What causes PMS to appear? PMS: what it is and how to deal with it. They can play a cruel joke and provoke the syndrome
Premenstrual syndrome is a symptom complex that is characterized by neuropsychic, metabolic-endocrine and vegetative-vascular disorders that occur in the second phase of the menstrual cycle (about 3-10 days) and cease either at the beginning of menstruation or immediately after its completion.
Other names for premenstrual syndrome (PMS) are premenstrual illness, premenstrual tension syndrome, or cyclic illness.
As a rule, PMS is diagnosed in women after 30 years of age (occurs in 50% of the fairer sex), while at a young age it is familiar to only every fifth woman.
Kinds
Depending on the predominance of certain manifestations, 6 forms of premenstrual illness are distinguished:
- neuropsychiatric;
- edematous;
- cephalgic;
- atypical;
- crisis;
- mixed.
Based on the number of manifestations, their duration and intensity, there are 2 forms of PMS:
- light. 3-4 signs appear 3-10 days before menstruation, and the most pronounced of them are 1-2;
- heavy. 5-12 signs appear 3-14 days before menstruation, and 2-5 of them, or all 12, are maximally expressed.
But, despite the number of symptoms and their duration, in case of decreased performance, they speak of a severe course of PMS.
Stages of PMS:
- compensated. Symptoms appear on the eve of menstruation and disappear with their onset, while the symptoms do not intensify over the years;
- subcompensated. There is a progression of symptoms (their number, duration and intensity increase);
- decompensated. A severe course of PMS is observed; over time, the duration of the “light” intervals decreases.
Causes of premenstrual syndrome
Currently, the causes and mechanism of development of PMS are not well understood.
There are several theories explaining the development of this syndrome, although none of them covers the entire pathogenesis of its occurrence. And if previously it was believed that a cyclic condition is typical for women with an anovulatory cycle, it is now reliably known that patients with regular ovulation also suffer from premenstrual disease.
The decisive role in the occurrence of PMS is played not by the content of sex hormones (this may be normal), but by fluctuations in their levels throughout the cycle, to which the areas of the brain responsible for the emotional state and behavior react.
Hormonal theory
This theory explains PMS by a violation of the proportion of gestagens and estrogens in favor of the latter. Under the influence of estrogens, sodium and fluid are retained in the body (edema), in addition, they provoke the synthesis of aldosterone (fluid retention). Estrogenic hormones accumulate in the brain, which causes neuropsychiatric symptoms; their excess reduces the content of potassium and glucose and contributes to the occurrence of heart pain, fatigue and physical inactivity.
Increased prolactin
Theory of water intoxication
Explains PMS as a disorder of water-salt metabolism.
Among other versions that consider the causes of PMS, one can note the theory of psychosomatic disorders (somatic disorders lead to mental reactions), the theory of hypovitaminosis (lack of vitamin B6) and minerals (magnesium, zinc and calcium) and others.
Predisposing factors for PMS include:
- genetic predisposition;
- mental disorders in adolescence and the postpartum period;
- infectious diseases;
- poor nutrition;
- stress;
- frequent climate change;
- emotional and mental lability;
- chronic diseases (hypertension, heart disease, thyroid pathology);
- alcohol consumption;
- childbirth and abortion.
Symptoms
As already mentioned, signs of PMS appear 2-10 days before menstruation and depend on the clinical form of the pathology, that is, on the predominance of certain symptoms.
Neuropsychic form
Characterized by emotional instability:
- tearfulness;
- unmotivated aggression or melancholy, leading to depression;
- sleep disturbance;
- irritability;
- weakness and fatigue;
- periods of fear;
- weakening libido;
- thoughts of suicide;
- forgetfulness;
- increased sense of smell;
- auditory hallucinations;
- and others.
In addition, there are other signs: numbness of the hands, headaches, decreased appetite, bloating.
Edema form
In this case, the following prevail:
- swelling of the face and limbs;
- soreness and engorgement of the mammary glands;
- sweating;
- thirst;
- weight gain (and due to hidden edema);
- headaches and joint pain;
- negative diuresis;
- weakness.
Cephalgic form
This form is characterized by a predominance of vegetative-vascular and neurological symptoms. Characteristic:
- migraine-type headaches;
- nausea and vomiting;
- diarrhea (a sign of increased prostaglandins);
- palpitations, heart pain;
- dizziness;
- odor intolerance;
- aggressiveness.
Crisis form
It occurs according to the type of sympathoadrenal crises or “psychic attacks”, which differ:
- increased blood pressure;
- increased heart rate;
- heart pain, although there are no changes on the ECG;
- sudden attacks of fear.
Atypical form
It occurs as hyperthermic (with an increase in temperature to 38 degrees), hypersomnic (characterized by daytime sleepiness), allergic (the appearance of allergic reactions, not excluding Quincke's edema), ulcerative (gingivitis and stomatitis) and iridocyclic (inflammation of the iris and ciliary body) forms.
Mixed form
It is distinguished by a combination of several described forms of PMS.
Diagnosis of premenstrual syndrome
- mental pathology (schizophrenia, endogenous depression and others);
- chronic kidney diseases;
- brain formations;
- inflammation of the spinal cord membranes;
- arterial hypertension;
- pathology of the thyroid gland.
