Premenstrual syndrome (PMS for short) is a physically or psychophysically uncomfortable condition that occurs during the second phase of the menstrual cycle. Usually it is manifested by a set of unpleasant symptoms on the part of the body, combined with weakness, mood and emotional tone disorders, up to a neurotic state. It largely depends on the presence of diseases, the influence of stress or an imbalance of hormones. PMS is not the norm, as many women believe, and requires correction, including through medication.

General information, the role of hormones

According to statistics, up to a third of all women during the reproductive period experience manifestations of this syndrome. With age, the frequency of its occurrence increases, including due to changes in the balance of sex hormones. The typical age of the onset of the syndrome is from 20 to 40 years; closer to menopause, manifestations can sharply worsen, since sex hormones are produced in smaller quantities, which affects the female body. PMS usually manifests itself with emotional instability, choleric temperament, in emaciated, losing weight women, more often ladies engaged in intellectual activity are subject to it. In most women, the syndrome occurs in mild forms, but about 10% of cases require the intervention of doctors and intensive correction.

Causes of PMS: the role of stress, hormonal disorders

Causes of PMS: the role of stress, hormonal disorders

To date, the true causes that form the manifestations of PMS in some women have not been identified. But experts highlight certain provocateurs that can negatively affect sex hormones and the work of the neuroendocrine system that regulates menstrual functions and sensations throughout the cycle. The leading place is occupied by stress, and it can be both emotional (experiences, fears, problems at home or at work), and physical — overwork, physical labor, chronic physical inactivity. Stress and hormonal imbalances, previous severe infections, miscarriages or abortions, pelvic surgery or genital trauma can provoke. Contribute to the development of PMS gynecological diseases and malformations in the uterus and appendages.

Theories of development, the role of disease, vitamin deficiency

Can contribute to the development and severe course of PMS diseases of internal organs that are actively involved in metabolic processes — the liver and kidneys, as well as problems with the circulatory system. May aggravate the manifestations of metabolic diseases — diabetes mellitus, thyroid pathology, sudden changes in weight (obesity or, conversely, exhaustion). To date, several theories of the development of PMS have been put forward, which have the greatest amount of real evidence of consistency. So, the leading role, according to researchers, is played by hormones, the ratio of progestogens and estrogens. With an excess of the estrogen group against the background of an increase in testosterone levels or increased secretion of prolactin, there may be PMS phenomena.

There is also a theory that prostaglandins, inflammatory mediators, are responsible for the development of PMS, the formation of which is excessive in the second phase of the cycle. There is a connection with a change in the balance of salts and fluids, with the formation of excessive swelling of tissues in the second phase, as well as with a deficiency of vitamins (tocopherol with retinol), or with mineral deficiency.

There is also a theory of genetic predisposition, in which excessive sensitivity of tissues to hormonal fluctuations and changes in the settings of the hypothalamus are inherited.

Classification of PMS: from mild weakness to severe malaise

According to the form of the leading disorders, the main forms of premenstrual syndrome are distinguished — edematous, cephalgic, crisis, neuropsychic, mixed or atypical. There is a classification of PMS according to the severity of its course. Allocate:

  • mild PMS with minor disturbances in well-being, mild weakness and no disability
  • moderate PMS with the appearance of several symptoms, some of them are quite pronounced
  • severe PMS with pronounced manifestations. Severe weakness is typical, habitual activity and ability to work are limited.

A premenstrual symptom may exist at a certain stage of development. A compensation stage is distinguished, in which manifestations occur only before menstruation, in the second phase, gradually disappearing with the onset of discharge. A subcompensation stage is possible, with an increase in the number and severity of symptoms that also accompany menstruation, gradually subsiding.

The most severe stage of decompensation — there are symptoms of severe PMS with a long period of manifestations and a slight period of relief.

Manifestations of PMS: from the side of the body and emotions

Manifestations of PMS: from the side of the body and emotions

Manifestations vary greatly from form to severity. If this is a neuropsychic form, they manifest:

  • weakness and unstable mood;
  • periods of insomnia;
  • aggressiveness, irritability and tearfulness, mood swings;
  • severe fatigue, depressive thoughts up to suicide;
  • panic attacks, unmotivated fears;
  • hearing and olfactory impairments.

The edematous forms of the syndrome are manifested by fluid retention with swelling of the face and hands, weight gain, decreased urine output, severe thirst, impaired appetite, attacks of flatulence, pain and engorgement in the mammary glands.

The crisis form manifests itself as a rise in pressure, attacks of palpitations, pain in the heart, panic fears, and profuse urination.

The cephalgic form usually presents with migraines, headaches with nausea, bowel problems, heart pain, increased sensitivity to sound and smell, irritability, and sleep problems. Combinations of two or even more forms can often stand out.

Treatment Methods: Are Medications Necessary?

PMS is diagnosed and treated by gynecologists. A set of measures is applied, and drugs are not always the first on the list. Psychotherapy, compliance with the daily regimen, moderate exercise, taking herbal tinctures or teas, oxygen cocktails, and vitamins are shown. It is important to change the diet with the restriction of irritating and stimulating foods, the rejection of alcohol. The treatment is supplemented with mild sedative drugs (Persen, motherwort, Novo-Passit), diuretics in the form of kidney tea, Canephron. For pain, drugs with analgesic and anti-inflammatory effects (ibuprofen, paracetamol), antihistamines (Suprastin, Tavegil) can be used. In severe PMS, hormonal medications with progesterone may be indicated. The prognosis in most cases is favorable — the manifestations sharply decrease or completely disappear.

Obstetrics / Ed. Savelieva G.M. 2000

Endocrinology / Ed. Dedova I.I., Melnichenko G.A. 2013