Premenstrual syndrome (PMS), causes, symptoms, diagnosis, treatment, prevention. Premenstrual Syndrome (PMS)

The nervous state of a woman before menstruation has become the object of ridicule from men. Premenstrual syndrome (PMS) "spoils" the life of both of them, often causing disagreement in a pair and quarrels in the family. Therefore, what is PMS in girls should be known to men.

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 provides this opportunity: following certain rules and using safe drugs will help you survive the premenstrual period without shocks and depression.

PMS in women - transcript

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

• Premenstrual syndrome: are men right when ironic over a woman’s condition?

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

• Does PMS occur in all women?

Every second woman is faced with 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, as the cause of PMS, are not always justified. In some women, changes in the levels of the hormones progesterone and estrogen are not so significant. Closest to the truth is the theory of a temporary change in neuroregulation.

• How many days before menstruation do PMS symptoms appear?

The condition of the woman 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 facilitate menstrual syndrome, several rules have been developed for the regimen of the day and nutrition. Also, in the case of its manifestations, the gynecologist may prescribe some medications (they will be discussed below).

• Does PMS pass after childbirth?

In some women, premenstrual syndrome is initially absent and may appear after childbirth. In others, on the contrary, unpleasant symptoms disappear or subside (especially swelling and tenderness of the chest) after the birth of the baby.

Important! PMS and menstruation are always related: painful symptoms disappear after the onset of bleeding.

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

Characteristic Symptoms of PMS

There are hardly any women with the same PMS pattern: 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 can cry for nothing or for no reason at all. Ready to "tear to shreds", the degree of aggression also does not coincide with the insult inflicted. In the best case, a woman is depressed and feels irritable, which she cannot always cope with.

• Hormonal changes

Due to the increased level of progesterone in 1-2 weeks. before menstruation, a woman noticeably enlarges and coarsens the mammary glands. Many women need a bra a size larger than usual for this period. Bursting soreness in the chest can be so intense that just walking causes discomfort.

In some women, 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 a temperature increase of up to 37.0-37.2ºС is recorded. Often, the abdomen increases in size due to the accumulation of gases and constipation.

• Vegetative disorders

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

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

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

• 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 pains, irradiation in the lower back is most often caused by a long inflammatory process in the genitals (thrush, chronic adnexitis, etc.);
• goosebumps and less often numbness of fingers and toes associated with deficiencies vit. B6 and magnesium;
• rejection of pungent odors, even their own perfumes.

Severe PMS is diagnosed in the presence of severe 5-12 symptoms.

Premenstrual syndrome can occur in the following scenarios:

• Compensation stage - signs of PMS are not very pronounced, disappear immediately when menstruation occurs. The course is stable, the 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 disturbed 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 often show violence, especially against their children (they beat them violently).

With severe symptoms of PMS, a sick leave is acceptable. However, severe premenstrual syndrome can be a reason for refusing employment. In European countries, when divorcing, if the ex-wife has a pronounced PMS, children can be left with their father.

Premenstrual Syndrome or Pregnancy

Symptoms of premenstrual syndrome are very similar to signs of pregnancy. The main question for women is how to distinguish: PMS or pregnancy? It is almost impossible if you do not do a pregnancy test or wait for a while of menstruation. However, according to some signs, we can assume the onset of pregnancy:

• Only during pregnancy is a perversion of taste observed. In addition to craving for salty or sweet, as with PMS, a pregnant woman refuses her previously beloved food and expresses an acute desire to consume chalk, earth. Addiction may occur, for example, to lard, which the woman had not previously tolerated.
• Pungent odors in a pregnant woman also cause a negative reaction. In addition, the pregnant woman may experience olfactory “hallucinations”: a specific smell appears in an inappropriate place.
• Pain in the lower abdomen during pregnancy is less annoying, occurs periodically and is milder, pulling in nature. Low back pain appears only when there is a threat of miscarriage or later in pregnancy.
• Changes in mood can occur already in the first weeks of pregnancy, which in time coincides with the period of PMS. However, a pregnant woman expresses positive emotions as violently as anger. The premenstrual period is characterized by a negative emotional reaction.
• Fatigue occurs closer to 1 month. pregnancy (approximately 2 weeks. delayed menstruation).
• PMS ends with the onset of menstruation. In this case, full uterine bleeding occurs. Sometimes during pregnancy, spotting also appears on the days when menstruation should occur. The difference between bleeding during pregnancy and menstruation is spotting in nature: only a few drops of blood are secreted, and the discharge is pink or brownish.
• Frequent urination is often observed only during pregnancy from the first weeks. For PMS, this symptom is not characteristic.
• Nausea can be triggered by premenstrual syndrome and is observed throughout the day. During pregnancy, nausea and vomiting occur a little later, at 4-5 weeks. and indicate early toxicosis.

