What happens to a woman during PMS. How to distinguish PMS from pregnancy before a delay. What happens to the body
Many scientists and medical specialists have been studying the characteristics of the female body for several centuries. And only recently it was finally possible to find out when PMS begins in females, and what are its true manifestations. Premenstrual syndrome has not been fully studied, 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 is a fairly common phenomenon and occurs 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 of intensity.
Some women do not have premenstrual syndrome at all, while others have it all the time. Age plays an important role here, 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. This affects the psycho-emotional and physiological processes, which causes changes in the behavior, well-being of a woman.
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, the following are of great importance:
- 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, PMS is not observed during this period.
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.
The main reason for the appearance of PMS 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 hormonal levels 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 health may worsen and general malaise and weakness appear.
Female hormones that ensure the normal and stable functioning of the whole body are presented below.
- Estrogen - is responsible for the physical and mental characteristics of the body, stabilizes muscle tone.
- Progesterone is a steroid hormone that 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.
- 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.
- A decrease in the hormone serotonin becomes the main cause of mood changes, as a result of which tearfulness and sadness appear.
- Lack of vitamin B6 - causes fatigue, mood changes.
- 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 of 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 the 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.
- Satisfied with rapid fatigue after light physical exertion.
- Enlargement of the mammary glands, their soreness when touched - during PMS, this manifestation is not long-term, but during pregnancy it continues until childbirth.
- Feeling of nausea, vomiting - PMS is rarely expressed by these symptoms, while pregnancy is characterized by such manifestations throughout the first trimester.
- Irritability, frequent mood swings.
- 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 there is a significant decrease in the activity of the body and its 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 a medical examination, the patient's complaints and the severity of PMS symptoms are taken into account.
Medications for PMS
To suppress the symptoms and treat PMS, medications are prescribed that can stabilize well-being and weaken the effect of the syndrome on the body. Medicines are prescribed by a gynecologist and taken under his supervision.
- Psychotropic drugs - with their help, the nervous system is restored, and the symptoms of premenstrual syndrome, such as irritability, nervousness, and others are weakened.
- Hormonal drugs - recommended for hormone deficiency in the body.
- Antidepressants - help to improve overall well-being, normalize sleep, reduce anxiety, frustration, panic, and eliminate depression.
- Non-steroidal drugs - used for minor manifestations of PMS, they help eliminate headaches, and pain in the abdomen.
- Drugs that improve blood circulation.
Medicines are selected according to the characteristics of the female body, the symptoms and the degree of manifestation of signs of premenstrual syndrome 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 prone to women engaged in mental work and residents of large cities.
- The term PMS was first used by Robert Frank, an obstetrician-gynecologist from England.
Why does premenstrual syndrome occur?
Numerous studies do not allow to identify the exact causes of premenstrual syndrome. There are many theories of its occurrence: “water intoxication” (violation of water-salt metabolism), allergic nature (increased sensitivity to endogenous), psychosomatic, hormonal, etc.
But the most complete is the hormonal theory, which explains 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, creativity, speed of assimilation of information, learning abilities
- progesterone - has a sedative effect, which can lead to depressive symptoms in the 2nd phase 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” response of the body, including the brain regions responsible for behavior and emotions, to cyclic changes in hormonal levels, 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. Women who smoke are twice as likely to get 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, the pain threshold decreases in women and they perceive pain more acutely.
neuropsychic |
crisis form |
Atypical manifestations of PMS |
Violations in the nervous and emotional spheres:
|
Most women have diseases of cardio-vascular system, kidneys, gastrointestinal tract. |
|
edematous form |
Cephalgic form |
|
There is a negative diuresis with fluid retention. |
Leading mainly neurological and vegetative-vascular manifestations:
The family history of women with this form is aggravated by hypertension, cardiovascular diseases, and gastrointestinal diseases. |
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:
| Symptom | frequency % |
Hormonal theory of PMS |
| irritability | 94 | |
| soreness of the mammary glands | 87 | |
| bloating | 75 | |
| tearfulness | 69 | |
|
56 | |
|
50 | |
|
44 | |
|
37 | |
|
19 | |
| vomit | 12 | |
| constipation | 6 | |
| back pain | 3 |
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 of PMS symptoms.
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 first days of the next cycle, they 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 other 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, computed tomography or MRI is prescribed to exclude organic brain diseases.
