A woman is a fickle creature. Just yesterday, affectionate and caring, today she turns into a real fury, and this transformation is repeated every month. Experienced men This is not surprising, they know that nothing special is happening, the next menstruation is just approaching. The magazine “Together with You” examined what PMS is, the signs and symptoms of this condition, as well as ways to smooth out its manifestations.
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Causes of premenstrual syndrome
Initially, official medicine believed that PMS symptoms in women develop solely against the background of an unstable nervous system. But as we studied the problem, it became clear that this is too simplified an explanation, and the development of the clinical picture is influenced by the combined influence of the following factors:
- Estrogen decline. In the second half of the cycle, the level of estrogen, responsible for femininity and softness, falls, and natural a small amount of testosterone manifests itself in the form of typically male aggressiveness and irritability.
- Progesterone rise. Estrogen is replaced by progesterone, which provokes fluid retention and vegetative symptoms during PMS.
- Thyrotoxicosis. Hyperfunction of the thyroid gland negatively affects irritability and nervousness, significantly increasing the manifestations of premenstrual syndrome.
- Constitutional features. It is reliably known that the most pronounced symptoms are experienced by thin girls with a BMI below 18. Excess weight is also not the best option, since after the BMI exceeds 30, the clinical picture also becomes darker.
- Diseases of the reproductive system. The manifestations are aggravated by concomitant endometriosis, erosions, polyps, endometritis, cervicitis, infections and other diseases.
- Psycho-emotional stress. Stressful situations and against a less favorable background change a woman’s character not in better side, and in combination with hormonal storms they give just a hellish effect.
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Finding out what causes PMS syndrome, the symptoms of which are already quite boring, is a thankless task. Doctors were not too lazy to conduct a study in which they fully participated healthy women. Their hormonal levels were corrected with medications, but in due time all the typical signs were evident.
Non-standard PMS symptoms in women 30 years old
Symptoms tend to intensify with age, but accomplished women are characterized by a very curious manifestation of premenstrual tension. Most purchases in stores are made in last week before menstruation. So you are not a shopaholic, but simply treating PMS.
Symptoms of PMS in women: a list of typical manifestations
The clinical picture largely depends on psychological characteristics And concomitant diseases. Patients can differentiate their sensations into specific symptoms, or complain of a general malaise.
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The most common reason for applying for medical care emotional lability becomes, as a result of which the social sphere of life suffers - relationships with loved ones and at work worsen. Typical symptoms of PMS are:
- changes emotional background– irritability, tearfulness, aggression;
- sudden mood changes;
- sensitivity and engorgement of the mammary glands;
- sleep disorders – insomnia, drowsiness, difficulty falling asleep;
- bloating, painful or pulling sensations lower abdomen;
- increased appetite, craving for sweets;
- oppression sexual desire, apathy;
- acne;
- sensitivity to odors;
- swelling, weight gain;
- headache, dizziness;
- palpitations, increased blood pressure;
- nausea, stool disorders, less often constipation;
- pain in the lower back or tailbone, joints.
This list includes only those symptoms whose incidence exceeds 20%. A special feature of the condition is the fact that symptoms vary greatly among different women.
Clinical forms of premenstrual syndrome
What symptoms of PMS will appear is determined by the initial predisposition to certain diseases. Depending on the prevailing manifestations, the following forms are distinguished:
Neuropsychic form
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Characteristic of women with emotional instability, and can vary from mild anxiety to severe neurotic disorders requiring inpatient treatment. Symptoms include the following:
- panic attacks;
- feeling of fear;
- irritability;
- depression;
- insomnia;
- anxiety, sadness;
- inattention, forgetfulness;
- sudden mood changes;
- dizziness;
- aggressiveness;
- decreased or increased libido.
With a significant manifestation of panic attacks, women stop leaving the house and are in dire need of relieving the symptoms of PMS. In this case, you need to contact a qualified psychotherapist and master the methods of self-control of an attack described in other materials on our website.
Painful form
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Typically, the prevalence of various pain syndromes manifests itself in women with a low threshold of pain sensitivity. Vegetative manifestations are a frequent accompaniment of the painful form. Patients complain of:
- migraine or headaches;
- pain in the heart area;
- pain in the lower abdomen;
- soreness of the mammary glands;
- cardiopalmus;
- sensitivity to smells, bright lights, sounds;
- nausea, vomiting;
- increased blood pressure;
- paroxysmal sweating.
Mandatory components of treatment in this case will be analgesics and maximum rest, thanks to which the state of health significantly improves and the symptoms become tolerable.
Edema form
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This form affects women with a predisposition to kidney disease. The severity of manifestations largely depends on compliance with the water-salt regime, and women are concerned about the following violations:
- swelling of the face and lower extremities;
- weight gain reaching 3-4 kg;
- increased thirst;
- headache;
- itchy skin;
- decreased amount of urine;
- stool disorders.
To remove the symptoms of edematous PMS, it is preferable to use diuretics of plant origin and limit salt intake. Be sure to control the amount of liquid you drink so that it does not exceed 2 liters per day.
Crisis form
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It is difficult for patients and often causes difficulties in diagnosis. A clear connection with the phases allows one to distinguish the crisis form from somatic pathology menstrual cycle and self-relief of symptoms with the onset of menstruation. The clinical picture includes the following manifestations:
- paroxysmal heartbeat;
- attacks of fear, panic or aggression;
- cardialgia;
- blood pressure surges;
- attacks of frequent urination.
A thorough examination of the patient often reveals pathology of the cardiovascular or urinary system. In this case, PMS acts only as a catalyst for the disease.
Atypical form
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A rare type of premenstrual syndrome, which manifests itself with the following changes:
- pathological drowsiness that does not go away even after a long sleep;
- increased body temperature, usually to low-grade levels;
- morning sickness, vomiting;
- allergic rash.
