Premenstrual syndrome (PMS). Premenstrual syndrome - what is it? PMS: symptoms, treatment

Premenstrual syndrome(PMS) - a set of symptoms that occurs a few days (from 2 to 10) before the onset of menstruation and disappears in its first days. At other times, there are no PMS symptoms.

The condition includes neuro- mental disorders, vegetative-vascular and metabolic manifestations. Almost every woman has experienced the symptoms of PMS at some point. However, it is severe only in every tenth patient.

How and why premenstrual syndrome occurs

In the middle of the menstrual cycle, ovulation occurs in the ovary - an egg is released from a mature follicle. She starts to move on abdominal cavity to fallopian tube for meeting with sperm and fertilization. In place of the ruptured follicle, a corpus luteum- education with high hormonal activity. In some women, in response to such endocrine "bursts", the parts of the brain responsible for emotions, vascular reactions, and metabolic regulation react. Often such idiosyncrasy response is inherited from mother to daughter.

Previously, it was believed that PMS occurs more often in women with disturbed hormonal levels. Now doctors are sure that such patients have a regular ovulatory cycle, and in all other respects they are healthy.

Theories for the development of PMS:

• hormonal;
• water intoxication;
• dysfunction of the renin-angiotensin-aldosterone system;
• lack of vitamins and fatty acids in nutrition;
• hyperprolactinemia;
• allergy;
• psychosomatic disorders.

With PMS, the relative content of estrogens increases with a relative decrease in the level of gestagens. Estrogens retain sodium and fluid in the body, causing swelling, flatulence, a headache, and chest pain. Estrogens activate the renin-angiotensin-aldosterone system, causing additional fluid retention. These sex hormones directly affect the area of ​​the brain responsible for the formation of emotions (the limbic system). The level of potassium and glucose in the blood also decreases, which causes weakness, pain in the heart, decreased activity.

It depends on the level of gestagens how many days before menstruation PMS occurs. These hormones delay the onset of menstruation. They also determine how long premenstrual syndrome lasts.

As a result of a violation of the activity of the renin-angiotensin-aldosterone system, fluid retention occurs, which causes swelling of the intestinal wall. There is bloating, nausea, constipation.

The development of PMS contributes to the lack of vitamins, magnesium and unsaturated fatty acids in food. Some scientists believe that depression, chest pain, irritability, fever body.

Of particular importance in the mechanism of development of PMS is an increase in the level of prolactin in the second half of the cycle, an allergy to internal progesterone, as well as interconnected bodily (somatic) and mental (mental) changes.

Clinical picture

There are three groups of main symptoms that determine the severity of the condition:

• neuropsychiatric disorders: tearfulness, depression, irritability;
• vegetative-vascular changes: nausea and vomiting, headache and dizziness, palpitations, pain in the heart area, increased pressure;
• metabolic disorders: breast enlargement, swelling, bloating, thirst and shortness of breath, itching, chills, fever, pain in the lower abdomen.

An aggravating factor in the course of PMS is depression. With her, women feel more pain and other unpleasant sensations, which can smoothly turn into painful menstruation and migraines.

Forms of premenstrual syndrome

PMS can occur in the following clinical forms:

• neuro-psychic;
• edematous;
• cephalgic;
• crisis.

The neuropsychic form is accompanied emotional disturbances. Young women have a reduced mood background. AT adulthood aggressiveness and irritability become the leading sign.

The edematous form is accompanied by swelling of the legs, face, eyelids. Becomes tight shoes rings don't fit well. Sensitivity to odors increases, bloating, skin itching appears. Due to fluid retention, weight increases (by 500-1000 g).

In the cephalgic form, the main symptom is a headache in the temples with spread to the orbit. It has a jerking, pulsating character, accompanied by dizziness, nausea and vomiting. Most of these women have changes in the pituitary gland.

The crisis form is manifested by sympathoadrenal attacks: blood pressure suddenly rises, pressing pain in the chest, fear of death. At the same time, worries strong heartbeat feeling of numbness and cold hands and feet. The crisis usually occurs late in the day, ends with the release of urine in a large volume. This form is more often observed as an outcome of untreated previous variants.

Flow

When does PMS start? At easy course 2-10 days before menstruation, three to four signs appear, one or two of which are most pronounced. At severe course symptoms appear 3-14 days before menstruation. There are more than five of them, and at least two are pronounced.

The course of PMS in all patients is different. For some, symptoms appear at the same time and stop with the onset of menstruation. In other patients, over the years, everything is recorded more signs. The state returns to normal only after menstrual bleeding. In the most severe cases the symptoms persist even after the cessation of menstruation, and the interval without complaints is gradually reduced. In such a situation, a woman may even lose her ability to work. In some patients, cyclic ailments continue after the onset of menopause. There is a so-called transformed PMS.