Important! A test for hCG will help diagnose pregnancy. Some tests are hypersensitive and may indicate pregnancy in 4 days. before the alleged menstruation begins. However, the optimal test time is considered to be 2 days of delay of menstruation and the next week.

It is quite possible to reduce and, at best, completely get rid of the premenstrual syndrome. If the symptoms are not too pronounced, the following recommendations will 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 soothe the nervous system. In the premenstrual period, dancing, yoga, and other relaxing practices (massage, bathing) are especially useful.
• Correction of nutrition - rejection of sweet and fatty foods, saturation of the diet with fruits and vegetables. Irritating to the nervous system of coffee, alcohol, energy and chocolate. These products should be excluded for the period of ICP.
• Regular sex is a source of oxytocin (the hormone of happiness). In addition, the uterus relaxes, spastic pain disappears. Do not drown the increased sexual desire: nature itself suggests what the body needs.
• Hold on to your emotions. The best tactics for the premenstrual period - I'll think about it later. Of course, you should not ignore the serious negative that coincided with the ICP. 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 in the premenstrual period. There is a high likelihood of a waste of money, which in the future can turn into a family conflict.

In severe cases, a woman is prescribed drug therapy:

• PMS pain, what to do? - let's say No-shpa’s reception. However, do not get involved in this drug. Providing an antispasmodic effect, No-spa in large doses can increase menstrual bleeding. NSAIDs (Ibuprofen, Naproxen) give a good analgesic effect. It is worth remembering: Ibuprofen (Nurofen, Mig-400) is not recommended for women after 40 years due to the negative effect on the heart.
• Soreness in the chest and swelling - easily eliminated by taking diuretics (Veroshpiron 25 mg, Furosemide 40 mg).
• Multivitamins - make up for the lack of magnesium, calcium and vit. AT 6. An excellent tool for PMS is the drug Magne-B6, the reception lasts 1 month. followed by a second course. A good effect is given by the homeopathic remedy Mastodinon and saffron broth.
• Removing nervous system excitement - herbal preparations are most often used (Novo-Passit, Persen). Mixed tinctures of valerian and motherwort will help reduce stress and improve sleep, take 15-25 cap. 2-3 times a day or just an hour before bedtime. In severe cases, a tranquilizer Afobazole is prescribed, which effectively eliminates the state of anxiety. In this case, the drug does not adversely affect the psyche, women can drive a car while it is being taken. It is advisable to take antidepressants (Fluoxetine, Zoloft, Paxil) and antipsychotics (Nootropil, Sonapax, Aminalon). Tranquilizers, antidepressants and antipsychotics are used only as directed by a doctor!
• Hormonal drugs - oral contraceptives (Midiana, Yarina) are used to stabilize the hormonal level and level the symptoms of PMS, the course is 3 months, followed by a repetition. Prevents engorgement of glands and swelling of the gestagen drug Drospirenone (Anabella, Angelique, Vidora).

Premenstrual syndrome cannot be tolerated. The condition with PMS, especially in women with an unstable psyche and neurosis, may worsen over time, which 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 aggravate the course of premenstrual syndrome. Their treatment, compliance with recommendations for lifestyle changes and, if necessary, medicines will help to cope even with severe PMS.

How long PMS (premenstrual syndrome) lasts and why it occurs, has remained a mystery to physicians for a long time. Some healers claimed that the phases of the moon have a strong influence on the female body during this period. Some explained the malaise by the area where the woman lives. Only in the 20th century was it possible to open the veil of obscurity. Doctors have proven that PMS is a complex of 150 mental and physical symptoms. Almost 75% of women suffer from varying degrees of complexity from this syndrome.

Scientists still have not been able to identify specific causes of premenstrual syndrome. There are many different theories that explain its appearance:

1. “Water intoxication” when the body’s water-salt balance is disturbed.
2. An allergic reaction of a woman's body to the hormone progesterone.
3. Psychosomatic cause.