Mixed forms are often encountered, in which a woman has symptoms from different groups. Despite the variety of manifestations, a number of common features make it possible to diagnose them as belonging to the clinical picture of premenstrual syndrome:
- The first manifestations are observed between the ages of 20 and 25, and increase with age. PMS symptoms in women aged 40 are at their maximum severity, and after that they decline.
- The degree of intensity of unpleasant sensations differs from cycle to cycle, but their set usually remains the same.
- On the first day of menstruation, all symptoms disappear without additional therapeutic measures.
PMS symptoms: how many days before menstruation
The time at which symptoms appear depends on the length of the cycle. With a standard 28-day cycle, PMS begins 2-7 days before the expected menstruation, and its severity gradually increases. In women with a 40-day cycle, the period of poor health can last for 2 weeks.
How to get rid of PMS symptoms on your own
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Treatment should always begin with the mildest methods, leaving the heavy artillery in the form of medications for later. Simple recommendations that will be useful to absolutely all women will help ease your condition:
- Full sleep - allow yourself at least 1 week a month to get enough sleep, devoting 8-9 hours to it. This relieves psycho-emotional symptoms well.
- Physical activity – regularly engage in any sport. This way you will increase the level of endorphins and your psychological resistance to irritants.
- Aromatherapy has a beneficial effect on the nervous system. Add a few drops to your bath, shower gel or shampoo essential oil lavender, bergamot, juniper or geranium.
- Magnesium supplements will help your nervous and cardiovascular systems. 2 weeks before your period, start taking Magnerot, Dopelgerts active magnesium, Magne B6, Complevit magnesium or Magnesium plus.
- Proper nutrition - in the case of PMS, this means excluding coffee, black tea, cocoa and chocolate from the diet, so as not to further increase emotionality. Load up on vegetables to replenish your supply of vitamins, and the fiber they contain will ensure regular bowel movements.
- Listen to your desires. If you want to wrap yourself in a blanket and watch a tearful melodrama, do so. Don’t force yourself to do household chores, and if your family goes on strike, remind them that, according to statistics, greatest number crimes committed by women occur in the last week of the cycle.
Don’t be shy about talking about your emotions, if you honestly admit to your family that you can expect outbursts of negativity in the coming days, they will be ready and will survive difficult period easier.
Professional help: make an appointment with a doctor
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By contacting a doctor, you will receive specialized help that will quickly and effectively alleviate the condition. Treatment is prescribed after a detailed interview with the patient, as it is mainly symptomatic:
- Consultation with a psychotherapist. Psychocorrection techniques are used for any form of the disease, but the greatest effect is achieved when psycho-emotional manifestations are dominant.
- Sedatives. Start with herbal medicines, such as glycine, valerian, novopassit, etc. If the effect is not pronounced, the doctor will prescribe more effective medicines like adaptol or phenibut.
- Diuretics. The edematous form responds well to treatment with decoctions of lingonberries, viburnum or cranberries. They also use medicinal herbs– nettle, yarrow, sage and chamomile.
- Oral contraceptives. The preferred method of contraception for women with PMS, as it eliminates the influence of the main provoking factor - hormonal fluctuations.
- Antidepressants and tranquilizers. They are prescribed according to strict indications and cannot be used for a long time so as not to cause addiction.
- Analgesics. Expressed pain syndrome– a direct indication for the prescription of painkillers such as indomethacin, ibuprofen or spasmalgon.
It is important to know that intense pain in the lower abdomen can signal endometriosis, polyp or other gynecological diseases, so be sure to undergo a preventive examination with a gynecologist twice a year.
Premenstrual syndrome is very insidious. On the one hand, nothing extraordinary happens in the body, this is just a reflection of normal physiological processes. But at the same time, it is absolutely impossible to endure these storms every month, and it is not necessary. Take action and remain calm, regardless of the phase of the cycle.
During this period, the most cheerful and balanced individuals are capable of turning into furies or monstrous crybabies. To the inadequate psychological state Purely physical, rather uncomfortable sensations are also added. Every woman has experienced this condition to a greater or lesser extent at least once in her life. And those who endure it regularly do not wait with fear for the arrival of their periods, but for these few days in anticipation of them. To get rid of the feeling of helplessness in front of nature, it is worth understanding what PMS is in girls and what causes it.
How is PMS deciphered and what is this phenomenon? While waiting for an answer to these questions, it is worth remembering that nature entrusted the mission of giving birth to a new life to a woman. It is this feature that is associated with the monthly rejection of the upper layer of the uterine mucosa in the form of menstrual bleeding. The process is regulated by changes in concentration in the body, which are responsible for PMS.
The decoding of all this is nothing more than premenstrual syndrome, that is, a combination of those same physical and psychological sensations early signs menstruation, which can bring a woman to a hospital bed.
What causes premenstrual syndrome in the first place?
There was a time when experts believed that PMS in women was associated exclusively with their state of mind and lay in the plane of psychology. With the development of medical science, it was discovered that this syndrome has an organic basis. It has been established that during this period the amount of estrogen and progesterone decreases, which provokes:
- An increase in aldosterone, which retains fluid in the body, affects general health and the functioning of the nervous system;
- Increased concentration of monoamine oxidase in brain tissue, which can cause depression;
- A decrease in the “hormone of joy” serotonin, which gives a clear understanding of what PMS is in girls, not only for themselves, but also for their loved ones.
Other reasons
The processes occurring in the female body during this period are the same for everyone. But the first signs of menstruation appear differently due to individual reactions to hormonal fluctuations. Some perceive them more sharply, while for others everything goes more smoothly and smoothly. There may also be some other reasons for this:
- “Jumping” levels of endorphins in the brain and blood, which affect work endocrine system and are responsible for reducing sensitivity to physical and mental pain;
- Errors in nutrition. A lack of vitamin B provokes tissue swelling, which causes excessive sensitivity of the mammary glands and increased fatigue. A deficiency of magnesium in the body causes frequent dizziness;
- Genetic predisposition. As a rule, women from the same family experience similar sensations before menstruation. This applies not only to mothers and daughters, but also to twin sisters;
- Stressful situations and sudden changes in climatic living conditions aggravate the syndrome and its manifestations.