Mild PMS is accompanied by the appearance a small amount symptoms, slight malaise, without limiting normal rhythm life. In more severe situations, the symptoms of this condition affect family life, performance, conflicts with others may appear. In severe cases, especially during a crisis course, a woman cannot work and needs to issue a certificate of incapacity for work.

Diagnostics

PMS - clinical diagnosis, based on the analysis of symptoms, their severity, cyclical occurrence. An examination by a gynecologist is prescribed, the genital organs are performed. For the correct hormone therapy it is necessary to determine the level of sex and other hormones in the blood.

The patient is consulted by a neurologist, if necessary - a psychiatrist, ophthalmologist, endocrinologist. She may be assigned to such studies as electroencephalography, CT scan brain, ultrasound procedure kidneys, .

Only after comprehensive survey and observation, the gynecologist makes such a diagnosis and prescribes treatment.

PMS treatment

How to relieve premenstrual syndrome? To this end, the following scheme is recommended:

• psychotherapy;
• proper nutrition;
• physiotherapy;
• physiotherapy;
• treatment of premenstrual syndrome drugs.

Psychotherapy

Rational psychotherapy helps to get rid of such unpleasant symptoms, as excessive emotionality, mood swings, tearfulness or aggressiveness. For this purpose, methods of psycho-emotional relaxation are used, stabilizing behavioral techniques. A woman is taught how to relieve PMS, help to cope with the fear of the onset of menstruation.

It is very useful to conduct psychotherapeutic sessions not only with a woman, but also with her relatives. Relatives learn to better understand the patient's condition. Conversations with the close environment of the patient improve the microclimate in the family. Through psychosomatic mechanisms improve physical state patients, to alleviate the objective manifestations of premenstrual syndrome.

Lifestyle and nutrition

In the diet, it is necessary to increase the content of vegetable fiber. It normalizes the work of the intestines, removes excess fluid from the body. Daily ration should consist of 75% carbohydrates (mostly complex), 15% protein and only 10% fat. The use of fats must be limited, as they affect the participation of the liver in the exchange of estrogen. It is better to avoid beef as well, as it often contains small doses of artificially introduced hormones. Thus, the most useful source protein with PMS will be fermented milk products.

It is useful to increase the consumption of juice, in particular, carrot juice with the addition of lemon. Recommended herbal teas with the addition of mint, lemon balm, valerian. Herbal sedative for PMS helps to cope with emotional disorders improve sleep and overall well-being.

You should abandon the excess of salt, spices, limit the consumption of chocolate and meat. Should not be consumed alcoholic drinks, because they reduce the body's content of B vitamins, minerals, change the metabolism of carbohydrates. The work of the liver suffers, which can lead to a violation of estrogen metabolism and an increase in the severity of the condition.

You do not need to take many drinks with caffeine (tea, coffee, Coca-Cola) during PMS. Caffeine causes fluid retention, disrupts sleep, promotes neuropsychiatric disorders. In addition, it enhances the engorgement of the mammary glands.

Preparations for the treatment of PMS

If you have symptoms of PMS, you should consult a doctor. He will tell you how to deal with his symptoms by applying medications. Consider the main groups of drugs for the treatment of premenstrual syndrome.

1. After examination by a gynecologist, if high content estrogens (absolute or relative hyperestrogenism), gestagens are prescribed. These include Duphaston, Norkolut and others. Gonadotropin-releasing factor agonists, in particular, Danazol, also have an antiestrogenic effect.
2. Antihistamines are prescribed in connection with an increase in the level of histamine and serotonin in such patients. Tavegil, Suprastin are usually used at night starting two days before the expected onset of PMS and ending with the first day of menstruation.
3. To normalize work brain structures, responsible for vascular regulation and mental disorders, prescribe nootropics - Nootropil, Aminalon, starting from the first day of menstruation for two weeks. Such courses are repeated for three months in a row, then they take a break.
4. If, after determining the level of hormones, an increase in the level of prolactin is detected, Parlodel (bromocriptine) is prescribed, starting two days before the expected onset of PMS, for 10 days.
5. In the presence of pronounced edema, the appointment of a diuretic with a potassium-sparing effect of Veroshpiron, which is an aldosterone antagonist, is indicated. Assign it 4 days before the deterioration of health and stop taking it with the onset of menstruation. If the edematous syndrome is manifested by a headache, visual impairment, it is recommended to use Diakarb.
6. In the presence of pain, the main means for the treatment of PMS are non-steroidal anti-inflammatory drugs, in particular, Diclofenac. It is prescribed two days before the deterioration of health. These drugs inhibit the synthesis of prostaglandins - biologically active substances causing many of the symptoms of PMS. Course treatment is carried out for three months. The effect of such a course lasts up to four months after its termination. Then PMS symptoms return, but are usually less intense.
7. excessive emotionality, depressive disorders, neurosis may be an indication for the appointment of tranquilizers. There are special "day" drugs that do not suppress normal activity, in particular, Grandaxin and Afobazol. Antipsychotics and antidepressants may be used. These drugs are prescribed by a psychiatrist. They need to be taken continuously for 3-6 months.
8. Vitamins A and E provide beneficial action for women's reproductive system, including reducing the severity of premenstrual syndrome. They are taken orally or injected intramuscularly for a month, alternating with each other. With the appearance of anxiety and depressive disorders in the second half of the cycle, magnesium preparations and vitamin B6 are prescribed.