- With an abundance of neuropsychiatric diseases, an EEG is indicated to exclude the 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:
| Symptoms | Pregnancy | Premenstrual syndrome |
|
accompanies the entire pregnancy | Pain goes away with menstruation |
|
the attitude to food changes, you want inedible, salty, beer, something that a woman usually does not like, the sense of smell is greatly aggravated, ordinary smells can be very annoying | can crave sweet and savory, sensitivity to odors |
|
only late | may have back pain |
|
starts 4-5 weeks after conception | can appear both immediately after ovulation, and 2-5 days before menstruation |
| mild, short-term pain | individually in each case | |
|
frequent mood swings, tearfulness | irritability |
|
possibly | No |
|
from 4-5 weeks after conception | possible nausea, vomiting |
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. A pharmacy test will give reliable results only with a delay in menstruation. 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 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 the temporary relief of pain (, Nimesulide, Ketanov, see).
- Diuretics for excretion excess fluid from the body with edema (see).
- Hormone therapy is prescribed for insufficiency of the second phase of the cycle, only after tests of 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 2nd generation antihistamines (see) 2 days before the expected worsening of the condition at night 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 the 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 work immune system. If you suffer from insomnia, try walking before bed, breathing techniques.
- 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 are a great way to treat symptoms of premenstrual syndrome in women. Regular exercise increases endorphin levels, which can help fight depression and insomnia, as well as reduce the severity of 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.
- Nutrition
Eat more fruits and vegetables, high-fiber foods, 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 the reserves of mineral salts and B vitamins, disrupts the metabolism of carbohydrates, and reduces the ability of the liver to utilize hormones.
- Relaxation practices
Avoid stress, try not to overwork and maintain a positive mood and thinking, relaxation practices such as yoga and meditation help with this.
- Regular sex
It helps fight insomnia, stress and bad mood, increase the level of endorphins, strengthen the immune system. At this time, many women have increased 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.
A balanced diet, adequate exercise, vitamin supplements, healthy sleep, regular sex, a positive attitude towards life will help alleviate the psychological and physical manifestations of premenstrual syndrome.
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PMS- This is a large group of physical and psycho-emotional pathological changes in the body of a cyclic nature, closely related to the approaching menstruation. Perhaps there is no woman who has not experienced at least once unpleasant changes in the general condition on the eve of the next menstruation. Moreover, if the frequency of occurrence of PMS in girls does not exceed 20%, then among women who have overcome the thirty-year age limit, it occurs in every second.
PMS rightfully belongs to one of the most mysterious conditions of the female body. Its reliable causes are unknown, therefore it is customary to talk about predisposing conditions for its development.
PMS is not a disease, it is an extensive list of possible pathological symptoms that a woman may have before menstruation and pass without a trace after it ends. The severity of PMS and the nature of the clinical manifestations in all patients is different, so this syndrome does not have certain clinical signs, but it has one clear diagnostic criterion - the connection with the approaching menstruation. One or two weeks before the next menstruation, the woman's well-being changes: psycho-emotional disorders appear, peripheral edema of the extremities, weight gain, enlargement and sensitivity of the mammary glands, vegetative-vascular manifestations, and so on.
The clinical characterization of PMS consists of a huge number (about 150) of potential symptoms, but each patient has her own, sometimes unique, set of clinical signs. Finding two women with identical PMS symptoms is nearly impossible.
The presence of a clear connection of a regular deterioration in the condition of a woman on the eve of the next menstruation indicates the hormonal nature of PMS. Often occurring PMS in adolescents is obviously associated with the incomplete process of formation of the hormonal function of the ovaries, and PMS in menopausal women is caused by its natural extinction.
The clinical signs of PMS in women are not equally expressed, and vary widely from mild ailment to severe, disturbing the usual rhythm of life, condition. Regardless of the form and severity of pathological signs, their appearance in the second phase of the cycle and disappearance in the first is usually correlated with PMS.
Since PMS is accompanied by a large number of symptoms that are not associated with gynecology, patients often initially turn to other specialists: neurologists, endocrinologists, therapists, and others. Unfortunately, before getting to the right specialist, they often undergo long-term treatment for non-existent ailments.
Physiological changes in the body on the eve of menstruation are always accompanied by changes in well-being. Periodically occurring mood changes, increased appetite, enlargement of the mammary glands and other common precursors of menstruation are associated with physiological hormonal changes in the body and are not always manifestations of PMS. In healthy women, these symptoms do not recur regularly before each menstruation, but appear sporadically.
PMS is indicated by the presence of a certain number of symptoms that recur before each menstruation and disappear on their own after it is completed.
