Premenstrual syndrome (PMS), causes, symptoms, diagnosis, treatment, prevention. Premenstrual Syndrome (PMS)

Many scientists and medical specialists For several centuries, they have been studying the characteristics of the female body. And only recently it was finally possible to find out when PMS begins in females, and what are its true manifestations. not fully understood, but it is already known that when it appears, women do not feel well: fatigue, malaise appear, excessive aggression or tearfulness can also be observed.

There is no exact framework for how many years PMS occurs. Premenstrual syndrome- a fairly common phenomenon and is observed in 75% of women. This is a condition in which various pseudo-symptoms appear that are characteristic of PMS.

It is characterized by certain psychological and physiological characteristics. For each woman or girl, this condition manifests itself in different ways and is expressed in varying degrees intensity.

Some women do not have premenstrual syndrome at all, while others have it all the time. Here important role age plays, because PMS occurs only in women who have reached puberty with a formed menstrual cycle. This condition is observed only once a month and is accompanied by characteristic symptoms that are individual for each woman.

How many days before menstruation does PMS show up?

As noted earlier, in all women the syndrome is expressed differently, therefore, how many days before menstruation it manifests itself and how long it lasts - all this is purely individual. As a rule, the first symptoms can be observed in a woman 2-10 days before the onset of menstruation. Depending on the individual characteristics of the body, the symptoms of PMS can be expressed to a greater or lesser extent.

The appearance of PMS is explained by the fact that at a certain point in the menstrual cycle, the level of hormones in the body changes. It affects psycho-emotional and physiological processes, which causes changes in the behavior, well-being of women.

Before the onset of menstruation, in a few days, the restructuring of hormones begins, which accordingly causes changes in the functioning of the body as a whole. This condition can often last two weeks, after which the hormonal background returns to normal and the woman can again feel normal.

But this is not the case for everyone - each organism is individual, so often the manifestations of PMS in women may differ. Among the external and internal factors that affect the severity of symptoms, great importance have:

• the presence of any diseases;
• food quality;
• Lifestyle;
• ecology.

It may happen that menstruation began earlier, and as a result, PMS will also appear a few days earlier than expected. To identify the exact period of the onset of premenstrual syndrome, you need to know your own cycle, it is especially easier for those girls who have menstruation regularly at the same interval. In the first year after the onset of menstruation, adolescents may have a period for the duration of menstruation, but, as a rule, this PMS period not visible.

Causes of premenstrual syndrome

PMS can begin for many reasons, but, as a rule, the onset of the syndrome is due to some internal factors:

• violations in the body of water-salt balance;
• allergic reactions;
• psychological reasons;
• physiological factors.

main reason appearance of PMS there is a change in the level of hormones when their number increases in the second phase of the cycle. For a woman, the balance of the hormonal background is very important, since any deviations from the norm entail not only changes in the psycho-emotional plan, but also contribute to the exacerbation of certain diseases, as a result of which the state of health may worsen and appear general malaise and weakness.

Female hormones that ensure the normal and stable functioning of the whole body are presented below.

1. Estrogen - is responsible for the physical and mental characteristics of the body, stabilizes muscle tone.
2. Progesterone - steroid hormone, which is necessary to prepare the body for pregnancy, but with an increase in its level in the 2nd phase of the cycle, a woman may experience a depressive state.
3. Androgens - increase physical and mental activity.

The beginning of the menstrual cycle can contribute to the occurrence of PMS, which is due to several reasons.

1. Decrease in the hormone serotonin main reason mood changes, resulting in tearfulness, sadness.
2. Lack of vitamin B6 - causes fatigue, mood changes.
3. Lack of magnesium - contributes to dizziness.

Often, PMS is genetically transmitted, which is the main reason for its occurrence in a woman.

PMS symptoms

PMS in females has a lot of manifestations. For some, they may not be particularly pronounced, for others they may be more intense. Symptoms may last one day or may last up to 10 days. Basically, they are divided into psychological and physiological manifestations.

Psychological symptoms of premenstrual syndrome:

• depression;
• depressed state;
• stress, nervousness;
• unexplained aggression;
• irritability;
• frequent mood swings.