PMS is treated in cycles. In the first three months they use a diet, vegetable sedatives, vitamins, non-steroidal anti-inflammatory drugs. Then make a break in treatment for 3-6 months. Upon return signs of PMS other drugs with more serious effects are added to the treatment. Don't expect quick effect. Therapy should be carried out for a long time, accompanied by a modification of nutrition and lifestyle.

For 75% of women, the last week before menstruation is associated with increased fatigue, emotionality and irrepressible appetite. Clearly severe symptoms PMS (premenstrual syndrome) is more often observed in the fair sex, exercising intellectual activity or living in large cities with developed infrastructure and poor ecology. Read more about the factors of occurrence, signs and means that facilitate the course of this process, read later in the article.

The second phase of the menstrual cycle in most women is characterized by physical manifestations, which are commonly called premenstrual syndrome or tension. Symptoms of PMS, expressed in a significant deterioration in well-being, occur in 4-8% of women. Changes in mood and general condition 7-10 days before the onset of menstruation occur primarily due to natural hormonal failure after ovulation. As a result of scientific research, some regularities in the occurrence of symptoms of premenstrual tension syndrome have been established:

1. Increased content of the enzyme monoamine oxidase in the blood causes short-term depression.
2. Decrease in serotonin, which refers to the neurotransmitters responsible for good mood a person becomes the cause of apathy and despondency.
3. Increased production of the adrenal hormone aldosterone leads to a state of permanent fatigue and a change in taste sensations.

Mood swings, outbursts of anger, tearfulness and irritability - the combination of these feelings clearly indicates premenstrual syndrome. What it is, many of the fair sex know, but they are not able to control their condition. Some girls and women feel noticeably worse, and pain before menstruation is a very real reason to see a doctor.

complex mechanism

Menstruation in women is directly related to procreation. The first day is considered the beginning of the cycle, and each stage is aimed at preparing for conception.

During menstrual phase there is a rejection of the mucous membrane of the uterus, which is accompanied by bleeding. The first appearance of menstruation occurs on average at 12-14 years of age. Over time, the cycle is established, and its duration is from 21 to 35 days.

The absence of menstruation can signal pregnancy or serious illnesses. Besides, women Health deserves special attention at various disorders, such as dysmenorrhea ( painful periods) or increased bleeding.

If we add manifestations of premenstrual syndrome to these problems, then you definitely won’t envy some girls and women.

Story

PMS (premenstrual syndrome) is a complex set of symptoms that occurs in women on average 1-10 days before menstruation. By studying given state people have been doing since ancient times. AT Ancient Rome, for example, doctors associated ailments before menstruation with the place of residence and even with the phases of the moon.

According to official data, Russian scientists Dmitry Ott and Alexander Reprev conducted the first Scientific research concerning physiological parameters and the cyclicity of their fluctuations. Then Robert Frank in 1931 voiced the term “premenstrual tension” in his article, and ten years later, psychosexual disorders in PMS time were described by Lewis Gray.

Research and scientific justification allowed the World Health Organization to include premenstrual syndrome in the classification of diseases. What is it, diagnostic methods, causes of appearance, recommendations for alleviating the condition - read about all this in our review.

The reasons

There is no consensus on the occurrence of PMS today, but experts still managed to formulate a number of reasons:

hereditary predisposition;

Violation of water-salt metabolism;

Hormonal failures;

Thyroid diseases;

Lack of vitamins (magnesium, zinc, calcium, vitamin B6).

Risk factors for the development of PMS include the presence of depression and stress, living in large cities, late reproductive age, insufficient physical activity and nutritional imbalance.

Some research shows that overweight and smoking affect the likelihood of developing premenstrual syndrome.

Symptoms

Exists great amount jokes and humorous stories about premenstrual syndrome in women. However, the impressive list of symptoms leaves little cause for rejoicing.

