Very strong PMS. Premenstrual syndrome: causes, symptoms and treatment
Doctors have long broken heads over the causes of female malaise before menstruation. Some Lekari tied him with the moon phases, others - with a terrain in which a woman lives.
The state of the girl before the monthly long time remained a mystery. Only in the twentieth century, the curtain of the mystery was a little shut.
PMS is a certain mix of 150 different physical and mental symptoms. In one, or a different degree, about 75% of women face manifestations of premenstrual syndrome.
How long does the PMS last? Unpleasant symptoms begin to appear 2-10 days before the start of menstruation, and disappear with the advent of the "red" days of the calendar.
- Criminal Chronicle. PMS is not only broken nerves and broken plates. Most accidents, crimes, thefts committed by women occurred from the 21st to the 28th day of the menstrual cycle.
- Shopping therapy. If you believe research, then a few days before the monthly women, the most supportiles are tempted to buy as much as possible.
- Symptoms of PMS are more susceptible to women engaged in mental labor and residents of large cities.
- The term PMS for the first time used Robert Frank, an obstetrician gynecologist from England.
Why does premenstrual syndrome occur?
Numerous studies do not allow to identify the exact causes of premenstrual syndrome. Theories of its occurrence: "Water intoxication" (violation of water-salt metabolism), allergic nature (increased sensitivity to endogenous), psychosomatic, hormonal, etc.
But the most complete - hormonal theory explaining the symptoms of PMS by fluctuations in the level of sex hormones in 2 phases of the menstrual cycle. For normal, harmonious functioning of the body, the balance of sex hormones is very important:
- - They improve physical and mental well-being, increase the tone, creativity, the rate of assimilation of information, learning ability
- progesterone - has a sedative effect, which can lead to depressive symptoms in 2 cycles phase
- androgens - affect the libido, increase energy, efficiency
During the second phase of the menstrual cycle, a change in the hormonal background of a woman occurs. According to this theory, the cause of PMS lies in the "inadequate" reaction of the body, including the brain departments responsible for behavior and emotions, on cyclic changes of the hormonal background, which is often transmitted by inheritance.
Since days before menstruation are unstable in endocrine terms, many women occur in pillaget and somatic violations. At the same time, a decisive role plays not so much the level of hormones (which can be normal), how much fluctuations in the content of genital hormones during the menstrual cycle and how the limb of brain lymbic departments are responsible for behavior and emotions react:
- increase estrogen and first increase, and then reduced progesterone - Hence the delay of liquids, swelling, heat and soreness of the mammary glands, cardiovascular disorders, irritability, aggression, tearfulness
- hypersecretion - also leads to fluid delay, sodium in the body
- excess prostaglandinov -, disorders of digestive, head migrae-like pain
The most likely factors affecting the development of the syndrome, at which the opinions of the doctors do not diverge:
- Reduced serotonin levels - This is the so-called "hormone of joy," may be the cause of the development of mental signs of premenstrual syndrome, since the decrease in its level causes sadness, plasticity, longing and depression.
- Vitamin B6 deficiency- The lack of this vitamin indicates such symptoms as fatigue, fluid delay in the body, mood changes, chest hypersensitivity.
- Magnesium shortage - magnesium deficiency can, dizziness, headaches, craving for chocolate.
- Smoking. Smoking women are twice as much more premented syndrome.
- Overweight . Women, the mass index of which more than 30, are three times more often suffering from the symptoms of PMS.
- Genetic factor - It is possible that the peculiarities of the premenstrual syndrome are inherited.
- Complicated childbirth, stress, operational interventions, infections, gynecological pathologies.
Basic symptoms and manifestations of premenstrual syndrome
Groups of symptoms at PMS:
- Nervous: aggression, depression, irritability, plasticity.
- Vegeta violations: Dropper pressure drops, headache, vomiting, nausea, dizziness, tachycardia ,.
- Exchange and endocrine violations: Edema, body temperature increase, chills, brewing of the mammary glands, itching, flatulence, shortness of breath, thirst, reduction of memory ,.
PMS in women can be divided into several forms to be divided into several forms, but their symptoms are usually not manifested in isolation, but are combined. In the presence of psychohegetatic manifestations, especially depressed, women decreases the pain threshold and they more acutely perceive pain.
Neuropsychic |
Currency form |
Atypical manifestations of PMS. |
Disorders in the nervous and emotional spheres:
|
Most women have districts, of cardio-vascular system, kidneys, gastroy. |
|
Emirates |
Cefalgic form |
|
There is a negative durez with a fluid delay. |
The mainly neurological and vegetual-vascular manifestations are leading:
Family history of women in this form is burdened by hypertension, cardiovascular diseases, diseases of the gastrointestinal tract. |
PMS for each woman proceeds in different ways, symptoms varies significantly. According to some studies, women with PMS notes the following frequency of manifestation of a sign of PMS:
| Symptom | % frequency |
Hormonal theory of the occurrence of PMS |
| irritability | 94 | |
| milk soreness | 87 | |
| owl of belly | 75 | |
| flameness | 69 | |
|
56 | |
|
50 | |
|
44 | |
|
37 | |
|
19 | |
| vomot | 12 | |
| constipation | 6 | |
| pain in the spine | 3 |
Premenstrual syndrome can aggravate the course of other diseases:
- Anemia (see)
- (cm. )
- Diseases of thyroid gland
- Chronic fatigue syndrome
- Bronchial asthma
- Allergic reactions
- Inflammatory diseases of female genital organs
Diagnostics: What can be masked for manifestations of PMS?
Since dates and timing are easily forgotten to facilitate their task, you should start a calendar or diary, where to record the start and end date, ovulation (basal temperature), weight, symptoms that are worried. The maintenance of such a diary for 2-3 cycles will significantly simplify the diagnosis and will allow trace the frequency of signs of PMS.
The severity of the premenstrual syndrome is determined by the amount, duration and intensity of symptoms:
- Light form: 3-4 symptoms or 1-2, if they are significantly expressed
- Heavy form: 5-12 symptoms or 2-5, but very pronounced, as well as regardless of the duration and quantity, if they lead to disability (usually neuropsychic form)
The main feature that distinguishes the premenstrual syndrome from other diseases or states is cyclicality. That is, the deterioration of well-being occurs a few days before menstruation (from 2 to 10) and completely disappear with their arrival. However, in contrast to psychohegetal, physical unpleasant feelings in the first days of the next cycle may increase and smoothly move into such disorders, like menstrual migraine.
- If a woman feels relatively well in 1 cycle phase, it is premenstrual syndrome, and not a chronic disease - neurosis, depression,
- If the pain appears only immediately before menstruation and during it, especially when combining C is, it is most likely not PMS, but other gynecological diseases -, chronic endometrite, dysmenorrhea (painful menstruation) and others.
To establish the shape of the syndrome, hormone studies are conducted: prolactin, estradiol and progesterone. The doctor can also assign additional diagnostic methods, depending on the prevailing complaints:
- With strong headaches, dizziness, reducing vision and fainting, computed tomography or MRI are prescribed to eliminate organic brain diseases.
- With the abundance of neuropsychic diseases, the EEG is shown to eliminate epileptic syndrome.
- In severe edema, changes in the daily amount of urine (diurus) are carried out for diagnosing kidneys (see).
- With a strong and painful loading of the mammary glands, it is necessary to carry out ultrasound of the mammary glands and mammography to exclude organic pathology.
Conducts a survey of women suffering from PMS, not only a gynecologist, but also attracted: psychiatrists, neurologists, endocrinologists, nephrologists, cardiologists and therapists.
Premenstrual syndrome or pregnancy?