Psychological symptoms are quite pronounced and are common in women in the second phase of the cycle. Basically, the manifestations depend on the function of the nervous system and the work of hormones.

Physiological symptoms:

• feeling of nausea and vomiting;
• instability blood pressure;
• aching or stabbing;
• puffiness;
• breast swelling;
• Rarely enough, but a rise in temperature is possible;
• weight set.

Physiological manifestations during the period of premenstrual syndrome depend on hormonal level, lifestyle and environment.

How to distinguish pregnancy from PMS

Many women are unable to distinguish between the symptoms of PMS and pregnancy. To know for sure, you need to rely on the manifestations associated with premenstrual syndrome or pregnancy.

Some symptoms are similar to each other, but they differ in duration and degree of manifestation.

1. Satisfied with rapid fatigue after light physical exertion.
2. Enlargement of the mammary glands, their soreness when touched - during PMS time this manifestation is not long-term, and during pregnancy continues until childbirth.
3. Feeling of nausea, vomiting - PMS is rarely expressed by these symptoms, while pregnancy is characterized by such manifestations throughout the first trimester.
4. Irritability, frequent mood swings.
5. Pain in the lumbar region.

During pregnancy, the attitude to nutrition changes, often women may want to try a specific food. With menstruation, this does not happen, only a craving for sweet or salty is possible.

How to relieve premenstrual syndrome

This condition in the female can begin a few days before menstruation. Often observed significant reduction body activity and performance. Any physical activity causes rapid fatigue, drowsiness and malaise.

In this case, you need to visit a doctor who should prescribe treatment. It is carried out after medical examination, the patient's complaints and the severity of PMS symptoms.

Medications for PMS

To suppress the symptoms and treat PMS, prescribe medications, which are able to stabilize well-being and weaken the effect of the syndrome on the body. Medicines are prescribed by a gynecologist and taken under his supervision.

1. Psychotropic drugs - with their help, the nervous system is restored, and the symptoms of premenstrual syndrome, such as irritability, nervousness, and others are weakened.
2. Hormonal drugs - recommended for hormone deficiency in the body.
3. Antidepressants help improve general well-being, normalize sleep, reduce anxiety, frustration, panic, eliminate depression.
4. Non-steroidal drugs - used for minor manifestations of PMS, they help eliminate headaches, and pain belly.
5. Drugs that improve blood circulation.

Medicines are selected according to the characteristics of the female body, symptoms and degree of manifestation are taken into account.

Doctors have long puzzled over the causes of women's malaise before menstruation. Some healers associated it with the phases of the moon, others with the area in which the woman lives.

The condition of the girl before menstruation remained a mystery for a long time. Only in the twentieth century the veil of secrecy was slightly opened.

PMS is a mix of 150 different physical and mental symptoms. To one degree or another, about 75% of women experience manifestations of premenstrual syndrome.

How long does PMS last for girls? Unpleasant symptoms begin to appear 2-10 days before the onset of menstruation, and disappear with the advent of the "red" days of the calendar.

• Crime chronicle. PMS is not only shattered nerves and broken plates. Most traffic accidents, crimes, thefts committed by women occurred between the 21st and 28th days of the menstrual cycle.
• Shopping therapy. According to research, a few days before menstruation, women are most susceptible to the temptation to buy as much as possible.
• PMS symptoms are more common in women who exercise mental labor and residents of big cities.
• The term PMS was first used by Robert Frank, an obstetrician-gynecologist from England.

Why does premenstrual syndrome occur?

Numerous studies fail to identify exact reasons premenstrual syndrome. There are many theories of its occurrence: “water intoxication” (violation water-salt metabolism), allergic nature (hypersensitivity to endogenous), psychosomatic, hormonal, etc.

But the most complete hormonal theory explaining the symptoms of PMS by fluctuations in the level of sex hormones in the 2nd phase of the menstrual cycle. For the normal, harmonious functioning of a woman's body, the balance of sex hormones is very important:

• - they improve physical and mental well-being, increase tone, Creative skills, speed of assimilation of information, ability to learn
• progesterone - renders sedative action, which may give rise to depressive symptoms in phase 2 of the cycle
• androgens - affect libido, increase energy, performance

During the second phase of the menstrual cycle, a woman's hormonal levels change. According to this theory, the cause of PMS lies in the “inadequate” reaction of the body, including the parts of the brain responsible for behavior and emotions, to cyclic changes hormonal background, which is often inherited.