Modern medicine distinguishes the following forms of PMS:

1. Neuropsychic. This form is characterized by symptoms such as heightened perception of noise, increased fatigue, weakness, sleep disturbance, absent-mindedness, headaches, difficulty speaking, and even fainting. Aggression and irritability often lead to conflicts in the family and at work, as well as to making rash decisions.
2. Edema. A weight gain of a few kilograms does not improve mood at all, swelling of the legs and arms appears. Sometimes girls and women experience joint pain and cramps. the whole body seems to be filled with fluid.
3. Cephalgic. Throbbing headaches are observed, which are accompanied by nausea or vomiting. However, blood pressure remains unchanged. In addition, a third of patients develop pain in the region of the heart, numbness of the hands, excessive sweating and depression.
4. Crisis. which begins with an increase blood pressure. Then there is a rapid heartbeat and fear of death. Such attacks are most often disturbed in the evening and at night, and various stresses, fatigue or infectious diseases aggravate the situation.

Experts also highlight atypical form PMS, among the symptoms of which are noted allergic reactions, skin rashes, nagging pain in the lower back and lower abdomen, nosebleeds, fever.

Stages of PMS

In medicine, there is a division of PMS into three stages:

Compensated (symptoms disappear with the onset of menstruation, the disease does not develop with age);

Subcompensated (symptoms cease to bother with the end of menstruation, the clinic of premenstrual syndrome worsens over the years);

Decompensated (symptoms appear a few more days after the end of menstruation).

As you may have noticed, PMS in some cases is not at all like a mild ailment. In severe form, this disease can seriously affect the ability to work and well-being. Of course, don't panic about fatigue or muscle pain. However, if you have more than six symptoms, be sure to make an appointment with a doctor who, with the help of research, will be able to diagnose "premenstrual syndrome".

Diagnostics

It is very important to distinguish real symptoms from the inability to control their emotions and manifestations of bad manners or bad character. Premenstrual syndrome is characterized by cyclicity. In other words, the same symptoms should disturb a woman with a certain frequency.

Often, premenstrual tension syndrome is confused with other diseases, so for accurate diagnosis contact a specialist. During the diagnosis, a blood test is mandatory (in different phases menstrual cycle). The level of hormones (progesterone, estradiol and prolactin) allows us to draw conclusions about the form of PMS.

Depending on the results of the analysis and complaints of the patient, the attending physician may refer her to other specialists (psychiatrist, endocrinologist, therapist and neuropathologist) or prescribe additional research(MRI, mammography, EEG, blood pressure monitoring and others).

How to relieve premenstrual syndrome?

Millions of women are asking this question, knowing full well that living in a bad state of health and mood even for a week is simply unbearable. The most accessible measure is the revision of the diet.

It is believed that the use complex carbohydrates(cereals and vegetables) makes it easier to experience the condition before menstruation. Some experts also talk about limiting the consumption of sweets and sugar, but in terms of relieving PMS symptoms. this measure has not been fully studied.

It is advisable to control the intake of salt, because the body already has a tendency to edema associated with fluid retention. Salty foods only exacerbate the situation.

And finally, coffee. Studies have shown that women with severe PMS consume much more coffee. Today there is no unambiguous opinion about whether an invigorating drink and premenstrual syndrome are related. We already know what it is and the causes of the latter, but coffee helps or worsens the situation, probably, it is worth deciding on an individual basis.

Lifestyle

Pain before menstruation can make serious adjustments to your plans. However, experts advise not to give up light physical activity. Swimming, hiking, yoga or dancing can help reduce symptoms and definitely improve your mood.

If your chest hurts before your period, then deal with unpleasant sensations and supportive underwear will help with increased sensitivity.

Of course, the instant disappearance of PMS symptoms should not be expected, but the first conclusions can be drawn after 3-4 months. In most cases these recommendations eliminate the need for medical treatment.

As alternative methods of dealing with premenstrual syndrome can be recommended different kinds massage, physiotherapy, reflexology and balneotherapy.

Many experts studying women's health consider the most effective acupressure. Stimulation biologically active points raises vitality and enhances the body's ability to self-regulate.

Medical treatment

Pharmacotherapy is the main method, but it will definitely not help to cure completely. It is believed that PMS is chronic illness, and some drugs only improve quality of life by relieving symptoms.

Please note that all medicines the doctor prescribes, and no life stories or advice from “friends in misfortune” will replace the advice of a specialist. Our review is for informational purposes, and if you think that one of the drugs could help you, then be sure to discuss this point with your doctor.

Depending on the form of PMS, the following groups are distinguished:

1. Combined oral contraceptives.
2. Drugs to treat symptoms.
3. Hormonal preparations.
4. Diuretics.
5. Antidepressants.
6. Antiprostaglandin drugs.

