Premenstrual syndrome

Description:

Premenstrual syndrome, or PMS (syndrome of premenstrual tension, premenstrual disease, cyclic syndrome) — the difficult cyclic symptom complex arising at some women in premenstrual days (in 2 — 10 days prior to periods) and characterized by psychoemotional, vegeto-vascular and exchange and endocrine disturbances which, in turn, negatively affect a way of life, usual for the woman.

A part in manifestation of symptoms of PMS is played by provocative factors, such as childbirth and abortions, psychological stresses, infectious diseases. The exact reason of development of a cyclic syndrome is still unknown.

Symptoms of the Premenstrual syndrome:

The clinical picture of a premenstrual syndrome is characterized by the symptomatic variety. It includes:

    * psychoemotional symptoms (for example, irritability, depression, tearfulness);
    * symptoms of vegeto-vascular disturbances (headache, nausea, vomiting, heartaches);
    * the symptoms reflecting exchange and endocrine disturbances (a nagrubaniye of mammary glands, hypostases, an itch, fervescence, etc.).

Depending on dominance of these or those symptoms allocate four main of a clinical form of a disease: psychological, edematous, tsefalgichesky and krizovy. In addition, depending on quantity, duration and intensity of symptoms during PMS distinguish easy and heavy forms of a course of a disease. Carry a state at which 3 — 4 symptoms in 2 — 10 days prior to periods are observed to the PMS easy form, and carry a state to which manifestation of 5 — 12 symptoms in 3 — 14 days prior to the beginning of periods is characteristic to a severe form. Also allocate three stages of a syndrome: compensated, subcompensated and dekompensirovanny.
The clinic of the PMS psychological form is expressed by such symptoms as irritability, a depression, weakness, aggression, tearfulness, and also hypersensitivity to smells and sounds, numbness of extremities, a nagrubaniye of mammary glands and a meteorism. It is noted that if at young women at this form of a premenstrual syndrome the depression prevails, then in awkward age aggression prevails. The psychological form wins first place on prevalence among other forms, it is observed approximately at 43,3% of sick women. Average age of patients with this form of PMS makes 33±5 years. At early reproductive age this form is registered at 18%, in active reproductive — at 69%, in late — at 40% suffering from a premenstrual syndrome.

In a clinical picture of the PMS edematous form morbidity of mammary glands, puffiness of the person and extremities, abdominal distention, a skin itch, and also perspiration, irritability and weakness prevails. At most of women with PMS in a lyuteinovy phase the liquid delay to 500 — 700 ml is observed. The edematous form of a premenstrual syndrome takes the third place on prevalence among other forms of a cyclic disease, conceding psychological and tsefalgichesky (occurs at 20% of women). This form of PMS is the most widespread among women of early reproductive age (≈ 46%), and most less often the edematous form occurs at women of active reproductive age (≈ 6%).

To clinical picture of a tsefalgichesky form of a premenstrual syndrome headaches, irritability, nausea, vomiting, dizziness, hypersensitivity to smells and sounds, depressions, heartaches, a nagrubaniye of mammary glands, numbness of hands, perspiration are characteristic. The headache at this form of a disease pulsing, pulling also begins in a temporal share. To the PMS Tsefalgichesky form the heavy current with a constant recurrence is characteristic. On prevalence this form takes the second place and occurs approximately at 20% of the women suffering from a syndrome. It is most often observed at patients of early and late reproductive age (≈ 32% and 20%, respectively.

At the PMS krizovy form sympathoadrenal crises which begin with increase in arterial pressure, emergence of fear of death, feeling of a prelum of a breast, numbness of extremities are brightly expressed. Crises, as a rule, arise in the evening or at night and come to an end with a plentiful mocheotdeleniye. Such crises can be result of long stresses, fatigue, infections. This form — the heaviest manifestation of a premenstrual syndrome, however the least widespread. At only 4% of sick women of early reproductive age the PMS krizovy form, at 12,5% of patients of active fertile age and at 20% of late is observed.

However in addition to these main four forms of a premenstrual syndrome, there is an atypical form including hyper thermal, gipersomnichesky forms, an ophthalmoplegic form of migraine, and also cyclic allergic reactions. To a hyper thermal form fervescence in the second phase and its decrease from the beginning of periods, a gipersomnichesky form — drowsiness in this phase of a menstrual cycle is characteristic. The ophthalmoplegic form of migraine is characterized by unilateral closing of an eye, and also a hemiparesis in a lyuteinovy phase. Cyclic allergic reactions include an ulocace and stomatitis, vomiting, bronchial asthma, an iridocyclitis, menstrual migraine.

Reasons of the Premenstrual syndrome:

Frequency of a premenstrual syndrome completely depends on age of the woman: than is more senior — that frequency more, it fluctuates from 25 to 90%. Aged from 19 up to 29 years of PMS it is observed at 20% of women, after 30 years the syndrome occurs approximately at every second woman. After 40 years frequency reaches 55%. Cases when the premenstrual syndrome was observed at girls on approach of menarche at once were also registered. In addition, more often PMS is observed at emotionally labile women with a lack of body weight and intellectual work. A part in manifestation of symptoms of a cyclic syndrome is played by provocative factors, such as childbirth and abortions, psychological stresses, infectious diseases. PMS meets at women with disturbances of the central nervous system, digestive tract, and also cardiovascular system more often and can be observed as at an ovulatory cycle (a cycle at which an ovum exit from an ovary in a perigastrium is characteristic), and at anovulatory  (a cycle at which there is no ovum exit).

Today etiopatogenetichesky mechanisms of a syndrome are insufficiently studied. There is a set of the hypotheses explaining emergence of symptomatology of PMS however at the moment of accurate pathophysiological and biochemical justification of its emergence and development is not present. Today several theories of an etiology of a premenstrual syndrome are considered by scientists:

    * hormonal;
    * allergic;
    * theory of "water intoxication";
    * theory of hyper adrenocortical activity and increase in Aldosteronum;
    * theory of psychosomatic disturbances.

Treatment of the Premenstrual syndrome:

Main goal of treatment of a premenstrual syndrome is normalization of functions of a hypothalamus, dehydration, and also elimination of the accompanying female diseases, infections and toxicosis. Treatment of PMS depends on weight of a current of a syndrome which initial course lasts about one year. Improvement of a state can achieve only by a three-months cycle of therapy with a break in 2 — 3 months, and at emergence of a recurrence the course of treatment needs to be continued again. The main methods of treatment of a premenstrual syndrome are the pharmacotherapy, hormonal therapy and non-drug treatment (acupuncture, physical therapy, etc.).
At positive effect from the carried-out therapy, the preventive supporting treatment including vitamin drugs and tranquilizers is recommended.