With all of these diseases, the patient complains regardless of the phase of the menstrual cycle, while with PMS, symptoms occur on the eve of menstruation.
In addition, of course, the manifestations of PMS are in many ways similar to the signs of pregnancy in the early stages. In this case, it is easy to resolve doubts by independently conducting a home pregnancy test or donating blood for hCG.
Diagnosis of premenstrual tension syndrome has some difficulties: not all women turn to a gynecologist with their complaints; most are treated by a neurologist or therapist.
When making an appointment, the doctor must carefully collect anamnesis and study complaints, and during the conversation, establish the connection of the listed symptoms with the end of the second phase of the cycle and confirm their cyclicity. It is equally important to make sure that the patient does not have mental illness.
Then the woman is asked to mark the signs she has from the following list:
- emotional instability (crying for no reason, sudden mood changes, irritability);
- tendency towards aggression or depression;
- feeling of anxiety, fear of death, tension;
- low mood, hopelessness, melancholy;
- loss of interest in her usual way of life;
- increased fatigue, weakness;
- inability to concentrate;
- increased or decreased appetite, bulimia;
- sleep disturbance;
- a feeling of engorgement, tenderness of the mammary glands, as well as swelling, headaches, pathological weight gain, pain in muscles or joints.
The diagnosis of “PMS” is established if a specialist ascertains the presence of five signs in the patient, with the obligatory presence of one of the first four listed.
A blood test for prolactin, estradiol and progesterone is required in the second phase of the cycle; based on the results obtained, the expected form of PMS is determined. Thus, the edematous form is characterized by a decrease in progesterone levels. And neuropsychic, cephalgic and crisis forms are characterized by increased prolactin.
Further examinations vary depending on the form of PMS.
Neuropsychiatric
- examination by a neurologist and psychiatrist;
- radiography of the skull;
- electroencephalography (detection of functional disorders in the limbic structures of the brain).
Edema
Shown:
- delivery of the BAC;
- study of renal excretory function and measurement of diuresis (excreted fluid is 500-600 ml less than consumed);
- mammography and ultrasound of the mammary glands in the first phase of the cycle in order to differentiate mastopathy from mastodynia (pain in the mammary glands).
Krizovaya
Necessarily:
- Ultrasound of the adrenal glands (to exclude a tumor);
- testing for catecholamines (blood and urine);
- examination by an ophthalmologist (fundus and visual fields);
- x-ray of the skull (signs of increased intracranial pressure);
- MRI of the brain (exclude tumor).
It is also necessary to consult a therapist and keep a blood pressure diary (to rule out hypertension).
Cephalgic
Held:
- electroencephalography, which reveals diffuse changes in the electrical activity of the brain (a type of desynchronization of cortical rhythms);
- CT scan of the brain;
- examination by an ophthalmologist (fundus);
- X-ray of the skull and cervical spine.
And for all forms of PMS, consultations with a psychotherapist, endocrinologist and neurologist are necessary.
Treatment of premenstrual syndrome
PMS therapy begins with explaining to the patient her condition, normalizing the regime of work, rest and sleep (at least 8 hours a day), eliminating stressful situations, and, of course, prescribing a diet.
Women with premenstrual tension syndrome should adhere, especially in the second phase of the cycle, to the following diet:
- Hot and spicy dishes are excluded:
- salt is limited;
- a ban is imposed on the consumption of strong coffee, tea and chocolate;
- the consumption of fats is reduced, and in some types of PMS, animal proteins are reduced.
The main emphasis of the diet is on the consumption of complex carbohydrates: whole grain cereals, vegetables and fruits, potatoes.
In the case of absolute or relative hyperestrogenism, gestagens (Norkolut, Duphaston, Utrozhestan) are prescribed in the second phase of the cycle.
For neuropsychic signs of PMS, it is recommended to take sedatives and mild tranquilizers 2-3 days before menstruation (Grandaxin, Rudotel, phenazepam, sibazon), as well as antidepressants (fluoxetine, amitriptyline). MagneB6 has a good calming, sleep-normalizing and relaxing effect. Herbal teas, such as “Aesculapius” (daytime) and “Hypnos” (at night), also have a sedative effect.
In order to improve cerebral circulation (cephalgic form), nootropil, piracetam, and aminolon are recommended.
In case of edema, diuretics (spironolactone) and diuretic teas are prescribed.
Antihistamines (teralen, suprastin, diazolin) are indicated for atypical (allergic) and edematous forms of PMS.
Cephalgic and crisis forms of PMS require taking bromocriptine in the second phase of the cycle: this drug reduces prolactin levels. Mastodinon quickly relieves pain and tension in the mammary glands, and Remens normalizes the level of hormones in the body.
For hyperprostaglandinemia, non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, diclofenac) are indicated, which suppress the production of prostaglandins.
And, of course, indispensable drugs for PMS are combined oral contraceptives from the monophasic group (Jess, Logest, Janine), which suppress the production of their own hormones, thereby leveling the manifestations of the pathological symptom complex.