Some Symptoms of PMS are similar to the manifestations of pregnancy (see). After conception in the body of a woman, the content of progesterone hormone increases, which is happening during the PMS, so the following symptoms are identical:
- fast fatiguability
- swelling and soreness of the breast
- nausea, vomiting
- irritability, mood jumps
- pain in the lower back
How to distinguish pregnancy from PMS? Comparison of the most common symptoms of premenstrual syndrome and pregnancy:
| Symptoms | Pregnancy | Premenstrual syndrome |
|
accompanies all pregnancy | with the beginning of menstruation pain goes |
|
the attitude towards food, I want an inedible, salty, beer, the fact that the woman does not like is unlawful, the smell is greatly sharpened, ordinary smells can be very annoying | can pull on sweet and salty, sensitivity to smells |
|
only in late terms | there may be back pain |
|
starts from 4-5 weeks after conception | it may appear as immediately after ovulation, and 2-5 days before menstruation |
| soft, short pain | individually in each case | |
|
frequent mood change, plasticity | irritability |
|
possibly | not |
|
from 4-5 weeks after conception | possible nausea, vomiting |
The signs of both states are very similar, so it is going to understand what is happening in the body of a woman, and the pregnancy from the PMS is not easy:
- The easiest way to know what is caused by bad well-being - wait for the beginning of menstruation.
- If the calendar is already a delay, you should spend a pregnancy test. Pharmacy test will give reliable results only when menstruation delay. It is sensitive to pregnancy hormone (HCG), highlighted with urine. If there is not enough patience and nerves wait, you can hand over the blood test on hCG. It shows a practical one hundred percent result for the tenth days after conception.
- The most optimal option to find out what bothers you - the PMS syndrome or pregnancy is a visit to the gynecologist. The doctor will appreciate the state of the uterus and with suspected pregnancy will appoint an ultrasound.
When should I contact a doctor
If the manifestations of the premenstrual syndrome significantly reduce the quality of life, affect the ability to work and have a pronounced nature, without treatment it is not necessary. After a thorough examination, the doctor will prescribe medicinal therapy and give the necessary recommendations to facilitate the flow of syndrome.
How can a doctor help?
In most cases, treatment is carried out symptomatic. Depending on the shape, flow and symptoms of premenstrual syndrome, a woman is required:
- Psychotherapy - mood swings, irritability, depression, from which women and relatives suffer from, are adjusted by the methods of stabilizing behavioral techniques and psycho-emotional relaxation ,.
- Under headaches, non-steroidal anti-inflammatory drugs for temporary removal of pain syndrome (, nimesulide, otanov, see) are prescribed.
- Diuretics to remove excess fluid from the body at edema (see).
- Hormonal therapy is prescribed with deficiency of the second phase of the cycle, only after the tests of functional diagnostics, based on the results of the changes identified. Gestagens are used -, medroxyprogesterone acetate from 16 to 25 day cycle.
- Assigns with many neuropsychic symptoms (insomnia, nervousness, aggressiveness, anxiety, panic attacks, depressed): amitriptyline, Rudotel, Tazepam, Sonapaks, Sertraulin, Claim, Prozak, etc. in 2 cycle phase after 2 days from the beginning of symptoms.
- With crisis and cephalgic forms, it is possible to prescribe a pair model in 2 phase of the cycle or if prolactin is elevated, then in continuous mode, it has a normalizing effect on the CNS.
- With cephalgic and edema forms, anti-stroklandic drugs are recommended, (indomethacin, nosin) in the second phase of the menstrual cycle.
- Since women often have increased levels of histamine and serotonin, the doctor may appoint antihistamine drugs 2 generations (see) 2 days before the alleged worsening of the state for the night until the 2nd day of menstruation.
- To improve blood circulation in the CNS, the use of Grandaxin, Nootropyl, Aminolone for 2-3 weeks is possible.
- In crisis, cofalgic and neuropsychic form, drugs normalizing neurotiator exchange in the central nervous system - Peritol, diphenin, the doctor prescribes the drug for a period of 3-6 months.
- Homeopathic Remis or Mastodinon Preparations.
What can you do?
- Full Son.
Try to sleep as much as your body has time to fully rest, usually it is 8-10 hours (see. The lack of sleep leads to irritability, anxiety and aggression, negatively affects the work of the immune system. If insomnia is tormented, try walking before bedtime, breathing Technique.
- Aromatherapy
In the absence of allergies, the composition of specially selected aromatic oils is a good weapon against the symptoms of PMS. Geranium, rose and help normalize cycle. Lavender and basil are effectively fighting with spasms. Juniper and Bergamot increase the mood. Baths with aromatic oils start taking two weeks before menstruation.
Hiking, running, Pilates, Bodiflex, Yoga, Dancing - a great way to treat manifestations of premenstrual syndrome in women. Regular training increases the level of endorphins, which allows you to overcome depression and insomnia, and also reduce the severity of physical symptoms.
- Two weeks before menstruation, take vitamin B6 and magnesium
Magne B6, Magnerot, as well as vitamins E and a - this will make it much more efficient to fight with such manifestations of PMS, like: rapid heartbeat, heart pain, fatigue, insomnia, anxiety and irritability.
- Food
Eat more fruits and vegetables, high-content products, and also include products rich in calcium. Temporarily limit the use of coffee, chocolate, cola, because caffeine enhances the change of moods, irritability, anxiety. The daily diet should include 10% fat, 15% protein and 75% carbohydrates. Fat consumption should be reduced, as well as limit beef use, some species of which contain artificial estrogens. Herbal teas are useful, fresh juices, especially carrot and lemon. It is better not to drink alcohol, it depletes the reserves of mineral salts and vitamins of the B Group, violates carbohydrates, reduces the ability of the liver to dispose of hormones.
- Relaxation practices
Avoid stress, try not to overwear and maintain a positive mood and thinking, relaxation practices - yoga, meditation help.
- Regular sex sessions
It helps to fight insomnia, stress and bad mood, increase the level of endorphins, strengthen the immune system. At this time, many women rises sexy appetite - why not surprise your partner and do not try something new?
- Medicinal plants
Also can help alleviate the symptoms of the premenstrual syndrome: Witex - removes heaviness and pain in the lactic glands, primrose (survea evening) - from headache and swelling, is a great antidepressant, normalizes libido, improves well-being and reduces fatigue.
Balanced nutrition, adequate physical activity, vitamin supplements, healthy sleep, regular sex sessions, a positive attitude to life will help relieve psychological and physical manifestations of premenstrual syndrome.
There are three cherished letters in the lives of many women who turn a gentle nymph into an unpredictable explosive person. Loving friends and relatives are rapidly abstract from the situation and run away. What is the exclusive female disease leaving all the horror? This is an inevitable premenstrual syndrome, briefly.
The most common manifestations of the premenstrual syndrome is a headache, sometimes reaching migraine, unprecedented irritability, depression, depression, problems with a chair and urination, thirst, acne and other rashes on the face, swelling, the desire of the sweet and salty in uncontrolled quantities.
In my practice there were cases when the girl called an ambulance, the stomach ached so much before month. And nothing helped her, except to be loosened. And in others after 35 years old, the chest began to root, bowel and pour, like Pamela Anderson.
Unfortunately, in such a situation, a woman often depends on that, because these processes are regulated by its hormonal background.
Of course, there are happy among us, there are never in life who have not experienced the charms of premenstrual syndrome. But the majority, alas, knows perfectly, about what we are talking about.
By the way, I want to notice that men were met in my practice, which with a calendar counted, when the beloved menstruation appears. And exactly the week began to be attenuated by a beloved sedative in tea and ensure chocolates. (Men, if you read this article, please do not do that!)
As one of my patient said, ¨Do you know this period in women called PMS? Because the term "cow's rabies" has already been busy. In fact, the fault is not bitching, but some hormonal changes occurring in the female organism during the cycle.
So let's deal with what is and how to make friends with him.
Premenstrual syndrome is a complex complex of regularly repetitive symptoms leading to an imbalance in the physical and psycho-emotional state of a woman. It is found in 7 out of 10 women aged 20-45 years. As a rule, cyclically occurs for several (on average 5-10) days before the start of menstruation.
