PMS symptoms and signs. PMS treatment

Most women are familiar with the symptoms of premenstrual syndrome. Many of them suffer not so much from the ailments of menstruation itself, but from the condition that precedes it. The reason for this is the hormonal changes that occur in the body on the eve of menstruation. The functioning of various organs is disrupted, as well as nervous system. This leads to headaches, depression, and irritability. It is necessary to know what physiological processes they are associated with. Then it may be easier to cope with unpleasant symptoms.

After ovulation, the so-called luteal phase begins, which precedes the onset of menstruation. Preparation for it begins in the body in advance. Under the influence of hormones, changes occur in the condition of the mammary glands and genitals. The brain and central nervous system react to hormonal processes.

Most women experience characteristic pre-menstrual symptoms as a result. For some, they begin 2 days before menstruation, for others – 10. Disorders appear with varying degrees of severity. With the onset of critical days, they disappear. These symptoms are grouped under the general name premenstrual syndrome(PMS). It has been noticed that PMS is stronger in women who suffer from gynecological or other diseases.

Night shift work, exposure to harmful substances, lack of sleep, poor diet, troubles and conflicts are all factors that increase ailments before menstruation.

Note: There is a theory that discomfort before menstruation is the body’s reaction to the lack of conception, which is the natural completion of the physiological processes occurring in the female reproductive system.

Signs of approaching period

Manifestations of PMS may vary for each individual woman. The nature of the manifestations is influenced by heredity, lifestyle, age, and health status. The most obvious signs that your period is approaching include the following:

• irritability;
• depressed state, feeling of inexplicable melancholy, depression;
• fatigue, headaches;
• fall blood pressure;
• inability to concentrate, deterioration of attention and memory;
• sleep disturbance;
• constant feeling hunger;
• painful sensations in the chest;
• the occurrence of edema and weight gain due to fluid retention in the body;
• indigestion, bloating;
• nagging pain in the lower back.

Distinguish light form the course of PMS (the presence of 3-4 symptoms that disappear with the onset of menstruation) and the severe form (the appearance of most symptoms simultaneously 5-14 days before menstruation). It is not always possible for a woman to cope with severe symptoms on her own. Sometimes only hormonal medications can help.

Types of PMS

Depending on what signs predominate in a woman before her period, the following forms of PMS are distinguished.

Edema. With this form, women feel pain in the mammary glands more acutely, their legs and arms swell, skin itching, and increased sweating appear.

Cephalgic. Every time before menstruation, dizziness, nausea, vomiting, and a headache radiating to the eyes appear. Often such symptoms are combined with heart pain.

Neuropsychic. Symptoms such as depressed mood, irritability, tearfulness, aggressiveness, and intolerance to loud sounds and bright lights predominate.

Krizovaya. Before menstruation, women experience crises: increases blood pressure, the pulse quickens, the limbs go numb, pain appears in the chest area, and the fear of death arises.

Causes of various PMS symptoms

The severity of PMS manifestations depends mainly on the degree of hormonal changes and the state of the nervous system. The psychological attitude plays an important role. If a woman is active, busy with interesting things, then she does not feel the symptoms of the onset of menstruation as acutely as a suspicious pessimist, suffering from the mere thought of upcoming ailments. Every symptom can have an explanation.

Increased body weight. On the one hand, its cause is a decrease in the level of estrogen in the blood in the second phase of the cycle. By accumulating adipose tissue capable of secreting estrogens, the body compensates for their deficiency. There is also a deficiency of glucose in the blood, which leads to an increased feeling of hunger. For many women, eating delicious food is a way to distract themselves from troubles and worries.

Changes in mood. The cause of aggressiveness, irritability, anxiety, and depression is the lack of “pleasure hormones” in the body (endorphin, serotonin, dopamine), the production of which decreases during this period.

Nausea. Before menstruation, the uterus enlarges slightly due to the growth and loosening of the endometrium. At the same time, it can put pressure on the nerve endings, the irritation of which causes the gag reflex. Nausea can be caused by taking hormonal medications and contraceptives. If a woman constantly has such a sign before her period, then perhaps this remedy it is contraindicated for her. It needs to be replaced with something else.