The average course of treatment for premenstrual tension syndrome is 3-6 months.
Consequences and prognosis
PMS, for which a woman has not been treated, threatens a severe course of menopausal syndrome in the future. The prognosis for premenstrual illness is favorable.
Doctors have always tried to determine the reasons why women feel unwell and irritable in the days immediately before menstruation . In ancient times, this phenomenon was associated with various factors - the phases of the moon, the woman’s health, and the characteristics of the area where she lived. However, the state before menstruation was a mystery to the Aesculapians. Only in the twentieth century were doctors able to understand to some extent what was happening to the ladies.
Speaking about PMS - what it is, you should know how PMS stands for - what it means is a manifestation characteristic of women in the days before menstruation. PMS is a set of symptoms that appear in women and girls a few days before the onset of menstruation.
Scientists are still researching what causes such manifestations and what this syndrome means. Those who are interested in how PMS is translated should learn in more detail what manifestations are characteristic of this condition. Each decoding of what PMS is in girls contains a description of all the characteristic symptoms and manifestations.
After all, PMS in women is a whole complex of symptoms, both physical and mental—scientists have counted about 150 of them. Approximately 75% of women experience premenstrual syndrome to varying degrees.
As a rule, PMS in girls begins to appear approximately 2-10 days before the day when signs of menstruation appear. After menstruation ends, menstrual syndrome also completely disappears.
Why does PMS develop?
So far, all the studies conducted have not made it possible to determine why premenstrual syndrome manifests itself? There are many theories that explain why this condition develops.
- The so-called “water intoxication” is a disrupted water-salt metabolism.
- Allergic nature – high sensitivity of the body to endogenous substances.
- Psychosomatic – the development of physiological symptoms due to the influence of mental factors.
The most complete and broadest theory today is the hormonal theory, according to which PMS is explained by strong hormonal fluctuations in the second phase of the cycle. After all, for the female body to function correctly, normal hormonal balance is important:
- are able to improve well-being, both physical and mental, activate mental activity, increase vitality;
- progesterone provides a sedative effect, which can lead to a depressive state in the second phase;
- affect libido, increase performance and energy.
In the second phase of the cycle, a woman’s hormonal background changes. Consequently, the hormonal theory suggests that the body reacts inadequately to such a “storm”. Interestingly, premenstrual tension syndrome is inherited.
Since during the premenstrual period the body experiences endocrine instability , this leads to the manifestation of somatic and psycho-vegetative disorders. The main reason for this is the fluctuation of sex hormones during the monthly cycle and the reaction of the limbic parts of the brain to this.
- When the level increases estrogen and first increases, and then decreases the level progesterone , swelling, tenderness of the mammary glands, dysfunction of the heart and blood vessels, pressure surges, irritability are also observed in women.
- With increased secretion fluid is also retained in the body.
- When content increases , there are vegetative-vascular disorders, digestive disorders - diarrhea, nausea, as well as headaches reminiscent of.
Thus, modern doctors identify the following factors that determine the development of PMS:
- A decrease in the level, which leads to the manifestation of mental symptoms of premenstrual syndrome: when this hormone decreases, sadness and melancholy are noted.
- Deficiency leads to fluid retention, increased breast sensitivity, and mood changes.
- A lack of magnesium leads to the development of symptoms such as headache, desire to eat sweets.
- Smoking – women who smoke suffer from PMS twice as often.
- – Those with a body mass index greater than 30 are much more likely to experience symptoms of this syndrome.
- Genetics – the tendency to PMS can be inherited.
- Difficult childbirth, abortion, gynecological operations.
The main symptoms of PMS in women
When talking about what PMS symptoms are, how many days before menstruation do they appear in girls and women, we should take into account the individual characteristics of each organism. Doctors divide the main signs of PMS before menstruation into several different groups. The following symptoms of premenstrual syndrome are distinguished (by group):
- Neuropsychiatric : depression, aggression, irritability and tearfulness.
- Exchange-endocrine : chills, swelling due to impaired water-salt metabolism, fever, discomfort in the mammary glands, bloating, blurred vision and memory.
- Vegetative-vascular : headache, pressure changes, nausea, vomiting, tachycardia,.
Speaking about what symptoms women experience before menstruation, it should be taken into account that they can be conditionally divided into several forms. However, as a rule, they are combined. So, if pronounced psycho-vegetative disorders are observed, the pain threshold decreases, and the woman perceives pain very acutely - a week or a few days before menstruation.
What signs of menstruation can be observed in a week or in a few days?
Neuropsychic form | Disturbances in the emotional and nervous spheres appear:
|
|
Crisis form |
|
|
Atypical manifestations |
|
|
Edema form |
|
|
Cephalgic form | Most manifest vegetative-vascular and neurological symptoms:
Approximately 75% of women experience increased vascular patterns and hyperostosis. With this form, as a rule, the family history includes hypertension, diseases of the digestive system, heart and vascular diseases. |
Wikipedia and other sources indicate that each woman experiences PMS differently, and the symptoms may vary.