Physiological manifestations
PMS symptoms are more pronounced in some people, less pronounced in others. Even if a woman has forgotten about the beginning of a new cycle, she will be reminded of the imminent arrival of her period:
- Nagging pain in the abdomen and lower back;
- Swelling of the limbs, puffiness of the face;
- Increase in body weight by a couple of kilograms;
- Swelling of the mammary glands, aching pain in them;
- , in severe cases, migraine;
- Sensation, sometimes vomiting;
- “Twisting” pain in the joints and spine;
- Errors in bowel function (constipation or diarrhea);
- (increased cravings for sweet or salty foods);
- Thirst and;
- Quick fatigue or unnatural vigor;
- Increased skin greasiness and...
How long a girl’s PMS lasts largely depends on her immunity, physical health and lifestyle. Usually these symptoms disappear with the onset of menstruation, but they may linger for a couple of days.
Emotional Signs
They are often more difficult to tolerate than physiological ones, since they cause bewilderment among others and the woman herself. It is the psychological inadequacy associated with PMS that causes car accidents, failed exams and damaged relationships:
- Mood swings from severe despondency to wild joy;
- Increased emotional reaction to stimuli, in severe cases can turn into aggressiveness;
- Drowsiness or, on the contrary, overexcitation and associated insomnia;
- Inability to concentrate;
- Unreasonable fears, panic.
To rule out mental illness, it is worth knowing how many days before PMS begins. This usually happens 7-10 days before menstruation. If such a condition accompanies a woman throughout the entire cycle or a significant part of it, you need to look for another cause of the disease together with a specialist. To avoid doubts about your own mental health, when PMS begins, you can track it on the calendar.
PMS or pregnancy
According to the description, the symptoms before menstruation are difficult to distinguish from the first signs of pregnancy. Especially if we are talking about an inexperienced girl. And yet it’s really possible to do it yourself:
- Discharge during pregnancy is noticed between 6 and 12 days after pregnancy, it is short-lived and has a pink-brown color. PMS produces bleeding that is bright red and more profuse;
- Pain in the mammary glands accompanies the entire pregnancy. The nipple areas become brighter and darker. With PMS, this does not happen, and breast sensitivity goes away by the beginning of menstruation;
- last until blood begins to flow; they are localized in the lumbar and pelvic areas. The initial stage of pregnancy gives short, mild cramps for a couple of days;
- An increase in temperature, if it occurs, with PMS does not linger longer than ovulation occurs. Pregnancy can cause this symptom at 18 days;
- Nausea during PMS occurs regardless of the time of day. Pregnancy is accompanied by this symptom and vomiting mainly in the morning, complemented by an aversion to certain foods and their aroma, an irresistible desire to eat something, sometimes unfit for food. The harbingers of menstruation are characterized by an abnormal appetite for some food, but there is no rejection of other dishes and no craving for inedible things.
Based on the listed signs, it is possible to determine whether it is PMS or. The differences between both conditions are clearly visible using a pharmacy test. A gynecologist will identify them even more accurately using palpation and ultrasound.
Even knowing what PMS syndrome is in women and young girls, and the temporary limitations of this condition, it can be difficult to endure it. The consolation can be that it is characteristic of the majority of representatives of the fair half of the population. There are also medications and other ways to reduce the impact of premenstrual syndrome on a woman’s well-being and life.
Good day, dear readers!
In this article we will consider questions about PMS: what is PMS, causes and signs of PMS how to relieve premenstrual syndrome etc. So…
What is PMS?
PMS (premenstrual syndrome)- a special period for many women, occurring 2-10 days before the onset, which is characterized by psycho-emotional, vegetative-vascular and metabolic-endocrine disorders.
About 75% of women experience PMS to varying degrees, 10% of whom have symptoms so severe that they become unable to work.
An interesting fact is also that not only women, but also men are showing interest in PMS online, perhaps trying to find a solution to the sometimes strange behavior of their other halves.
PMS symptoms
Each woman has her own individual symptoms of premenstrual syndrome and a different number of them. Depending on the various factors PMS symptoms may be less or more pronounced each time.
Symptoms of premenstrual syndrome:
- frequent mood changes;
- tearfulness;
- forgetfulness;
- anxiety, feeling of fear;
- attacks of irritability, aggression;
- psychological stress;
- fast fatiguability;
- increased appetite;
- swelling;
- swelling and pain in the chest;
- lower abdominal pain;
- pain in the lower back and legs;
- cardiopalmus;
- weight gain;
There are several theories that explain the causes and complexity of PMS.
Hormonal theory. It is assumed that the development and course of premenstrual syndrome is associated with an excess of estrogen and a lack of progesterone.
Theory of water intoxication. This theory believes that the appearance and complexity of PMS is determined by changes in the renin-angiotensin-aldosterone system and high levels of serotonin.
The theory of prostaglandin disorders. Explains the presence and course of premenstrual syndrome by changes in the balance of prostaglandin E1.
Neuropeptide metabolism disorder(serotonin, dopamine, opioids, norepinephrine, etc.). Pituitary melanostimulating hormone, when interacting with beta-endorphin, can promote mood changes. Endorphins increase the level of prolactin, vasopressin and inhibit the action of prostaglandin E in the intestines, resulting in swelling of the mammary glands, etc.
The development of PMS can also be facilitated by:, (in particular, deficiency of vitamins and microelements - calcium, magnesium and zinc), childbirth, abortion, neuroinfections, genetic factor (the presence and nature of PMS can be inherited), etc.
