Strong PMS. PMS or premenstrual syndrome - symptoms and treatment. What can you do

Mood swings, outbursts of anger, tearfulness and irritability - the combination of these feelings clearly indicates premenstrual syndrome. Many representatives of the fair sex know what it is, but they are unable to control their condition. Some girls and women feel a noticeable deterioration in their health, and pain before menstruation is a very real reason to see a doctor.

Complex mechanism

Menstruation in women is directly related to procreation. The first day is considered the beginning of the cycle, and each stage is aimed at preparing for conception.

During the menstrual phase, the lining of the uterus is shed, which is accompanied by bleeding. The first appearance of menstruation occurs on average at 12-14 years of age. Over time, the cycle is established, and its duration ranges from 21 to 35 days.

The absence of menstruation can signal pregnancy or serious illness. Besides, women Health deserves special attention for various disorders, such as dysmenorrhea (painful menstruation) or increased bleeding.

If we add to these problems the manifestations of premenstrual syndrome, then some girls and women will definitely not be envied.

Story

PMS (premenstrual syndrome) is a complex set of symptoms that manifests itself in women on average 1-10 days before menstruation. People have been studying this condition since ancient times. IN Ancient Rome, for example, doctors associated ailments before menstruation with the place of residence and even with the phases of the moon.

According to official data, Russian scientists Dmitry Ott and Alexander Reprev conducted the first Scientific research concerning physiological parameters and the cyclicity of their fluctuations. Then Robert Frank coined the term “premenstrual tension” in his article in 1931, and ten years later psychosexual disorders during PMS were described by Lewis Gray.

Research and scientific evidence have allowed the World Health Organization to include premenstrual syndrome in its classification of diseases. What it is, diagnostic methods, reasons for its appearance, recommendations for alleviating the condition - read about all this in our review.

Causes

Today there is no consensus regarding the occurrence of PMS, but experts still managed to formulate a number of reasons:

Hereditary predisposition;

Violation of water-salt metabolism;

Hormonal imbalances;

Thyroid diseases;

Lack of vitamins (magnesium, zinc, calcium, vitamin B6).

Risk factors for the development of PMS include the presence of depression and stress, living in major cities, late reproductive age, insufficient physical activity and nutritional imbalance.

Some studies show that overweight and smoking affect the likelihood of developing premenstrual syndrome.

Symptoms

There are a huge number of jokes and humorous stories about premenstrual syndrome in women. However, the impressive list of symptoms leaves little reason for cheer.

Modern medicine identifies the following forms of PMS:

Neuropsychic. This form is characterized by symptoms such as heightened perception of noise, increased fatigue, weakness, sleep disturbances, absent-mindedness, headaches, difficulty speaking and even fainting. Aggression and irritability often lead to conflicts in the family and at work, as well as to making rash decisions.
Edema. Gaining a few kilograms of weight does not improve your mood at all; swelling of the legs and arms appears. Sometimes girls and women experience joint pain and cramps. the whole body seems filled with fluid.
Cephalgic. There are throbbing headaches that are accompanied by nausea or vomiting. However, blood pressure remains unchanged. In addition, a third of patients experience pain in the heart, numbness of the hands, increased sweating and depression.
Krizovaya. the beginning of which is an increase in blood pressure. Then there is a rapid heartbeat and fear of death. Such attacks most often occur in the evening and at night, and the situation is aggravated by various stresses, fatigue or infectious diseases.

Experts also identify an atypical form of PMS, the symptoms of which include allergic reactions, skin rashes, nagging pain in the lower back and lower abdomen, nosebleeds, and elevated body temperature.

Stages of PMS

In medicine, PMS is divided into three stages:

Compensated (symptoms disappear with the onset of menstruation, the disease does not develop with age);

Subcompensated (symptoms cease to bother you with the end of menstruation, the clinical picture of premenstrual syndrome worsens over the years);

Decompensated (symptoms appear several days after the end of menstruation).

As you may have already noticed, PMS in some cases is not at all like a mild illness. In severe form, this disease can seriously affect your ability to work and your well-being. Of course, there is no need to panic due to increased fatigue or muscle pain. However, if you notice more than six symptoms, be sure to make an appointment with a doctor who, with the help of tests, can diagnose “premenstrual syndrome.”

Diagnostics

It is very important to distinguish real symptoms from the inability to control your emotions and manifestations of bad manners or bad character. Premenstrual syndrome is characterized by cyclicity. In other words, the same symptoms should bother a woman with a certain frequency.