Scientists, having conducted a series of studies, determined the frequency of symptoms of premenstrual syndrome:
In addition, PMS can significantly aggravate the course of other diseases:
- anemia ;
- thyroid diseases;
- migraine ;
- chronic fatigue syndrome;
- inflammatory diseases of the female genital area.
What conditions and diseases can masquerade as PMS?
To know how many days before menstruation begins, every woman needs to keep a calendar or a special notebook and write down the start date of menstruation, how long menstruation lasts, as well as the day of ovulation (to do this, just measure your basal temperature). It is also worth noting the manifestation of symptoms before menstruation and how you feel during ovulation.
If a woman keeps such records over several cycles, this helps her determine how often signs of PMS appear. Also, the diary will help determine whether there is a delay in menstruation, etc.
To establish a diagnosis of PMS, the doctor determines the presence of at least 4 signs listed below:
- , insomnia ;
- deterioration of attention and memory;
- increased appetite, decreased appetite;
- severe fatigue, weakness;
- chest pain;
- swelling;
- pain in joints or muscles;
- exacerbation of chronic diseases.
This condition can also be diagnosed if at least one of the following signs is observed:
- conflict, tearfulness, nervousness and irritability, sudden mood swings in women;
- groundless anxiety, fear, tension;
- feeling of melancholy without reason, depression;
- depression;
- aggressiveness.
To determine the severity of PMS, it is important to take into account the number of manifestations, their severity and duration:
- Mild form - manifests itself from 1 to 4 symptoms, if these are 1-2 signs, then they are significantly expressed.
- Severe form - manifests itself from 2 to 12 signs, if these are 2-5 symptoms, then they are significantly pronounced. Sometimes they can lead to a woman becoming unable to work the day or several days before her period.
The cyclical nature of manifestations is the main feature that distinguishes premenstrual syndrome from other diseases. That is, this condition is premenstrual syndrome when it begins before menstruation (from 2 to 10 days) and completely disappears after menstruation. But if psychovegetative symptoms disappear, then physical sensations sometimes turn into painful periods or migraines in the first days of the cycle.
If a woman’s sensations in the first phase of the cycle are relatively good, then this is precisely PMS, and not an exacerbation of chronic diseases - depression, neurosis, fibrocystic disease.
If pain is observed only immediately before menstruation and during menstruation, and is combined with bleeding in the middle of the cycle, this indicates that, most likely, a gynecological disease is developing in the body - and etc.
To determine the form of PMS, hormones are examined: estradiol , prolactin , progesterone .
Additional research methods may also be prescribed, depending on which complaints predominate:
- If you are concerned about very severe headaches, dizziness, fainting, or blurred vision, it is necessary to perform a CT or MRI to exclude organic diseases of the brain.
- If neuropsychiatric symptoms predominate, an EEG is performed to exclude epileptic syndrome.
- If swelling is a concern, the amount of urine per day changes, tests are performed to diagnose the kidneys.
- In case of significant breast engorgement, an ultrasound of the mammary glands should be performed.
Women who suffer from PMS are examined not only by a gynecologist, but also by other specialists: neurologists, psychiatrists, nephrologists, endocrinologists, cardiologists, and therapists.
How to figure it out - PMS or pregnancy?
Since some symptoms during pregnancy are very similar to signs of PMS, it is important to take into account the differences that can distinguish between these conditions.
After conception occurs, the hormone increases in the female body progesterone . As a result, a woman may confuse pregnancy with PMS when the following symptoms begin to appear: breast tenderness and swelling, vomiting, nausea, mood swings, lower back pain, irritability.
Often, when you go to one or another thematic forum, you can see women’s arguments about how to distinguish PMS from pregnancy before a delay. Of course, if your periods started on time, then the issue goes away by itself. However, even pregnant women sometimes experience discharge during the day. When should your period be? There are differences between discharge before menstruation and during pregnancy - in pregnant women it is usually more scanty. But still, in order to verify the presence or absence of pregnancy, it is worth doing a test or conducting tests at the medical center. institution.
Below is a comparison of the most common symptoms during pregnancy and PMS.
Symptom | During pregnancy | For premenstrual syndrome |
Chest pain | Appears throughout pregnancy | Disappears with the onset of menstruation |
Appetite | Taste preferences change, the sense of smell becomes more acute, and familiar smells become irritating. | You may crave sweets, salty foods, there is sensitivity to smells, and there may be an increase in appetite |
Backache | Worrying in the last trimester | Possible lower back pain |
Fatigue | It appears about a month after conception. | Possible both after ovulation and a few days before menstruation |
Pain in the lower abdomen | Brief, mild pain | Manifests individually |
Emotional condition | Mood changes often | Irritability and tearfulness appear |
Frequent urination | May be | No |
Toxicosis | Begins to develop approximately 4-5 weeks after conception | There may be nausea and vomiting |
Since the symptoms for these conditions are actually similar, and in some cases it is even possible to become pregnant during your period (at least that is the impression a woman gets if discharge appears), it is important to act correctly.
It is best to wait until your period begins. If a woman notes that she is already experiencing a delay, it is imperative to conduct a pregnancy test, which reliably determines pregnancy after a delay. For those who want to immediately verify whether conception has occurred, you can take (pregnancy hormone). Such a test accurately determines pregnancy already on the tenth day after conception.