Vitamins and minerals

Patients with a mild form of premenstrual syndrome are primarily prescribed not hormonal preparations- homeopathy, vitamins and minerals. Efficiency and minimal side effects are the main advantages of such products. In addition, non-hormonal drugs are not perceived “as medicine”.

According to studies, reduce swelling and bloating helps to reduce fluid retention and increased appetite calcium carbonate affects, and B vitamins are able to cope with the psycho-emotional manifestations of the disease.

Diuretics

These are diuretics, the appointment of which is justified in the edematous form of PMS. One of the most effective and safe is considered - "Veroshpiron"). The drug increases the excretion of sodium and chlorine ions, water, reduces the titratable acidity of urine. Has a hypotensive effect.

As an initial daily dose appoint 25 mg (maximum 100 mg). Experts consider it appropriate to take diuretics during the period of expected fluid retention, that is, from the 16th to the 25th day of the menstrual cycle.

Among side effects observed: hypotension, drowsiness, decreased libido and

COOK

The use of combined oral contraceptives is the most common tactic in the treatment of premenstrual syndromes. To date, attending physicians prefer COCs containing drospirenone. This substance is an analogue of natural progesterone.

The composition of one of the most known drugs called "Yarina" is a combination of the progestogen drospirenone (3 mg) and ethinyl estradiol (30 mcg). In patients taking this COC, there was a slight decrease in body weight and no fluid retention in the body. In addition, drospirenone has an effect on the secretion sebaceous glands, which reduces the number of rashes on the skin before menstruation.

Contraceptives containing drospirenone have minimal amount side effects. However, despite the effectiveness of the drug, PMS symptoms (swelling, breast tenderness, headaches and bloating) may return after a seven-day break. For this reason, it is advisable to introduce extended regime taking COCs.

Antidepressants

For elimination psychological symptoms the attending physician most often prescribes antidepressants ("Sertraline", "Fluoxetine"), the effectiveness of which has been proven by many clinical studies.

In the treatment of premenstrual syndrome, in contrast to the treatment of depression, these drugs are prescribed in shorter courses and at lower doses. There are two treatment regimens:

Taking medication when a symptom occurs;

Taking medication in the second half of the menstrual cycle.

For many of the fair sex, taking antidepressants is effective method, which allows you to eliminate the symptoms almost completely.

However, in some cases, the result achieved is not enough, so the doctor may decide to increase the dose or prescribe a different drug.

Taking antidepressants should be accompanied by keeping a diary and detailed notes about how you feel. Despite the fact that improvement can occur as early as two days after the start of the course, a competent specialist will draw conclusions about the effectiveness only after observing 2-4 menstrual cycles.

AT rare cases stopping antidepressants can cause nausea, dizziness, and irritability. Fortunately, these symptoms pass fairly quickly.

ethnoscience

Antidepressants, hormonal drugs and oral contraceptives have many side effects, therefore, first of all, the fair sex remembers folk methods.

So, what herbs will help us overcome PMS:

1. Melissa. cook healing infusion at the rate of 2 tbsp. l. dry plant in a glass of boiling water. This drink eliminates irritability, soothes and relieves pain. A mixture of lemon balm, chamomile, jasmine, mint and valerian will help improve the result.
2. Calendula, plantain leaves, calamus root and arnica flowers. Infusion wetted gauze strips, which are applied to the body to reduce swelling.
3. Yarrow and jasmine. Against pain in the lower back and abdomen, pour boiling water over yarrow (40 g) and jasmine flowers (30 g). Three cups of infusion should be drunk per day.

Myth or reality?

So, we are talking about such an ailment as premenstrual syndrome. What it is, many girls and women are well aware, but only 3-6% of the fairer sex are faced with a diagnosis of “premenstrual dysphoric disorder” (PMDD). This disease leaves a serious imprint, limits communication with people and social life and also increases the number of days of disability. In patients with mental illness their exacerbation is observed.

Interestingly, some scientists even question the existence of pathologies such as PMDD and premenstrual syndrome. The causes of the latter have not been proven at all, and most studies rely only on reports of well-being. Agree, such a point of view has the right to exist. Moreover, Western girls and women often almost consciously expect appearance of PMS rather than programming themselves to feel its specific symptoms.

How long does PMS (premenstrual syndrome) last and why it occurs, for doctors for a long time remained a secret. Some healers argued that the phases of the moon strongly influence the female body during this period. Some attributed the malaise to the area where the woman lives. Only in the 20th century was it possible to lift the veil of obscurity. Doctors have proven that PMS is a complex of 150 mental and physical symptoms. AT varying degrees almost 75% of women suffer from this syndrome.

Scientists have not yet been able to identify the specific causes of premenstrual syndrome. There are many different theories explaining its appearance:

1. "Water intoxication" when the body's water-salt balance is disturbed.
2. An allergic reaction of a woman's body to the hormone progesterone.
3. Psychosomatic reason.