Types of PMS
The PMS classification divides premenstrual syndrome into the following types:
Forms of PMS according to the predominance of symptoms:
Edema form of PMS. This form is characterized by the following symptoms: swelling of the legs, face, fingers, tenderness and swelling of the mammary glands, thirst, sweating, itchy skin, gastrointestinal disorders (or constipation), irritability, headaches, joint pain, weight gain.
Neuropsychic form. Characterized by irritability, aggressiveness, depression, apathy, and fatigue. Some women may experience olfactory and auditory hallucinations, sadness, fear, memory loss, suicidal thoughts, reasonless laughter or crying. Symptoms such as dizziness, headache, flatulence, loss of appetite, tenderness and swelling of the mammary glands, and sexual dysfunction may also occur.
Cephalgic form. Manifested by neurological and vegetative-vascular symptoms: headache, pain with nausea, dizziness, diarrhea, rapid heartbeat, pain in the heart, increased sensitivity to odors, aggressiveness, irritability and insomnia.
Crisis form. In this form of premenstrual syndrome, sympathoadrenal crises occur, during which blood pressure increases, pain in the heart area, and a feeling of fear may also occur. The attacks usually end with profuse urination. This form of PMS can occur due to stressful situations or overwork, and can also develop as a result of untreated edematous, neuropsychic or cephalgic forms. Women over 40 are more susceptible to the crisis form.
Forms of PMS by severity, duration and number of symptoms:
Light form. Symptoms appear 2-10 days before the onset of menstruation, most often there are 3-4 of them, only 1 or 2 symptoms are significantly pronounced.
Severe form. Symptoms occur 3-14 days before the start of your period. There are 5-12 symptoms in total. At the same time, 2-5 or all of them are expressed to the maximum.
Diagnosis of PMS
To diagnose PMS, you need to contact. He will get acquainted with the patient’s complaints and medical history. Diagnosis of PMS will be helped by the cyclical nature of attacks of the disease and symptoms that occur before the onset of menstruation and weaken or disappear when it appears.
To confirm the diagnosis, it is also necessary to determine the level of hormones in the blood in different phases of the menstrual cycle, then it is necessary to determine the form of PMS based on the presence of symptoms, their number and severity.
For some forms of PMS, the following examinations may be prescribed:
- consultation with a neurologist, psychiatrist, mammologist;
- , or skulls;
- mammary glands and mammography;
- samples of Reberg, Zimnitsky, etc.
Gynecologists recommend that women keep a diary in which they should describe and note symptoms. Such records can be kept in a notepad, or you can install a special “women’s” application on your smartphone, where it is possible to describe all the symptoms by day. These records will help make a diagnosis and also reflect the dynamics of the therapy (if any).
PMS treatment 
How to relieve or alleviate premenstrual syndrome? Treatment for premenstrual syndrome includes:
- rest;
— physical therapy;
- massage;
— balanced diet(consumption of alcoholic beverages, chocolate and caffeine is not recommended).
Premenstrual syndrome - medications
Medicines for the treatment of premenstrual syndrome are prescribed strictly individually and only by a doctor, depending on the severity of PMS and its clinical manifestations.
In mild forms of the syndrome, magnesium supplements and sedatives are usually recommended to make you feel better.
In severe cases, may be prescribed hormonal drugs, antidepressants, diuretics and painkillers.
Medicines to relieve or relieve symptoms of premenstrual syndrome:“Valerian”, “Peony extract”, “Glycine”, “Saridon”, “Belastezin”, “Spazmalgon”, “No-shpa”.
How to relieve PMS with folk remedies
Melissa. 2 tbsp. Pour 1 cup of boiling water over spoons of lemon balm. Let stand for 2 hours, strain and drink instead of tea.
Blue cornflower. 1 tbsp. Pour 1 cup of boiling water over a spoonful of cornflower flowers, cover tightly with a lid and leave to steep for 30 minutes. Strain and take 0.5 cups several times a day.
Dandelion. 1 tbsp. Pour a glass of boiling water over a spoonful of dandelion roots, let it brew for 1-2 hours in a warm place, strain. Take a quarter glass 2-3 times a day.
Mint and lavender tea. Brew mint or lavender and drink instead of tea.
Blooming Sally. 1 tbsp. Pour a spoonful of fireweed tea into 0.5 liters of water and place on low heat. Boil for 3 minutes, remove from heat, cover and let stand for 1 hour. Strain and take a quarter glass before meals.
St. John's wort with oregano. 1 tbsp. Pour a spoonful of a mixture of 2 parts and 1 part oregano into a glass of boiling water. Let stand for 1 hour, then strain. When to cool down, take a third of a glass 30 minutes before meals. You can add for taste.
Tincture. Take the purchased ready-made tincture 10 drops 3 times a day before meals.
Valerian tincture. Drink 20-30 drops of tincture.
Aroma oils. Light lavender, sage or tea tree oil in an aroma lamp, they will help you relax and calm down.
Massage. A light massage will relieve pain. The massage consists of stroking, kneading, vibration, sawing and shaking the rectus and oblique muscles of the abdomen, sternum, lower back, spine and gluteal region.
Prevention of PMS
In order for premenstrual syndrome to pass less painfully and not cause inconvenience to the fair sex and the people around them, it is necessary to adhere to the following recommendations:
- eat properly, mainly food rich in microelements;
— take additional vitamins, especially in winter and spring;
- Limit your consumption of caffeine-containing drinks - coffee, energy drinks;
— get enough sleep, follow a work and rest schedule;
- lead active image life (run, ride a bike, roller skate, swim, etc.);
- go for walks more often fresh air;
- smile more often, try to always be in good mood;
- give up bad habits.