Premenstrual tension syndrome is often confused with other diseases, so consult a specialist for an accurate diagnosis. During the diagnosis, a blood test is required (in different phases menstrual cycle). The level of hormones (progesterone, estradiol and prolactin) allows us to draw conclusions about the form of PMS.

Depending on the results of the analysis and the patient’s complaints, the attending physician may refer her to other specialists (psychiatrist, endocrinologist, therapist and neurologist) or prescribe additional tests (MRI, mammography, EEG, blood pressure monitoring and others).

How to relieve premenstrual syndrome?

Millions of women ask this question, fully aware that living in poor health and mood for even a week is simply unbearable. The most accessible measure is to review your diet.

It is believed that the use complex carbohydrates(cereals and vegetables) helps to cope easier before menstruation. Some experts also talk about limiting the consumption of sweets and sugar, but from the point of view of alleviating PMS symptoms, this measure has not been fully studied.

It is advisable to control salt intake, because the body already has a tendency to edema associated with fluid retention. Salty foods only make the situation worse.

And finally, coffee. Studies have shown that women with severe PMS drink much more coffee. Today there is no clear opinion about whether the invigorating drink and premenstrual syndrome are related. What it is and the reasons for its occurrence are already known to us, but whether coffee helps or worsens the situation should probably be decided on an individual basis.

Lifestyle

Pain before your period can make serious adjustments to your plans. However, experts advise not to give up light physical activity. Swimming, walking, yoga or dancing can help reduce symptoms and definitely improve your mood.

If you have chest pain before your period, then cope with unpleasant sensations And hypersensitivity Supportive underwear will help.

Of course, you shouldn’t expect immediate disappearance of PMS symptoms, but you can draw the first conclusions after 3-4 months. In most cases, these recommendations eliminate the need for drug treatment.

As alternative methods of combating premenstrual syndrome may be recommended different kinds massage, physiotherapy, reflexology and balneotherapy.

Many experts who study women's health consider acupressure to be the most effective. Stimulation of biologically active points increases vitality and enhances the body's ability to self-regulate.

Drug treatment

Pharmacotherapy is the main method, but a complete cure will definitely not help. It is believed that PMS is chronic illness, and some drugs only improve quality of life by relieving symptoms.

Please note that all medications are prescribed by a doctor, and no life stories or advice from “friends in misfortune” can replace consultation with a specialist. Our review is for informational purposes only, and if you think that one of the drugs could help you, be sure to discuss this issue with your doctor.

Depending on the form of PMS, the following groups are distinguished:

Combined oral contraceptives.
Drugs to treat symptoms.
Hormonal drugs.
Diuretics.
Antidepressants.
Antiprostaglandin drugs.

Vitamins and minerals

Patients with a mild form of premenstrual syndrome are not primarily prescribed hormonal drugs- homeopathy, vitamins and minerals. Efficiency and minimal side effects are the main advantages of such products. In addition, non-hormonal drugs are not perceived “as medicine.”

According to research, calcium carbonate helps reduce swelling and bloating. Calcium carbonate affects fluid retention and increased appetite, and B vitamins can cope with the psycho-emotional manifestations of the disease.

Diuretics

These are diuretics, the prescription of which is justified for the edematous form of PMS. Veroshpiron is considered one of the most effective and safest). The drug increases the excretion of sodium and chlorine ions, water, and reduces the titratable acidity of urine. Has a hypotensive effect.

As an initial daily dose Prescribe 25 mg (maximum 100 mg). Experts consider it advisable to take diuretics during the period of expected fluid retention, that is, from the 16th to the 25th day of the menstrual cycle.

Among side effects observed: hypotension, drowsiness, decreased libido and

COOK

The use of combined oral contraceptives is the most common tactic in the treatment of premenstrual syndromes. Today, attending physicians prefer COCs containing drospirenone. This substance is an analogue of natural progesterone.

The composition of one of the most famous drugs called "Yarina" is a combination of the gestagen drospirenone (3 mg) and ethinyl estradiol (30 mcg). Patients taking this COC experienced a slight decrease in body weight and no fluid retention in the body. In addition, drospirenone affects the secretion of the sebaceous glands, which reduces the number of skin rashes before menstruation.

Contraceptives containing drospirenone have minimal side effects. However, despite the effectiveness of the drug, PMS symptoms(swelling, breast tenderness, headaches and bloating) may return after a seven-day break. For this reason, it is advisable to introduce an extended regimen of COCs.

