OVERVIEW
Premenstrual syndrome is characterized by moderate, repeated symptoms on both the emotional and physical levels that start during the luteal phase of menstruation and end with menstruation. For one to two days before the start of menstruation, the majority of women of reproductive age experience one or more moderate mental or physical symptoms. Premenstrual syndrome is not thought to be represented by these modest symptoms, such as breast discomfort and bloating, which do not result in significant distress or functional impairment.
DEFINITION
PMS is characterized as recurring emotional or physical symptoms (or both) which only occur during the luteal phase of the menstrual cycle and go away in the follicular phase at least by the end of menstruation.
SIGN AND SYMPTOMS
Disturbing physiological, physical, and behavioral manifestations
occur during the menstruation cycle’s luteal phase.
significant symptom regression at the start of the period or during it (bleeding)
PHYSICAL SYMPTOMS
- Abdominal bloating
- Body aches
- Breast tenderness and/or fullness
- Cramps, abdominal pain
- Fatigue
- Headaches
- Nausea
- Swelling of extremities
- Weight gain
PSYCHOLOGICAL AND BEHAVIORAL
- Anger Irritability
- Anxiety
- Changes in appetite
- Changes in libido
- Decreased concentration
- Depressed Mood
- Feeling out of control
- Mood Swings
- Poor sleep
- Tension
INVESTIGATIONS AND DIAGNOSIS
There is no need to investigate the case unless something horrifying is suspected. It is vital to maintain that the woman’s signs and symptoms do not occur outside of the luteal phase of the menstrual cycle. It is indeed critical to rule out other organ illnesses and significant psychiatric illnesses.
Diagnosis The diagnosis of PMS or PMDD is based on the clinical history. While other affective disorders including sadness and anxiety may experience premenstrual cyclic deterioration, they lack the symptom-free space necessary for the clinical diagnosis of PMS or PMDD during the mid-follicular phase (days 6 through 10 of the menstrual cycle).
PATHOPHYSIOLOGY
The exact etiology of PMS does appear to have at least three elements:
a portion of the brain
a menstrual cycle that is ovulatory
Other factors and psychosocial factors women with severe mental illness
PMS frequently trace their issues back to a case of postpartum depression. Additionally, progestogens like levonorgestrel, norethisterone, and medroxyprogesterone acetate often produce depressive side effects in women.
MANAGEMENT
HORMONAL TREATMENT
- Combined Oral contraceptive pills
- GnRH analogs
NON-HORMONAL
- SSRI/SNRIs
- TCA
SELF-MANAGING STRATEGIES
- Healthy diet
- Vitamins and Minerals
- Exercise
- Stress reduction (yoga, tai-chi)
- Cognitive Behavioural Therapy
- Acupuncture
- Herbal remedies
- Mind-body therapy (aromatherapy, reflexology, magnotherapy)
| NATURAL THERAPIES THAT HAVE POSITIVE EVIDENCE FOR THE TREATMENT OF PMS |
| Vitamin B6 |
| Calcium |
| Magnesium |
| Evening Primrose Oil |
| Premular (an extract of the berries form the chaste tree) |
PROGNOSIS
Women with PMS and PMDD who begin medical therapy should be monitored at least every 3 months for the efficacy of the treatment. The need for treatment continuation should be reviewed regularly.