Doctors are unanimous that the most probable causes PMS development are:

• a decrease in the level of the “hormone of joy”, which is serotonin. Its deficiency causes depression and tears for no reason;
• a lack of vitamin B6 in the body affects the physical condition of the breast (appears);
• smoking can doubly exacerbate PMS symptoms;
• overweight with an index over 30 is the key to the onset of the syndrome (observed 3 times more often);
• the genetic factor suggests the transmission of the disease by inheritance.

One of causes of PMS are the consequences and difficult childbirth. In some cases, the cause should be sought in existing gynecological diseases.

Hormonal theory

According to this theory, PMS is the result of a change in the content of sex hormones in a woman's body in the second phase of menstruation. female body functions normally when hormonal background does not change.

Hormones perform a number of important functions in the body. As for estrogens, they are:

• improve the physical condition of the body, and also affect the mental well-being of a woman;
• increase the general tone and contribute to the development of creativity;
• affect the speed of assimilation and processing of incoming information;
• enhance learning ability.

The function of progesterone is sedative action. This explains the appearance in women depressive states. Androgen hormones affect libido, improve performance and increase energy.

In case of imbalance of hormones, and this is typical for the period of the 2nd phase of the cycle, the body begins to fail. Some parts of the brain react sharply to such changes. As a result, a number of disorders occur, including a delay in the outflow of fluid.

This explains:

• the appearance of edema;
• disruption of the cardiovascular system;
• breast swelling;
• irritability;
• disorder of the gastrointestinal tract.

Premenstrual syndrome is dangerous due to complications of a woman's chronic diseases. Such a simple sign as the cyclical nature of PMS will help to distinguish them.

Periods should be noted regularly. feeling unwell and their duration. They usually happen before menstruation and then pass.

Syndrome symptoms

How to get rid of discomfort

In the presence of severe symptoms doctors suggest that the woman first exclude other diseases. To do this, you need to pass tests and check general state health. and is not excluded.

If these are symptoms of premenstrual syndrome, then the course can be followed by the following recommendations of doctors:

1. You need to sleep at least 8 hours. Full sleep restores strength and relieves irritability and aggression. With obvious insomnia, do not refuse walks in the fresh air.
2. Use aromatherapy. If you are not allergic to aroma oils, they greatly alleviate the severe condition caused by PMS. Baths with oils are recommended to be taken 2 weeks before critical days.
3. Don't give up on physical activity. It can be yoga, hiking, dancing, Pilates. Regular physical exercise Can boost endorphins. This will help get rid of depression.
4. Take vitamins B6, A and E to help with heart palpitations and fatigue.
5. Get your nutrition in order. Include foods that contain calcium and fiber in your menu. AT daily diet the following ratio should be observed: 10% - fats, 15% - proteins, 75% - carbohydrates. Beneficial herbal teas fresh juices. Alcohol should be excluded.
6. Relaxation practices and regular sex increase the content of endorphins and can strengthen the immune system.

Turning to the doctor, the woman receives drug treatment. She surrenders everything necessary tests to determine the level of hormones. If necessary, an ultrasound is prescribed. After that, the doctor prescribes the right drugs, mainly hormonal "Janine", "Novinet" and others.

According to the criminal chronicle, women make the majority of road accidents during PMS. Thefts, murders and various crimes involving the beautiful half of humanity also occur during this period of time. PMS is considered a mitigating circumstance in sentencing in some countries.

An interesting fact is that many women with PMS want to raid stores and make numerous purchases.

PMS or premenstrual syndrome- aggregate pathological symptoms, arising a few days before menstruation and disappearing in the first days of menstruation. Premenstrual syndrome is mainly manifested by dysfunction of the central nervous system, vegetative-vascular and metabolic-endocrine disorders. Approximately 90% of women reproductive age feel certain changes, or, so to speak, "signs" indicating the approach of menstruation. In most women, these symptoms are mild and do not interfere with their Everyday life- This is a mild form of premenstrual syndrome that does not require treatment. However, approximately 3-8% of women have severe forms of PMS that require special treatment.

Causes of PMS

There are many theories that explain the complexity of premenstrual syndrome. Hormonal theory suggests that the development of the syndrome is associated with an excess of estrogens and a lack of progesterone in the second phase of the menstrual cycle. The theory of "water intoxication" explains the cause of premenstrual syndrome by changes in the renin-angiotensin-aldosterone system and high level serotonin. Activation of the renin-angiotensin system increases the level of serotonin and melatonin.

