Premenstrual Syndrome
Definition[edit | edit source]
Premenstrual Syndrome (PMS) is a combination of physical, psychological, and emotional symptoms that start one or two week before the beginning of menstruation after ovulation period. The severity range from mild to sever that may hinder their work and ADL activities. And they start to resolve with the beginning of the menstruation as the hormones levels start to return to their levels. PMS symptoms may change throughout your life in severity and complain, depression, stress, or history with post partum depression are all contributing factors that may worsen your symptoms. PMS may get worse when women approach to menopause specially at the end of 30s or 40s and stop after menopause. If the woman has a history of seizure disorders, migraines, asthma, or allergies they will get worse during PMS period. PMS represents about 75% of women of reproductive age, and sever symptoms find in about 5–8% of women.
Premenstrual dysphoric disorder (PMDD) is similar to PMS but characterized by sever irritability, depression, and anxiety and affects 3–8% of menstruating women[1].
Cause of Premenstrual Syndrome[edit | edit source]
The definite cause for PMS still not fully understood and may be multifactorial causes, the most suggested is fluctuation in hormones levels during the menstruation cycle which in turn affect on centrally neurotransmitters. There is an evidence suggested that low level of circulating serotonin and enhanced progesterone sensitivity can explain PMS in some cases.
Prostaglandin (PG) deficiency, PG has a role in forming prostaglandin precursors from linoleic acid.
Genetic factors and depression may worsen the symptoms of PMS[2].
Clinical Presentation[edit | edit source]
Physical symptoms:
- Abdominal bloating and cramping.
- Fatigue.
- Constipation
- Headache.
- Breast tenderness.
- Constipation or diarrhea.
- Change in appetite.
- Disturbance with sleeping ( sleeping more than usual or sleeping too little)
- Skin problems, acne.
- Gastrointestinal symptoms.
Emotional symptoms:
- Depression.
- Anxiety.
- Anger.
- Oversensitivity.
- Mood swing.
- Crying spells
- Less interest in sex.
- Insomnia.
- Poor concentration.
Diagnostic Procedures[edit | edit source]
There is no definite diagnostic test and the diagnosis of PMS depends on reporting to the symptoms for at least for two or three months.
When rating the symptoms they must be present in five days before the start of menstruation for at least three cycles and resolve within 4 days after the start of period, and these symptoms affect negatively to some extent on her ADLs. She can use daily reporting severity scale to record her symptoms daily.
Outcome Measures[edit | edit source]
Premenstrual Tension Syndrome Observer (PMTS-O)
Premenstrual Tension Syndrome Self-Rating (PMTS-SR).
Management / Interventions
[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis
[edit | edit source]
Premenopause.
Resources
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References[edit | edit source]
- ↑ Gao M, Gao D, Sun H, Cheng X, An L, Qiao M. Trends in Research Related to Premenstrual Syndrome and Premenstrual Dysphoric Disorder From 1945 to 2018: A Bibliometric Analysis. Frontiers in Public Health. 2021 Apr 21;9:380.
- ↑ 2.0 2.1 Dickerson LM, Mazyck PJ, Hunter MH. Premenstrual syndrome. American family physician. 2003 Apr 15;67(8):1743-52.
- ↑ Steiner M, Streiner DL, Steinberg S, Stewart D, Carter D, Berger C, Reid R, Grover D. The measurement of premenstrual mood symptoms. Journal of affective disorders. 1999 Jun 1;53(3):269-73.
