worse.

Often women are interested in why they want salt before menstruation. The fact is that appetite fluctuations are normal during PMS, and sometimes you just need to “meet the requirements” of the body in order to feel better.

Relaxation

You need to try to avoid stressful situations, not overwork and think positively. To do this, it is recommended to practice yoga, meditation.

regular sex

Sex also has a beneficial effect on health - it helps to sleep better, overcome stress, cope with bad emotions, strengthen immunity and increase endorphins. In addition, in the period before menstruation, a woman often has an increased libido, which contributes to an active sex life.

Medicinal herbs

With the help of herbal teas, you can significantly alleviate the condition with PMS. The main thing is to choose the right herbs. Tea can be made from St. John's wort, primrose, as well as other herbs recommended by the doctor.

findings

Thus, premenstrual syndrome is a serious condition that sometimes becomes an obstacle for a woman to a full life and ability to work. According to studies, the most common symptoms of PMS occur in residents of large cities and women who are engaged in mental work.

However, with the help of specialists, as well as by practicing proper nutrition, regular exercise, taking vitamins and minerals, this condition can be significantly alleviated.

Education: She graduated from the Rivne State Basic Medical College with a degree in Pharmacy. Graduated from the Vinnitsa State Medical University. M.I. Pirogov and an internship based on it.

Experience: From 2003 to 2013 she worked as a pharmacist and head of a pharmacy kiosk. Awarded with certificates and distinctions for long-term and conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.

Premenstrual syndrome (PMS) is a complex of symptoms that occurs a few days (from 2 to 10) before the onset of menstruation and disappears in its first days. At other times, there are no PMS symptoms.

The condition includes neuropsychiatric disorders, vegetative-vascular and metabolic manifestations. Almost every woman has experienced the symptoms of PMS at some point. However, it is severe only in every tenth patient.

How and why premenstrual syndrome occurs

In the middle of the menstrual cycle, ovulation occurs in the ovary - an egg is released from a mature follicle. She begins to move through the abdominal cavity to the fallopian tube to meet with the sperm and fertilization. In place of the bursting follicle, a corpus luteum is formed - a formation with high hormonal activity. In some women, in response to such endocrine "bursts", the parts of the brain responsible for emotions, vascular reactions, and metabolic regulation react. Often this individual response is inherited from mother to daughter.

Previously, it was believed that PMS occurs more often in women with disturbed hormonal levels. Now doctors are sure that such patients have a regular ovulatory cycle, and in all other respects they are healthy.

Theories for the development of PMS:

• hormonal;
• water intoxication;
• dysfunction of the renin-angiotensin-aldosterone system;
• lack of vitamins and fatty acids in the diet;
• hyperprolactinemia;
• allergy;
• psychosomatic disorders.

With PMS, the relative content of estrogens increases with a relative decrease in the level of gestagens. Estrogens retain sodium and fluid in the body, causing swelling, flatulence, a headache, and chest pain. Estrogens activate the renin-angiotensin-aldosterone system, causing additional fluid retention. These sex hormones directly affect the area of ​​the brain responsible for the formation of emotions (the limbic system). The level of potassium and glucose in the blood also decreases, which causes weakness, pain in the heart, decreased activity.

It depends on the level of gestagens how many days before menstruation PMS occurs. These hormones delay the onset of menstruation. They also determine how long premenstrual syndrome lasts.

As a result of a violation of the activity of the renin-angiotensin-aldosterone system, fluid retention occurs, which causes swelling of the intestinal wall. There is bloating, nausea, constipation.

The development of PMS contributes to the lack of vitamins, magnesium and unsaturated fatty acids in food. Some scientists believe that the result is depression, chest pain, irritability, and elevated body temperature.

Of particular importance in the mechanism of development of PMS is an increase in the level of prolactin in the second half of the cycle, an allergy to internal progesterone, as well as interconnected bodily (somatic) and mental (mental) changes.