Estrogens can also cause sodium and fluid retention in the body by increasing aldosterone production. The theory of prostaglandin disorders explains many various symptoms premenstrual syndrome by changing the balance of prostaglandin E1. Increased expression of prostaglandin E is observed in schizophrenia due to a change in the processes of excitation of the brain. The main role in the pathogenesis of premenstrual syndrome is assigned to a violation of the metabolism of neuropeptides (serotonin, dopamine, opioids, norepinephrine, etc.) in the central nervous system and related peripheral neuroendocrine processes.

AT last years great attention is given to peptides of the intermedial lobe of the pituitary gland, in particular to the melanostimulating hormone of the pituitary gland. This hormone, when interacting with beta-endorphin, can contribute to mood changes. Endorphins increase the level of prolactin, vasopressin and inhibit the action of prostaglandin E in the intestine, resulting in breast engorgement and bloating. The development of premenstrual syndrome is promoted by stress, neuroinfections, complicated childbirth and abortion, especially in women with congenital or acquired inferiority of the hypothalamic-pituitary system.

PMS symptoms

Symptoms of premenstrual syndrome include:

• irritability,
• depression
• tearfulness,
• aggressiveness,
• headache,
• dizziness,
• nausea,
• vomiting,
• pain in the region of the heart,
• tachycardia,
• breast engorgement,
• swelling,
• flatulence,
• thirsty
• shortness of breath
• increase in body temperature.

The neuropsychic symptoms of PMS are reflected not only in complaints, but also in the inappropriate behavior of patients. Depending on the predominance of certain symptoms, neuropsychic, edematous, cephalgic and crisis forms of premenstrual syndrome are distinguished. AT clinical picture the neuropsychic form of premenstrual syndrome is dominated by irritability or depression (young women are more likely to be depressed, and in transitional age aggression is noted), as well as weakness, tearfulness.

Symptoms of the edematous form of PSM

The edematous form of premenstrual syndrome is manifested by severe engorgement and soreness of the mammary glands, swelling of the face, legs, fingers, and bloating. Many women with the edematous form experience sweating, hypersensitivity to smells. The cephalgic form of premenstrual syndrome is clinically manifested by an intense throbbing headache radiating to eyeball. Headache accompanied by nausea, vomiting, blood pressure does not change. One third of patients with cephalgic form of premenstrual syndrome observed depression, pain in the heart, sweating, numbness of the hands. The crisis form of premenstrual syndrome is accompanied by sympathetic-adrenal crises. The crisis begins with an increase in blood pressure, there is a feeling of pressure behind the sternum, fear of death, palpitations. Typically, crises occur in the evening or at night and can be triggered by stress, fatigue, infectious disease. Crises often end with copious urination.

Symptoms of mild and severe SCI

Depending on the number, duration and intensity of symptoms, mild and severe premenstrual syndrome are distinguished. With mild premenstrual syndrome, 3-4 symptoms are observed, 1-2 of them are significantly expressed. Symptoms appear 2-10 days before the onset of menstruation. In severe premenstrual syndrome, 5-12 symptoms occur 3-14 days before menstruation, and 2-5 of them are pronounced. Diagnosis of premenstrual syndrome has certain difficulties due to the diversity clinical symptoms. The identification of premenstrual syndrome is facilitated by an adequate survey of the patient, in which it is possible to identify the cyclicity of pathological symptoms that occur on premenstrual days.

Diagnosis of PMS

In all clinical forms of premenstrual syndrome, it is advisable to perform an EEG and REG of vessels brain. These studies show functional disorders various structures of the brain. The hormonal status of patients with premenstrual syndrome reflects some features functional state hypothalamic-pituitary-ovarian-adrenal system. So, with the edematous form of premenstrual syndrome, the level of progesterone is reduced and the content of serotonin in the blood is increased; in the neuropsychic form, the level of prolactin and histamine is increased, in the cephalgic form, the content of serotonin and histamine is increased, in the crisis form, the level of prolactin and serotonin is increased in the second phase of the menstrual cycle.

Use of others additional methods diagnosis largely depends on the form of premenstrual syndrome. In the edematous form, the measurement of diuresis, the study of the excretory function of the kidneys are shown. Soreness and swelling of the mammary glands are an indication for ultrasound of the mammary glands and mammography in the first phase of the menstrual cycle for differential diagnosis mastodynia and mastopathy. A neurologist, psychiatrist, therapist, endocrinologist, allergist are involved in the examination of patients.

PMS treatment

The first step in the treatment of PMS is psychotherapy, which includes a confidential conversation, autogenic training. It is necessary to normalize the regime of work and rest, exclude coffee, chocolate, spicy and salty foods, limit fluid intake in the second phase of the menstrual cycle. Recommend general massage and neck massage. drug therapy carried out taking into account the duration of the disease, clinical form premenstrual syndrome, age of the patient and concomitant extragenital pathology. With neuropsychic manifestations in any form of premenstrual syndrome, sedatives and psychotropic drugs: tazepam, rudotel, seduxen 2-3 days before the onset of symptoms.