Since the days before menstruation are endocrine unstable, many women experience psychovegetative and somatic disorders. In this case, the decisive role is played not so much by the level of hormones (which can be normal), but by fluctuations in the content of sex hormones during the menstrual cycle and how the limbic parts of the brain responsible for behavior and emotions react to these changes:

• an increase in estrogen and first an increase, and then a decrease in progesterone- hence the retention of fluids, swelling, engorgement and soreness of the mammary glands, cardiovascular disorders, irritability, aggression, tearfulness
• hypersecretion - also leads to fluid retention, sodium in the body
• excess prostaglandins- , digestive disorders, migraine-like headaches

The most likely factors affecting the development of the syndrome, on which the opinions of physicians do not differ:

• Decreased serotonin levels- this is the so-called "hormone of joy", may be the cause of the development of mental signs of premenstrual syndrome, since a decrease in its level causes sadness, tearfulness, melancholy and depression.
• Vitamin B6 deficiency- Symptoms such as fatigue, fluid retention in the body, mood changes, and breast hypersensitivity indicate a lack of this vitamin.
• Magnesium deficiency – Magnesium deficiency can cause dizziness, headaches, cravings for chocolate.
• Smoking. smoking women twice as likely to have premenstrual syndrome.
• Overweight . Women with a body mass index over 30 are three times more likely to suffer from PMS symptoms.
• genetic factor- it is possible that the features of the course of premenstrual syndrome are inherited.
• , complicated childbirth, stress, surgical interventions, infections, gynecological pathologies.

The main symptoms and manifestations of premenstrual syndrome

Groups of symptoms in PMS:

• Neuropsychiatric disorders: aggression, depression, irritability, tearfulness.
• Vegetovascular disorders: changes in blood pressure, headache, vomiting, nausea, dizziness, tachycardia,.
• Metabolic and endocrine disorders: swelling, fever, chills, breast engorgement, itching, flatulence, shortness of breath, thirst, memory loss,.

PMS in women can be conditionally divided into several forms, but their symptoms usually do not appear in isolation, but are combined. In the presence of psycho-vegetative manifestations, especially depression, in women, the pain threshold and they are more sensitive to pain.

PMS is different for every woman, and the symptoms vary greatly. According to the results of some studies, women with PMS have the following frequency of manifestation of one or another sign of PMS:

Premenstrual syndrome can aggravate the course of other diseases:

• Anemia (see)
• (cm. )
• Thyroid diseases
• chronic fatigue syndrome
• Bronchial asthma
• allergic reactions
• Inflammatory diseases of the female genital organs

Diagnosis: what can masquerade as manifestations of PMS?

Since dates and dates are easily forgotten, in order to make it easier for yourself, you should keep a calendar or diary where you write down the start and end dates of menstruation, ovulation ( basal body temperature), weight, symptoms that bother. Keeping such a diary for 2-3 cycles will greatly simplify the diagnosis and allow you to trace the frequency signs of PMS.

The severity of premenstrual syndrome is determined by the number, duration and intensity of symptoms:

• Mild: 3-4 symptoms, or 1-2 if severe
• Severe form: 5-12 symptoms or 2-5, but very pronounced, and also regardless of the duration and their number, if they lead to disability (usually neuropsychic form)

The main feature that distinguishes premenstrual syndrome from other diseases or conditions is cyclicity. That is, a deterioration in well-being occurs a few days before menstruation (from 2 to 10) and completely disappears with their arrival. However, unlike psychovegetative, physical discomfort in the early days next cycle can intensify and smoothly turn into disorders such as or menstrual migraine.

• If a woman feels relatively well in the 1st phase of the cycle, then this is premenstrual syndrome, and not chronic illness- neurosis, depression,
• If the pain appears only immediately before and during menstruation, especially when combined with - this is most likely not PMS, but others gynecological diseases — , chronic endometritis, dysmenorrhea ( painful menstruation) and others.