Diagnostic measures include the mandatory study of indicators of hormonal function, and the list of other studies depends on the clinical manifestations of PMS.
There are no clear treatment regimens or special pills for PMS, because its manifestations are individual and very diverse. The drugs used for PMS belong to different groups and are designed to gradually eliminate all existing symptoms and predisposing factors.
The success of treatment is determined by the normal hormonal function of the ovaries, the biphasic cycle and the disappearance of pathological symptoms.
Among women, there is an erroneous belief that PMS, especially its mild forms, is the norm and does not need medical correction. Meanwhile, PMS can become more severe over the years, and pathological menopause in women with PMS develops more often.
Causes of PMS
PMS cannot be associated with disorders in one system, since its manifestations belong to almost the entire body. Therefore, all existing theories of the occurrence of PMS explain the development of pathological symptoms in only one system of the body, but cannot link them together.
One of the most reliable causes of PMS is hormonal dysfunction. It is she who explains PMS in adolescents during the period of unstable ovarian function. It can appear with the first menstruation or after a few normal cycles. If the period of formation of hormonal function in adolescence has passed properly, the chances of developing PMS in girls are significantly reduced.
A change in the normal ratio of hormones provokes a temporary disruption of the entire body. Therefore, PMS in women often occurs after abortion, pathological pregnancy, removal or ligation of the fallopian tubes, as well as against the background of improperly used hormonal contraception.
Hormonal imbalance, namely a violation of the normal ratio of estrogens and progesterone, increases the lability of the nervous system and causes psycho-emotional disorders inherent in PMS.
There is also an assumption about the initial impact of changes in the central nervous system on the development of PMS. It is based on the fact that more often PMS is diagnosed in emotionally labile patients with high mental stress, frequent stress or significant overwork. Among the residents of megacities, there are significantly more PMS owners than those living in rural areas.
Changes in the mammary glands on the eve of the next menstruation also has hormonal causes. In response to a provoking factor in the pituitary gland, too much of the hormone prolactin is synthesized, which is responsible for the condition of the mammary glands. On the eve of menstruation, they become sensitive, dense and increase in volume.
With PMS, the normal indicators of the water-salt balance change. Fluid and sodium retention in the kidneys lead to edema.
A significant role in the formation of PMS belongs to tissue hormones prostaglandins, which are synthesized by almost all organs and tissues. It has been noted that some symptoms of PMS are similar to those with an excess of prostaglandins: migraine headaches, impaired defecation, nausea or vomiting, and a variety of behavioral changes. Prostaglandins are also responsible for autonomic and vascular disorders in the premenstrual period.
Among the reasons for the development of PMS are also present: deficiency of zinc, magnesium, calcium and vitamin B6; lack of weight or exhaustion; endocrine disorders; neuroinfections and thyroid diseases. A genetic predisposition to the appearance of PMS has been established.
Thus, the leading place among the causes of PMS is occupied by functional disorders in the central nervous system and hormonal dysfunction of the ovaries of a congenital or acquired nature.
Symptoms and signs of PMS
The clinical characteristics of PMS cover numerous cyclically recurring pathological changes in almost all body systems. However, each woman has her own unique set of symptoms. Depending on the predominance of certain clinical signs of PMS, there are four main forms of its course:
Neuropsychic (sometimes referred to as psychovegetative) form of PMS. They are distinguished by pronounced disorders in the emotional sphere and changes in the functioning of the nervous system. On the eve of menstruation, the mood changes: the patient becomes depressed, irritable, tearfulness, insomnia, may appear. In addition to mood changes, headaches and dizziness, changes in appetite, fatigue, heart pain and other neurological symptoms occur. In adult women, depressive disorders prevail in the clinic, and PMS in adolescents is characterized by manifestations of excessive aggressiveness.
The edematous form of PMS is associated with the predominance of signs of a violation of the water-salt balance and is associated with fluid retention in the tissues. The main symptom is swelling of varying severity that occurs on the face, shins and hands. Fluid retention in the tissues leads to an increase in the volume of the mammary glands and their soreness (), as well as to weight gain. Appears thirst, joint pain, changes in bowel function.
The cephalgic form of PMS occurs with severe vegetovascular disorders. The leading symptom is migraine-like headaches. As a rule, such pains have a characteristic unilateral localization in the temple area and are characterized by patients as jerking or throbbing. Often they are accompanied by nausea, vomiting, uncontrollable diarrhea and dizziness. Women with cephalgic PMS usually have a history of cardiovascular disease, stomach and intestinal disease, and psychological trauma.