Clinical picture

There are three groups of main symptoms that determine the severity of the condition:

• neuropsychiatric disorders: tearfulness, depression, irritability;
• vegetative-vascular changes: nausea and vomiting, headache and dizziness, palpitations, pain in the heart area, increased pressure;
• metabolic disorders: breast enlargement, swelling, bloating, thirst and shortness of breath, itching, chills, fever, pain in the lower abdomen.

An aggravating factor in the course of PMS is depression. With her, women feel more pain and other unpleasant sensations, which can smoothly turn into painful menstruation and migraines.

Forms of premenstrual syndrome

PMS can occur in the following clinical forms:

• neuro-psychic;
• edematous;
• cephalgic;
• crisis.

The neuropsychic form is accompanied by emotional disturbances. Young women have a reduced mood background. In adulthood, aggressiveness and irritability become the leading sign.

The edematous form is accompanied by swelling of the legs, face, eyelids. Shoes become tight, rings don't fit well. Sensitivity to odors increases, bloating, skin itching appears. Due to fluid retention, weight increases (by 500-1000 g).

In the cephalgic form, the main symptom is a headache in the temples with spread to the orbit. It has a jerking, pulsating character, accompanied by dizziness, nausea and vomiting. Most of these women have changes in the pituitary gland.

The crisis form is manifested by sympathoadrenal attacks: blood pressure suddenly rises, pressing pain in the chest appears, fear of death. At the same time, a strong heartbeat, a feeling of numbness and coldness of the hands and feet are disturbing. The crisis usually occurs late in the day, ends with the release of urine in a large volume. This form is more often observed as an outcome of untreated previous variants.

Flow

When does PMS start? With a mild course, 2-10 days before menstruation, three to four signs appear, one or two of which are most pronounced. In severe cases, symptoms appear 3-14 days before menstruation. There are more than five of them, and at least two are pronounced.

The course of PMS in all patients is different. For some, symptoms appear at the same time and stop with the onset of menstruation. In other patients, more and more signs are recorded over the years. The condition is normalized only after the end of menstrual bleeding. In the most severe cases, the symptoms persist even after the cessation of menstruation, and the period without complaints is gradually reduced. In such a situation, a woman may even lose her ability to work. In some patients, cyclic ailments continue after the onset of menopause. There is a so-called transformed PMS.

The mild course of PMS is accompanied by the appearance of a small number of symptoms, mild malaise, without limiting the normal rhythm of life. In more severe situations, the signs of this condition affect family life, working capacity, conflicts with others may appear. In severe cases, especially during a crisis course, a woman cannot work and needs to issue a certificate of incapacity for work.

Diagnostics

PMS is a clinical diagnosis based on the analysis of symptoms, their severity, and the cyclical occurrence. An examination by a gynecologist is prescribed, the genital organs are performed. For proper hormonal therapy, it is necessary to determine the level of sex and other hormones in the blood.

The patient is consulted by a neurologist, if necessary - a psychiatrist, ophthalmologist, endocrinologist. She may be assigned to such studies as electroencephalography, computed tomography of the brain, ultrasound of the kidneys,.

Only after a comprehensive examination and observation, the gynecologist makes such a diagnosis and prescribes treatment.

PMS treatment

How to relieve premenstrual syndrome? To this end, the following scheme is recommended:

• psychotherapy;
• proper nutrition;
• physiotherapy;
• physiotherapy;
• treatment of premenstrual syndrome drugs.

Psychotherapy

Rational psychotherapy helps to get rid of such unpleasant symptoms as excessive emotionality, mood swings, tearfulness or aggressiveness. For this purpose, methods of psycho-emotional relaxation are used, stabilizing behavioral techniques. A woman is taught how to relieve PMS, help to cope with the fear of the onset of menstruation.

It is very useful to conduct psychotherapeutic sessions not only with a woman, but also with her relatives. Relatives learn to better understand the patient's condition. Conversations with the close environment of the patient improve the microclimate in the family. Through psychosomatic mechanisms, it is possible to improve the physical condition of the patient, to alleviate the objective manifestations of premenstrual syndrome.