The PMS feature is that the number of symptoms is huge, and they are diverse.
Bright emotional manifestations
- Depression
- Irritability
- Sometimes aggressiveness
Changes in the tele
- Swelling and disease soreness
- Vulvovaginal or so-called ¨Momolenny
- Eveny
- Insomnia
- Elevated appetite, and, accordingly, weight set
Simply put, these days, some of the fair sex representatives turn into multiple-aggressive hungry fury.
There are clear medical criteria explaining the phenomena leading to the appearance of PMS.
- Lack of some genital hormones.
One of the most important "female" hormones is traditionally accepted by progesterone - steroid hormone, providing a very wide comprehensive impact on the woman's body. Its shortage in the second phase of the cycle is directly related to the emergence of PMS. -
If you do not hurt, then the hormone of stress begins to be produced by the body in elevated amounts. What, accordingly, causes a reduction in the hormone of a healthy sleep and the emotional well-being of progesterone. After all, both of these hormones unites a single metabolic path in the adrenal glands. Therefore, if even three months ago, you had a sufficient content of sex hormones in the body, then as a result of the lack of sleep, they are guaranteed their insufficiency, and, as a result, PMS. - A lack of , especially B6. This primarily concerns vegetarians.
- Disadvantageit may cause tachycardia and headaches.
- Estrogen domination.
At the age of 30 years, a woman begins a gradual decrease in the level of sex hormones. Most often, progesterone fastests faster than. The factors of the external environment affect the distortion of sex hormones: fake estrogens (xenastrogens). All of these components lead to the state of estrogen domination
Often women doomed to premenstrual syndrome and think that it is life. Not necessarily! Modern medicine has a wide range of PMS therapy capabilities. These are vitamins and trace elements, the restoration of hormonal background, physiotherapy and much more.
I note that women over 35 years old with brightly flowing PMS generally needed regular observation from a functional medicine physician. It is high like that they will be hard to leak and menopause.
Secondly, pay close attention to your menstrual cycle. If the cycle began to change, and, both on shortening and elongation, is the first signal to reduce the ovarian function. Be sure to contact a specialist in functional medicine.
Most effective method Check the operation of the ovaries and adrenal glands - from 18 to 21 days of the cycle to pass a multi-system test for hormones. And to understand how much your sex hormones are in the balance sheet, you can use estrogen progesterone ratio.
For example, the lack of vitaminD. Or can lead to a violation of the menstrual cycle and PMS.
If more coarse deviations were found in the analyzes, the doctor jewelry adds what the patient lacks. Someone chooses monocomponential therapy. But it happens on the contrary, when it is necessary to balance the shortage of all hormones.
Preventive measures for PMS
- First of all - pour! Healthy sleep until 23.00 is the key to the beauty of a woman.
- Watch the weight. Fit fractionally, maximum 3-4 times a day. Choose non-private vegetables, organic protein products, vegetable oils And greens.
- Before menstruation, reduce the consumption of flour, salty and sweet. Exclude alcohol, strong tea and coffee.
- Provide your day diet due the number of vitamins and trace elements.
- Another secret: refuse soy products. They make an imbalance into a female hormonal background.
Also during this period it is useful to engage in yoga and meditation. These technicians will help relax and calm down. Fully rest, and, if possible, keep calm.
Finally, the Council of Men. Do not look for logic in female words. Hold your beloved on the days of PMS a little more patience, love and affection. Once again, show you the road you. Give some gift, even if symbolic.
Editorial opinion may not reflect the views of the author.
In case of health problems, do not engage in self-medication, consult your doctor.
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Premenstrual syndrome is a complex of symptoms that develop in the lutein phase of the cycle in ovulant women.
Behavioral symptoms include quick fatigue, irritability, anxiety, depression, emotional lability, insomnia, elevated appetite, reduced disability. Physical symptoms are manifested by blown out the abdomen, the voltage of dairy glasses, an edema of ankle joints and headache.
At least 60% of women suffer from PMS. Most often, the syndrome occurs after 30 years, however, there are early cases of its manifestation - in his youth, and late - in front of the climax. Although the PMS phenomenon is known from antiquity, only published in the 1980s. In the magazine "Family Circle" article in which the clear formulation of PMS was given and focused on the mass character of this dysfunction attracted the attention of the general public. The press picked up the topic, and after a few months the millionth audience got acquainted with the problem, and the definition of PMS entered the daily lexicon. Feminists began an active discussion about this, arguing that the diagnosis will be used to discriminate against women. Doctors worried that this indefinite diagnosis would be a convenient excuse for women and their families when the relationship is spoiled for any incomprehensible reason. At the same time, millions of women received an explanation of their monthly pains and began to seek help to doctors.
Interestingly, professional obstetricians and gynecologists began to discuss the problem of PMS only after publication in the "Family Circle" when women began to seek help with this formulated by them by their diagnosis. And we, doctors, were not ready for this. We just did not teach how to treat such disorders. By the mid-1980s. Formulated by the media and circulation of women "Demand" for the treatment of PMS was so great that 108 the topic began to be discussed at congresses on obstetrics and gynecology, and articles appeared in medical journals on this issue. It also happened with natural childbirth, when the desire for the women of the women forced obstetricians to revise the traditional approach to the problem. And in the case of PMS, the need for women to understand their condition before menstruation influenced medical practice and formed a deeper approach to the female body.
Premenstrual syndrome (PMS) - cyclicly repeated psychological, behavioral and physical symptoms during the lutein phase of the menstrual cycle. It begins for 2 weeks before menstruation and disappears with her start. The woman should not have any symptoms in the interval between the end of menstruation and ovulation.
Psychological and somatic disorders are part of the normal physiology of the menstrual cycle, but their excessive severity leads to severe psychological and behavioral disorders. Symptoms - bloating, grabs, pain, pain and diseases of the mammary glands, temporary increase in body weight and some emulsion of palms and feet. Emotional tension, poor mood, nervousness, irritability, headache, the difficulty of concentrating attention, depression and insomnia, sufficient to change normal satisfaction with life. Some premenstrual symptoms note most of the women (95%), no manifestation is not experiencing a very small number of women (5%).
At a small group of women (5%), the symptoms of PMS significantly affect life and sometimes lead to suicides, acts of aggression; He refers to him in court, as to justify the murder.
Diagnostics of premenstrual syndrome (PMS)
Diagnostics is based on regular daily frequency registration and symptom intensity for one or two menstrual cycles using an estimated scale.
Premenstrual syndrome estimation scale
PMS may be accompanied by the symptoms of a different nature. When diagnosis is found, it is important not to describe the state of a woman before menstruation, but to determine which cyclicality it is repeated. The leading diary of their cycles at least three months of women, as a rule, see a certain pattern of the emergence of the symptoms of PMS. Most women (except the most difficult cases) during the monthly cycle there are at least three days when all unpleasant symptoms are absent. In the second half of the cycle, many are exacerbated chronic diseases - Glaucoma, arthritis and depression. This exacerbation cannot be fully identified with PMS, although the relationship between them exists. At the moment, more than hundreds of symptoms of the manifestation of PMS are known. All of them are probably due to an imbalance of eikosanoids at the cellular level caused by a complex of psychological, physiological and genetic factors.
Causes of premenstrual syndrome (PMS)
The exact nature of endocrine changes underlying premenstrual syndrome is not installed. The role of changes in the content of endorphins, prostaglandins and prolactin is shown. Due to the distinct connection of symptoms with the lutein phase of the menstrual cycle, the main place in the mechanism for the development of this syndrome, apparently belongs to violation of the secretion of progesterone.