The most appropriate thing to do in such a situation is to visit a gynecologist who will help you figure out what a woman actually has - PMS or pregnancy through an examination and an ultrasound. Sometimes the question also arises of how to distinguish pregnancy from – in this case, you also need to consult a doctor or do a test.
When should you contact a specialist?
If pain, irritability, and increased tearfulness in women, the causes of which are associated with PMS, significantly reduce the quality of life and are very pronounced, you should consult a doctor and carry out the treatment prescribed by him. The doctor can also give effective recommendations on how to alleviate certain unpleasant symptoms.
As a rule, with such manifestations, symptomatic therapy is prescribed. How to treat PMS, and whether it is worth prescribing any drugs for treatment, the specialist determines, taking into account the form, symptoms, and course of premenstrual syndrome. The following treatment methods may be prescribed:
- For mood swings, depression, and irritability, psychotherapy sessions, relaxation techniques, and sedatives are prescribed.
- If you are worried about pain in the abdomen, lower back, or headaches, it is recommended to take non-steroidal anti-inflammatory drugs to relieve pain (tablets, and etc.).
- Drugs are also prescribed for the treatment of premenstrual syndrome - diuretics to remove excess fluid and eliminate swelling.
- Hormonal treatment is prescribed if there is insufficiency in the second phase of the cycle, after conducting functional diagnostic tests, guided by the results of the changes that have been identified. Assign gestagens — medroxyprogesterone acetate , they should be taken from the 16th to 25th day of the menstrual cycle.
- Tranquilizers and antidepressants are prescribed to women who develop numerous neuropsychiatric symptoms before menstruation: aggressiveness, nervousness, panic attacks, insomnia, etc. In such cases, they are prescribed. The drugs should be taken in the second phase of the cycle, two days after the onset of symptoms.
- If crisis or cephalgic forms are diagnosed, it may be prescribed in the second phase of the monthly cycle. If prolactin is elevated, then Parlodel must be taken continuously.
- If a woman develops edematous or cephalgic forms, antiprostaglandin medications are prescribed (,.
- The doctor may also prescribe homeopathic remedies, as well as vitamin and mineral complexes - for example, anti-depression vitamins for women.
How to relieve the condition yourself?
If a woman is worried about PMS (sometimes mistakenly called “postmenstrual syndrome”), then she should use some recommendations to alleviate the condition.
Have a good rest
You need to sleep as much time as your body needs for proper rest. As a rule, this is 8-10 hours. Many women who write on any thematic forum note that it was the normalization of sleep that made it possible to reduce the severity of unpleasant symptoms. With a lack of sleep, anxiety, irritability, aggressiveness may develop, and worsen. For those who suffer from insomnia, taking short evening walks can help.
Aromatherapy
Provided that the woman does not suffer from allergies, you can practice aromatherapy by selecting a special composition of aromatic oils. It is recommended to use lavender, basil, sage, geranium, rose, juniper, and bergamot oils. It is worth starting to take baths with aromatic oils two weeks before menstruation.
Physical exercise
Any reasonable load has a positive effect on the body - running, dancing, yoga, bodyflex, etc. If you train fully and regularly, the body’s content increases. endorphins . And this allows you to overcome depression and insomnia, and reduce the severity of physical symptoms.
Vitamins and minerals
To reduce the severity of symptoms, two weeks before menstruation you need to take magnesium and. It is also recommended to drink and. This will help reduce the severity of a number of symptoms: palpitations, insomnia, anxiety, fatigue, irritability.
Nutrition
It is important to include as many vegetables and fruits as possible in your diet, as well as foods containing calcium and fiber. It is worth reducing the amount of coffee, cola, and chocolate consumed, as caffeine provokes anxiety and mood swings. It is important to reduce the amount of fat in your diet.
It is also not recommended to eat beef, which may contain artificial estrogens. You should drink herbal teas, lemon and carrot juices. It is better to exclude or limit alcohol, since under its influence reserves of minerals and vitamins are depleted, and the liver utilizes hormones worse.
Women often wonder why they crave salty foods before menstruation. The fact is that fluctuations in appetite are normal during PMS, and sometimes you just need to “satisfy the demands” of the body in order to feel better.
Relaxation
You need to try to avoid stressful situations, not overwork and think positively. To do this, it is recommended to practice yoga and meditation.
Regular sex
Sex also has a beneficial effect on health - it helps you sleep better, overcome stress, cope with bad emotions, strengthen your immune system and increase endorphins. In addition, in the period before menstruation, a woman’s libido often increases, which contributes to an active sex life.
Medicinal herbs
With the help of herbal teas, you can significantly alleviate the condition of PMS. The main thing is to choose the right herbs. Tea can be made from St. John's wort, primrose, and other herbs that your doctor recommends.
conclusions
Thus, premenstrual syndrome is a serious condition, which sometimes becomes an obstacle for a woman to a full life and ability to work. According to research, the most severe symptoms of PMS occur in residents of large cities and women who engage in mental work.
However, with the help of specialists, as well as by practicing proper nutrition, regular exercise, and taking vitamins and minerals, this condition can be significantly alleviated.