Lifestyle and nutrition

In the diet, it is necessary to increase the content of vegetable fiber. It normalizes the work of the intestines, removes excess fluid from the body. The daily diet should consist of 75% carbohydrates (mostly complex), 15% protein and only 10% fat. The use of fats must be limited, as they affect the participation of the liver in the exchange of estrogen. It is better to avoid beef as well, as it often contains small doses of artificially introduced hormones. Thus, fermented milk products will be the most useful source of protein for PMS.

It is useful to increase the consumption of juice, in particular, carrot juice with the addition of lemon. Recommended herbal teas with the addition of mint, lemon balm, valerian. Herbal sedative for PMS helps to cope with emotional disorders, improve sleep and overall well-being.

You should abandon the excess of salt, spices, limit the consumption of chocolate and meat. Alcoholic beverages should not be consumed, as they reduce the body's content of B vitamins, minerals, and change the metabolism of carbohydrates. The work of the liver suffers, which can lead to a violation of estrogen metabolism and an increase in the severity of the condition.

You do not need to take many drinks with caffeine (tea, coffee, Coca-Cola) during PMS. Caffeine causes fluid retention, disrupts sleep, and contributes to neuropsychiatric disorders. In addition, it enhances the engorgement of the mammary glands.

Preparations for the treatment of PMS

If you have symptoms of PMS, you should consult a doctor. He will tell you how to deal with his symptoms using medications. Consider the main groups of drugs for the treatment of premenstrual syndrome.

1. After examination by a gynecologist, if an increased content of estrogens (absolute or relative hyperestrogenism) is detected, gestagens are prescribed. These include Duphaston, Norkolut and others. Gonadotropin-releasing factor agonists, in particular, Danazol, also have an antiestrogenic effect.
2. Antihistamines are prescribed in connection with an increase in the level of histamine and serotonin in such patients. Tavegil, Suprastin are usually used at night starting two days before the expected onset of PMS and ending with the first day of menstruation.
3. To normalize the functioning of the brain structures responsible for vascular regulation and mental disorders, nootropics are prescribed - Nootropil, Aminalon, starting from the first day of menstruation for two weeks. Such courses are repeated for three months in a row, then they take a break.
4. If, after determining the level of hormones, an increase in the level of prolactin is detected, Parlodel (bromocriptine) is prescribed, starting two days before the expected onset of PMS, for 10 days.
5. In the presence of pronounced edema, the appointment of a diuretic with a potassium-sparing effect of Veroshpiron, which is an aldosterone antagonist, is indicated. Assign it 4 days before the deterioration of health and stop taking it with the onset of menstruation. If the edematous syndrome is manifested by a headache, visual impairment, it is recommended to use Diakarb.
6. In the presence of pain, the main means for the treatment of PMS are non-steroidal anti-inflammatory drugs, in particular, Diclofenac. It is prescribed two days before the deterioration of health. These drugs inhibit the synthesis of prostaglandins, biologically active substances that cause many of the symptoms of PMS. Course treatment is carried out for three months. The effect of such a course lasts up to four months after its termination. Then PMS symptoms return, but are usually less intense.
7. Excessive emotionality, depressive disorders, neurosis may be an indication for the appointment of tranquilizers. There are special "day" drugs that do not suppress normal activity, in particular, Grandaxin and Afobazol. Antipsychotics and antidepressants may be used. These drugs are prescribed by a psychiatrist. They need to be taken continuously for 3-6 months.
8. Vitamins A and E have a beneficial effect on the female reproductive system, including reducing the severity of premenstrual syndrome. They are taken orally or injected intramuscularly for a month, alternating with each other. With the appearance of anxiety and depressive disorders in the second half of the cycle, magnesium preparations and vitamin B6 are prescribed.

PMS is treated in cycles. In the first three months, a diet, herbal sedatives, vitamins, non-steroidal anti-inflammatory drugs are used. Then make a break in treatment for 3-6 months. When the symptoms of PMS return, other drugs with more serious effects are added to the treatment. Don't expect a quick effect. Therapy should be carried out for a long time, accompanied by a modification of nutrition and lifestyle.