Doctors are unanimous that the most likely causes of PMS are:

• decrease in the level of the “hormone of joy”, which is serotonin. Its lack is the cause of depression and tears for no reason;
• a lack of vitamin B6 in the body affects the physical condition of the breast (appears);
• smoking is doubly able to increase the symptoms of PMS;
• overweight with an index over 30 is the key to the appearance of the syndrome (observed 3 times more often);
• genetic factor involves the transmission of the disease by inheritance.

One of the causes of PMS are the consequences of complex labor. In some cases, you should look for the cause in existing gynecological diseases.

Hormonal theory

According to this theory, PMS is the result of changes in the content of sex hormones in a woman’s body in the second phase of menstruation. The female body functions normally when its hormonal background does not change.

Hormones perform a number of important functions for the body. As for estrogens, they are:

• improve the physical condition of the body, and also affect the mental well-being of women;
• increase the general tone and contribute to the development of creativity;
• affect the speed of assimilation and processing of incoming information;
• increase learning abilities.

The functions of progesterone include sedation. This explains the appearance of depressive conditions in women. Androgen hormones affect libido, improve performance and increase energy.

In case of imbalance of hormones, and this is characteristic for the period of the 2nd phase of the cycle, the body begins to malfunction. Some parts of the brain react sharply to such changes. As a result, a number of violations occur, including delayed fluid outflow.

This explains:

• the appearance of edema;
• violation of the cardiovascular system;
• breast swelling;
• irritability;
• digestive tract upset.

Premenstrual syndrome is dangerous due to complications of a woman’s chronic diseases. To distinguish them will help such a simple sign, as the cyclic PMS.

It is worth regularly observing periods of feeling unwell and their duration. They usually come before menstruation and then go away.

Symptoms of the Syndrome

How to get rid of discomfort

If there are severe symptoms, doctors suggest that the woman first exclude other diseases. To do this, it is necessary to pass tests and check the general state of health. Not excluded and.

If these are symptoms of premenstrual syndrome, then the course can be, following the following recommendations of doctors:

1. You must sleep at least 8 hours. A full sleep restores strength and relieves irritability and aggression. With obvious insomnia, do not give up walks in the fresh air.
2. Use aromatherapy. If there is no allergy to aromatic oils, then they greatly alleviate the serious condition caused by PMS. Baths with oils are recommended to be taken 2 weeks before the critical days.
3. Do not give up physical activity. It can be yoga, hiking, dancing, Pilates. Regular exercise can increase endorphins. This will help get rid of depression.
4. Take vitamins B6, A and E, which help with heart palpitations and fatigue.
5. Get your nutrition in order. Include foods containing calcium and fiber in the menu. In the daily diet, the following ratio should be observed: 10% - fats, 15% - proteins, 75% - carbohydrates. Useful herbal teas and fresh juices. Alcohol should be excluded.
6. Relaxation practices and regular sex increase the content of endorphins and can strengthen immunity.

Turning to a doctor, a woman receives medication. She passes all the necessary tests to determine the level of hormones. If necessary, an ultrasound is prescribed. After that, the doctor prescribes the necessary drugs, mainly hormonal “Janine”, “Novinet” and others.

According to the criminal chronicle, women commit most accidents during PMS. Thefts, murders and various crimes involving the fair half of humanity also occur during this period of time. When sentencing in some countries, premenstrual syndrome is considered a mitigating circumstance.

An interesting fact is that many women in the state of PMS want to make shopping raids and make numerous purchases.

Premenstrual syndrome (PMS) is the physical and emotional symptoms observed in women 1–2 weeks before menstruation. Symptoms in different women often differ and cease at the beginning of menstruation. Common symptoms are acne, breast tenderness, bloating, feeling tired, anxiety, and mood changes. Often, symptoms are observed within six days. Symptoms may change over time. During pregnancy or after menopause, symptoms disappear. The diagnosis of PMS requires the presence of a constant pattern of emotional and physical symptoms in the period after ovulation and before the onset of menstruation, and the severity of these symptoms should be sufficient to interfere with the normal functioning of the woman in everyday life. Emotional symptoms should be absent at the beginning of the menstrual cycle. For diagnosis, a diary of symptoms for several months can be used. Before diagnosis, other diseases that may cause similar symptoms should be ruled out. The cause of PMS is unknown. Some symptoms may worsen if the diet contains large amounts of salt, or. It is believed that the basis of the mechanism of PMS is a change in hormonal levels. In the presence of mild symptoms, women are advised to reduce their intake of salt, caffeine and reduce stress, as well as increase physical activity. In some cases, supplementation with and may be helpful. Anti-inflammatory drugs, such as, help fight physical symptoms. For more severe symptoms, birth control pills or can be used. Up to 80% of women report some symptoms before menstruation. In 20-30% of women, these symptoms qualify as PMS. (PMDD) is a more severe form of PMS with more pronounced psychological symptoms. PMDD affects three to eight percent of women in the period before menopause. In addition to the usual drugs used in PMS, a class of selective serotonin reuptake inhibitors can be used in PMDD.