Education: Graduated from Rivne State Basic Medical College with a degree in Pharmacy. Graduated from Vinnitsa State Medical University named after. M.I. Pirogov and internship at his base.
Experience: From 2003 to 2013, she worked as a pharmacist and manager of a pharmacy kiosk. She was awarded diplomas and decorations for many years of conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.
Obstetrician-gynecologist, highest category, endocrinologist, ultrasound diagnostics doctor, specialist in the field of aesthetic gynecology Make an appointment
Obstetrician-gynecologist, ultrasound diagnostics doctor, candidate of medical sciences, specialist in the field of aesthetic gynecology Make an appointment
Obstetrician-gynecologist, endocrinologist, candidate of medical sciences Make an appointment
What is PMS (premenstrual syndrome)
Premenstrual syndrome (abbreviated as PMS, or as it is sometimes mistakenly called “postmenstrual syndrome”) is a complex set of negative symptoms that occurs in women in the days leading up to menstruation. Premenstrual syndrome (PMS) can manifest itself in a number of neuropsychic, metabolic-endocrine or vegetative-vascular disorders, and the symptoms of PMS are individual for each patient.
According to statistics, premenstrual syndrome (PMS) affects, according to various sources, from 50 to 80% of all women on the planet. Many of them are in a fairly mild form, in which there is no need to see a doctor. However, you need to know that over time and under the right circumstances, PMS can progress, so if you experience any pain or nervous disorders before menstruation, try to prevent the situation from worsening.
It happens that changes in a woman’s well-being or behavior occur after the onset of menstruation. Since this happens after 2-3 weeks, many people mistakenly call it postmenstrual syndrome.
In general, according to the doctors of our medical center, women aged 20 to 40 years most often suffer from PMS; cases of premenstrual syndrome occurring together with the onset of menarche are less common, and even less common in the premenopausal period.
1Array ( => Pregnancy => Gynecology) Array ( => 4 => 7) Array ( => https://akusherstvo.policlinica.ru/prices-akusherstvo.html =>.html) 7
Symptoms of PMS (premenstrual syndrome)
Gynecologists and specialists in this field say that there are about 150 symptoms of premenstrual syndrome (PMS), which, moreover, occur in different combinations. However, the most common of them are the following: slight weight gain, pain in the lower back and pelvic organs, bloating, nausea, hardening and tenderness of the mammary glands, increased fatigue, irritability, insomnia or, in some cases, on the contrary, excessive drowsiness.
Most young women say that in the days leading up to menstruation, they often experience not only physical, but also emotional and psychological discomfort. Many experience attacks of unreasonable aggression; inappropriate behavioral reactions, tearfulness, and rapid mood swings may be observed. At the same time, it has been noticed that some women unconsciously experience fear of the onset of PMS and menstruation, and therefore become even more irritable and withdrawn, even before the onset of this period.
At one time, studies were conducted aimed at clarifying the effect of PMS on a woman’s activity and ability to work. Their results turned out to be very disappointing. Thus, the last few days of the menstrual cycle account for about 33% of cases of acute appendicitis, 31% of acute viral infections and respiratory diseases, about 25% of women are hospitalized during this period. 27% of women during postmenstrual syndrome begin to take tranquilizers or some other drugs that affect the neuropsychic state, which also negatively affects both their future health and ability to work.
As Fyodor Nikolaevich Usatenko, a gynecologist at our medical center Euromedprestige, notes, in clinical practice there are four most common forms of premenstrual syndrome. The first form of postmenstrual syndrome is neuropsychic, characterized by weakness, tearfulness, depression or, conversely, excessive and unreasonable irritability and aggression. Moreover, the latter, as a rule, predominates among young girls, while slightly older women are more often susceptible to depression and melancholy.
The edematous form of PMS is characterized by hardening, swelling and tenderness of the mammary glands, swelling of the face, legs and hands, and sweating. With this form of PMS, sensitivity to smells is sharply expressed, and a change in taste sensations is possible. Many women suffering from this type of premenstrual syndrome believe that the cause of such conditions is respiratory or viral infections and seek help from a therapist. Meanwhile, gynecologists at our medical center recommend that you carefully monitor yourself and, if symptoms occur exclusively before the onset of menstruation, visit a gynecologist. In this case, only he will be able to prescribe the appropriate treatment for you.
The third form of PMS is called cephalgic. With this form of PMS, a woman experiences headaches, nausea, sometimes vomiting, and dizziness. About a third experience heart pain and a depressed psychological state. If a cranial x-ray is performed in this situation, you can see an increase in the vascular pattern in combination with hyperostosis (overgrowth of the bone layer). In addition, the amount of calcium in a woman’s body changes, which can lead to fragility and brittle bones.
And finally, the last, so-called crisis form of postmenstrual syndrome (PMS), manifests itself in the appearance of adrenaline crises, which begin with a feeling of squeezing under the chest and are accompanied by a significantly increased heart rate, numbness and coldness of the arms and legs. Frequent and copious urination may occur. In addition, half of the women say that during such crises they experience a very heightened fear of death, which negatively affects their mental and emotional state.