Premenstrual syndrome (PMS) (also called premenstrual tension, cyclic or premenstrual illness) is a complex of physical and mental symptoms that are cyclical and occur several days before the onset of menstruation. This specific condition is caused by the pathological course of the second phase of the menstrual cycle, which is characteristic of most women.
It has been revealed that the risk of developing PMS increases over the years. According to statistics, city residents are more susceptible this disease than the village ones. About ninety percent of women of reproductive age experience some changes in their body that occur before the approach of menstruation, usually seven to ten days before it begins. In some women, these manifestations of symptoms are mild and do not affect daily life(mild form of PMS), accordingly, do not require treatment, but in others (about 3-8%), the symptoms manifest themselves in a severe form, requiring mandatory medical intervention. The fact that certain symptoms manifest themselves cyclically makes it possible to distinguish PMS from other diseases.
Changes of an emotional and physical nature in a woman’s state before menstruation pass almost immediately after their onset. If symptoms are observed throughout the entire menstrual cycle, you should consult a doctor, since the cause of this condition may not be PMS at all, but a more serious illness. IN in this case Consultation with a psychiatrist is recommended.
Causes of premenstrual syndrome.
More recently, premenstrual syndrome was considered a kind of psychological disorder, until it was proven that it is based on changes in the level of hormones in the body. The presence or absence of premenstrual tension syndrome in women is due to fluctuations hormonal levels during the menstrual cycle and the different reactions of the body of each representative of the fair sex to them.
The most common causes of PMS are:
- Violation of water-salt metabolism.
- Hereditary predisposition.
- Frequent stress and conflict situations in the family (in most cases, PMS develops in women of a certain mental make-up: overly irritable, thin, overly concerned about their health).
- Hormonal imbalances, namely, disturbances in the levels of the hormones estrogen and progesterone in the second phase of the menstrual cycle (the level of estrogen increases with insufficient function of the corpus luteum with a decrease in the level of progesterone, which affects the nervous and emotional state of the woman).
- Increased secretion of the hormone prolactin, against the background of which changes occur in the mammary glands.
- Various thyroid diseases.
- Inadequate nutrition: lack of vitamin B6, as well as zinc, magnesium, calcium.
- Cyclic fluctuations in the levels of certain substances (neurotransmitters) in the brain (particularly endorphins) that affect mood.
As mentioned earlier, with the onset of menstruation, PMS symptoms completely disappear or are significantly reduced. There are several main forms of PMS that have pronounced symptoms:
- Psychovegetative form, in which PMS manifests itself in the form of forgetfulness, excessive irritability, conflict, touchiness, often tearfulness, weakness, fatigue, drowsiness or insomnia, constipation, numbness of the hands, decreased libido, unpredictable outbursts of anger or depression, sensitivity to odors, flatulence. . It has been noted that most often in young women of reproductive age, premenstrual tension syndrome is expressed in the form of attacks of depression, and in adolescents in transitional age Aggression prevails.
- Edema form of PMS, most often characterized by engorgement and soreness of the mammary glands, as well as swelling of the fingers, face, legs, slight weight gain, itching of the skin, acne, muscle pain, weakness, sweating, bloating.
- Cephalgic form of PMS In this form, the main symptoms are headaches, dizziness, fainting, increased irritability, nausea and vomiting. I note that headaches with this form can be paroxysmal, accompanied by swelling and redness of the face.
- "Crisis" form, in which symptoms of so-called “panic attacks” are observed - increased blood pressure, increased heart rate, attacks of compression behind the sternum, and the presence of fear of death. Basically, this condition worries women with this form of PMS in the evening or at night. This form is mainly observed in premenopausal women (aged 45-47 years). In most cases, patients with the crisis form of PMS have diseases of the gastrointestinal tract, kidneys and cardiovascular system.
- Atypical form of PMS accompanied by an increase in body temperature to 38°C with migraine attacks during menstruation, ulcerative gingivitis and stomatitis, attacks of suffocation before and during menstruation.
- A combination of several forms of PMS at once (mixed). As a rule, there is a combination of psychovegetative and edematous forms.
- The mild form is characterized by the manifestation of three to four symptoms, one or two of which predominate.
- The severe form is expressed in the simultaneous manifestation of from five to twelve symptoms, in which two to five symptoms are the most pronounced.
Stages of premenstrual syndrome.
There are three stages of PMS:
- compensated, in which the severity of the symptoms of the disease is insignificant, with the onset of menstruation the symptoms disappear, while the disease does not develop with age;
- subcompensated, which has pronounced symptoms that affect a woman’s ability to work, and over the years the manifestations of PMS only get worse;
- decompensated stage, expressed in severe symptoms that persist for several days after the end of menstruation.
Since the symptoms of premenstrual syndrome are quite extensive, some women confuse it with other diseases, often turning to the wrong specialists (therapist, neurologist, psychiatrist) for help. Only a thorough examination can reveal the cause of the disease.
Diagnosis of premenstrual syndrome.
To make a diagnosis, the doctor examines the patient’s medical history and listens to any existing complaints. The cyclical nature of attacks is the first sign of PMS.
To diagnose the disease, blood tests for hormones done in both phases of the menstrual cycle (prolactin, estradiol, progesterone) are examined. Depending on the form of PMS, the hormonal characteristics of patients differ. For example, with the edematous form of PMS, a decrease in the level of progesterone is observed in the second phase of the cycle; with neuropsychic, cephalgic and crisis forms, the level of prolactin in the blood increases.
After this, taking into account the patient’s form and complaints, additional studies are carried out (mammography, MRI, blood pressure control, electroencephalography, measurements of daily diuresis, etc.) with the involvement of other specialists (endocrinologist, neurologist, therapist, psychiatrist).
For the most accurate diagnosis of the disease, as well as to identify the dynamics of the treatment, experts recommend that all patients with PMS write down their complaints in detail every day in a kind of diary.