Warning: Nausea before your expected period can be a sign of pregnancy. With this in mind, a woman should first of all do a test and visit a doctor to clarify her condition.

Pain in the lower abdomen. A slight nagging pain in the lower abdomen is considered normal before menstruation if the woman does not have cycle disorders, there are no pathological discharge or other signs of genital diseases. If the pain is severe and does not subside after taking painkillers, then you must definitely go to the doctor and undergo an examination to find out the causes of the pathology.

Increase in temperature. Before menstruation, the temperature can normally rise to 37°-37.4°. The appearance of more high temperature becomes a sign of presence inflammatory process in the uterus or ovaries. As a rule, there are other signs of disturbances that force the woman to visit a doctor.

The appearance of acne. This symptom occurs before menstruation as a result of endocrine disorders, intestinal diseases, decreased body defenses, and impaired fat metabolism due to changes in hormone production.

The appearance of edema. Hormonal changes cause the process to slow down water-salt metabolism in the body, which leads to fluid retention in the tissues.

Enlargement of the mammary glands. Progesterone levels increase and the body prepares for a possible pregnancy. The ducts and lobules swell, blood circulation increases. The breast tissue is stretched, which leads to a dull pain when you touch it.

Video: Why does your appetite increase before your period?

Under what conditions do similar manifestations occur?

Women often confuse the symptoms of PMS and pregnancy. Nausea, dizziness, enlargement and tenderness of the mammary glands, and increased leucorrhoea are characteristic of both conditions.

If there are symptoms and your periods are late, then you are most likely pregnant. To make sure that this is exactly the case, it is recommended to take a blood test for human chorionic hormone levels (hCG is formed after pregnancy).

Similar symptoms also appear when endocrine diseases, formation of mammary tumors, use of hormonal drugs.

Symptoms of approaching first menstruation in adolescents

Puberty begins in girls aged 11-15 years. Their character is finally established only after 1-2 years. A girl can find out about the imminent onset of her first menstruation by characteristic manifestations. Already 1.5-2 years before the onset of this event, a teenage girl begins to develop white discharge. Immediately before the appearance of the first menstruation, leucorrhoea becomes more intense and thin.

Possible appearance of weak nagging pain in the ovaries, arising due to their growth and stretching. PMS often manifests itself quite weakly, but there may also be deviations comparable in nature to the manifestations of PMS in adult women. One of characteristic features Teenage PMS is the formation of acne on the face. The reason is fluctuations in the level of sex hormones, the influence of this process on the condition of the skin.

Video: Signs of approaching menstruation in girls

Manifestations of PMS in premenopausal women

After 40-45 years, women experience the first signs of aging and a decrease in the level of sex hormones. arise menstrual irregularities, metabolism slows down, chronic diseases of the genital organs often worsen. The condition of the nervous system worsens. As a result, the manifestations of PMS intensify even more.

Many women of this age experience severe headaches, dizziness, increased sweating, increased heart rate, mood swings, and depression before menstruation. Often, such manifestations of PMS are so painful that to alleviate the condition, hormonal therapy is prescribed with drugs that regulate the content of estrogen, progesterone and other hormones in the body.

(PMS) is characterized by a pathological symptom complex manifested by neuropsychic, vegetative-vascular and metabolic-endocrine disorders in the second phase menstrual cycle in women.

In the literature you can find various synonyms for premenstrual syndrome: premenstrual tension syndrome, premenstrual illness, cyclic illness.

The frequency of premenstrual syndrome is variable and depends on the age of the woman. Thus, before the age of 30, it is 20%; after 30, PMS occurs in approximately every second woman. In addition, premenstrual syndrome is more often observed in emotionally labile women with asthenic physique and underweight. There was also a significantly higher incidence of PMS in women with intellectual work.

Symptoms of premenstrual syndrome

Depending on the prevalence of certain signs in the clinical picture, four forms of premenstrual syndrome are distinguished:

• Neuropsychiatric;
• edematous;
• cephalgic;
• crisis.

This division of premenstrual syndrome is arbitrary and is determined mainly by treatment tactics, which are largely symptomatic.

