Premenstrual syndrome ( PMS ) refers to the physical and emotional symptoms that occur within one to two weeks before the woman's period. Symptoms often vary between women and resolve around early bleeding. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood swings. Often symptoms are present for about six days. Female patterns of symptoms may change over time. Symptoms do not occur during pregnancy or after menopause.
Diagnosis requires a consistent pattern of emotional and physical symptoms that occur after ovulation and before menstruation to levels that interfere with normal life. Emotional symptoms do not have to be present during the early part of the menstrual cycle. List of symptoms every day for several months can help in diagnosis. Other disorders that cause similar symptoms should be excluded before the diagnosis is made.
The cause of the STD is unknown. Some of the symptoms can be exacerbated by a diet high in salt, alcohol, or caffeine. The underlying mechanism is believed to involve changes in hormone levels. Reducing salt, caffeine, and stress along with increased exercise is usually all that is recommended in those with mild symptoms. Calcium and vitamin D supplements may be useful in some. Anti-inflammatory drugs such as naproxen may help with physical symptoms. In those with more significant symptoms, birth control pills or spironolacton diuretics may be useful.
Up to 80% of women report having some symptoms before menstruation. These symptoms qualify as PMS in 20 to 30% of pre-menopausal women. Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that has greater psychological symptoms. PMDD affects three to eight percent of pre-menopausal women. Antidepressant drugs from the selective serotonin reuptake inhibitor class can be used in addition to the usual steps for PMDD.
Video Premenstrual syndrome
Signs and symptoms
More than 200 different symptoms have been associated with PMS. Emotional and non-specific general symptoms include stress, anxiety, sleeping difficulties, headaches, fatigue, mood swings, increased emotional sensitivity, and a change of interest in sex.
Physical symptoms associated with the menstrual cycle include bloating, lower back pain, abdominal cramps, constipation/diarrhea, swelling or tenderness in the breast, cyclic acne, and joint or muscle pain, and food cravings. The exact symptoms and intensity vary significantly from woman to woman, and even from cycle to cycle and over time. Most women with premenstrual syndrome experience only a few possible symptoms, in a relatively predictable pattern.
Maps Premenstrual syndrome
Cause
While PMS is associated with the luteal phase, the cause of PMS is unclear, but several factors may be involved. Hormonal changes during the menstrual cycle seem to be an important factor; changing hormone levels affects some women more than others. Chemical changes in the brain, stress, and emotional problems, such as depression, do not seem to cause STDs but they can make it worse. High levels of vitamins and minerals, sodium, alcohol, and/or high caffeine can exacerbate symptoms such as water retention and bloating. PMS occurs more frequently in women aged between 20s and early 40s; have at least 1 child; have a family history of depression; and have a past medical history of either postpartum depression or mood disorder.
Diagnosis
There are no unique laboratory tests or physical findings to verify the diagnosis of STDs. The three main features are:
- A woman's main complaint is one or more of the emotional symptoms associated with PMS (usually irritability, tension, or unhappiness). The woman does not have an STD if she has only physical symptoms, such as cramps or bloating.
- Symptoms appear predictably during the luteal phase (premenstrual), decrease or disappear predictorally immediately before or during menstruation, and remain absent during the follicular phase (preovulatory).
- The symptoms must be severe enough to interfere with her daily life.
Mild PMS is common, and more severe symptoms will qualify as PMDD. PMS is not listed in DSM-IV, unlike PMDD. To establish the pattern and determine whether it is PMDD, the female doctor may ask her to keep a prospective record of her symptoms on the calendar for at least two menstrual cycles. This will help determine whether the symptoms are limited to premenstrual time, can be expected to recur, and interfere with normal functioning. A number of standard instruments have been developed to describe PMS, including the Premenstrual Syndrome Experiences (COPE) Calendar of Impact and Severity of Menstruation (PRISM) , and Visual Analogue Scales (VAS) .
Other conditions that may better explain the symptoms should be excluded. A number of medical conditions are subject to exacerbations during menstruation, a process called menstrual enlargement. This condition can lead a woman to believe that she has PMS, when the underlying disorder may have other problems, such as anemia, hypothyroidism, eating disorders and substance abuse. The main feature is that this condition can also be present outside the luteal phase. Conditions that can be enlarged perimenstrual include depression or other affective disorders, migraine, seizure disorders, fatigue, irritable bowel syndrome, asthma, and allergies. Problems with other aspects of the female reproductive system should be excluded, including dysmenorrhea (pain during menstruation, not before that), endometriosis, perimenopause, and side effects produced by oral contraceptive pills.
The study's definition of the National Mental Health Institute compares the intensity of symptoms from days 5 to 10 cycles for six-day intervals before the onset of menstrual periods. To qualify as PMS, the intensity of symptoms should increase by at least 30% within the six days before menstruation. In addition, this pattern should be documented for at least two consecutive cycles.