The crisis form of PMS resembles undulating "panic attacks". Suddenly, more often in the evening or at night, the patient has attacks of palpitations, suffocation and unmotivated fear. The crisis form of PMS is inherent in the premenopausal period, therefore it is more often present in patients after 45 years of age.
The allocation of PMS forms is conditional and does not mean that the patient can simultaneously have only the symptoms inherent in one form of PMS. With mixed forms of PMS, a combination of psychovegetative and edematous forms is more common.
The clinical picture of PMS does not always fit into the designated framework, sometimes PMS proceeds atypically. Before and during menstruation, symptoms appear, fever, inflammation of the oral mucosa, vomiting. Any atypical symptoms, the regular occurrence of which has a clear connection with menstruation, is referred to as an atypical form of PMS.
The number of symptoms and their severity determine how severe PMS is. The presence of 3-4 clinical signs, of which only one or two are strongly pronounced, indicate a mild course of PMS. A severe degree is characterized by pronounced 2-5 symptoms out of 5-12 available.
If PMS is manifested by small symptoms and has not progressed for many years, it is considered compensated. As a rule, all its manifestations disappear at the time of the onset of the next menstruation.
The subcompensated stage of PMS is characterized by a gradual increase in clinical manifestations and disrupts the patient's usual rhythm of life.
Severe PMS with severe symptoms, disability speaks of a decompensated process. His symptoms disappear a few days after menstruation.
Often, patients do not know whether it is possible and how to distinguish from PMS in the event of the appearance of similar symptoms. Indeed, short-term pregnancy and PMS may have similar symptoms: fatigue, changes in appetite and weight, enlargement and sensitivity of the mammary glands, swelling, psycho-emotional changes, and others. As a rule, the doctor is able to distinguish these conditions by examining the history and the results of a blood test for hCG - the “pregnancy hormone”. However, before the onset of a delay in menstruation, this method is not always reliable.
So how to distinguish pregnancy from PMS in anticipation of the next menstruation? By carefully observing the change in the state of her body, a woman herself can come to the right conclusion. You can think about small terms of pregnancy if:
You recently had unprotected sexual intercourse;
These symptoms do not recur every month before your period;
Your condition is not associated with a non-gynecological ailment: a cold, an intestinal infection, stress, climate change, and others.
If the presence of a short term pregnancy is not excluded, the next menstruation will not occur on time. If it is delayed, you can do an express test, and then consult a doctor.
Diagnosis of PMS
As a rule, patients with PMS symptoms initially turn to endocrinologists, therapists or neuropathologists according to the PMS form, but their therapy does not give the desired result, so the treatment of a non-existent ailment can last for years.
If a woman manages to notice a clear connection between the deterioration of the condition and the approaching menstruation, the diagnosis of PMS begins in a timely manner. Since PMS does not have a clear list of clinical signs, its primary diagnosis relies on two diagnostic criteria: a clear relationship of symptoms with the menstrual cycle and the absence of mental disorders in the patient.
Based on the analysis of the most common forms of PMS, a list of symptoms has been compiled to make a correct diagnosis. It is considered reliable if the patient has at least five of the following clinical signs, with the obligatory presence of the first four:
Feeling of unmotivated anxiety and tension;
Feeling of hopelessness and longing, bad mood;
Indifference to surrounding people and events;
Rapid fatigue and physical weakness;
Decreased memory, inability to concentrate;
Poor appetite, tendency to;
Changes in the usual rhythm of sleep - insomnia or drowsiness;
Severe headaches, painful mammary glands, swelling of the face and limbs, weight gain, pain in muscles and joints.
The final diagnosis is made after observing the patient's condition for several menstrual cycles. She is encouraged to regularly record premenstrual symptoms in a special observation diary. After 3-4 cycles, the data presented in the diary are analyzed. If during the observation period the records reflect the regularity of pathological symptoms and their clear relationship with menstruation, the diagnosis of PMS is obvious.
The diagnosis of PMS implies a mandatory study of the hormonal status of the patient. The nature of the change in the amount of hormones (prolactin, estradiol and progesterone) in different phases of the cycle is determined. With different forms of PMS, these changes are not equivalent. Thus, a decrease in normal progesterone levels in the second phase of the cycle is observed with the edematous form of PMS, and with others, an increase in the level of prolactin occurs.