Treatment of premenstrual syndrome.
Treatment is carried out comprehensively, regardless of the form of the disease.
To eliminate psycho-emotional manifestations, psychotropic and sedative drugs are prescribed: the sedatives Seduxen, Rudotel and the antidepressants Tsipramine, Coaxil. It is recommended to take these medications for two months in both phases of the menstrual cycle.
To normalize the levels of sex hormones, hormonal drugs are prescribed:
- gestagens (Utrozhestan and Duphaston) during the second phase of the menstrual cycle;
- monophasic combined oral contraceptives (Zhanine, Logest, Yarina and others), which are well tolerated by patients, are suitable for all women of reproductive age in the absence of contraindications;
- androgen derivatives (Danazol) in the presence of severe pain in the mammary glands;
- premenopausal women are prescribed GnRH agonists (gonadotropin-releasing hormone agonists) - Zoladex, Buserelin, which block the process of ovarian functioning, excluding ovulation, thereby eliminating the symptoms of PMS.
Symptomatic therapy is carried out in the form of additional treatment to the main one, in order to quickly eliminate PMS symptoms: non-steroidal anti-inflammatory drugs (Indomethacin, Diclofenac) and antihistamines ( allergic reactions) - Tavegil, Suprastin.
For the treatment of premenstrual syndrome, homeopathic medications are often prescribed, in particular Mastodinon and Remens are herbal non-hormonal remedies, the effect of which extends directly to the cause of PMS. In particular, they normalize the imbalance of hormones, reducing the manifestations of the disease of a psychological nature (irritability, feelings of anxiety and fear, tearfulness). Mastodinon is often recommended for the edematous form of the disease, including chest pain. It is prescribed to be taken twice a day, thirty drops, diluted with water, for three months. If the drug is in tablet form, then take one tablet twice a day. The drug Remens is also taken for three months, ten drops, or one tablet three times a day. Both drugs have virtually no contraindications: excessive sensitivity to the components of the drugs, age restrictions - up to 12 years, pregnancy and lactation.
If the cause of the development of PMS is a lack of B vitamins and magnesium, then vitamins of this group (Magne B6), as well as calcium to prevent osteoporosis and iron to combat anemia, are prescribed.
The course of treatment averages from three to six months, depending on the severity of the disease.
Self-treatment of premenstrual syndrome.
To speed up the recovery process, as well as rapid rehabilitation, it is necessary to lead a certain lifestyle:
- Proper nutrition - limit the consumption of coffee, salt, cheese, chocolate, fats (they provoke the occurrence of PMS manifestations such as migraines), include fish, rice, dairy products, legumes, vegetables, fruits, and herbs in the diet. To maintain insulin levels in the blood, it is recommended to eat at least five to six times a day in small portions.
- Exercising two to three times a week helps increase the level of endorphins that improve your mood. However, you should not overuse exercise, as excessive amounts only aggravate the symptoms of PMS.
- You need to keep an eye on your emotional state, try not to be nervous, avoid stressful situations, get enough sleep (at least eight to nine hours of good sleep).
- As an aid, it is recommended to use herbal medicine: tincture of motherwort or valerian, thirty drops three times a day, warm chamomile tea, green tea with mint.
- It is recommended to take as much vitamin C as possible. It has been proven that women with PMS get sick more often, this is due to weakening immune system before menstruation, making her vulnerable to viral and bacterial infections.
Lack of timely treatment threatens the transition of the disease to the decompensated stage, characterized by severe depressive disorders, cardiovascular complications (high blood pressure, rapid heartbeat, heart pain). In addition, the number of symptom-free days between cycles decreases over time.
Prevention of PMS.
- systematic use of oral contraceptives in the absence of contraindications;
- healthy lifestyle;
- regular sex life;
- exclusion of stressful situations.
Premenstrual syndrome is a complex of cyclically recurring symptoms of a woman’s physical and psycho-emotional state shortly before the start of her next menstruation. The incidence of premenstrual syndrome ranges from 5-40% and increases with age. In young patients who have not overcome the thirty-year mark, it does not exceed 20%, but after thirty years, every second woman experiences premenstrual syndrome.
The reliable causes of premenstrual syndrome are unknown, so it is customary to talk about predisposing factors for the development of this pathology. Among them there are hormonal, metabolic, neuropsychic and endocrine abnormalities.
Premenstrual syndrome can be confidently called a “mystery condition”, because... Almost no genital pathology is manifested by so many symptoms from numerous body systems. However, all owners of this condition have a pronounced hormonal imbalance.
Despite the diversity clinical manifestations and the degree of their severity, premenstrual syndrome has a close connection with the menstrual cycle, namely its second phase. 1-2 weeks before the next menstruation, a woman experiences negative changes in mood, swelling of the limbs and face, sleep disturbances, engorgement of the mammary glands, weight gain, vascular disorders and so on. Scroll pathological symptoms with premenstrual syndrome is large, and the manifestations are individual. There are no two patients with completely identical manifestations of this syndrome.
The severity of the pathological signs of premenstrual syndrome is also ambiguous, so there is a mild form, which does not cause much physical and psychological inconvenience, and a severe form, which prevents one from maintaining the usual rhythm of life.
Diagnosis of premenstrual syndrome cannot be called simple, since all the most important systems of the body are involved in the formation of pathology, and the number of possible symptoms is approaching 150. Often, patients initially turn to a neurologist, therapist, endocrinologist and other specialists. If during the first phase of the cycle there are no deviations in the functioning of organs and systems, the resulting disturbances are usually correlated with premenstrual syndrome.
There is a misconception among women that any deviation from the usual state of the body on the eve of the next menstruation is associated with the presence of premenstrual syndrome. For most women, the harbingers of menstruation are often enlarged mammary glands, increased appetite and excessive emotionality, but these signs can also be a variant of the norm. Such symptoms do not always recur regularly before each menstruation, but are episodic in nature.