To establish the form of the syndrome, hormone studies are carried out: prolactin, estradiol and progesterone. The doctor may also prescribe additional methods diagnostics, depending on the prevailing complaints:

• With severe headaches, dizziness, decreased vision and fainting, it is prescribed CT scan or MRI to rule out organic brain disease.
• With an abundance of neuropsychiatric diseases, it is indicated EEG to exclude epileptic syndrome.
• With severe edema, changes in the daily amount of urine (diuresis), tests are performed to diagnose the kidneys (see).
• With severe and painful engorgement of the mammary glands, it is necessary to conduct an ultrasound of the mammary glands and mammography to exclude organic pathology.

Conducts a survey of women suffering from PMS, not only a gynecologist, but also involved: psychiatrists, neurologists, endocrinologists, nephrologists, cardiologists and therapists.

Premenstrual syndrome or pregnancy?

Some symptoms of PMS are similar to those of pregnancy (see). After conception, the content of the hormone progesterone in a woman’s body increases, which also happens during PMS, so the following symptoms are identical:

• fast fatiguability
• swelling and soreness of the breast
• nausea, vomiting
• irritability, mood swings
• lower back pain

How to distinguish pregnancy from PMS? Comparison of the most common symptoms of premenstrual syndrome and pregnancy:

The signs of both conditions are very similar, so it’s not easy to understand what exactly happens in a woman’s body and distinguish pregnancy from PMS:

• The easiest way to find out what caused poor health is to wait for the onset of menstruation.
• If the calendar is already late, you should take a pregnancy test. Pharmacy test will give reliable results only when menstruation is delayed. It is sensitive to the pregnancy hormone (hCG) excreted in the urine. If you do not have enough patience and nerves to wait, you can take a blood test for hCG. It shows almost one hundred percent result on the tenth day after conception.
• Most best option to find out what worries you - PMS syndrome or pregnancy - is a visit to the gynecologist. The doctor will assess the condition of the uterus and, if pregnancy is suspected, will prescribe an ultrasound.

When to See a Doctor

If the manifestations of premenstrual syndrome significantly reduce the quality of life, affect the ability to work and have a pronounced character, treatment is indispensable. After a thorough examination, the doctor will prescribe drug therapy and will give the necessary recommendations to alleviate the course of the syndrome.

How can a doctor help?

In most cases, treatment is symptomatic. Depending on the form, course and symptoms of premenstrual syndrome, a woman needs:

• Psychotherapy - mood swings, irritability, depression, from which both the woman and loved ones suffer, are corrected by the methods of stabilizing behavioral techniques and psycho-emotional relaxation,.
• For headaches, pain in the lower back and abdomen, non-steroidal anti-inflammatory drugs are prescribed for temporary relief pain syndrome(, Nimesulide, Ketanov, see).
• Diuretics for removing excess fluid from the body with edema (see).
• Hormone therapy is prescribed for insufficiency of the second phase of the cycle, only after tests functional diagnostics, based on the results of the identified changes. Apply gestagens - Medroxyprogesterone acetate from 16 to 25 days of the cycle.
• are prescribed for many neuropsychic symptoms (insomnia, nervousness, aggressiveness, anxiety, panic attacks, depression): Amitriptyline, Rudotel, Tazepam, Sonapax, Sertraline, Zoloft, Prozac, etc. in the 2nd phase of the cycle after 2 days from the onset of symptoms.
• With crisis and cephalgic forms, it is possible to prescribe Parlodel in the 2nd phase of the cycle, or if prolactin is elevated, then in a continuous mode, it has a normalizing effect on the central nervous system.
• With cephalgic and edematous forms, antiprostaglandin drugs are recommended (Indomethacin, Naprosin) in the second phase of the menstrual cycle.
• Since women often have elevated levels of histamine and serotonin with PMS, the doctor may prescribe antihistamines 2 generations (see) 2 days before the expected worsening overnight before the 2nd day of menstruation.
• To improve blood circulation in the central nervous system, it is possible to use Grandaxin, Nootropil, Aminolone for 2-3 weeks.
• In the crisis, cephalgic and neuropsychic form, drugs are indicated that normalize neurotransmitter metabolism in the central nervous system- Peritol, Difenin, the doctor prescribes the drug for a period of 3-6 months.
• Homeopathic preparations Remens or Mastodinone.