Signs and Symptoms

Over 200 different symptoms have been associated with PMS. Common emotional and non-specific symptoms include stress, anxiety, difficulty falling asleep (insomnia), headache, fatigue, mood changes, increased emotional sensitivity, and changes in libido. Physical symptoms associated with the menstrual cycle include bloating, lower back pain, abdominal cramps, constipation or diarrhea, swelling or tenderness of the breasts, cyclic acne, joint or muscle pain, and gluttony. The exact symptoms and their intensity are different for all women. In one woman, in different cycles, the symptoms may vary and change over time. Most women with PMS have only a few of the possible symptoms, and the onset of symptoms is relatively predictable.

Causes

Despite the fact that the association of PMS with the luteal phase has been established, the exact causes of the syndrome are not clear, however, it is clear that several factors may be involved in the pathogenesis. One of the important factors is hormonal changes during the menstrual cycle; these changes are more pronounced in some women compared to others. Chemical changes in the brain, stress, and emotional problems, such as depression, do not cause PMS, but can worsen its course. Low intake of minerals, high levels of sodium, and / or consumption can worsen symptoms such as water retention and bloating. PMS is more common in women between 20 and 40 years old; in women with at least one child; women with a family history of depression; and women with a history of postpartum depression or mood disorder.

Diagnosis

There are no laboratory testing methods or unique physical research methods to confirm the diagnosis of PMS. The three main attributes of PSM include:

The main complaint of a woman is one or more emotional symptoms associated with PMS (most often irritability, tension, or a feeling of unhappiness). If there are only physical symptoms (bloating or abdominal pain), PMS cannot be diagnosed.

Symptoms occur predictably during the luteal (premenstrual) phase, and decrease or completely disappear predictably immediately before or during menstruation, and do not appear in the period before ovulation.

Symptoms must be serious enough to disrupt or interfere with a woman’s daily life.

Often there is a mild form of PMS. More severe symptoms will indicate PMDD. PMS, unlike PMDD, is not listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Illness (DSM-IV). To establish PMDD, the doctor must ask the woman to keep track of her symptoms for at least two menstrual cycles. This will help to establish whether the symptoms are limited to the premenstrual period, whether they are predictable in nature and whether the normal functioning of the woman is impaired. A number of standardized tools have been developed to describe PMS, including a calendar of premenstrual syndrome, a perspective record of the effects and severity of menstruation, and visual analogue scales. When making a diagnosis, it is necessary to exclude other disorders that may be associated with the observed symptoms. A number of disorders tend to worsen during menstruation, which can lead to an incorrect conclusion about PMS. These disorders include anemia, hypothyroidism, eating disorders and drug addiction. The key difference between these diseases is that PMS is that they are observed not only in the luteal phase of the cycle. In the period before menstruation, diseases and symptoms such as depression or other affective disorders, migraines, epilepsy, fatigue, irritable bowel syndrome, asthma, and allergies can worsen. When making a diagnosis, problems associated with other aspects of the female reproductive system should be excluded, including dysmenorrhea (pain during menstruation, and not before it), endometriosis, premenopause, as well as side effects of oral contraceptives. The National Institute of Mental Health conducted a study in which it compared the intensity of the symptoms observed from 5 to 10 days of the cycle with the symptoms observed six days before the onset of menstruation. For the diagnosis of PMS, the intensity of symptoms should increase at least 30% 6 days before menstruation. This pattern should be observed for at least two consecutive cycles.

Control

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

Antidepressants

In severe PMS, SSRIs such as and can be used. Women with PMS can only use these drugs on days when symptoms are expected. Despite its effectiveness in some cases, intermittent therapy may be generally less effective than long-term treatment. Common side effects of SSRIs are nausea and weakness.