The etiology of PMS remains unclear, and therefore therapeutic difficulties arise. The main reason is a combination of imbalance / violations of steroid synthesis in ovaries and mediators in the central nervous system. Studies showed that women with PMS are lower concentrations of serotonin in blood and platelets. Some selective inhibitors of serotonin re-seizure reduce the symptoms of PMS. The exclusion of the cyclic function of the ovaries leads to the complete suppression of all the symptoms. Despite the fact that the commissioning impulse of the PMS is a cyclic synthesis of steroids in the ovaries, an accurate test that allows to distinguish its other diseases is absent. The origin of symptoms plays a less important role than the time of their occurrence, therefore, the diary of the diary of the symptoms is useful for the differential diagnosis of primary and secondary PMS. Secondary PMS - True PMS in combination with the main psychopathology. If the symptoms do not comply with the described scheme, another diagnosis should be considered.
Symptoms and signs of premenstrual syndrome (PMS)
- Owl of belly
- Spastic abdominal pain
- Exposure to accidents
- Acne
- Aggressiveness
- Alcohol intolerance
- Anxiety
- Asthma
- Back pain
- Swelling and pain in lactic glands
- Ears (bruises)
- Status of confusion
- Problems with coordination of movements
- Depression
- Eveny
- Unstable emotional state
- Aggravation of existing chronic diseases (arthritis, ulcers, skin tuberculosis, etc.)
- Worsening vision
- Weakness
- Tired
- "Wolf" hunger
- Headaches
- Strong heartbeat
- Hemorrhoids
- Herpes (deprive)
- Insomnia
- Irritability
- Swimming and pain in the joints
- Apathy
- Migraine
- Nausea
- Traction to Solenoma
- Sigger
- Change of sexual desire
- Fistula
- Sore throat
- Yachna
- Thoughts about suicide
- Tract for sweets
- Problems with urination
- Challenge in me
In the absence of treatment, syndrome progresses, and its manifestations are stretched over time. If in the early stages of a woman's disease complain about pain arising a few days before menstruation and sharply stopped with the beginning of the blood flow, then in the launched state, these symptoms occur in another one or two weeks before the start of menstruation. Some women feel the totality of symptoms during the ovulation period, then one week feel fine, and the last one before the month is - again bad. Over time, these patients remain only two to three days a month, when symptoms do not manifest. Ultimately, the difference between the "good" and "bad" days is erased, and the woman actually constantly feels the symptoms of PMS.
Some women equate menstrual pain (dismenor) to PMS, but in fact it is not. This difference is not always clearly determined by even the authors of articles on PMS. Many women suffering from premenstrual syndrome there are periods when they do not feel pain at all, and vice versa - in women with cruel menstrual pains, there are often no premenstrual disorder at all. Menstrual pain is caused by cutouts and spasms originating from excess PGF2-alpha - hormone, which is produced as the endometrium cavity dealers during menstruation. Some studies indicate that prostaglandins also affect PMS. That is why the diet, the reception of vitamins and mineral additives, as well as anti-prostaglandic therapy (usually such non-steroidal anti-inflammatory drugs, as Advil), is equally well helped from menstrual pains, and from PMS.
Although many doctors are still trying to find the "violation of biochemical processes" causing PMS and hundreds of articles have been written on this topic, no one has yet been able to detect a "weak link" or create a magic pill capable of getting rid of unpleasant symptoms. Reductionist approach - search for biochemical "causes" of syndrome and "medicines", which will be able to suppress it, is unpromising, since the PMS is influenced by a number of factors, so the treatment must be carried out comprehensively, considering everything: diet, mentality, emotional type, attitude to peace, Exercise, relations with other people, heredity and children's psychological injuries.
All of the above and causes hormonal changes provoking PMS or enhancing it, unless not to begin treatment on time.
About 20-40% of women feel some kind of indisposition in the late lutein phase of the cycle, at the beginning of the menstrual phase and 1-2 days in the middle of the cycle. The pathogenesis of the syndrome is still not disclosed.
Acne in premenstrual syndrome
Ordinary acne is one of the most common diseases in the practice of a dermatologist. Open and closed comedones belong to aseptic lesions, papules and pustulas - to surface inflammatory, and cysts and nodules, and sometimes deep pustulas - to deep. Most patients have several clinical types of acne at the same time. With a light form of the disease, predominantly comedones and papules are formed, as well as single pustulas, with moderate form - papules and pustules, nodules and cysts are characteristic of severe.
A light shape of the disease characterized by the appearance of acne on the face is observed in 70% of women in the premenstrual period. Periioral dermatitis, which is usually observed among girls, is often cyclical. In addition, premenstrual syndrome can manifest edema of brushes and feet and less often - spotted skin pigmentation.
For the treatment of premenstrual acne, antiseptic and keratolithic means of local action (benzoyl peroxide) or antibiotics (1% clintamycin solution) are usually successful, but a good effect is allowed to suppress ovulation and preventing the post-dealership of the progesterone secretion. Women accepting oral contraceptives, it is also important to choose the right to choose the drug, as some synthetic gestagens (for example, a norethysterone, levonorgestrel) worsen the condition of the skin, affected by eel. Patients prone to acne rash are recommended combined preparations containing guestogen, desogestrel or Northestimat. These gestagens increase the GSPG level, thereby reducing the level of free testosterone with a clinical antagandogenic effect.
Although, during premenstrual syndrome, gestagens are often prescribed with suspicion of progesterone deficiency, currently this method for the treatment of premenstrual acne does not apply.
Strengthening dermatosis manifestations before menstruation
Many women suffering from dermatosis complain to the strengthening of clinical manifestations of the disease in the premenstrual period. Inflammatory diseases of the skin, especially the skin of the face, often exacerbate in front of menstruation. In some way, this is due to the strengthening of blood flow to the skin under the influence of hormones and its consequences (Seborrhea, swelling). Examples of such diseases can serve ordinary acne, rosacea, various clinical forms of system red lupus (SC). The premenstrual exacerbation is also observed in other skin diseases in young women, in particular with psoriasis, atopic eczema, red flat delica, herpetyiform dermatitis, dyshydrosis and urticule. Gestational pemphigoid (gestational herpes) can be preserved after delivery. In such cases, it is accompanied by premenstrual exacerbations. Simple herpes and aftenosis, despite frequent relapses, usually do not have explicit cyclicity.
Enhanced blood flow to leather and more intensive metabolism in it in front of menstruation contribute to the exacerbation of items of the dermatosis (for example, eczema and itching vulva). In general, the condition of the skin in front of menstruation in women experiencing premenstrual stress is often deteriorating.
Chronic dermatoses exacerbating before menstruation
- Ordinary acne
- Rosacea
- Systemic Red Volchanka
- Psoriasis, atopic eczema
- Red flat lichen
- Herpetyiform dermatitis
- Dishydrosis
- Hives
- Polymorphic exudative erythema
- Itching vulva
- Gestational pemphigoid
Events associated with the emergence of premenstrual syndrome (PMS)
- The beginning of menstruation or year or two before menopause.
- Termination of oral contraceptives.
- After the period, during which menstruation was not (amenorrhea).
- Birth or abortion.
- Pregnancy complicated by toxicosis.
- Publishing pipes, especially if it was made in the 1970s, when now the not practicing method was applied - the migration of electric. The most part of the phallopy pipes (electrocouy).
- Sharp mental injury, for example, the death of some of the relatives.
- Light failure due to the time of the year (autumn-winter).
A whole "bouquet" of factors related to nutrition aggravates the PMS. Studies of women suffering from syndrome revealed what kind of power scheme they adhere to and what their physiological characteristics are.
Factors predisposing to premenstrual syndrome (PMS)
- Abundant use of dairy products.
- Excessive consumption, caffeine in the form of non-alcoholic beverages, coffee and chocolate.
- Excessive consumption of refined sugar and insufficient-bube of fiber, which is in fresh vegetables.