What can you do?

• Full sleep

Try to sleep as much as your body has time to fully rest, usually 8-10 hours (see. Lack of sleep leads to irritability, anxiety and aggression, negatively affects the immune system. If you suffer from insomnia, try walking before bed, breathing technology.

• aromatherapy

In the absence of allergies, compositions of specially selected aromatic oils are a good weapon against PMS symptoms. Geranium, rose and will help normalize the cycle. Lavender and basil effectively fight spasms. Juniper and bergamot are uplifting. Start taking baths with aromatic oils two weeks before your period.

Hiking, running, Pilates, body flex, yoga, dancing - great way treat manifestations of premenstrual syndrome in women. Regular exercise increases the level of endorphins, which helps to overcome depression and insomnia, as well as reduce the severity physical symptoms.

• Take vitamin B6 and magnesium two weeks before your period

Magne B6, Magnerot, as well as vitamins E and A - this will make it much more effective to deal with such manifestations of PMS as: heart palpitations, heart pain, fatigue, insomnia, anxiety and irritability.

• Food

Eat more fruits and vegetables, foods with high content fiber, and include calcium-rich foods in your diet. Temporarily limit the use of coffee, chocolate, cola, as caffeine increases mood swings, irritability, anxiety. The daily diet should include 10% fat, 15% protein and 75% carbohydrates. Fat intake should be reduced, as well as beef, some types of which contain artificial estrogens. Useful herbal teas, freshly squeezed juices, especially carrot and lemon. It is better not to drink alcohol, it depletes reserves mineral salts and vitamins of group B, disrupts the metabolism of carbohydrates, reduces the ability of the liver to utilize hormones.

• Relaxation practices

Avoid stress, try not to overwork and keep positive mood and thinking, relaxation practices help with this - yoga, meditation.

• Regular sex

It helps fight insomnia, stress and bad mood, increase the level of endorphins, strengthen the immune system. At this time, many women increase their sexual appetite - why not surprise your partner and try something new?

• medicinal plants

They can also help alleviate the symptoms of premenstrual syndrome: Vitex - relieves heaviness and pain in the mammary glands, Primrose (evening primrose) - from headaches and swelling, - an excellent antidepressant, normalizes libido, improves well-being and reduces fatigue.

Balanced diet, adequate physical activity, vitamin supplements, healthy sleep, regular sex, a positive attitude towards life will help alleviate the psychological and physical manifestations of premenstrual syndrome.

Premenstrual syndrome (PMS) is a complex 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. It begins to move along the abdominal cavity to fallopian tube for meeting with sperm and fertilization. In place of the bursting follicle, a corpus luteum is formed - a formation 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 this individual 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 the result is depression, chest pain, irritability, and elevated body temperature.

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 appears, 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 the normal rhythm of 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, computed tomography of the 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 using 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 have a beneficial effect on the female 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. When the symptoms of PMS return, 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.

Premenstrual syndrome (PMS) (also called premenstrual tension, cyclical or premenstrual sickness) is a complex of physical and mental symptoms that are cyclical in nature and occur a few days before the onset of menstruation. This specific condition is caused by the pathological course of the second phase of the menstrual cycle, which is characteristic of most women.

It was found that the risk of developing PMS increases over the years. According to statistics, urban residents are more susceptible to this disease than rural ones. About ninety percent of women of reproductive age observe in themselves some changes in the body that occur before the approach of menstruation, usually seven to ten days before it begins. In some women, these manifestations of symptoms are mild and do not affect everyday life (mild form PMS), respectively, do not require treatment, but in others (such as about 3-8%), the symptoms appear in a severe form that requires mandatory medical intervention. The fact of cyclic manifestation certain symptoms makes it possible to distinguish PMS from other diseases.

Changes of an emotional and physical nature in the state of a woman before menstruation pass almost immediately after they begin. If symptoms are observed throughout the entire menstrual cycle, you should consult a doctor, since the cause of this condition may not be PMS at all, but more serious illness. AT this case psychiatric consultation is recommended.