Reading time: 12 minutes

The term "PMS" (premenstrual syndrome) is familiar to almost every woman. As practice shows, one out of 4 girls and women of childbearing age is faced with manifestations of this condition before the onset of menstruation. PMS is a complex of symptoms that occurs on premenstrual days (in the second phase of the menstrual cycle) and manifests itself as neuropsychic, vegetative-vascular and metabolic-endocrine disorders. Premenstrual syndrome is a pathological condition caused by the physiological characteristics of the structure of the female body.

What factors increase the risk of PMS?

The issue of the occurrence of PMS in women is still being studied, so there is no consensus on what exactly causes the appearance of one or another type of this pathology.

It has been established that some factors can significantly increase the likelihood of a deterioration in well-being and an increase in pain. These include:

• diseases of the nervous system, neuralgia of various origins;
• endocrine disruptions; (advised by an endocrinologist)
• high level of pollution in the area of ​​residence;
• vascular diseases;
• heart defects, VVD, arterial hypertension or hypotension;
• work associated with great mental stress, highly intellectual activity.

Causes of PMS

The main reason that causes the appearance of specific signs of premenstrual syndrome lies in the hormonal changes in the body, which occurs 1-2 weeks before the onset of menstruation.

During this period, the reproductive system of a woman begins to actively produce female sex hormones necessary to maintain the health and normal functioning of the reproductive system.

A change in the hormonal background causes disturbances in the work of the nervous system: a woman becomes irritable, tearful, sometimes she can even show unreasonable aggression.

If there is a history of diseases associated with the activity of nerve cells of the central or peripheral systems, then the manifestations of PMS can be several times more intense. As a rule, a woman during such periods experiences difficulties in communicating with colleagues, friends and family members.

Contribute to the deterioration of the condition can:

• stress and scandals; (the help of a psychologist will help to cope)
• bad habits;
• sedentary lifestyle;
• saturated with fats and refined foods;
• deficiency of minerals and vitamins (especially vitamin B 6 , magnesium, sodium, potassium);
• slow metabolism.

Against the background of hormonal changes, chronic diseases can worsen, which are accompanied by characteristic symptoms. Do not confuse them with manifestations of PMS (this is not the same thing) - weakness, pain, nausea and other signs in this case are clinical manifestations of disorders of internal organs.

Types of PMS and their symptoms

Depending on the causes that caused the appearance of PMS, and the signs of pathology, several types of this condition are distinguished. This means that symptoms of one type may be present when diagnosing another form: most often, symptoms (for example, pain syndrome) are characteristic of several types of premenstrual syndrome and differ only in the degree of intensity.

neuropsychic type

Most often it is typical for young girls up to 23-24 years old. It is manifested by increased sensitivity to everyday things and situations.

During this period, girls become constant companions of sadness, a feeling of increased anxiety, lack of confidence in themselves and the results of their activities, as well as anger, aggressive behavior and uncontrolled bouts of anguish.

For some girls, this condition can cause serious problems in communicating with other people, since not everyone understands the true reasons for what is happening.

Taking any sedatives is allowed only with the permission of a doctor!

Crisis type of PMS

It is quite rare and is the most dangerous of all possible forms of premenstrual syndrome. It is characterized by disturbances in the work of the cardiac system and symptoms of vegetative-vascular dysfunction, namely:

• severe attacks of headache (migraine);
• sudden pressure surges;
• pain in the retrosternal space;
• tachycardia;
• feeling of numbness of the legs and arms;
• local decrease in temperature of the extremities (icy fingers);
• nausea (in some cases, vomiting is possible).

The crisis type may be accompanied by panic attacks and mental disorders. Some women during this period begin to be afraid of death, become suspicious and cannot sleep peacefully at night (they are afraid of fires, robbers, etc.).

Such symptoms require immediate seeking help, as a prolonged fear syndrome can become chronic.

edematous type

The most common form of premenstrual syndrome, in which there are physical changes that occur with the female body:

• weight gain;
• increased appetite (in some cases, a change in taste preferences is possible);
• the appearance of edema;
• dropsy of internal organs;
• flatulence;
• joint and muscle pain (especially often - spasms of the abdominal muscles);
• soreness of the mammary glands, especially when changing the position of the body;
• increased sweating with a characteristic odor;
• acne.