In the treatment of edematous form of premenstrual syndrome are effective antihistamines- tavegil, diazolin, teralen also in the second phase of the menstrual cycle; veroshpiron is prescribed in the second phase of the menstrual cycle 3-4 days before the manifestation clinical symptoms. To improve the blood supply to the brain, it is advisable to use nootropil or aminalon from the 1st day of the menstrual cycle for 2-3 weeks (2-3 menstrual cycles). In order to reduce the level of prolactin, parlodel is used in the second phase of the menstrual cycle for 8-9 days. In connection with the role of prostaglandins in the pathogenesis of premenstrual syndrome, antiprostaglandin drugs naprosin, indomethacin are recommended in the second phase of the menstrual cycle, especially in edematous and cephalgic forms of premenstrual syndrome.

Hormone therapy for PMS is carried out in case of insufficiency of the second phase of the menstrual cycle with gestagens: dufaston or uterogestan from the 16th to the 25th day of the menstrual cycle. In severe decompensated form, young women are shown combined estrogen-gestagen preparations or norkolut from the 5th day of the cycle, 5 mg for 21 days. In recent years for treatment severe forms premenstrual syndrome, releasing hormone agonists (zoladex, buserelin) were proposed for 6 months, giving an antiestrogenic effect. Treatment of patients with premenstrual syndrome is carried out for 3 menstrual cycles, then take a break for 2-3 cycles. In case of relapse, treatment is resumed. At positive effect recommended preventive maintenance treatment, including vitamins and tranquilizers.

Questions and answers on the topic "PMS"

Question:Hello, I have a question for you. 5 days ago I started PMS - during PMS two days before it ended, I had sexual intercourse with my husband, and for two days in a row he left his seed in me! Question - can I get pregnant when I had intercourse during PMS? And should I take an ESCAPEL pill? I am very worried that this will somehow affect my health, and in the future, the fact that I will have problems with childbirth?

Answer: Pregnancy is not excluded and it is not worth hoping that PMS will protect against pregnancy.

Question:Good afternoon. At 19 terrible pain the first 1-2 days of menstruation. What to do?

Answer: We recommend that you consult a gynecologist, as in some cases dysmenorrhea (severe pain during menstruation) may indicate pathological process such as endometriosis, inflammation pelvic organs, etc.

Question:Previously, the chest did not hurt before menstruation, but now it hurts. I had delays in the winter, I started drinking iodomarin (I drink until now), the delays have passed. Now it's summer and sunny days more. Could it be that the chest is sore before menstruation due to the large amount of hormones from the sun and iodine? There were no sexual acts.

Answer: No, the phenomena indicated by you cannot be the cause of pain in the mammary glands. It is possible that you have started Premenstrual Syndrome, which may be related to the delays that you had during the winter. Be sure to consult a gynecologist.

Question:How can PMS be treated without medication and doctors' help?

Answer: PMS symptoms may be present for many years. This means that you cannot simply try to wait it out or endure them. If you notice that the symptoms of PMS are interfering with your quality of life, be sure to try to eliminate them with treatment. Otherwise, you risk spending a significant part of your life in bad mood and feeling unwell.

Question:I have obvious symptoms premenstrual syndrome (PMS). What does it mean if I am taking birth control pills?

Answer: As a rule, with a properly selected contraceptive drug, all the symptoms of premenstrual syndrome are minimized. In the event that symptoms persist, it is recommended to consult a gynecologist for a personal examination and additional examination: blood for sex hormones, ultrasound of the pelvic organs, to select the optimal contraceptive. In the event that for some time when taking a contraceptive drug, symptoms of premenstrual syndrome were not observed and in some cycle they reappeared, before menstrual bleeding, then it is recommended to exclude pregnancy. AT this case, it is recommended to donate blood for hCG and consult a gynecologist.

Question:How long before the onset of menstruation can signs of PMS appear?

Answer: As a rule, the first signs of premenstrual syndrome can appear 10 days before the onset of menstrual bleeding. At different women this period varies and averages 2-10 days.

Question:What should I do if my wife has PMS? How should I behave during this time?

Answer: First of all, try to distract your wife, keep her busy. In the event that your guardianship annoys her, try to leave her alone and not bother her, because. any of your actions can cause a fit of irritation and an unmotivated scandal. It is recommended to support the wife and, if necessary, visit a gynecologist to prescribe an adequate symptomatic treatment, which will help reduce the manifestations of premenstrual syndrome. Try not to hint and argue, this irritates the woman even more, but you should not give up your opinion.