Hormonal drugs

With PMS, hormonal contraception is often used; often use a combination of oral contraceptive and contraceptive patch. In some women, this class of drugs can provoke symptoms associated with PMS, while in others, on the contrary, reduce the physical manifestations of the syndrome. Hormonal drugs do not alleviate emotional symptoms. PMS often uses progesterone, but there is insufficient evidence to support this. In severe PMS, gonadotropin-releasing hormone antagonists can be used, however, such drugs themselves have significant side effects.

Alternative medicine

Forecast

PMS as a whole is a stable diagnosis. PMS-exposed women experience the same symptoms with the same intensity at the end of each cycle for many years. The treatment of specific symptoms is usually effective. Even if untreated, symptoms decrease in the premenopausal age. However, women with PMS or PMDD are more likely to show symptoms of menopause, such as hot flashes.

Prevalence

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

Story

Initially, PMS was considered a fictitious disease, and women who had symptoms were told that "the reason is in their head." It was believed that the reproductive organs of women have complete control over her. Women were warned against wasting energy needed for the functioning of the uterus and ovaries. In the 19th century, it became obvious that this view was not true: young girls in America worked in factories for a long and difficult working day; newspapers in the 19th century were literally full of messages about magical means to get rid of the "tyranny" of the natural processes of the menstrual cycle. In 1873, Edward Clarke published a book that had a great influence on the generation, entitled Sex in Education. Clark concluded that female workers are less likely to suffer than schoolgirls because they "less strain their brains." Presumably, women engaged in physical labor have a stronger and more developed body, and a more “normally constructed" apparatus of the reproductive system. Later, feminists will take a position opposite to Clark's opinion that women should not leave home, demonstrating that a woman can function in the world and outside of home space. A formal medical description of premenstrual syndrome (PMS) and its more severe form, premenstrual dysphoric disorder (PMDD), was carried out 70 years ago in a paper presented at the New York Academy of Medicine by Robert T. Frankl entitled "Hormonal causes of premenstrual tension." The term “premenstrual syndrome” was first used in an article published in 1953 by Dalton and Green in the Medical Journal of Great Britain. Since then, PMS has been firmly rooted in popular culture, but there have been few studies of PMS as a medical diagnosis. It is believed that women are partly responsible for the medicalization of PMS. By legitimizing the disorder, women contribute to the concept of PMS as a disease. It is also assumed that the hype surrounding PMS and PMDD is influenced by organizations and people who may benefit from it, such as feminists, psychologists, doctors and scientists.

Alternative Theories

Most proponents of PMS as a social concept believe that PMS and PMDD have little in common: the cause of PMDD is the chemical processes that occur in the brain, and the cause of PMS is hypochondria. Most PMS and PMDD studies take data solely from women's reports. According to sociologist Carol Tavris, in the West women are in such conditions that they are aware of the disorder in advance and expect its symptoms to appear. Anthropologist Emily Martin claims that PMS is a cultural phenomenon that continues to increase with positive feedback and, therefore, is a social concept that contributes to women's helplessness or serves as a convenient excuse. Tavrit argues that PMS serves as an explanation of anger or sadness in women. The decision to call PMDD a disease has been criticized as inappropriate medicalization. In both cases, we are talking about emotional aspects, not normal physical symptoms.

If you suddenly find that you craved a sandwich with butter, or burst into tears of emotion at the sight of a small child, or you painfully wanted to buy a pair of earrings that you are unlikely to wear, stop for a while and ask yourself if your period will begin . If soon, your unusual behavior may be caused by premenstrual syndrome or premenstrual tension syndrome (PMS). This is a specific condition that precedes menstruation and is more or less characteristic of most women. When PMS comes, just calm down and control your actions. When your period begins, you will return to your normal state.

Syndrome of premenstrual tension is associated with regular fluctuations in the level of hormones in the blood.

Previously, premenstrual syndrome was considered a psychological disease, until researchers proved that this condition has an organic nature, due to changes in the level of hormones in the body.

Increase aldosterone production, which causes a lot of changes in the body,
  - increase the level of monoamine oxidase (a substance released in the tissues of the brain and capable of causing depression),
  - lower the level (substances released in the tissues of the brain and affecting the level of activity and mood).

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

Causes of Premenstrual Syndrome

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

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

Symptoms of Premenstrual Syndrome

Physical symptoms:

Hypersensitivity or even soreness of the chest,
  - breast enlargement,
  - fluid retention in the body, leading to swelling of the legs and arms and to an increase in weight 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 rapid urination,
  - craving for food, especially salty or sweet, intolerance to alcohol,
  - lethargy, fatigue or vice versa, energy,
  - a strong heartbeat and flushing of the face,
  - an increase in 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, a tendency to violence.