Depending on the number of symptoms, their duration and severity, it is proposed to distinguish between mild and severe forms of premenstrual syndrome:

• Light form PMS- the appearance of 3-4 symptoms 2-10 days before menstruation with significant severity of 1-2 symptoms;
• severe form PMS- the appearance of 5-12 symptoms 3-14 days before menstruation, of which 2-5 or all are significantly pronounced.

It should be noted that disability, regardless of the number and duration of symptoms, indicates a severe course of premenstrual syndrome and is often combined with the neuropsychiatric form.

During PMS Three stages can be distinguished:

• Compensated stage: symptoms appear in premenstrual period, which disappear with the onset of menstruation; over the years, the clinical picture of premenstrual syndrome does not progress;
• subcompensated stage: over the years, the severity of premenstrual syndrome progresses, the duration, number and severity of symptoms increases;
• decompensated stage: severe premenstrual syndrome, “light” intervals gradually decrease.

The neuropsychic form is characterized by the presence the following symptoms: emotional lability, irritability, tearfulness, insomnia, aggressiveness, apathy towards others, depression, weakness, fatigue, olfactory and auditory hallucinations, memory loss, feelings of fear, melancholy, causeless laughter or crying, sexual dysfunction, suicidal thoughts. In addition to the neuropsychological reactions that come to the fore, the clinical picture of PMS may include other symptoms: headaches, dizziness, loss of appetite, engorgement and tenderness of the mammary glands, chest pain, bloating.

The edematous form is characterized by the prevalence of the following symptoms in the clinical picture: swelling of the face, legs, fingers, engorgement and tenderness of the mammary glands (mastodynia), itching, sweating, thirst, weight gain, dysfunction gastrointestinal tract(constipation, flatulence, diarrhea), joint pain, headaches, irritability, etc. The vast majority of patients with the edematous form of premenstrual syndrome in the second phase of the cycle experience negative diuresis with retention of up to 500-700 ml of fluid.

The cephalgic form is characterized by the prevalence of vegetative-vascular and neurological symptoms in the clinical picture: migraine-type headaches with nausea, vomiting and diarrhea (typical manifestations of hyperprostaglandinemia), dizziness, palpitations, heart pain, insomnia, irritability, increased sensitivity to odors, aggressiveness. The headache has a specific character: twitching, pulsating in the temple area with swelling of the eyelid and is accompanied by nausea and vomiting. These women often have a history of neuroinfections, traumatic brain injuries, and mental stress. The family history of patients with the cephalgic form of premenstrual syndrome is often burdened by cardiovascular diseases, hypertension and pathology of the gastrointestinal tract.

In the crisis form, the clinical picture is dominated by sympathoadrenal crises, accompanied by increased blood pressure, tachycardia, a feeling of fear, and pain in the heart without changes on the ECG. Attacks often end with profuse urination. As a rule, crises occur after overwork or stressful situations. The crisis course of premenstrual syndrome can be the outcome of an untreated neuropsychic, edematous or cephalgic form of premenstrual syndrome at the stage of decompensation and manifests itself after the age of 40 years. The vast majority of patients with the crisis form of premenstrual syndrome have diseases of the kidneys, cardiovascular system and gastrointestinal tract.

Atypical forms of premenstrual syndrome include vegetative-dysovarial myocardiopathy, hyperthermic ophthalmoplegic form of migraine, hypersomnic form, “cyclic” allergic reactions(ulcerative gingivitis, stomatitis, bronchial asthma, iridocyclitis, etc.).

Diagnosis of premenstrual syndrome

Diagnosis presents certain difficulties, since patients often turn to a therapist, neurologist or other specialists, depending on the form of premenstrual syndrome. Symptomatic therapy provides improvement in the second phase of the cycle, since after menstruation the symptoms disappear on their own. Therefore, the identification of premenstrual syndrome is facilitated by an active survey of the patient, which reveals the cyclical nature of the pathological symptoms that occur in the premenstrual days. Considering the variety of symptoms, the following clinical diagnostic criteria have been proposed: premenstrual syndrome:

• A psychiatrist's conclusion excluding the presence of mental illness.
• There is a clear connection between symptoms and the menstrual cycle - the appearance of clinical manifestations 7-14 days before menstruation and their disappearance at the end of menstruation.