- A relatively high level of estrogen in the blood - or due to abuse of dairy products and overweightor due to weak estrogen splitting in the liver. The high level of estrogen is associated with the lack of complex vitamins of the group B, especially in 6 and at 12. These vitamins are needed liver for inactivation and estrogen cleavage.
- The relatively low level of progesterone in the blood. This hormone levels excessive estrogen content. The level of progesterone is a consequence of either its insufficient production or overweight of this hormone in the blood. Opinions of scientists on this issue disagree.
- A diet provoking the large content of the globular hormone, as well as the raising estrogen level associated with a low level of progesterone. In the steuly of vegetarians who do not eat fat and consume products with large quantity Coarse fiber is contained in two or three times more estrogen than in the feces of nonsense. In the blood plasma of vegetarians, 50% is less than unconjugated estrogen (learned estrogen) than in the blood of people who eat the standard food for Americans. As a result, the first - Women-Vegetarians - are much less susceptible to PMS. (Note: My practice shows that vegetarians eat much more fruits, vegetables and less transgiilic acids than nonsense. Great meat is accumulated by If it is in small quantities and together with vegetables, greens, solid cereal grains, as well as to use a lot of fruits and other rich coarse fiber products. It should be excluded from the diet containing a lot of sugar and transgenerate products.)
- Overweight increases the likelihood of an increase in estrogen level and, therefore, the symptoms of PMS. In fatty sediments, estrone is produced (one of the estrogen).
- Low level of vitamins C, E and Selena. Our liver needs them in the same way as in the vitamins of the group in to correctly recycle estrogen.
- Lack of magnesium. Scientists associate a passion for chocolate with low magnesium content. He (magnesium) is the same as the vitamins of the B group, allows the most productive to recycle estrogen.
Seasonal emotional disorders and PMS: Space Light on the connection of these syndromes
Many people suffering from PMS noticed that their condition worsens in the fall, when the day becomes shorter. Most of the PMS symptoms are characteristic of the so-called seasonal emotional disorder (sir). Light feeds our body. Finding on the retina, it is through the hypothalamus and the pineal gland (epiphysis, or sishkovoid, body) begins to affect the entire neuroendocrine system. During one experiment, the patient with PMS was perfectly reacted with light therapy. After a two-hour evening session, during which the room was flooded with a bright light, they stopped gaining weight; Depression disappeared, there is a constant desire to eat sweet (carbohydrates), closure, fatigue, irritability. And it is not surprising, because the natural light, as well as the consumption of carbohydrates, raises the level of production of serotonin, which facilitates depression. If you spend most of the time with artificial light, you can get a serious cycle dysfunction and PMS.
The connection between PMS and Sir reveals the wisdom of the female nature, "encoded" simultaneously in seasonal and monthly cycles. That period of the month, when the PMS is most often arising, is superimposed during the seasonal emotional disorder. Natural self-profitability in the premenstrual period of each month finds a parallel in the autumn "dying" of nature. So perceives our body wisdom change of seasons. In the fall and in winter, the energies of trees goes into the roots, where the process of life is imperceptible to us. During the initial phase of the menstrual cycle and subsequent ovulation, our energy goes deep into and accumulates there to be drawn in the next phase of development. Since our technogenic culture is far from the natural wisdom of the natural cycle, women are learning to be afraid of menstruation and the time of year, when nature requires darkness, privacy and rethinking of being.
PMS refers to the month as Sir to the annual natural cycle of seasons change. Both syndrome are treated approximately equally and require us a deeper and serious "listening" in the wise nature of your body.
We were also taught to treat our natural energy states suspiciously, as a result of which too many women regard cycle as weakness that you need to overcome or not take into account. God forbid to follow the wisdom of your own body and take a time-out for this period!
Treatment of premenstrual syndrome (PMS)
Treatment begins with community events: the optimal mode of operation and recreation, if possible, eliminating stressful situations, psychotherapy, regular exercise, restriction of alcohol consumption, coffee, etc. The restriction of the cook salt in the diet can reduce the edema and bloating.
Spironolactone is a potassium drug.
Naproxen (XI.: For exampler) and ibuprofen are effective in the appearance of such symptoms as headache, cramps, back pain and muscles, and in some patients with increased irritability and depression. These drugs are taken until menstruation occurs.
Danazole, tamoxifen (anti-estrogen) and bromocriptine (pairodel, agonist of dopamine receptors) are effective with pains in lactic glands. Danazole, appointed by symptoms, until the occurrence of menstruation, significantly facilitates the severity of symptoms without affecting ovulation. Bromocriptine in these cases is prescribed in the premenstrual period.
Alprazolam (tranquilizer) is used when irritability dominates in the clinical picture of the Karassinrome.
Fluoksetin (antidepressant) is effective in depressive states. Note that in the case of pronounced mental disorders, the patient should be consulted in a psychiatrist, as well as before the appointment of psychotropic drugs.
It is shown that placebo gives a short-term improvement of the state of half suffering from premenstrual syndrome. At the same time, the previously recommended treatment with pyridoxin, vitamin E, progesterone is not effective than placebo.
When the symptoms are bothering the patient for more than a week or premenstrual syndrome manifests itself in severe form, you can try to suppress ovulation. Patients with suppressed Danazole, analogue of GNVG, a medroxyprogesterone or an implantation of estrogen ovulation symptoms may not disturb some time (about a year) and after the cessation of such treatment. However, if the symptoms relapse or are not eliminated, some patients can be proposed by ovarectomy, in a patient with a documented proven premenstrual syndrome, which is eliminated against the background of anointing caused by an analogue of GNVG, Danazole or estrogens, and in which the heavy manifestations of the syndrome do not allow normal life, ovarectomy May be pleased rational method Treatment, if a woman is ready to take premature shutdown of ovarian function.
Symptoms of relief symptoms of premenstrual syndrome (PMS)
- Diet contributing to the regulation of eikosanoid imbalance.
- Multivitamins and mineral supplements. They should contain from 400 to 800 mg of magnesium (magnesium deficiency is often characteristic of women with PMS) and 50-100 mg of group Vitamins complex. All women should daily (and not only before menstruation) take these drugs during the whole month.
- Exclusion from the Scripture of refined sugar, flour products from flour of fine grinding, as well as saturated fatty acids.
- Exception from the caffeine ration. Just a refusal of caffeine, even if earlier the woman drank just one cup of coffee or one bank of Kola per day, significantly weakened the symptoms of PMS.
- Consumption of sufficient number of essential fatty acids. These substances are in raw nuts and cereals living in cold waters of fish (salmon, sardines) and in many plants. An excellent source of fatty acids is sesame, as well as vegetable and safflower oil and walnut oil. You can also take nutritional supplementssold without recipe in pharmacies and selling environmentally friendly products stores. It usually happens 500 mg fish fat three or four times a day. Linen oil is also suitable - three or four receptions of 500 mg per day. For optimal digestibility of basic fatty acids, the body requires an adequate amount of magnesium, vitamin C, zinc, vitamins 3 and in 6.
- Reducing stress and restoration of the body's energy balance. Practicing meditation and other methods of deep relaxation of women are able to independently soften the PMS. Many relaxation techniques reduce the level of cortisol and adrenaline (epinephrine) in the blood, which helps to balance the biochemical processes in the body, including the content of eikosanoids. Useful to the most different kinds Meditation. Each woman should pick up what is suitable for her and include such classes in their routine of the day. For example, relaxation according to the RA-Raerert Benson scheme is held for 15-20 minutes twice a day and includes the following: you first need to sit with closed eyes in a convenient position; Then deeply relax all the muscles, starting with the face and ending with foot feet; breathe a nose, concentrating on every breath and exhale; With each exhalation, the word "one" mentally say. In one study, it was proved that three months of regular classes for this scheme give a significant relief of the symptoms of PMS.
- Reflexology. It is proved that therapy based on pressure on certain points on the ear, hand and foot facilitates the symptoms of PMS. Usually, the course under the guidance of a qualified reflexology is eight weeks (one half-hour session per week).