In reality, the diagnosis confirms the presence of a certain number of symptoms that recur regularly, are associated with menstruation and disappear after it ends. The diagnosis of premenstrual syndrome can only be established after a specialist has excluded the presence of mental illness.
The scope of laboratory and instrumental studies is determined by the form of the disease and the degree of its manifestation. All patients are prescribed laboratory test hormonal status, electroencephalogram and additional examinations according to the leading symptoms of the disease.
Therapy for premenstrual syndrome does not have clear regimens or a list of necessary medications. Special tablets with premenstrual syndrome do not exist. Treatment consists of several stages and consists of sequential elimination of all existing disorders. The key to successful therapy is the correct hormonal function of the ovaries and a two-phase ovulatory menstrual cycle.
Premenstrual syndrome in the absence of adequate therapy often transforms into pathological menopause.
Causes of premenstrual syndrome
There are several assumptions about the causes of premenstrual syndrome, but each theory explains the development of pathological processes only in one or several body systems and cannot establish a single trigger mechanism that links all changes together.
Changes in the patient’s psycho-emotional status on the eve of menstruation are associated with disturbances in the proper ratio of estrogen and progesterone. The resulting hyperestrogenism and decrease in progesterone concentration increases the lability of the nervous system.
Hormonal dysfunction is considered one of the most likely triggers in the development of premenstrual syndrome, therefore its development is correlated with abortion, removal or ligation of the fallopian tubes, pathological pregnancy and childbirth, incorrect hormonal contraception.
Changes in the mammary glands are provoked by the hormone prolactin. With its excess, the mammary glands become engorged and become overly sensitive.
Violation of the water-salt balance with the subsequent development of edema occurs due to the retention of water and sodium in the tissues by the kidneys.
Lack of certain vitamins (zinc, magnesium, B6 and calcium), disruption of the endocrine glands, weight loss and many other abnormalities can also be involved in the development of premenstrual syndrome.
Premenstrual syndrome is closely related to the state of the psycho-emotional sphere. First of all, it affects women with high mental stress, experiencing frequent stress and overwork. Among residents of large cities, there are more people suffering from premenstrual syndrome than residents of rural areas.
A genetic predisposition to the development of premenstrual syndrome has been established.
Premenstrual syndrome, which occurs infrequently in adolescents, is associated with hormonal dysfunction and neurological disorders. The disease may appear with the first menstruation or several months later.
Symptoms and signs of premenstrual syndrome
The number of symptoms accompanying premenstrual syndrome is extremely large, so we can say that there are no two women with the same manifestations of this disease. However, there is a list of symptoms that are more common than others. If they are conditionally divided according to their belonging to body systems, we can distinguish several forms of clinical manifestation of premenstrual syndrome:
— Psychovegetative (sometimes called neuropsychic) form. It includes symptoms of disruption of the normal functioning of the psycho-emotional sphere and nervous system. Possible irritability, touchiness, tearfulness, increased sensitivity to smells and sounds, as well as flatulence and/or. Patients complain of sleep disturbances, fatigue, and numbness of the limbs. In adult women, depression is more common, and premenstrual syndrome in adolescents is characterized by aggression.
- Edema form. It develops against the background of a temporary change in kidney function; they retain sodium and excess water accumulates in tissues, including the mammary glands. The patient experiences swelling on the face, legs and hands, slight weight gain and engorgement of the mammary glands. Due to swelling of the stroma of the mammary glands, the nerve endings are compressed, and discomfort or pain.
- Cephalgic form. It is expressed by headaches (usually migraines), with nausea and vomiting.
— Crisis form. A complex symptom complex associated with impaired renal, cardiovascular and digestive systems. There are chest pains and panic attacks - “panic attacks”. This form is typical for premenopausal patients (45-47 years old).
- Atypical form. According to the name, it has different symptoms of the disease from the usual ones: attacks of suffocation during the premenstrual period, fever up to 38°C, vomiting, etc.
- Mixed form. It is characterized by the simultaneous combination of several forms of premenstrual syndrome. Preference is given to the joint manifestation of the psychovegetative and edematous forms.
Premenstrual syndrome, which lasts a long time, can worsen in some women, so several stages of its development can be distinguished:
— Compensated stage. Premenstrual syndrome is mild and does not progress over the years. All symptoms that appear disappear immediately after the end of menstruation.
— Subcompensated stage. Significantly pronounced symptoms of the disease limit the patient’s ability to work and continue to worsen over time.
— The decompensated stage of premenstrual syndrome is characterized by an extreme degree of severity of the symptoms of the disease, which disappear a few days after the end of menstruation.
Impaired ability to drive normal life and work, regardless of the severity of symptoms and their duration, always indicates a severe course of the disease and is often associated with mental disorders. Changes in the psycho-emotional sphere can be so pronounced that the patient does not always control her behavior; 27% of women who have committed crimes are diagnosed with premenstrual syndrome.
The number of pathological symptoms that form premenstrual syndrome in patients is unequal, therefore it is customary to distinguish between mild and severe degree severity of the disease. The presence of three or four symptoms with a leading value of only one or two of them indicates a mild form of the disease. A severe form of the disease is indicated by the appearance of 5-12 symptoms, with the obligatory severity of two or five of them.
Unfortunately, there is an opinion that premenstrual syndrome is inherent in all women without exception, and that it should not be the reason for visiting a doctor. Popularization of medical knowledge in the media allows women to independently purchase medications for premenstrual syndrome in a free pharmacy chain. Self-medication cannot cure the disease, but it can eliminate or weaken its symptoms, creating the illusion of healing. Any pills taken independently for premenstrual syndrome will not replace full-fledged comprehensive treatment.