Some doctors rely on diagnosis premenstrual syndrome according to the following characteristics:

1. Emotional lability: irritability, tearfulness, rapid mood swings.
2. Aggressive or depressive state.
3. Feelings of anxiety and tension.
4. Deterioration of mood, feeling of hopelessness.
5. Decreased interest in the usual way of life.
6. Fatigue, weakness.
7. Inability to concentrate.
8. Changes in appetite, tendency to bulimia.
9. Drowsiness or insomnia.
10. Breast engorgement and tenderness, headaches, swelling, joint or muscle pain, weight gain.

The diagnosis is considered reliable in the presence of at least five of the above symptoms, with the obligatory manifestation of one of the first four.

It is advisable to keep a diary for at least 2-3 menstrual cycles, in which the patient notes all pathological symptoms.

An examination using functional diagnostic tests is impractical due to their low information content.

Hormonal studies include determination of prolactin, progesterone and estradiol in the second phase of the cycle. The hormonal characteristics of patients with premenstrual syndrome have features depending on its form. Thus, in the edematous form, a significant decrease in progesterone levels was noted in the second phase of the cycle. In neuropsychic, cephalgic and crisis forms, an increase in the level of prolactin in the blood was detected.

Additional research methods are prescribed depending on the form of premenstrual syndrome.

For severe cerebral symptoms (headaches, dizziness, tinnitus, blurred vision), computed tomography or nuclear magnetic resonance is indicated to exclude volumetric formations brain

When conducting an EEG in women with a neuropsychic form of premenstrual syndrome, functional disorders are detected mainly in the diencephalic-limbic structures of the brain. In the edematous form of premenstrual syndrome, EEG data indicate an increase in activating influences on the cortex cerebral hemispheres nonspecific structures of the brain stem, more pronounced in the second phase of the cycle. In the cephalgic form of premenstrual syndrome, EEG data indicate diffuse changes electrical activity of the brain according to the type of desynchronization of cortical rhythms, which intensifies during the crisis of premenstrual syndrome.

With edematous form PMS measurement of diuresis and examination of renal excretory function are indicated.

In case of pain and swelling of the mammary glands, mammography is performed in the first phase of the cycle to differential diagnosis Mastodonia and mastopathy.

Mandatory examination of patients with PMS related specialists are involved: neurologist, psychiatrist, therapist, endocrinologist.

It should be remembered that in premenstrual days the course of existing chronic extragenital diseases worsens, which is also regarded as premenstrual syndrome.

Treatment of premenstrual syndrome

Unlike the treatment of other syndromes (for example, post-castration syndrome), the first stage is psychotherapy with an explanation to the patient of the nature of the disease.

How to alleviate premenstrual syndrome? Normalization of the work and rest regime is mandatory.

Nutrition should follow a diet in the second phase of the cycle, excluding coffee, chocolate, spicy and salty foods, and also limiting fluid intake. Food should be rich in vitamins; It is recommended to limit animal fats and carbohydrates.

Considering the presence of neuropsychic manifestations of varying severity in any form of premenstrual syndrome, sedative and psychotropic drugs are recommended - Tazepam, Rudotel, Seduxen, Amitriptyline, etc. Drugs are prescribed in the second phase of the cycle 2-3 days before the onset symptoms.

Antihistamines are effective for edema PMS, allergic manifestations. Tavegil, Diazolin, Teralen are prescribed (also in the second phase of the cycle).

Drugs that normalize neurotransmitter metabolism in the central nervous system are recommended for neuropsychic, cephalgic and crisis forms of premenstrual syndrome. “Peritol” normalizes serotonin metabolism (1 tablet 4 mg per day), “Difenin” (1 tablet 100 mg twice a day) has an adrenergic effect. The drugs are prescribed for a period of 3 to 6 months.

In order to improve blood circulation in the central nervous system, the use of Nootropil, Grandaxin (1 capsule 3-4 times a day), Aminolon (0.25 g for 2-3 weeks) is effective.