- At least three twenty-minute activities by aerobics or gymnastics similar to it per week. It will also be just fast walking. Such physical fitting exercises are very effective - help from many manifestations of PMS. They also increase the level of endorphins (producing naturally producing substances that help the body to cope with depression and physical pain). It is estimated that more than half of the depression cases are treated only by exercise.
- Full day light. Spend two hours in the morning and in the evening at the light source (2500-10000 luxury; luxury - unit of measurement of light intensity). It can be a natural daylight or lamp of artificial light. Gloomy day, typical of Northern Europe, gives 10,000 suite. And a sunny day somewhere from the equator - 80,000 suite.
- If necessary, progesterone therapy. The reception of natural progesterone in combination with a change in lifestyle often gives a serious positive result in the treatment of PMS. As neurotransmitters estrogen and progesterone obviously affect the change of mood. The estrogen not balanced by progesterone is annoying the nervous system. On the contrary, progesterone is associated with the state of rest and relaxes the central nervous system. It is possible that progesterone favorable for the removal of the PMS syndrome is valid because it is due to the reassuring of the central nervous system.
Natural progesterone is not at all the same as synthetic (progestin), for example, the medroxyprogesterone acetate - provisions. In the treatment of natural progesterone in standard doses of serious side effects almost does not occur. Only sometimes there are delays in menstruation. Dysfunction usually disappears after two-month reception. Very large doses, much big, cause the state of Euphoria and, in rare cases, sporadic dizziness. Oral natural progesterone can be bought in pharmacies for a doctor's prescription. It is also released in the form of creams for the skin. Note that although natural progesterone is obtained from a wild mexican yams, containing only the yams extract creams let them help some women, but do not go to comparison with a similar amount of natural oral progesterone. Not in all pharmacies prepare natural progesterone, and not all doctors know where to get it.
For applying to the skin, you can use one of several natural progesterone creams that are available without a recipe, or ask the doctor to order it in a pharmacy that specializes in making drugs to order. 2% cream protest. The content of natural progesterone in a 2% cream is at least 400 mg per ounce. A quarter or half of a tea spoon of cream on the skin of a quarter or half of the teaspoon gives the physiological level of progesterone, almost similar to that is produced by naturally during the period of the normal luteal cycle phase.
It is usually prescribed to apply a quarter of a teaspoon of cream (approximately 20 mg) on \u200b\u200bsoft skin areas (chest, lower abdomen, neck, face, inner surfaces or palms) in the morning and evening. Skin areas that are lubricated with cream must alternate. It is better to apply it, starting from the fourteenth and ending the twenty-eighth day of the menstrual cycle, at least for three months. However, the dosage and time of applying are individual for each patient. It is only important to include progesterone in your exchange process until the mood has occurred. It is necessary to impose a cream for a day or another before the start of ovulation or one or two days before you usually show the symptoms of PMS. For some, this is twenty-first cycle, for others - twelfth or thirteenth. Continue to use the cream on the first day of monthly bleeding (the first day of the cycle). This can fully prevent PMS symptoms or significantly reduce their intensity. Wait for the beginning of the appearance of symptoms is meaningless: in this case therapy does not give the result. Increase or reduce the dosage depending on the severity of the symptoms; Most women have to experiment to choose the amount of the drug. It is possible to safely use these creams for two or more weeks of each cycle, given that once a month you need to do at least one break by 12 or more hours.
Unlike natural progesterone, synthetic progestins give many side effects, such as swelling of the abdomen, headaches and weight gain. Unfortunately, many women are trying to convince the fact that natural progesterone and progestin are one and the same. But in fact, synthetic progestins can even provoke the symptoms of PMS, since their reception reduces the natural level of progesterone in the blood.
Progesterone therapy helps very well to those women who are subject to sharp mood drops after ovulation that is continuing before the start of menstrual bleeding. They describe their condition like this: "I just felt perfectly, but suddenly black clouds are condensed over your head." When menstruation begins, the feeling arises that "light shed you." This is a very accurate description of the biochemical changes occurring in the body that really happen and have nothing to do with simulation or inventions.
Balance between estrogen levels, progesterone and other PMS hormone-related hormones, apparently wears an unstable, fluctuating character that cannot be fixed using currently existing methods and analyzes. Even a minor hormonal imbalance may cause dysfunction and emotional disruption. The latter, in turn, raises the level of the hormone asset (corticotropin), which results in a non-cancer cycle (when the egg release does not occur). It is characterized by an inadequate level of progesterone.
Over time, the reception of natural progesterone normalizes the balance of estrogen and progesterone. If regularly, for several months to carry out progesterone therapy, the symptoms of PMS become easier with each cycle. Many women reduce the dosage as they facilitate pain and improving the mood (although this drug has so many positive effects that some women continue to take it even after the complete disappearance of PMS symptoms). However, it is most effectively starting with high doses and continue for a few months.
Ultimately, women who are able to comprehend the psychological reasons for the occurrence of PMS can restore their hormonal balance in a natural way, without the use of additional hormones. As the emotional and physiological stress decreases, all biochemical processes in the body are changed.
PMS and relationship relationship
Between PMS and adulthood in a disadvantaged family, where parents or grandfather and grandmother are alcoholics, there is a direct dependence. When the girl grows with a permanent feeling that it is necessary to sacrifice themselves to someone's desires and indulge adults, the risk of PMS appearance is very high. In many families, where alcoholism is transmitted by the men's line, women very often suffer from PMS. In children drinking parents, a 40% chance to become alcoholics, and not only because of genetic predisposition, but because they see in alcohol means of dulling their negative emotions. Women from drinking families often get PMS as a result of constant need to suppress their negative emotions.
Premenstrual syndrome (PMS) is characterized by a pathological symptom complex manifested by neuropsychic, vegetative-vascular and exchange-endocrine disorders in the second phase of the menstrual cycle in women.
In the literature you can meet various synonyms of premenstrual syndrome: premenstrual stress syndrome, premenstrual disease, cyclic disease.
The frequency of premenstrual syndrome is variable and depends on the age of a woman. So, under the age of 30, it is 20%, after 30 years of PMS occurs approximately every second woman. In addition, premenstrual syndrome is more often observed in emotionally labile women of asthenic physique, with a body weight deficit. There is also a significantly large frequency of the occurrence of PMS in women of intellectual labor.
Symptoms of premenstrual syndrome
Depending on the prevalence of certain signs in the clinical picture, four forms of premenstrual syndrome are distinguished:
- Neuropsychic;
- edema;
- cephalgic;
- crossing.
Such a separation of premenstrual syndrome is conditionally and is determined mainly to the tactics of treatment, which is largely symptomatic.
Depending on the number of symptoms, their duration and severity, it is proposed to distinguish the light and severe form of premenstrual syndrome:
- Light form PMS - the appearance of 3-4 symptoms 2-10 days before menstruation with significant severity of 1-2 symptoms;
- heavy form PMS - The appearance of 5-12 symptoms 3-14 days before menstruation, of which 2-5 or all are significantly expressed.
It should be noted that disruption of disability, regardless of the number and duration of the symptoms, indicates the serious course of premenstrual syndrome and is often combined with the neuropsychiatric form.
During PMS Three stages can be distinguished:
- Compensated Stage: The appearance of symptoms in the premenstrual period, which with the beginning of menstruation pass; Over the years, the clinic of premenstrual syndrome does not progress;
- subcompensated Stage: Over the years, the severity of the premenstrual syndrome flow is progressing, the duration, number and severity of symptoms increases;
- decompensated Stage: The difficult course of premenstrual syndrome, "light" gaps are gradually reduced.