Additional examinations are carried out in order to exclude extragenital pathology, masquerading as PMS. With the neuropsychic and cephalgic form of PMS, a consultation with a neuropathologist and a psychiatrist is mandatory. To exclude mass formations in the brain with severe headaches, visual and hearing impairment, CT or MRI can be performed.
On electroencephalograms in patients with PMS, cyclic disturbances in the electrical activity of the brain are recorded.
With mastodynia, after visiting a mammologist, the patient undergoes an ultrasound of the mammary glands or a mammographic examination for exclusion.
The edematous form of PMS requires the study of kidney function, and in order to exclude the presence of cardiovascular pathology, patients with a crisis form of PMS are examined by a therapist.
Self-diagnosis with PMS is unacceptable. The presence of poor health on the eve of menstruation has many reasons and does not always mean PMS.
PMS treatment
Treatment of PMS is a very difficult task, because this condition affects almost all important systems of the body. The close connection of PMS with the hormonal function of the ovaries explains the complete disappearance of all its manifestations after the cessation of menstruation. In young women with preserved menstrual function, complete elimination of PMS is possible only with mild forms of the disease.
Since the only reliable cause of PMS has not been established, therapy is aimed at eliminating pathological premenstrual manifestations. Proper symptomatic therapy can make PMS easier, return to work, and improve quality of life.
Unfortunately, not all patients resort to the help of a doctor; many choose medications for PMS on their own. Self-medication can reduce the symptoms of the disease, but does not guarantee its cure. Any pills taken independently for PMS will not replace a full-fledged complex treatment.
All patients suffering from PMS, regardless of its form, have psycho-emotional disorders due to an incorrect attitude towards their condition. Before starting treatment, they need to explain in detail the essence of the disease itself and tell about the methods of treatment. In order for the patient to form the right emotional mood, and the treatment to have positive results, she is recommended to change her lifestyle: follow a proper diet, be physically active, give up bad habits, and so on. If necessary, sessions with a psychologist are included in the treatment plan.
Drug treatment is selected in accordance with the form of the disease and takes into account the list of existing symptoms. It is also necessary to take into account the data of the observation diary so that the prescribed treatment coincides with or ahead of the appearance of signs of PMS.
With psychoneurological deviations, sedatives and psychotropic drugs are prescribed. In the second phase of the cycle, Oxazepam, Diazepam, Amitriptyline and others are recommended.
With a pronounced edematous form, antihistamines (Tavegil, Suprastin and others) or light diuretics like Spironolactone help. Antihypertensive drugs help to normalize blood pressure, high levels of prolactin are eliminated with the help of Parlodel.
Homeopathic remedies have gained great popularity for the treatment of PMS. Among them there are herbal non-hormonal preparations that can restore the normal functioning of the nervous system, eliminate edema and stabilize the hormonal background. The presence of a large number of homeopathic remedies does not imply their self-administration without a preliminary conversation with a doctor.
There are a large number of symptoms in the arsenal of PMS, so for each patient, individual ways to eliminate them are selected.
With pronounced hormonal abnormalities, resort to the use of hormonal agents. They restore the normal ratio of hormones according to the phases of the cycle. Progestogens are used (Utrozhestan, Duphaston) or monophasic agents like Logest.
For the treatment to be more successful, it is necessary to exclude the onset of ovulation. Zoladex and the like cope with this task.
If PMS recurs many times, hormonal drugs are prescribed for a long time in a continuous rhythm.
PMS therapy lasts several months, and in case of relapses, it has to be repeated. Treatment is considered successful if PMS symptoms decrease or disappear completely.
The information provided in this article is for informational purposes only and cannot replace professional advice and qualified medical assistance. At the slightest suspicion of the presence of this disease, be sure to consult a doctor!
The treatment of PMS consists primarily in the prevention and elimination of the specific symptoms of this condition. Most women are familiar with this syndrome, which occurs about a week before the onset of menstruation. This period acutely affects the mental and physical condition and few can get rid of it. How to do it?
What it is
Premenstrual syndrome (PMS) is a combination of physical and psychological (emotional) symptoms that occur in women after ovulation and. During this period, there is a decrease in estrogen levels and an increase in progesterone. Some time must pass for their concentration in the blood to settle.
About 80% of women of reproductive age suffer from premenstrual syndrome every month. Almost every second woman after 40 years of age faces this problem. In 13-26% of cases, the psychological and physical symptoms are so severe that they interfere with normal daily activities.
The most severe form of PMS with a predominance of mental disorders is premenstrual dysphoric disorder, which occurs in girls in rare cases.