In cephalgic and crisis forms, the administration of Parlodel (1.25-2.5 mg per day) in the second phase of the cycle or in a continuous mode with elevated level prolactin. Being a dopamine agonist, Parlodel has a normalizing effect on the tubero-infundibular system of the central nervous system. Dihydroergotamine, which has antiserotonin and antispasmodic effects, is also an agonist of dopamine receptors. The drug is prescribed as a 0.1% solution, 15 drops 3 times a day in the second phase of the cycle.

With edematous form PMS the appointment of "Veroshpiron" is indicated, which, being an aldosterone antagonist, has a potassium-sparing diuretic and hypotensive effect. The drug is used 25 mg 2-3 times a day in the second phase of the cycle 3-4 days before the onset of clinical symptoms.

Considering the important role of prostaglandins in the pathogenesis of premenstrual syndrome, antiprostaglandin drugs are recommended, for example, Naprosyn, Indomethacin in the second phase of the cycle, especially in edematous and cephalgic forms PMS.

Hormonal therapy is carried out in case of insufficiency of the second phase of the cycle. Progestins are prescribed from the 16th to the 25th day of the cycle - Duphaston, Medroxyprogesterone acetate, 10-20 mg per day.

In cases of severe premenstrual syndrome, the use of gonadotropin-releasing hormone antagonists (GnRH agonists) for 6 months is indicated.

Treatment premenstrual syndrome long-term, takes 6-9 months. In case of relapse, therapy is repeated. In the presence of concomitant extragenital pathology, treatment is carried out jointly with other specialists.

Causes of premenstrual syndrome

To the factors contributing to the emergence premenstrual syndrome, include stressful situations, neuroinfections, complicated childbirth and abortion, various injuries And surgical interventions. A certain role is played by the premorbital background, burdened by various gynecological and extragenital pathologies.

There are many theories of the development of premenstrual syndrome that explain the pathogenesis various symptoms: hormonal, theory of “water intoxication”, psychosomatic disorders, allergic, etc.

Historically, the hormonal theory was the first. According to her, it was believed that PMS develops against the background of absolute or relative hyperestrogenism and insufficiency of progesterone secretion. But, as studies have shown, anovulation and corpus luteum deficiency occur with severe clinical symptoms of premenstrual syndrome very rarely. In addition, progesterone therapy was ineffective.

IN recent years Prolactin plays a major role in the pathogenesis of premenstrual syndrome. In addition to the physiological increase, hypersensitivity of target tissues to prolactin is noted in the second phase of the cycle. It is known that prolactin is a modulator of the action of many hormones, in particular adrenal hormones. This explains the sodium-retaining effect of aldosterone and the antidiuretic effect of vasopressin.

The role of prostaglandins in pathogenesis has been demonstrated premenstrual syndrome. Since prostaglandins are universal tissue hormones that are synthesized in almost all organs and tissues, impaired prostaglandin synthesis can manifest itself in many different symptoms. Many symptoms of premenstrual syndrome are similar to the condition of hyperprostaglandinemia. Violations of the synthesis and metabolism of prostaglandins explain the occurrence of symptoms such as migraine-type headaches, nausea, vomiting, bloating, diarrhea and various behavioral reactions. Prostaglandins are also responsible for the manifestation of various vegetative-vascular reactions.

The variety of clinical manifestations indicates involvement in pathological process 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 premenstrual syndrome is given to disturbances in the metabolism of neuropeptides in the central nervous system (opioids, serotonin, dopamine, norepinephrine, etc.) and associated peripheral neuroendocrine processes.

Thus, the development of premenstrual syndrome can be explained by functional disorders of the central nervous system as a result of exposure to unfavorable factors against the background of congenital or acquired lability of the hypothalamic-pituitary system.