The appearance of edema may not be noticeable during a visual examination, so a sharp increase in body weight should be the reason for going to the clinic. This symptom cannot be ignored, as this can lead to dropsy of the internal organs.

Cephalgic type of PMS

A fairly common form of PMS among women, in which pain in the abdomen increases due to spasms, and symptoms of general malaise appear: weakness, drowsiness, mood deterioration, headaches of mild and moderate intensity, etc.

Doctor's advice

PMS can be severe - the appearance of 5-12 symptoms in 3-14 days on the eve of menstruation with a significant severity of 2-5 of them. In some cases, PMS requires inpatient treatment, so if there is a deterioration in the days before menstruation, you do not need to endure it, you need to contact a gynecologist for qualified help.

Atypical Handicap

A rare type of disorder that causes uncharacteristic symptoms and signs:

• temperature increase;
• allergy;
• asthma attacks;
• oral infections (stomatitis, gingivitis, etc.);
• limitation of mobility due to severe pain in the muscles and joints.

Any of these signs that appear 3-10 days before the start of the menstrual cycle require medical attention. Calling a doctor or visiting a local doctor in this case is mandatory.

PMDD (premenstrual dysphoric disorder)

It represents uncontrollable anger, attacks of aggression, rage. It occurs in approximately 3-5% of cases of the total number of diagnosed manifestations of PMS.

In some cases, a woman may be a danger to others (for example, it is not uncommon for a mother to beat her children under the influence of PMDD). This type of disorder must be treated without fail.

Should PMS be treated?

PMS is an integral part of the functioning of the female body and does not require medical treatment. But in some cases, treatment is still necessary. This is required in situations where a woman's health may be at risk, or there are significant changes that make it impossible to lead a normal life.

PMS should be treated when:

• there is a severe form of depression or a progressive type of psychosis;
• a woman suffers from panic attacks;
• there are severe edema;
• heartbeat quickens;
• habitual indicators of arterial pressure change;
• pain syndrome has a high degree of intensity;
• there is a tremor of the limbs or numbness of parts of the body (a sign of impaired blood circulation).

Methods of treatment

It should be understood that PMS is not a disease, so the expression "treat PMS" is fundamentally wrong. Therapy is for the symptoms of the condition that interfere with daily activities, professional duties, or social interactions.

Non-drug treatment

It includes a set of preventive measures that prevent the appearance of pathology and the progression of associated symptoms. These include:

• organization of proper nutrition and drinking regimen (drinking clean water daily in the amount of at least 1.5-2 liters);
• limiting salt intake and reducing the amount of salty foods in the diet;
• physiotherapy;
• complete rest;
• relaxing activities (aromatherapy, warm salt baths, massage);
• regular walks to saturate the blood with oxygen.

Risk factors for the development of PMS: stressful situations; neuroinfections; complicated childbirth and abortion; various injuries and surgeries. Non-specific prevention: regular use of oral contraceptives (in the absence of contraindications), a healthy lifestyle (cessation of smoking, exercise, regular sexual activity, prevention of stressful situations).

Medical therapy

It is carried out according to indications and is prescribed by a doctor depending on the intensity of symptoms, as well as the type of PMS.

The following methods and drugs can be used for treatment:

• painkillers (used to relieve severe attacks of pain in the abdomen, as well as muscle and joint pain);
• antidepressants (necessary to normalize the psycho-emotional state and eliminate the symptoms of depression);
• are prescribed according to the identified violations of hormonal homeostasis individually in each case;
• physiotherapy treatment (as prescribed by the local doctor or physiotherapist);
• sedatives (to restore the functioning of the nervous system, fight insomnia, panic attacks, etc.);
• diuretics (used to remove excess fluid);
• drugs to improve heart function (with tachycardia);
• antihypertensive drugs (used when PMS is accompanied by an increase in blood pressure).