Antidepressants

For elimination psychological symptoms The attending physician most often prescribes antidepressants (Sertraline, Fluoxetine), the effectiveness of which has been proven by many clinical studies.

In the treatment of premenstrual syndrome, in contrast to the treatment of depression, these drugs are prescribed in shorter courses and in lower doses. There are two treatment regimens:

Taking medication when a symptom occurs;

Taking medication in the second half of the menstrual cycle.

For many representatives of the fair sex, taking antidepressants is effective method, which allows you to eliminate symptoms almost completely.

However, in some cases, the achieved result is not enough, so the doctor may decide to increase the dose or prescribe another drug.

Taking antidepressants should be accompanied by keeping a diary and detailed notes about how you feel. Despite the fact that improvement may occur within two days after the start of the course, a competent specialist will draw conclusions about the effectiveness only after observing 2-4 menstrual cycles.

In rare cases, stopping antidepressants may cause nausea, dizziness, and irritability. Fortunately, these symptoms go away quite quickly.

ethnoscience

Antidepressants, hormonal drugs and oral contraceptives have many side effects, so first of all, the fair sex remembers traditional methods.

So, what herbs will help us overcome PMS:

Melissa. Prepare a healing infusion at the rate of 2 tbsp. l. dry plant per glass of boiling water. This drink eliminates irritability, calms and relieves pain. A mixture of lemon balm, chamomile, jasmine, mint and valerian will help improve the result.
Calendula, plantain leaves, calamus root and arnica flowers. Gauze strips are moistened with the infusion and applied to the body to reduce swelling.
Yarrow and jasmine. For lower back and abdominal pain, pour boiling water over yarrow (40 g) and jasmine flowers (30 g). You need to drink three cups of infusion a day.

Myth or reality?

So, we are talking about such an ailment as premenstrual syndrome. Many girls and women know very well what it is, but only 3-6% of the fairer sex are diagnosed with premenstrual dysphoric disorder (PMDD). This disease leaves a serious impact, limits communication with people and social life, and also increases the number of days of disability. In patients with mental illnesses, their exacerbation is observed.

Interestingly, some scientists generally question the presence of pathologies such as PMDD and premenstrual syndrome. The causes of the latter have not been proven at all, and most studies rely only on reports of well-being. Agree, such a point of view has a right to exist. Moreover, Western girls and women often almost consciously expect the appearance of PMS, as if they are programming themselves to feel its certain symptoms.

PMS is a specific manifestation that occurs in women 2-10 days before the start of the menstrual cycle, and disappears in the first days of menstruation. On other days, signs of PMS are not observed.

Premenstrual manifestations include neuropsychiatric signs, as well as metabolic disorders and VSD. Every representative of the fair sex has experienced signs of PMS at some point. But only every tenth woman has very severe disorders.

Causes of PMS

Today, gynecologists do not have a clear answer to what causes and factors influence the development of PMS in a woman. One of the factors that provoke severe PMS is called gynecological operations and injuries, severe stress, infections, abortions.

There is an opinion that premenstrual syndrome is affected by hormonal changes that occur in a woman before the onset of menstruation.

The most common belief is that the reasons that determine the development of premenstrual syndrome are the hormonal fluctuations that occur in the female body during the menstrual cycle. These observations underlie hormonal theories of the origin of premenstrual syndrome.

Moreover, to the most common reasons, causing severe PMS include:

hyperprolactinemia (change in prolactin secretion);
disorders of the thyroid gland;
genetic factors;
lack of certain vitamins in the body;
neuropsychological factors;
Impaired kidney function, causing water and sodium retention in the body.

Some gynecologists are of the opinion that the causes of premenstrual syndrome are individual in each clinical case. As a result, diagnosing PMS can be quite difficult.

Premenstrual phenomena, depending on the prevailing symptoms, can occur in the following forms:

cephalgic;
neuropsychic;
crisis;
edematous.

The cephalgic form of PMS is accompanied by severe headaches, the epicenter of which is in the temples. A woman complains of throbbing, twitching painful sensations, which may be accompanied by nausea and dizziness.

When performing an MRI, changes in the pituitary gland are detected in the majority of the fair sex suffering from the cephalgic form of PMS.

Premenstrual syndrome of the neuropsychic form is accompanied by severe emotional stress. Representatives of the fairer sex at a young age deteriorate in mood, and more mature ladies these days become irritable and often show aggression.