The menstrual cycle is actually a regular stressor that can lead to changes in hormone levels and subsequently to various health problems. In such cases, it is recommended to take medications containing vitamins and microelements that will help the woman’s body cope with such stress and prevent complications. For example, “Estrovel Time Factor”, the packaging of which consists of 4 blisters, each of which contains components that help a woman in each of the 4 phases of the menstrual cycle.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

General information

Premenstrual syndrome (PMS), also called premenstrual illness or cyclic syndrome is a set of symptoms that appear regularly in women two to ten days before menstruation.
The syndrome is characterized by disturbances in mood, functioning of the autonomic nervous system, vascular and metabolic disorders.
Eight out of ten women experience this ailment. And in a third, the ailments are so serious that they interfere with normal work and rest. Women suffering from this ailment should keep in mind that if left untreated, the syndrome can develop into early menopause with a severe course.

According to joint estimates by doctors and police, most of the accidents that women get into occur around the very end of their menstrual cycle.
Almost a third of British female prisoners committed their offenses just a few days before the start of menstruation.
Foreign researchers claim that in exams taken in the last days of the cycle, most female students receive worse grades.

Reasons

All ailments that appear in the last days of the cycle are primarily associated with a change in the balance between the levels of the hormones progesterone and estrogen.
To date, no specific cause for the development of PMS has been identified. However, it is known that this phenomenon is more often observed in women who have had an abortion or several, after infectious diseases, as well as those in a state of constant stress.
Substances that enter the body with food packaged in plastic wrap can disrupt the level of hormones in the body.
Chips and noodle lovers instant cooking, beware!

Another factor contributing to the development of the syndrome is high blood glucose levels. Therefore, women who abuse carbohydrate foods and sweets are more susceptible to cyclic syndrome.

There is an opinion that the development of premenstrual syndrome can be caused by kidney disease, reproductive or digestive organs. In addition, there is a genetic predisposition to this disorder.

Symptoms

Most often, the symptoms of this syndrome are observed from the age of 20 or a little later and by the age of 30 they develop in full force. Most often, of all those listed, there are only two or three symptoms.

• Sleep disturbance
• Lethargy, decreased performance, inattention
• Noise intolerance
• Migraine-like pain, loss of coordination, fainting
• “goosebumps” on the body or limbs, inhibition of speech
• Unpleasant sensations in the mammary glands
• Nervousness, mood instability, excessive emotionality
• Decreased daily urine volume, weight gain, swelling
• Joint pain, swelling, myalgia, neck pain
• Digestive disorders
• Increased appetite, cravings for sweet or salty foods, aversion to alcohol
• Slight increase in body temperature, bleeding from the nose
• Exacerbation of allergies, asthma, hemorrhoids, etc. chronic diseases, frequent acute respiratory infections
• Change in libido.

If the set of symptoms different women is different, then for the same one from month to month they are the same. Only the degree of their expression differs.

PMS pain

Premenstrual syndrome is characterized by dull aching pain in the lower abdomen. They should not be too strong, otherwise they may indicate any diseases of the pelvic organs.
To relieve pain, you can use painkillers based on ibuprofen, paracetamol. Three days before the start of menstruation, you can take indomethacin in the dosage: one tablet three times a day. Long time You should not use it, as it does not have a very good effect on the stomach.

3. Eat less salt, it is advisable to give up nicotine.

Herbal treatment

This treatment is possible if the symptoms are not too severe. If the syndrome is already seriously interfering with normal life, you should consult a doctor and use herbal medicines as auxiliaries.

1. Bath with a decoction of mint and oregano, rosemary, lavender, yarrow, currant leaf, meadowsweet. A sachet of herbs should always be next to your pillow.

5. 2 tsp elderflower flowers, pour 200 ml of boiling water into a thermos for a quarter of an hour, pass through a sieve. Drink 100 ml three times a day on an empty stomach. You can add a little honey or sugar.

6. 1 tbsp. blue cornflower flowers, brew 200 ml of boiling water in a thermos for 2 hours, pass through a sieve. Drink 70 ml three or four times a day on an empty stomach.

7. Take 2 tbsp. St. John's wort and 1 tbsp. oregano, stir and brew 300 ml of boiling water. Leave in a thermos for 60 minutes, add a little lemon peel and cinnamon, pass through a sieve. Take 70 ml half an hour before meals.