What can you do

Do exercise. Research has shown that regular training reduces the onset of PMS symptoms, perhaps? this is due to the release of endorphins or other substances in the brain that relieve stress and increase 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 other simple relaxation methods at bedtime are in many cases very effective. Before going to bed, take hot baths and drink a glass of warm milk.

Eat a low-fat, high-fiber diet. During PMS, try to eat foods as low as coffee, cheese and chocolate as little as possible. Their use is associated with the appearance of migraines and many other symptoms of PMS, such as anxiety, frequent mood swings and a strong heartbeat.

Do not eat much, 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 to eat once a large portion. Try to eat right.

Nutritionists recommend daily use of vitamin B6 (50-100 mg) and magnesium (250 mg) as dietary supplements. In addition, doctors prescribe an additional intake of calcium, which together with magnesium eliminates the symptoms of PMS and protects against osteoporosis and iron (to combat anemia).

Many women say that primrose oil helps them (a substance rich in essential fatty acids). Consult your doctor about the dosage for you.

Stay away from crowds, do not go outside if it is bad weather, and consume as much vitamin C as possible (antioxidant and stimulant of the immune system). Women with PMS are more likely to get sick. Scientists believe that this is a consequence of a weakened immune system before the onset of menstruation, which makes the body vulnerable to viral, bacterial and fungal infections.

What can a doctor do

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

With anxiety, insomnia and other psychological symptoms, the doctor may prescribe tranquilizers or sedatives. However, long-term use of these drugs is undesirable due to the fact that they are addictive. The latest antidepressants have been shown to be effective in PMS, but they should 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 taken 5-7 days before the onset of menstruation.

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

Prevention of PMS

It is difficult to prevent any disorder in the body whose causes are not clear. To date, the best way to control this situation is to deal with it, rather than preventing it.

Changes in moods, outbursts of anger, tearfulness and irritability - the combination of these feelings clearly indicates a premenstrual syndrome. What is it, many representatives of the fair sex know, but they are not able to control their condition. Some girls and women feel noticeably worse, and pain before menstruation is a very real reason to see a doctor.

Complex mechanism

Menstruation in women is directly related to procreation. The first day is considered the beginning of the cycle, and each stage is aimed at preparing for conception.

During the menstrual phase, rejection of the uterine mucosa occurs, which is accompanied by bleeding. The first appearance of menstruation on average occurs at 12-14 years. Over time, the cycle is established, and its duration is from 21 to 35 days.

The absence of menstruation can indicate pregnancy or serious illness. In addition, women's health deserves special attention for various disorders, such as dysmenorrhea (painful menstruation) or increased bleeding.

If you add to these problems the manifestations of premenstrual syndrome, then some girls and women are definitely not envious.

Story

PMS (premenstrual syndrome) is a complex set of symptoms that occurs in women on average 1-10 days before menstruation. People have been studying this condition since ancient times. In ancient Rome, for example, doctors associated malaise before menstruation with the place of residence and even with the phases of the moon.

According to official data, Russian scientists Dmitry Ott and Alexander Reprev first conducted research on the physiological parameters and the cyclical nature of their oscillations. Then, in 1931, Robert Frank voiced the term “premenstrual tension” in his article, and ten years later, psychosexual disorders during PMS were described by Lewis Gray.

Research and scientific evidence have enabled the World Health Organization to include premenstrual syndrome in the classification of diseases. What is it, diagnostic methods, causes of occurrence, recommendations for alleviating the condition - read about all this in our review.

Causes

There is no consensus on the occurrence of PMS today, but experts still managed to formulate a number of reasons:

Hereditary predisposition;

Violation of water-salt metabolism;

Hormonal disruptions;

Thyroid disease;

Lack of vitamins (magnesium, zinc, calcium, vitamin B6).

The risk factors for the development of PMS include the presence of depression and stress, living in large cities, late reproductive age, lack of physical activity and nutritional imbalance.

Some studies show that overweight and smoking affect the likelihood of developing premenstrual syndrome.

Symptoms

There are a huge number of jokes and humorous stories about premenstrual syndrome in women. However, an impressive list of symptoms leaves little reason for fun.