Management
Many treatments have been tried in STDs. Reducing salt, caffeine, and stress along with increased exercise is usually all that is recommended in those with mild symptoms. Calcium and vitamin D supplements may be useful in some. Antiinflammatory drugs such as naproxen may help with physical symptoms. Those with more meaningful pill symptoms may be useful.
Diuretics have been used to handle water retention. Spironolactone has been proven in several worthwhile studies.
Antidepressants
SSRIs such as fluoxetine, sertraline can be used to treat severe PMS. Women with STDs may be able to take medication only on days when symptoms are expected to occur. Although intermittent therapy may be more acceptable for some women, it may be less effective than ongoing regimens. Side effects such as nausea and weakness are, however, relatively common.
Hormonal drugs
Hormonal contraception is usually used; Common forms include combined oral contraceptive pills and contraceptive patches. This class of drugs may cause PMS-related symptoms in some women, and may reduce physical symptoms in other women. They do not relieve emotional symptoms.
Progesterone support has been used for many years but evidence of its efficacy is inadequate.
Gonadotropin-releasing hormone agonists can be useful in the form of severe PMS but have significant potential side effects.
Alternative medicine
Temporary evidence supports vitamin B6 and chasteberry. The evidence does not support the use of St. John's wort, soy, vitamin E, and saffron. Evening primrose oil can be beneficial.
Prognosis
PMS is generally a stable diagnosis, with women who are prone to experience the same symptoms at the same intensity near the end of each cycle for years. Treatment for specific symptoms is usually effective.
Even without treatment, symptoms tend to decrease in perimenopausal women. However, women who experience PMS or PMDD are more likely to have significant symptoms associated with menopause, such as hot flashes.
Epidemiology
Up to 80% of women from reports of childbearing age have some symptoms before menstruation. These symptoms qualify as PMS in 20 to 30% of women and in three to eight percent weight.
History
PMS was initially seen as a conceivable illness. Women who report symptoms often say it's "all in their head". Female reproductive organs are considered to have complete control over them. Women are warned not to divert the required energy away from the uterus and ovaries. This view of this limited energy was rapidly confronted with the reality in 19th-century America that young girls worked very hard in factories; Newspapers in the 19th century were flavored with medicines to aid in the "tyrannical process" of the menstrual cycle. In 1873 Edward Clarke published an influential book titled Sex in Education . Clarke came to the conclusion that female cooperatives suffer less than female students because they "work their brains less". This suggests that they have a stronger body and "more normal built-in" reproductive equipment. The feminists then opposed Clarke's argument that women should not leave the private space by showing how women can function in the world outside the home regardless of their bodily functions.
A formal medical description of premenstrual syndrome (PMS) and more severe, diagnosis of premenstrual dysphoric disorder (PMDD) returns at least 70 years to a paper presented at New York Academy of Medicine by Robert T. Frank entitled "Causes of Premenstrual Tension Hormonal". The premenstrual syndrome of certain terms appears to date from an article published in 1953 by Dalton and Greene in the British Medical Journal . Since then, PMS has become a sustainable presence in popular culture, occupying a larger place of research attention given as a medical diagnosis. It has been argued that women are partly responsible for the treatment of STDs. By legitimizing this disorder, women have contributed to the social construction of STDs as a disease. It has also been suggested that public debates on PMS and PMDD are influenced by organizations that have shares in the results including feminists, American Psychiatric Association, doctors and scientists. Until the 1950s, there was little research done about PMS and it was not seen as a social problem. In the 1980s, however, seeing PMS in a social context has begun to take place.
Alternate view
Some proponents of STDs as social constructs believe PMDD and PMS to be unrelated issues: according to them, PMDD is a brain chemical product, and PMS is a product of a hypochondriatic culture. Most of the research on STDs and PMDD only relies on self-reporting. According to sociologist Carol Tavris, Western women are socially conditioned to expect STDs or at least know where they are, and therefore report their symptoms accordingly. Anthropologist Emily Martin argues that PMS is a growing cultural phenomenon in a positive feedback loop, and thus is a social construct that contributes to learned helplessness or a comfortable reason. Tavris said that the PMS is blamed as an explanation for anger or sadness. The decision to call for PMDD has been criticized as an inappropriate drug. In both cases, they refer to the emotional aspect, not the normal physical symptoms that are subjectively present.
See also
- Leaving menstruation
References
External links
- US. Ministry of Health & amp; Human Services
- Direct Online Health Encyclopedia: Premenstrual syndrome (UK) on NHS
- "Premenstrual Syndrome (PMS) (Premenstrual Tension)" in Merck Manual
Source of the article : Wikipedia
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