8. Take 500 gr. Grind unpeeled oranges in a meat grinder, 150 gr. horseradish in a meat grinder, 0.3 kg of sugar and 1000 ml of red wine. Simmer everything together in a steam bath for 60 minutes under the lid, pass through a sieve. Drink 200 ml three or four times a day.

PMS or pregnancy?

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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 be aware that PMS can progress over time and under the right circumstances, 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 information of our doctors medical center, PMS most often affects women aged 20 to 40 years; cases of premenstrual syndrome occurring together with the onset of menarche are less common, and even less common in the premenopausal period.

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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 sleepiness.

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 elucidating 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. 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, the 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 depression. 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 hands and feet. 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 the specialists of our medical center note, 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 worsening general condition 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.

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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, headache, exacerbation of cardiovascular problems. In addition, estrogens can accumulate in the limbic system of the body, affecting the neuro-emotional state of a woman. Hence - depressive or aggressive states, irritability, etc.

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 maximize precise setting diagnosis.

Treatment of PMS (premenstrual syndrome)

The direction of treatment for premenstrual syndrome (PMS) is largely determined by individual characteristics 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, including the use of sex hormones, vitamins, and other medicines as needed, as well as 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.

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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 analogs 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.

PMS treatment 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 may 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, and 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 physical exercise can relieve stress and balance the hormonal system. However, you should not get involved in sports such as weightlifting, boxing, etc. Too strong physical activity Not only do they not treat, but they also aggravate premenstrual syndrome (PMS). Gynecologists at our medical center recommend that women suffering from PMS engage in sports such as jogging, walking, and cycling on level ground at low speed. First, of course, you should consult a doctor who will select the best exercise regimen.

– a cyclically recurring symptom complex observed in the second half of the menstrual cycle (3-12 days before menstruation). It has an individual course and can be characterized by headache, severe irritability or depression, tearfulness, nausea, vomiting, skin itching, swelling, pain in the abdomen and in the heart area, palpitations, etc. Swelling, skin rashes, flatulence, painful engorgement of the mammary glands. In severe cases, neurosis may develop.

General information

Premenstrual syndrome, or PMS, are called vegetative-vascular, neuropsychic and metabolic-endocrine disorders that occur during the menstrual cycle (usually in the second phase). Synonyms this state found in the literature are the concepts of “premenstrual illness”, “premenstrual tension syndrome”, “cyclic illness”. Every second woman over the age of 30 is familiar with premenstrual syndrome firsthand; in women under 30, this condition occurs somewhat less frequently - in 20% of cases. In addition, manifestations of premenstrual syndrome are usually associated with emotionally unstable, thin, asthenic women who are more often engaged in intellectual activities.

Causes of premenstrual syndrome

The course of the crisis form of premenstrual syndrome is manifested by sympatho-adrenal crises, characterized by attacks of increased blood pressure, tachycardia, heart pain without abnormalities on the ECG, and panic. The end of a crisis is usually accompanied by copious urination. Often attacks are provoked by stress and overwork. The crisis form of premenstrual syndrome can develop from untreated cephalgic, neuropsychic or edematous forms and usually manifests itself after 40 years. The background for the crisis form of premenstrual syndrome is diseases of the heart, blood vessels, kidneys, and digestive tract.

Cyclic manifestations of atypical forms of premenstrual syndrome include: increased body temperature (in the second phase of the cycle up to 37.5 ° C), hypersomnia (drowsiness), ophthalmoplegic migraine (headaches with oculomotor disorders), allergic reactions (ulcerative stomatitis and ulcerative gingivitis, asthmatic syndrome, uncontrollable vomiting, iridocyclitis, Quincke's edema, etc.).

When determining the severity of premenstrual syndrome, they proceed from the number of symptomatic manifestations, distinguishing between mild and severe forms of premenstrual syndrome. A mild form of premenstrual syndrome appears 3-4 characteristic symptoms appearing 2-10 days before the onset of menstruation, or the presence of 1-2 significantly pronounced symptoms. In severe forms of premenstrual syndrome, the number of symptoms increases to 5-12; they appear 3-14 days before the onset of menstruation. Moreover, all of them or several symptoms are significantly expressed.