As noted by specialists from our medical center, the crisis form of PMS is the most severe and requires mandatory medical intervention. Moreover, it does not arise on its own, but is a consequence of the untreated previous three forms. Therefore, for any negative symptoms and deterioration in general health in the days preceding menstruation, it is best to consult a gynecologist, since only he will be able to determine how serious the situation is and prescribe the necessary treatment.
5360 rub. Cost of a comprehensive program with a gastroenterologist
DISCOUNT 25% AT AN APPOINTMENT WITH A CARDIOLOGIST
- 25%primary
Doctor visit
therapist on weekends
Causes of PMS (premenstrual syndrome)
For several decades, medical scientists have been trying to figure out the causes and factors that lead to the occurrence of premenstrual syndrome. Today, there are several theories, but none of them can explain all the symptoms that accompany PMS.
The most complete theory so far is considered to be the hormonal theory, according to which premenstrual syndrome is a consequence of an imbalance of estrogen< и прогестерона в организме женщины. Наиболее обоснованной в рамках этой теории является точка зрения, говорящая о гиперэстрогении (избытке эстрогенов). Действие этих гормонов таково, что в большом количестве они способствуют задержке жидкости в организме, что, в свою очередь, вызывает отеки, набухание и болезненность молочных желез, головную боль, обострение сердечно-сосудистых проблем. Кроме того, эстрогены могут скапливаться в лимбической системе организма, влияющей на нервно-эмоциональное состояние женщины. Отсюда — депрессивные или агрессивные состояния, раздражительность и т.п.
Another theory, the theory of water intoxication, suggests that PMS symptoms appear when there are disturbances in the water-salt metabolism of fluids in the body. In addition, there is an opinion that PMS is a consequence of vitamin deficiency, in particular, a lack of vitamins B6, A, magnesium, calcium, and zinc. However, this has not yet been fully tested in practice, although in some cases vitamin therapy gives a positive result in the treatment of PMS. Also, some doctors talk about a genetic factor in the development of premenstrual syndrome.
At our medical center "Euromedprestige", gynecologists and gynecological endocrinologists are of the opinion that the basis of premenstrual syndrome is not one reason, but a combination of them, and for each woman they can be individual. Therefore, before prescribing treatment, our doctors conduct a comprehensive mini-examination in order to make the most accurate diagnosis.
Treatment of PMS (premenstrual syndrome)
The direction of treatment for premenstrual syndrome (PMS) is largely determined by the individual characteristics of the female body and the symptoms that the patient experiences. Common to all forms of PMS is the advice to keep a menstrual calendar, and, if possible, write down your feelings in the days before menstruation. This clearly shows whether a woman has PMS or whether the causes of the malaise lie in another, non-gynecological disorder.
At our medical center, doctors practice complex treatment of premenstrual syndrome, which includes the use of sex hormones, vitamins, other medications as needed, as well as a special diet and physical therapy. The last two methods are recommended in any case, whatever the symptoms. Drug therapy is prescribed by the doctor at his own discretion.
1Array ( => Pregnancy => Gynecology) Array ( => 4 => 7) Array ( => https://akusherstvo.policlinica.ru/prices-akusherstvo.html =>.html) 7
Hormonal theory of PMS
Let's talk a little about what medications are prescribed to women suffering from premenstrual syndrome (PMS). Firstly, these are synthetic analogues of natural gestagen hormones, which help restore hormonal balance and eliminate the manifestations of PMS. They have been used for quite a long time, since about the 50s of the twentieth century, and remain popular to this day, as they are effective in most cases. Rarely, but still there are situations in which gestagens are not recommended to be used due to the individual characteristics of a woman’s hormonal system. Therefore, before prescribing treatment, specialists at our Euromedprestige medical center first conduct a study using functional diagnostic tests, and also examine the level of hormones in the patient’s blood. All this allows us to draw a conclusion about the possibility of using gestagens for the treatment of PMS. If there are contraindications, the doctor selects another treatment using other medications.
Treatment of PMS with vitamin preparations usually includes the use of vitamins A and E in combination. A series of approximately 15 injections is performed. In addition, at the discretion of the specialist and on the basis of analysis, magnesium, calcium or vitamin B6 preparations can be prescribed for the treatment of PMS, which activates estrogen metabolism and prevents their accumulation.
Diet also plays an important role in the treatment of premenstrual syndrome. It is based on the fact that a woman should consume food that contains a sufficiently large amount of fiber. The approximate ratio of proteins, fats and carbohydrates should be 15%, 10% and 75%. It is worth limiting beef, as some types contain artificial estrogens, and reducing the amount of fat consumed due to the fact that they can negatively affect the liver and cause fluid retention in the body. Excess proteins are also not recommended, as they increase the body's need for mineral salts, which can disrupt the water-salt metabolism.
The theory of water intoxication in postmenstrual syndrome
In addition to foods rich in fiber, a woman suffering from PMS can be advised to eat more vegetables, fruits, drink herbal teas and juices, especially carrot and lemon. But drinks containing caffeine should be avoided, as this component can increase irritability, anxiety and sleep disturbances. The same applies to alcohol, but its effect is even more negative, since it directly affects the liver, reducing its ability to process hormones, and thus estrogens accumulate in the body.