Diagnosis of premenstrual syndrome
The diagnosis of premenstrual syndrome is not always obvious. The disease has many non-gynecological symptoms, so patients often initially turn to an endocrinologist, neurologist and other specialists. Patients often visit related specialists for years and unsuccessfully try to cure a non-existent extragenital pathology.
The only diagnostic criterion in such cases is the close connection of the existing pathological symptoms with the approaching menstruation and the cyclical nature of their recurrence.
It is also necessary to take into account the peculiarities of the psycho-emotional personality of the patient, since each woman has her own criteria for assessing her condition.
To navigate correctly among large quantity probable symptoms and to distinguish them from other conditions, there are several clinical diagnostic criteria:
— The initial conclusion of a psychiatrist about the absence of mental illness in the case of abundant psycho-emotional symptoms.
— Cyclicity of the increase and decrease of symptoms according to the phases of the menstrual cycle.
The diagnosis of premenstrual syndrome is made only if the patient has at least five of the following clinical signs, and one of them must be among the first four:
— Emotional instability: frequent mood swings, unmotivated tearfulness, negative attitude.
- Aggressive or depressed, .
— Unmotivated feeling of anxiety and emotional stress.
- Feeling of hopelessness, worsening mood.
- Indifferent attitude to events happening around.
- Fatigue and weakness.
— Impaired concentration: forgetfulness, inability to concentrate on something specific.
- Change in appetite. Often, girls with premenstrual syndrome are diagnosed during examination.
— Change in the usual rhythm of sleep: the patient cannot fall asleep at night due to anxiety and emotional stress, or experiences a constant desire to sleep throughout the day.
- Headaches or migraines, swelling, engorgement and tenderness of the mammary glands, joint and/or muscle pain (sometimes severe), slight weight gain.
A reliable diagnosis of premenstrual syndrome is established together with the patient. She is asked to keep an “observation diary” and record in it all the symptoms that arise over several menstrual cycles.
Laboratory diagnostics help to identify the nature of hormonal disorders. The level of prolactin, progesterone and estradiol is determined. The study is carried out in the second half of the cycle, and its results are correlated with the form of the disease. A decrease in progesterone levels is inherent in the edematous form of the disease, and high level prolactin is detected in patients with psychovegetative, cephalgic or crisis forms of the disease.
For headaches, tinnitus, dizziness, blurred vision and other cerebral symptoms, differential diagnosis is carried out with space-occupying formations in the brain area. Computed tomography (CT) or magnetic resonance imaging (MRI) of the brain is indicated.
In case of pronounced neuropsychological abnormalities, electroencephalography is performed, confirming cyclic changes in the brain area.
The edematous form of premenstrual syndrome requires differential diagnosis with kidney disease, as well as with pathology of the mammary glands. Kidney function is examined using laboratory (urine tests, diuresis monitoring) and instrumental (ultrasound) diagnostics. Mammography excludes and.
Related specialists help the gynecologist make the diagnosis of premenstrual syndrome, excluding the presence of “their” diseases. Therefore, the list of diagnostic procedures may increase significantly due to additional methods prescribed by other doctors.
The opinion that all women have premenstrual syndrome to varying degrees of severity is indeed true, but it becomes a disease if the accompanying symptoms regularly disrupt the usual way of life and bring physical and mental suffering.
Treatment of premenstrual syndrome
The mechanisms of development of premenstrual syndrome are closely related to the menstrual cycle and the psychosomatic processes that accompany it. Therefore, total elimination of premenstrual symptoms is possible only if the menstrual function is completed. However, with the help of correctly chosen treatment tactics, it is possible to save the patient from painful monthly suffering and transform the disease into a mild form.
Therapy for premenstrual syndrome is always long-term (at least three to six months) and is aimed at all parts of the pathological process, depending on the form and degree of its manifestation. Unfortunately, often after completing a course of therapy, the disease returns, and we have to again look for new approaches to treating the disease.
Typically, patients with premenstrual syndrome have severe emotional and neurological disorders associated with their attitude to their condition. In order for the treatment process to be successful, a positive attitude is necessary, therefore the first stage of treatment is a detailed conversation in which the attending physician talks about the disease and explains treatment tactics, and also recommends the necessary lifestyle changes: diet, necessary physical activity, giving up bad habits and others.
Medications for premenstrual syndrome, they are selected according to the list of symptoms that accompany it. Are used:
— Psychotropic and sedatives for the elimination of neuropsychic disorders.
— Hormonal drugs are used to restore the necessary hormonal balance. Progestins (Utrozhestan, Duphaston), monophasic contraceptives (Yarina, Logest, Zhanine) can be used. For severe pain in the mammary glands, androgen derivatives (Danazol) help. If for successful treatment it is necessary to exclude ovulation, Zoladex and similar drugs are used.
Parlodel and its analogues are used to reduce prolactin levels.
All hormonal drugs are prescribed taking into account the phase of the menstrual cycle.
- Diuretics. Group medicines, removing excess fluid from the body and stabilizing blood pressure, successfully copes with the edematous form of premenstrual syndrome. Spironolactone and similar drugs are prescribed.
— Symptomatic medications. Used for liquidation accompanying symptoms. Non-steroidal anti-inflammatory drugs (Indomethacin, Diclofenac), antihistamines (Suprastin, Tavegil) and antispasmodics (No-spa and the like) are prescribed.
Therapy of premenstrual syndrome with the help of homeopathic remedies has proven itself well. The drugs Remens and Mastodinon are herbal non-hormonal drugs that can restore proper hormonal balance and eliminate psycho-emotional disorders. Mastodinon effectively eliminates swelling and tenderness in the mammary glands.
In case of relapse of the disease, the course of treatment is repeated. At hormonal disorders reception hormonal drugs may be prescribed on a permanent basis. The success of therapy implies a decrease in the severity or complete subsidence of the symptoms of premenstrual syndrome.