In addition, an indicator of a severe form of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. Decreased ability to work is usually observed in the neuropsychic form of premenstrual syndrome.

It is customary to distinguish three stages in the development of premenstrual syndrome:

1. compensation stage - symptoms appear in the second phase of the menstrual cycle and disappear with the onset of menstruation; the course of premenstrual syndrome does not progress over the years
2. stage of subcompensation - the number of symptoms increases, their severity worsens, manifestations of PMS accompany the entire menstruation; Premenstrual syndrome becomes more severe with age
3. stage of decompensation - early onset and late cessation of symptoms of premenstrual syndrome with minor “light” intervals, severe PMS.

Diagnosis of premenstrual syndrome

Main diagnostic criterion premenstrual syndrome is cyclical, the periodic nature of complaints arising on the eve of menstruation and their disappearance after menstruation.

The diagnosis of premenstrual syndrome can be made based on the following signs:

• State of aggression or depression.
• Emotional imbalance: mood swings, tearfulness, irritability, conflict.
• Bad mood, feeling of melancholy and hopelessness.
• State of anxiety and fear.
• Decreased emotional tone and interest in current events.
• Increased fatigue and weakness.
• Decreased attention, memory impairment.
• Changes in appetite and taste preferences, signs of bulimia, weight gain.
• Insomnia or drowsiness.
• Painful tension in the mammary glands, swelling
• Headaches, muscle or joint pain.
• Worsening of the course of chronic extragenital pathology.

The manifestation of five of the above signs with the obligatory presence of at least one of the first four allows us to speak with confidence about premenstrual syndrome. An important part of the diagnosis is the patient’s keeping a self-observation diary, in which she should note all disturbances in her well-being over the course of 2-3 cycles.

A study of hormones (estradiol, progesterone and prolactin) in the blood allows us to determine the form of premenstrual syndrome. It is known that the edematous form is accompanied by a decrease in progesterone levels in the second half of the menstrual cycle. Cephalgic, neuropsychic and crisis forms of premenstrual syndrome are characterized by an increase in the level of prolactin in the blood. The prescription of additional diagnostic methods is dictated by the form of premenstrual syndrome and leading complaints.

Severe manifestation of cerebral symptoms (headaches, fainting, dizziness) is an indication for an MRI or CT scan of the brain to exclude focal lesions. EEG results are indicative for neuropsychic, edematous, cephalgic and crisis forms of the premenstrual cycle. In the diagnosis of the edematous form of premenstrual syndrome, an important role is played by measuring daily diuresis, recording the amount of fluid drunk, and conducting tests to study the excretory function of the kidneys (for example, Zimnitsky's test, Rehberg's test). In case of painful engorgement of the mammary glands, an ultrasound of the mammary glands or mammography is necessary to exclude organic pathology.

An examination of women suffering from one or another form of premenstrual syndrome is carried out with the participation of doctors of various specialties: neurologist, therapist, cardiologist, endocrinologist, psychiatrist, etc. Prescribed symptomatic treatment, as a rule, leads to an improvement in well-being in the second half of the menstrual cycle.

Treatment of premenstrual syndrome

In the treatment of premenstrual syndrome, drug and non-drug methods are used. Non-drug therapy includes psychotherapeutic treatment, adherence to work and proper rest, physical therapy, and physiotherapy. An important point is to maintain a balanced diet with sufficient amounts of plant and animal protein, plant fiber, and vitamins. In the second half of the menstrual cycle, you should limit the consumption of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, and alcoholic beverages.

Drug treatment is prescribed by a medical specialist, taking into account the leading manifestations of premenstrual syndrome. Since neuropsychic manifestations are expressed in all forms of premenstrual syndrome, almost all patients are advised to take sedative (sedative) drugs several days before the expected onset of symptoms. Symptomatic treatment Premenstrual syndrome involves the use of painkillers, diuretics, and antiallergic drugs.

Leading place in drug treatment Premenstrual syndrome is treated with specific hormonal therapy with progesterone analogues. It should be remembered that the treatment of premenstrual syndrome is a long process, sometimes continuing throughout the entire reproductive period, requiring internal discipline from the woman and strict compliance with all doctor’s instructions.