The neuropsychic form is characterized by the presence of the following symptoms: emotional lability, irritability, plasticity, insomnia, aggressiveness, apathy for the surrounding, depressive condition, weakness, fast fatigue, olfactory and auditory hallucinations, memory weakening, feeling of fear, longing, caustible laughter or crying, sexual disorders , suicidal thoughts. In addition to neuropsychic reactions, which appear on the fore, in the clinical picture of PMS, there may be other symptoms: headaches, dizziness, disruption of appetite, heat and soreness of the mammary glands, chest pain, scrawling.
Eye-shape is distinguished by prevailing in the clinical picture of the following symptoms: swelling of the face, the legs, the fingers of the hands, heat and soreness of the dairy glands (median), skin itching, sweating, thirst, weight gain, violation of the gastrointestinal tract (constipation, meteorism, diameter ), joint pain, headaches, irritability, etc. In the overwhelming majority of patients with an euldered form of premenstrual syndrome in the second phase of the cycle, a negative diurez is noted with a delay of up to 500-700 ml of liquid.
The cephalgic form is characterized by prevailing in a clinical picture of vegetative-vascular and neurological symptoms: headaches on the type of migraine with nausea, vomiting and diarrhea (typical manifestations of hyperprostaglandinemia), dizziness, heartbeat, heart pain, insomnia, irritability, increased sensitivity to smells, aggressiveness. Headache It has a specific character: the twigging, pulsating in the area of \u200b\u200bthe temple with an edema of the century and is accompanied by nausea, vomiting. In the history of these women, neuroinfection, cranial injuries, mental stress are often noted. Family history of patients with a cephalgic form of premenstrual syndrome is often burdened by cardiovascular diseases, hypertensive disease and the pathology of the gastrointestinal tract.
In crisis form, sympathoyadrenal crises prevailed in a clinical picture, accompanied by an increase in blood pressure, tachycardia, a feeling of fear, pain in the heart without changes to the ECG. The attacks often end with abundant urinary. As a rule, crises arise after overwork, stressful situations. The crisis of premenstrual syndrome may be the outcome of an untreated neuropsychic, edema or cofalgic form of premenstrual syndrome at the decompensation stage and manifests aged after 40 years. In the overwhelming majority of patients with crisis form of premenstrual syndrome, diseases of the kidneys, a cardiovascular system and a gastrointestinal tract are noted.
The atypical forms of premenstrual syndrome include vegetative-dysicial myocardiopathy, hyperthermic ophthalmoplegic form of migraine, hypersmatic form, "cyclic" allergic reactions (ulcerative gingivitis, stomatitis, bronchial asthma, iridocyclite, etc.).
Diagnosis of premenstrual syndrome
Diagnostics are certain difficulties, since patients often turn to the therapist, a neurologist or other specialists, depending on the form of premenstrual syndrome. Conducted symptomatic therapy gives an improvement in the second phase of the cycle, since after menstruation, the symptoms disappear independently. Therefore, the identification of premenstrual syndrome contributes to the active survey of the patient, in which the cyclic nature of pathological symptoms arising in premenstrual days is revealed. Given the variety of symptoms, the following clinical and diagnostic criteria are proposed. premenstrual syndrome:
- Conclusion of a psychiatrist, excluding the presence of mental illness.
- A clear connection of symptoms with a menstrual cycle is the occurrence of clinical manifestations for 7-14 days before menstruation and their disappearance at the end of menstruation.
Some doctors are based on diagnostics premenstrual syndrome According to the following features:
- Emotional lability: irritability, fiscalness, fast mood change.
- Aggressive or depressive condition.
- Feeling alarm and tension.
- Detection of mood, feeling hopelessness.
- Reducing interest in the usual way of life.
- Fast fatigue, weakness.
- The inability to concentrate attention.
- Change of appetite, tendency to bulimia.
- Drowsiness or insomnia.
- Screwing and painfulness of the mammary glands, headaches, swelling, articular or muscle pain, weight gain.
The diagnosis is considered to be reliable in the presence of at least five of the above symptoms with a binding manifestation of one of the first four.
It is desirable to keep a diary for at least 2-3 menstrual cycles, in which the patient marks all pathological symptoms.
Examination on tests of functional diagnosis is impractical due to their small informativeness.
Hormonal studies include the definition of prolactin, progesterone and estradiol in the second phase of the cycle. The hormonal characteristic of patients with premenstrual syndrome has features depending on its shape. Thus, with a sweepy form, a reliable decrease in the level of progesterone in the second phase of the cycle was marked. With neuropsychic, cephalgic and crisis forms, an increase in blood prolactin is revealed.
Additional research methods are prescribed depending on the form of premenstrual syndrome.
With pronounced cerebral symptoms (headaches, dizziness, noise in the ears, impairment of vision) showing computed tomography or nuclear magnetic resonance to eliminate the volume formations of the brain.
When conducting EEG in women with a neuropsychic form of premenstrual syndrome, functional disorders are detected mainly in the diancefral-limbic structures of the brain. With the echo form of the premenstrual syndrome, the EEG data indicate the strengthening of the activating effects on the bark of large hemispheres of non-specific structural structures of the brain, more pronounced in the second phase of the cycle. Under the cephalgic form of the premenstrual syndrome, the EEG data indicates diffuse changes in the brain's electrical activity on the type of teenchronization of cortical rhythm, which is enhanced with the crime of the premenstrual syndrome.
With silent form PMS The diurea measurement is shown, the study of the excretory function of the kidneys.
In the disease and edema of the dairy gland, mammography is carried out in the first phase of the cycle for the differential diagnosis of mastonia and mastopathy.
Necessarily to survey patients with PMS Adjustable specialists are involved: neuropathologist, psychiatrist, therapist, endocrinologist.
It should be remembered that the premenstrual days deteriorates the course of existing chronic extragenital diseases, which is also regarded as premenstrual syndrome.
Treatment of premenstrual syndrome
Unlike the treatment of other syndromes (for example, postcase syndrome), the first stage is psychotherapy with an explanation of the patient of the disease of the disease.
How to facilitate the premenstrual syndoma? Mandatory is the normalization of labor and recreation regime.
The food must be in compliance with the diet in the second phase of the cycle, excluding coffee, chocolate, sharp and salty dishes, as well as limiting fluid consumption. Food should be rich in vitamins; Animal fats, carbohydrates are recommended to limit.
Considering the presence of neuropsychic manifestations of various severity in any form of premenstrual syndrome, sedative and psychotropic drugs are recommended - "Tazepam", "Rudotel", "Seduksen", "Amitriptyline" and others. Preparations are prescribed in the second phase of the cycle 2-3 days before manifestation Symptoms.
Antihistamine Action Preparations are effective for edema PMS, allergic manifestations. Appointed "Tueva", "Diazolin", "Teralen" (also in the second phase of the cycle).
Drugs that normalize neurotiator exchange in the CNS are recommended for neuropsychic, cephalgic and crisis forms of premenstrual syndrome. Peritol normalizes serotonin exchange (1 tablet 4 mg per day), "diphenin" (1 tablet 100 mg twice a day) has an adrenergic effect. Preparations are prescribed for a period of 3 months.
In order to improve blood circulation in the CNS, the use of "Nootropyl", "Grandaxina" (1 capsule 3-4 times a day), "Aminolona" (0.25 g within 2-3 weeks).
With cephalgic and crisis forms, the Parlodel's appointment is effective (1.25-2.5 mg per day) in the second phase of the cycle or in continuous mode with an elevated level of prolactin. Being a dopamine agonist, "Parlohel" has a normalizing effect on the Tubero-Infundibular CNS system. The dihydroergotamine dihydroeergotamine, which has antisomputerotonin and antispasmodic effect, is also an agonist of dofamic receptors. The drug is prescribed as a 0.1% solution of 15 drops 3 times a day in the second phase of the cycle.
With silent form PMS The appointment of Veroshpiron is shown, which, being an aldosterone antagonist, has a potassium-saving diuretic and hypotensive effect. The drug is applied at 25 mg 2-3 times a day in the second phase of the cycle 3-4 days before the manifestation of clinical symptoms.