Modern medicine distinguishes the following forms of PMS:

1. Neuropsychic.   Symptoms such as increased perception of noise, increased fatigue, weakness, sleep disturbance, distraction, headaches, difficulty speaking, and even fainting are characteristic of this form. Aggressiveness and irritability often lead to conflicts in the family and at work, as well as to the adoption of rash decisions.
2. Edematous.   A weight gain of several kilograms does not improve mood at all, swelling of the legs and arms appears. Sometimes girls and women experience joint pain and cramps. the whole body seems to be full of fluid.
3. Cephalgic.   Throbbing headaches are observed, which are accompanied by nausea or vomiting. However, blood pressure remains unchanged. In addition, a third of patients develop pain in the heart, numb hands, excessive sweating and depression.
4. Crisis. the beginning of which is an increase in blood pressure. Then there is a rapid heartbeat and fear of death. Such attacks are most often disturbed in the evening and at night, and various stresses, fatigue, or infectious diseases exacerbate the situation.

Experts also identify an atypical form of PMS, among the symptoms of which are allergic reactions, skin rashes, pulling pain in the lower back and lower abdomen, nosebleeds, and increased body temperature.

ICP stages

In medicine, there is a separation of PMS in three stages:

Compensated (symptoms disappear with the onset of menstruation, the disease does not develop with age);

Subcompensated (symptoms cease to bother with the end of menstruation, the clinic of premenstrual syndrome worsens over the years);

Decompensated (symptoms appear several days after the end of menstruation).

As you may have noticed, PMS in some cases is not at all like mild ailment. In severe form, this disease can seriously affect working capacity and well-being. Of course, do not panic due to increased fatigue or muscle pain. However, if you find yourself with more than six symptoms, be sure to make an appointment with a doctor who, using research, will be able to diagnose "premenstrual syndrome."

Diagnostics

It is very important to distinguish between real symptoms and inability to control your emotions and manifestations of bad manners or bad character. Premenstrual syndrome is cyclical. In other words, the same symptoms should bother a woman at regular intervals.

Often, premenstrual tension syndrome is confused with other diseases, so consult an expert for an accurate diagnosis. During the diagnosis, a blood test is mandatory (in different phases of the menstrual cycle). The level of hormones (progesterone, estradiol and prolactin) allows us to draw conclusions about the form of PMS.

Depending on the results of the analysis and the patient’s complaints, the attending physician may refer her to other specialists (psychiatrist, endocrinologist, therapist and neurologist) or prescribe additional studies (MRI, mammography, EEG, blood pressure control, and others).

How to relieve premenstrual syndrome?

Millions of women are asking this question, fully aware that living in a poor state of health and mood even for a week is simply unbearable. The most affordable measure is a dietary review.

It is believed that the use of complex carbohydrates (cereals and vegetables) makes it easier to survive the condition before menstruation. Some experts also talk about limiting the consumption of sweets and sugar, but from the point of view of alleviating the symptoms of PMS, this measure has not been fully studied.

It is advisable to control the intake of salt, because the body already has a tendency to edema associated with fluid retention. Salty foods only make things worse.

And finally, coffee. Studies have shown that women with severe PMS use much more coffee. Today there is no unequivocal opinion on whether an invigorating drink and premenstrual syndrome are related. What is it and the reasons for the occurrence of the latter are already known to us, but coffee helps or worsens the situation, probably it should be decided individually.

Lifestyle

Pain before menstruation can make serious adjustments to your plans. However, experts advise not to give up light physical exertion. Swimming, walking, yoga or dancing help to reduce symptoms and definitely improve your mood.

If your chest hurts before your period, then supporting underwear will help to cope with discomfort and increased sensitivity.

Of course, you should not expect an instant disappearance of PMS symptoms, but you can draw the first conclusions after 3-4 months. In most cases, these recommendations eliminate the need for drug treatment.

As alternative methods of combating premenstrual syndrome, various types of massage, physiotherapy, reflexology and balneotherapy can be recommended.

Many specialists who study women's health consider acupressure the most effective. Stimulation of biologically active points increases vitality and enhances the body's ability to self-regulate.

Drug treatment

Pharmacotherapy is the main method, but they certainly will not help to completely cure. PMS is believed to be a chronic disease, and some drugs only improve the quality of life by relieving symptoms.

Please note that all medicines are prescribed by a doctor, and no life stories or advice from “unfortunate friends” can replace a specialist’s consultation. Our review is for guidance only, and if you think that one of the drugs could help you, be sure to discuss this point with your doctor.