Most women consider this period an integral part of women's lives and are in no hurry to seek professional help.
Many doctors claim that premenstrual syndrome disappears after the first pregnancy. There is some truth in this, since after the birth of a child, hormones change, which has a significant impact on the course of PMS. Often during pregnancy, hormonal drugs are prescribed, which subsequently alleviate the symptoms of PMS or completely eliminate them.
Causes
Although scientists are still trying to explain the causes of the various symptoms of premenstrual syndrome, the main culprits of this condition remain the “warring” hormones estrogen and progesterone. This hormonal imbalance can cause mood swings and pain.
The form and intensity of this state directly depends on the way of life and our emotional state. Some problems associated with PMS are often inherited. It is highly likely that you will also have to go through this period, as your mother or grandmother once did.
Symptoms of the syndrome may worsen as a result of illness or physical exhaustion.
PMS symptoms can also be caused by low levels of serotonin, which is responsible for signaling between brain cells. An unbalanced diet, especially a lack of iron in the body, is also a risk factor. Danger also carries a violation of blood clotting.
Since premenstrual syndrome affects the emotional and mental state, psychological disorders, depression, increased anxiety and other problems of this nature can occur against its background.
Hormones during the menstrual cycle
Signs of premenstrual syndrome
Experts say premenstrual syndrome can include up to 300 signs. This high number is partly due to the fact that there is no definitive diagnosis that can better distinguish PMS from both the normal state and other illnesses such as depression or anxiety disorders.
Most common :
- irritability and mood swings;
- anxiety, tearfulness, depression;
- headaches;
- increased sensitivity and soreness of the mammary glands;
- pain in the lower abdomen;
- bloating, decreased or increased appetite;
- change in libido;
- sleep disorders;
- fatigue;
- swelling of the joints.
All these symptoms can remain during menstruation and disappear after it stops.
PMS treatment
Since most often the main causes of premenstrual syndrome are hormonal imbalance and stress, it is impossible to effectively treat PMS.
Every woman knows what helps her best during this period. Some lie down, while others actively engage in physical activity. Massage of the lower back and the use of warm or cold cream on the massaged area often help.
Video about premenstrual syndrome
Medications to relieve symptoms
To relieve PMS, it is not necessary to immediately resort to the use medicines. It is enough to improve your lifestyle and add relaxation exercises to your regimen.
But if healthy lifestyle life is not able to alleviate your condition, you can use homeopathic remedies, which often completely eliminate all unpleasant symptoms.
Many women who suffer significantly from PMS use hormonal contraceptives. Their main function is to protect against unplanned pregnancy, so every day a woman receives a drug with a certain amount of hormones.
Their concentration in tablets differs from the amount in which they are contained in the female body during ovulation and PMS. During the menstrual cycle, you should stop taking hormones.
Remember that the treatment of PMS with drugs only temporarily removes the symptoms, but does not eliminate the problem and is a kind of "camouflage". In order to in the long run, you need to regulate your diet and change your lifestyle.
Folk remedies
First of all, women should provide themselves with an adequate supply of B vitamins, iron, zinc, magnesium and calcium.
Herbal teas and infusions help to alleviate the condition:
- Half a teaspoon of ground cumin and chopped dill seeds pour 200 ml of boiling water, let it brew for 10 minutes, strain and drink throughout the day.
- Use an aroma lamp, for this, take 3 tablespoons of water, 2 drops of lavender, 2 drops of ylang-ylang and 2 drops of bergamot. Add the resulting mixture to the lamp, light the candle and exit the room. This combination helps to balance emotions and promotes a change in mood for the better.
- 2 tablespoons of olive oil, 3 drops of lavender, 1 drop of lemon balm, 2 drops of ylang-ylang add to the bathroom, it will help relieve tension and relax.
- Mix spinach and carrot juices in a ratio of 1:2. Drink every day on an empty stomach before meals.
Most positive effect Premenstrual syndrome is affected by lifestyle changes.
In order to do this, try following these rules:
- eat small meals and more often;
- limit your intake of salt and salty foods;
- choose food rich in important vitamins and minerals;
- avoid caffeine, alcohol and nicotine;
- go in for sports, it can be walking, cycling, swimming, such activity will help reduce stress, headaches and eliminate sleep problems;
- Contact with loved ones helps prevent social isolation and also affects your mood.
If symptoms persist, a doctor should be consulted for diagnosis. Only specialists will help identify the problem, take appropriate measures and prescribe treatment.