Physiotherapy is also quite effective for premenstrual syndrome (PMS). The woman is offered therapeutic aerobics or special hydrotherapy< в сочетании с массажем. Доказано, что физические упражнения способны снять стресс и сбалансировать гормональную систему. Однако не стоит увлекаться такими видами спорта, как тяжелая атлетика, бокс и т.п. Слишком сильные физические нагрузки не только не лечат, но и обостряют протекание предменструального синдрома (ПМС). Гинекологи нашего медицинского центра рекомендуют женщинам, страдающим ПМС, такие виды спорта, как бег трусцой, ходьба, велосипед по ровной местности на небольшой скорости. Предварительно, конечно, стоит посоветоваться с врачом, который подберет наилучший режим упражнений.
In women, this condition usually develops a few days before their period and is called “premenstrual syndrome.”
Unpleasant symptoms
This condition is familiar to most women. Many of them, several days (from one to 14) before the onset of menstruation, complain of:
- nagging pain in the lower abdomen;
- soreness and engorgement of the mammary glands;
- dizziness and nausea;
- swelling and constant thirst;
- poor appetite or, on the contrary, an irresistible desire to eat;
- feeling of palpitations, pain in the heart area;
- chills, fever.
In addition to physical discomfort, women may feel:
- irritability and aggression;
- tearfulness, bad mood;
- a sharp increase or decrease in sexuality;
- memory impairment;
- sleep disorders.
These manifestations disappear immediately after the onset of menstruation or in the first days after it.
Where does it come from?
It is believed that the condition is based on hormonal disorders, namely the excessive production of female sex hormones, which leads to disruption of the neuroendocrine regulation of various organs and systems of the body.
There is a point of view that nagging pain in the lower abdomen appears because the endometrial rejection has already begun in the uterus, which occurs during menstruation, and the cervix has not yet opened, which leads to the accumulation of blood and mucous fragments in the uterus, its overstretching and, accordingly, pain .
How to relieve PMS
PMS is a typical female ailment and, unfortunately, we cannot get rid of it, but we can alleviate it. To make it easier to overcome premenstrual irritation, a woman should monitor her health not only on the eve of her period.
1. Contact the specialists:
- visit a gynecologist and get tested to identify hormonal disorders;
- in case of severe emotional disturbances, consult a neurologist;
- Since diseases of other endocrine glands can worsen the condition, visit an endocrinologist.
2. Depending on the severity and duration of PMS manifestations, start taking medications prescribed by your doctor in advance (2-3 days in advance):
- if you have severe pain, antispasmodics will help you;
- good means are aimed at normalizing the activity of the autonomic nervous system;
- normalize the functioning of the central nervous system during PMS with the simplest sedatives - preparations of plant origin: motherwort, valerian, peppermint;
- the doctor may recommend that you take oral contraceptives, which eliminate discomfort on the eve of menstruation;
- in case of excessively heavy menstrual bleeding, a decoction of raspberry leaves (or adding them to brewed tea) has a good effect.
- try to drink less strong tea and coffee;
- limit fluid intake (up to 1.5 liters per day);
- Add less salt to your food;
- limit the consumption of potassium-rich foods: raisins, dried apricots, potatoes;
- try to eat less fatty foods;
- exclude spices, hot seasonings, and alcohol from your diet;
- try to give up meat and dairy products.
4. At least a week before and during your period, your diet should include plenty of calcium-rich foods. There is a lot of calcium in fresh green leafy vegetables: spinach, lettuce, cabbage, parsley. It is recommended to take multivitamins (especially those containing vitamins A, B and E). It is equally important to consume seafood, grains and nuts, which are rich in macro- and microelements.
5. To prevent PMS, proper rest and sleep are important.
6. It is important to fall asleep before 23.00, because it is at this time that hormones are produced and later falling asleep disrupts the processes of neuroendocrine regulation. It's better to sleep in a cool room. IN Get enough sleep and rest before and during your period.
7. Walk more, breathe clean air, but heavy physical labor should be limited.
8. Try to quit smoking.
9. Take a contrast shower in the morning and evening. Complete the procedure with cool water. A 15-minute bath with a water temperature of 38-39 °C with a decoction of peppermint, chamomile and horehound (1:1:1) will help reduce premenstrual tension. After this, rub lavender or lemon wormwood oil into your lower back.
10. Try to worry and be less nervous.
11. During PMS, as during all periods, you should not go to the bathhouse. High temperature can cause severe pain, and menstruation will be delayed.
12. Breathing exercises and relaxation are good for strengthening the nervous system. Relax, close your eyes, concentrate your attention and try to mentally drive away the illness.
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 to this disease than rural 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 everyday life (mild form of PMS), and therefore 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 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 hormonal fluctuations 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 stressful 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 adolescence, aggressiveness 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 progesterone levels is observed in the second phase of the cycle, while 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: seduxen, Rudotel and 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 the symptoms of PMS: 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.
- It is necessary to monitor your emotional state, try not to be nervous, avoid stressful situations, and 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 the weakening of the immune system before menstruation, which makes it 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.