Therapy is prescribed individually

Any little thing during PMS takes a woman out of balance: tears, hysteria and, finally, someone's annoyed question: “Do you have your period coming soon?”. Some refer to this phenomenon as a necessary evil. However, you can get rid of PMS. The site consulted with a doctor, obstetrician-gynecologist Kokotyukha Irina.

October 13, 2008 · Text: Elena Vladimirova· A photo: Fotobank.ru

Premenstrual syndrome (PMS) is a complex of unpleasant symptoms that occurs in women 7-14 days before menstruation.

Symptoms

The symptoms of PMS are many, from depression, irritability and lethargy to severe headache (migraine), allergic skin reactions, diarrhea or constipation, swelling and tenderness of the mammary glands. Moreover, the signs of PMS and course options for each woman are individual. For example, some people have a terrible headache a week before menstruation, weight increases, and acne appears on their faces. While others only 2-3 days before menstruation begin to suffer from depression and insomnia.

Causes

During the premenstrual period, fluctuations in sex hormones occur in a woman's body, and the manifestations of PMS depend directly on the individual response to such fluctuations.

Hormones not only regulate the menstrual cycle, but also “hit” other body systems, for example, the central nervous system, urinary-genital, etc. Hence, irritability appears, and slowing down of the kidneys leads to edema. Fortunately, by the beginning of menstruation, everything returns to normal, and we temporarily forget about PMS.

There are other reasons, for example, a lack of vitamins and minerals in the body, the use of large amounts of salt, alcohol, coffee, smoking, a sedentary lifestyle and, of course, stress. So, if you feel that your PMS periods are getting more and more difficult, think about your lifestyle. Experts believe that severe PMS can also be inherited.

No. 1. Go to the doctor

Listen to yourself. Try to keep a diary for 4 to 6 months in which you clearly describe your emotional experiences and physical sensations.
Consult a gynecologist. Having studied your “mood”, the doctor will be able to understand whether this is really PMS and will help in choosing medications, diets, and tell you what regimen should be followed during the premenstrual period.

Generally, treatment for PMS is based on the symptoms you are experiencing. There are many drugs for this: sedatives, analgesics and antispasmodics, non-steroidal anti-inflammatory drugs, hormonal drugs, diuretics.

In addition, the doctor may prescribe oral contraceptives, vitamin preparations, and nutritional supplements.

#2 Change your diet

Very often, you can get rid of PMS without resorting to medication. To do this, it is enough to refrain from bad eating habits at least 10 to 7 days before the onset of menstruation:

• Limit the consumption of sugar, salt, coffee, strong tea and do not exceed the required daily amount of liquid - 1.5 liters per day (better if it is mineral water and unsweetened juices)! Excess fluid in the body leads to painful breast swelling and swelling.
• Alcohol is just as bad. It increases the feeling of hunger, headache, irritability.
• Forget about products containing artificial additives and flavors.
• Beware of large amounts of animal fats, as they are the main source of cholesterol, the excess of which contributes to circulatory disorders. But dishes from fish, poultry or lean beef will come in handy.
• Replace butter with vegetable oil. Do not limit yourself to fresh vegetables and fruits, as they contain the necessary vitamins, minerals, and fiber. By the way, vitamins of groups A and D improve the condition of the skin and prevent the appearance of acne during PMS. And vitamin E relieves pain in the mammary glands and relieves depression.

No. 3. Lead a healthy lifestyle

Sports activities increase the body's endurance, and this is important in the fight against premenstrual syndrome.

Do not overload the nervous system! Insufficient sleep only increases irritability and reduces the body's resistance to stress.

So take a week off from night work, try to get at least 8 hours of sleep in a well-ventilated room, and take a contrast shower before bed.

The fewer cigarettes you smoke, the easier PMS will be. Scientists have long proven that nicotine significantly worsens the course of premenstrual syndrome.

Yoga and breathing exercises are great for PMS headaches. For example, sit in a Turkish position and, gently raising your hands up, take a deep breath. With your arms above your head, hold the air for a few seconds. Then, slowly lowering your arms, exhale.

#4 Treat yourself

If PMS did start, and your eyes are practically wet, then the main thing is to convince yourself that this period will soon pass, but for now you can relax.