Causes of premenstrual syndrome.
More recently, premenstrual syndrome was considered a disorder. psychological nature, until it was proven that it is based on a change in the level of hormones in the body. The presence or absence of premenstrual tension syndrome in women is due to fluctuations in the hormonal background during the menstrual cycle and various reactions on them the body of each of the fair sex.

The most common causes of PMS are:

• Violation of water-salt metabolism.
• hereditary predisposition.
• Frequent stress and conflict situations in the family (in most cases, PMS develops in women of a certain mental make-up: overly irritable, thin, taking care of their health too much).
• Hormonal failures, namely, a violation of the level of the hormones estrogen and progesterone in the second phase of the menstrual cycle (the level of estrogen increases with a lack of function corpus luteum with a decrease in the level of progesterone, which affects the nervous and emotional state of a woman).
• Increased secretion of the hormone prolactin, against which changes occur in the mammary glands.
• Various diseases of the thyroid gland.
• Not good nutrition: lack of vitamin B6, as well as zinc, magnesium, calcium.
• Cyclical fluctuations in the level of certain substances (neurotransmitters) in the brain (particularly endorphins) that affect mood.

• Psychovegetative form, in which PMS manifests itself in the form of forgetfulness, excessive irritability, conflict, touchiness, often tearfulness, there is also weakness, fatigue, drowsiness or insomnia, constipation, numbness of the hands, decreased sexual desire, unpredictable outbursts of anger or depression, sensitivity to smells, flatulence . It has been noted that most often in young women of reproductive age, premenstrual tension syndrome is expressed in the form of bouts of depression, and in adolescents in transitional age aggressiveness prevails.
• edematous form of PMS, characterized most often by engorgement and soreness of the mammary glands, as well as swelling of the fingers, face, legs, slight weight gain, itchy skin, acne, muscle pain, weakness, sweating, bloating.
• Cephalgic form of PMS, with this form, the main symptoms of manifestation are headaches, dizziness, fainting, irritability, nausea and vomiting. I note that headaches in this form can be paroxysmal, accompanied by swelling and redness of the face.
• "Crisis" form, in which symptoms of the so-called "panic attacks" are observed - an increase in blood pressure, increased heart rate, attacks of compression behind the sternum, the presence of fear of death. Mostly similar condition worries women with this form of PMS in evening time or at night. Mostly given form observed in women in the premenopausal period (aged 45-47 years). In most cases, patients with a crisis form of PMS have diseases gastrointestinal tract, kidney and cardiovascular system.
• Atypical form of PMS accompanied by an increase in body temperature up to 38 ° C with migraine attacks on the days of menstruation, ulcerative gingivitis and stomatitis, asthma attacks before and during menstruation.
• The combination of several forms of PMS at once (mixed). As a rule, there is a combination of psychovegetative and edematous forms.

• The mild form is characterized by the manifestation of three to four symptoms, one or two of which prevail.
• The severe form is expressed in the simultaneous manifestation of five to twelve symptoms, in which two to five symptoms are most pronounced.

Stages of premenstrual syndrome.
There are three stages of PMS:

• compensated, in which the severity of the symptoms of the disease is insignificant, with the onset of menstruation, the symptoms disappear, while the disease does not develop with age;
• subcompensated, which has pronounced symptoms that affect the woman's ability to work, and over the years, the manifestations of PMS only get worse;
• decompensated stage, expressed in severe manifestation symptoms that persist for several days after the end of menstruation.

Since the symptoms of the manifestation of premenstrual syndrome are quite extensive, some women confuse it with other diseases, often seeking help from the wrong specialists (therapist, neurologist, psychiatrist). Only a thorough examination can reveal the cause of the disease.

Diagnosis of premenstrual syndrome.
To make a diagnosis, the doctor examines the patient's history and listens to existing complaints. The cyclicity of attacks of the disease is the first sign of PMS.

To diagnose the disease, blood tests for hormones made in both phases of the menstrual cycle (prolactin, estradiol, progesterone) are examined. Depending on the form of PMS, the hormonal characteristics of patients have differences. For example, with the edematous form of PMS, there is a decrease in the level of progesterone in the second phase of the cycle, with neuropsychic, cephalgic and crisis forms, the level of prolactin in the blood increases.