Considering the important role of prostaglandins in the pathogenesis of the premenstrual syndrome, antiprostaglandine drugs are recommended, for example, "Narosin", "Indomethacin" in the second phase of the cycle, especially with swelling and cephalgic forms PMS.
Hormone therapy is carried out with the insufficiency of the second phase of the cycle. Gestagens are appointed from the 16th to the 25th day of the cycle - "Dufeston", "MedroxyProgesterone acetate" for 10-20 mg per day.
In the case of severe premenstrual syndrome, the use of antagonists gonadotropin-rillation hormones (AGNG) for 6 months is shown.
Treatment premenstrual syndrome Long, takes 6-9 months. In the case of relapse therapy is repeated. In the presence of concomitant extragenital pathology, treatment is carried out in conjunction with other specialists.
Causes of premenstrual syndrome
To factors contributing to occurrence premenstrual syndromeinclude stressful situations, neuroinfection, complicated childbirth and abortion, various injuries and operational interventions. A certain role is played by a premoric background, burdened by various gynecological and extragenital pathologies.
There are many theories of the development of premenstrual syndrome explaining the pathogenesis of various symptoms: hormonal, theory of "water intoxication", psychosomatic disorders, allergic, etc.
Historically, the first hormonal theory was. According to her, it was believed that PMS Developed against the background of absolute or relative hyperstrogenation and deficiency of the secretion of progesterone. But, as studied studies, the annotulation and insufficiency of the yellow body are found in the pronounced clinical symptoms of premenstrual syndrome very rarely. In addition, progesterone therapy turned out to be ineffective.
In recent years, a large role in the pathogenesis of premenstrual syndrome is given to prolactin. In addition to the physiological increase, the hypersensitivity of target tissues to prolactin in the second phase of the cycle is noted. It is known that prolactin is a modulator of the action of many hormones, in particular adrenal. This explains the sodium-delaying effect of aldosterone and the antidiuretic effect of vasopressin.
The role of prostaglandins in pathogenesis is shown premenstrual syndrome. Since prostaglandins are universal tissue hormones, which are synthesized in almost all organs and tissues, the synthesis of prostaglandin synthesis can manifest itself a variety of different symptoms. Many symptoms of premenstrual syndrome are similar to the state of hyperprostaglandinemia. The synthesis of synthesis and metabolism of prostaglandins explains the occurrence of such symptoms as headaches according to migraine, nausea, vomiting, bloating, diarrhea and various behavioral reactions. Prostaglandins are also responsible for the manifestation of various vegetative-vascular reactions.
The manifold of clinical manifestations indicates the involvement in the pathological process of central, hypothalamic structures responsible for the regulation of all metabolic processes in the body, as well as behavioral reactions. Therefore, at present, the main role in the pathogenesis of the premenstrual syndrome is given to a violation of the exchange of neuropeptides in the central nervous system (opioids, serotonin, dopamine, norepinephrine, etc.) and peripheral neuroendocrine processes associated with it.
Thus, the development of premenstrual syndrome can be explained by the functional disorders of the CNS as a result of the effects of adverse factors against the background of congenital or acquired lability of the hypothalamic-pituitary system.
The menstrual cycle is actually regular stress, which can lead to a change in the level of hormones and, then, to various health problems. In such cases, it is recommended to receive drugs containing vitamins, microelements that will help the woman's body to cope with such stress and prevent complications. For example, the "Estrovale Time Factor", the packaging of which consists of 4 blisters, each of which contains components that help women in each of the 4 phases of the menstrual cycle.
The site provides reference information Exceptionally for familiarization. Diagnosis and treatment of diseases must be under the supervision of a specialist. All drugs have contraindications. Consultation of a specialist is obligatory!
General
Premenstrual syndrome (PMS), called back premenstrual disease or cyclic syndrome - This is a complex of symptoms that appear regularly in women in two to ten days before menstruation.The syndrome is characterized by a violation of the mood, the operation of the autonomic nervous system, vascular and metabolic disorders.
Eight women out of ten faced with this malaise. And the third of the alertness is so serious that they interfere with working normally and relax. Women suffering from these ailments should be borne in mind that in the absence of treatment, the syndrome can grow into an early climax with a difficult course.
According to joint estimates of doctors and policemen, the majority of accidents in which women fall are approximately the easiest of their menstrual cycle.
Almost a third of British female prisoners made their misconduct several days before the start of menstruation.
Foreign researchers argue that in the exams the last days Cycle, most students get worst grades.
The reasons
All the ailments that appear in the last days of the cycle are primarily associated with a change in equilibrium between the levels of progesterone hormones and estrogen.A certain reason for the development of PMS was not revealed today. However, it is known that this phenomenon is more often observed in women who have undergone abortion or several, after infectious diseases, as well as in a state of constant stress.
Violating the level of hormones in the body can substances falling into the body with food packaged in a plastic wrapper.
Lovers of chips and noodles fast cookingTake care!
Another factor contributing to the development of the syndrome is the high level of glucose in the blood. Therefore, more susceptible to cyclic syndrome of women, abusing carbohydrate food and sweet.
There is an opinion that the development of the premenstrual syndrome may cause kidney disease, reproduction or digestion organs. In addition, there is a genetic predisposition to this violation.
Symptoms
Most often, the symptoms of this syndrome are observed from 20 years or a little later and by 30 years they are developing in full force. Most often, only two are three symptoms listed in stock.- Sleep disturbance
- Lost, decrease in performance, inattention
- Non-continuousness of noise
- Migreen-like pain, coordination violation, fainting
- "Goosebumps" by body or limbs, speech braking
- Unpleasant feelings in breast glands
- Nervousness, mood instability, excessive emotionality
- Reducing the volume of daily urine, weight gain, swelling
- Pain in the joints, swelling, myalgia, pain in the neck
- Disruption of digestion of food
- Increased appetite, thrust to sweet or salty, disgust to alcohol
- Minor increase in body temperature, blood outflow from the nose
- Aggravation of allergies, asthma, hemorrhoids, other chronic diseases, frequent organs
- Change libido.
PCS pain
For premenstrual syndrome, blunt-having pains in the lower abdomen are characteristic. They should not be too strong, otherwise may indicate any diseases of the small pelvis.To facilitate pain, neglection preparations based on ibuprofen, paracetamol can be used. Three days before the start of menstruation, Indomethacin can be frowning in the dosage: on one tablet three times a day. For a long time, it is not worth using it, as it does not affect the state of the stomach too well.
3. There is less salt, it is desirable to abandon nicotine.
Treatment of herbs
Such treatment is possible if the symptoms are not too pronounced. If the syndrome already seriously interferes with normal life, you should consult a doctor and use herbal medicines as auxiliary.1. Bath with decoction of mint and souls, rosemary, lavender, yarrow, currant leaf, Toll. Sasha with herbs should always be near the pillow.
5. 2 tsp Flowers of elder pour 200 ml of boiling water on a quarter of an hour in thermos, skip through a sieve. Drink 100 ml three times a day on an empty stomach. You can put a little honey or sugar.
6. 1 tbsp. Colors of blue cornflower brew 200 ml of boiling water in a thermos for 2 hours, skip through a sieve. Use 70 ml three times or four times a day on an empty stomach.
7. Take 2 tbsp. Hypericum and 1 tbsp. Souls, mix and brew 300 ml boiling water. To withstand in a thermos 60 minutes, pour out a little lemon crust and cinnamon, skip through a sieve. Use for half an hour to meal at 70 ml.
8. Take 500 gr. Oranges grind on meat grinder not purified, 150 gr. Khrena on a meat grinder, 0.3 kg of sugar and 1000 ml of red wine. Together tomorrow on the steam bath of 60 minutes under the lid, skip through the sieve. Use 200 ml three times or four times a day.