Depending on the form of PMS, the following groups are distinguished:

1. Combined oral contraceptives.
2. Medications for treating symptoms.
3. Hormonal drugs.
4. Diuretics.
5. Antidepressants.
6. Antiprostaglandin preparations.

Vitamins and Minerals

Patients with a mild form of premenstrual syndrome are primarily prescribed non-hormonal drugs - homeopathy, vitamins and minerals. Effectiveness and minimal side effects - these are the main advantages of such funds. In addition, non-hormonal drugs are not perceived “as a medicine”.

According to studies, calcium carbonate helps to reduce swelling and bloating, and calcium carbonate affects fluid retention and increased appetite, and vitamins of group B can cope with the psychoemotional manifestations of the disease.

Diuretics

These are diuretics, the purpose of which is justified in the edematous form of PMS. One of the most effective and safe is considered - "Veroshpiron"). The drug increases the excretion of sodium and chlorine ions, water, reduces titratable acidity of urine. It has a hypotensive effect.

As an initial daily dose, 25 mg (maximum 100 mg) is prescribed. Experts consider it appropriate to take diuretics during the expected fluid retention, that is, from the 16th to the 25th day of the menstrual cycle.

Among the side effects observed: hypotension, drowsiness, decreased libido and

COC

The use of combined oral contraceptives is the most common tactic in the treatment of premenstrual syndromes. Today, attending physicians prefer COCs containing drospirenone. This substance is an analogue of natural progesterone.

The composition of one of the most famous drugs called "Yarina" is a combination of the gestagen drospirenone (3 mg) and ethinyl estradiol (30 mcg). Patients taking this COC showed a slight decrease in body weight and the absence of fluid retention in the body. In addition, drospirenone affects the secretion of the sebaceous glands, which reduces the number of skin rashes before menstruation.

Drospirenone-containing contraceptives have a minimal amount of side effects. However, despite the effectiveness of the drug, the symptoms of PMS (edema, tenderness of the mammary glands, headaches and bloating) may return after a seven-day break. For this reason, it is advisable to introduce an extended regimen of COCs.

Antidepressants

To eliminate psychological symptoms, the attending physician most often prescribes antidepressants (Sertralin, Fluoxetine), the effectiveness of which has been proven by many clinical studies.

In the treatment of premenstrual syndrome, in contrast to the treatment of depression, these drugs are prescribed in shorter courses and in lower doses. There are two treatment regimens:

Taking medication when a symptom occurs;

Taking medication in the second half of the menstrual cycle.

For many women, taking antidepressants is an effective way to eliminate the symptoms almost completely.

However, in some cases, the result achieved is not enough, so the doctor may decide to increase the dose or prescribe another drug.

Taking antidepressants must be accompanied by a diary and detailed notes on well-being. Despite the fact that improvement can occur within two days after the start of the course, a competent specialist will draw conclusions about the effectiveness only after observing 2-4 menstrual cycles.

In rare cases, discontinuation of antidepressants can cause nausea, dizziness, and irritability. Fortunately, these symptoms go away pretty quickly.

ethnoscience

Antidepressants, hormonal drugs and oral contraceptives have many side effects, therefore, the fair sex primarily recalls folk methods.

So, what herbs will help us overcome PMS:

1. Melissa. Prepare a healing infusion at the rate of 2 tbsp. l dry plants in a glass of boiling water. Such a drink eliminates irritability, soothes and relieves pain. A mixture of lemon balm, chamomile, jasmine, mint and valerian will help improve the result.
2. Calendula, plantain leaves, calamus root and arnica flowers.   The infusion is moistened with gauze strips, which are applied to the body to reduce swelling.
3. Yarrow and jasmine.   Against pain in the lower back and stomach, pour boiling water over yarrow (40 g) and jasmine flowers (30 g). On the day you need to drink three cups of infusion.

Myth or reality?

So, we are talking about such an ailment as premenstrual syndrome. What this is, many girls and women are well aware, but only 3-6% of the weaker sex are diagnosed with “premenstrual dysphoric disorder” (PMDD). This disease leaves a serious imprint, limits communication with people and social life, and also increases the number of days of disability. In patients with mental illness, their exacerbation is observed.

Interestingly, some scientists generally question the presence of pathologies such as PMDD and premenstrual syndrome. The causes of the latter have not been proven at all, and most studies rely only on reports on well-being. Agree, this point of view has a right to exist. Moreover, Western girls and women often almost consciously expect the appearance of PMS, as if they are programming themselves to feel certain symptoms.