After that, taking into account the form and complaints of patients, additional studies are carried out (mammography, MRI, blood pressure control, electroencephalography, measurements daily diuresis etc.) with the involvement of other specialists (endocrinologist, neuropathologist, therapist, psychiatrist).

For the most accurate diagnosis of the disease, as well as to identify the dynamics of the treatment, experts recommend that all patients with PMS every day write down their complaints in detail in a kind of diary.

Treatment of premenstrual syndrome.
Treatment is carried out in a complex, regardless of the form of the disease.

To eliminate psycho-emotional manifestations, psychotropic and sedatives: sedatives Seduxen, Rudotel and antidepressants Tsipramin, Koaksil. Data medicines it is recommended to take for two months in both phases of the menstrual cycle.

To normalize the levels of sex hormones, hormonal preparations are prescribed:

• gestagens (Utrozhestan and Duphaston) during the second phase of the menstrual cycle;
• monophasic combined oral contraceptives (Zhanin, Logest, Yarina and others), which are well tolerated by patients, are suitable for all women of reproductive age in the absence of contraindications;
• androgen derivatives (Danazol) if present severe pain in the mammary glands;
• women in the premenopausal period are prescribed aGnRH (gonadotropin-releasing hormone agonists) - Zoladex, Buserelin, which block the functioning of the ovaries, excluding ovulation, thereby eliminating the symptoms of PMS.

Symptomatic therapy is carried out in the form of an additional treatment carried out to the main one in order to quickly eliminate the symptoms of PMS: non-steroidal anti-inflammatory drugs (Indomethacin, Diclofenac) and antihistamines (allergic reactions) - Tavegil, Suprastin.

Often prescribed for the treatment of premenstrual syndrome homeopathic preparations, in particular Mastodinon and Remens are vegetable not hormonal agents, the effect of which extends directly to the cause of PMS. In particular, they normalize the imbalance of hormones, reducing the manifestations of the disease. psychological properties(irritability, anxiety and fear, tearfulness). Mastodinone is often recommended for the edematous form of the disease, including chest pain. It is prescribed for taking thirty drops twice a day, which are diluted with water, for three months. If the drug is in the form of tablets, then one tablet twice a day. Remens is also taken for three months, ten drops, or one tablet three times a day. Both drugs have practically no contraindications: excessive sensitivity to the components of the drugs, age restrictions - up to 12 years, pregnancy and lactation.

If the cause of the development of PMS was a lack of B vitamins and magnesium, then vitamins of this group (Magne B6), as well as calcium for the prevention of osteoporosis and iron in the fight against anemia, are prescribed.

The course of treatment averages from three to six months, depending on the severity of the disease.

Self-treatment of premenstrual syndrome.
To speed up the healing process, and rapid rehabilitation it is necessary to lead a certain lifestyle:

• Proper nutrition - limit the consumption of coffee, salt, cheese, chocolate, fats (they provoke the occurrence of such manifestations of PMS as migraine), include fish, rice, sour-milk products, legumes, vegetables, fruits, greens in the diet. To maintain the level of insulin in the blood, it is recommended to eat at least five to six times a day in small portions.
• Playing sports - two to three times a week, which helps to increase the level of endorphins that improve mood. However, you should not abuse the loads, since their excessive amount only exacerbates the symptoms of PMS.
• You need to look after your emotional state, try not to be nervous, avoid stressful situations Get enough sleep (at least eight to nine hours of good sleep).
• As an aid, it is recommended to use herbal medicine: tincture of motherwort or valerian thirty drops three times a day, warm chamomile tea, green tea with mint.
• Recommended to be taken as soon as possible more vitamin C. It has been proven that women with PMS get sick more often, this is due to the weakening of the immune system before menstruation, which makes it vulnerable to viral and bacterial infections.

PMS prevention.

• systematic reception oral contraceptives in the absence of contraindications;
• healthy lifestyle;
• regular sex life;
• exclusion of stressful situations.

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 both mental and physical symptoms. In varying degrees of complexity, 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 the causes of PMS is 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 her 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 includes a sedative effect. 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. Good 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 facilitate serious 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 could be yoga hiking, dancing, Pilates. Regular physical activity can increase the level of 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.