In women suffering from a crisis form of PMS, signs of vegetative-vascular dystonia can be observed:

pressure surges;
fear of death;
lack of air;
pressing pain in the chest.

The attacks begin in the evening and are accompanied by coldness and numbness of the extremities, and rapid heartbeat.

With the edematous form of PMS, swelling of the eyelids, face, and legs is observed. A woman complains of itching, bloating, and increased reaction to strong odors. As fluid is retained in the body, weight may increase.

PMS symptoms

Every girl or woman has different symptoms of premenstrual syndrome. Depending on the individual characteristics of the body, the signs of PMS are expressed differently.

The most common symptoms include:

sudden change in mood (tearfulness, fear, aggression, irritability, depression, etc.);
dizziness and headache;
increased appetite, and, as a result, weight gain;
painful sensations in the legs, lower back, chest or lower abdomen;
increased heart rate;
swelling;
fatigue and fatigue.

Based on the severity of symptoms, premenstrual syndrome occurs in mild or severe form.

With a mild form of PMS, a woman complains of 2-4 symptoms. But if there are more than five symptoms, then we are talking about a severe form of the disease

In addition, when severe course PMS in the fair sex reduces the ability to work.

There are 3 stages of PMS development:

compensation – symptoms go away with the onset of menstruation, PMS does not progress with age;
subcompensation - symptoms continue throughout menstruation, and their severity worsens, and over the years the symptoms become more acute;
decompensation is a severe course of premenstrual syndrome, the symptoms have practically no “bright” intervals.

Diagnosis of PMS

The diagnosis of the disease is not always obvious, since it has numerous non-gynecological symptoms. Sometimes women spend years being examined by various doctors, trying to cure the consequences of the disease, but do not find the root cause.

Only a gynecologist can diagnose PMS. The doctor will examine the history of the woman who contacted him and get acquainted with the complaints that have arisen. If a woman experiences a cyclical pattern of certain symptoms that disappear when her period comes, then most likely the doctor will diagnose premenstrual syndrome.

To make sure of the diagnosis, you will need to track hormonal levels in the blood, which are checked at various phases of the menstrual cycle.

In addition, the gynecologist may prescribe the following diagnostic tests:

Doctors advise representatives of the fair sex to keep a diary in which they record the symptoms of the disease day by day. The records will help the gynecologist determine the diagnosis, as well as monitor the dynamics of treatment. If a woman does not know what PMS is and how to deal with this disease, the doctor will definitely explain what is happening in her body.

The form of the disease can be determined by testing blood levels of prolactin, progesterone and estradiol. The level of prolactin increases in crisis, neuropsychic and cephalgic forms of the syndrome. But the edematous form is characterized by a decrease in the level of progesterone hormone (in the second half of the cycle).

If a woman complains of pain or swelling of the mammary glands, she may be prescribed an ultrasound or mammogram. Research will help rule out other pathologies.

Most researchers believe that premenstrual syndrome in varying forms and severity is present in all representatives of the fair sex. This opinion is correct. But minor health problems develop into serious illnesses if you do not pay attention to the symptoms and do not consult a doctor.

As a rule, symptomatic treatment is prescribed, which significantly improves the woman’s well-being.

PMS treatment

To alleviate premenstrual syndrome, the doctor prescribes treatment according to the following scheme:

diet;
consultation with a psychotherapist;
physical therapy;
drug treatment.

Let's look at each point in more detail.

Diet and lifestyle

Your daily diet should include foods rich in plant fiber. Fiber helps remove excess fluid from the body and also normalizes the functioning of the gastrointestinal tract.

During the day, the body of a woman suffering from PMS should receive 10% fat, 15% protein and 75% complex carbohydrates. The content of animal fats in the diet should be kept to a minimum, since they affect the liver, which is involved in the production of estrogen.

In addition, you should try to avoid beef, as this meat contains hormones. But protein can be obtained from fermented milk products.

Lemon and lemon juice are beneficial for PMS. carrot juice. Herbal tea with the addition of herbs (valerian, lemon balm or mint) is very soothing. Herbal infusions will improve sleep and help a woman cope with the irritability that always accompanies PMS.

For premenstrual syndrome, caffeine-containing drinks (Coca-Cola, coffee and strong tea) are contraindicated. Caffeine promotes engorgement of the mammary glands. In addition, coffee drinks cause irritability and disrupt the normal process of removing fluid from the body.

Try to lead an active lifestyle, play sports and walk outdoors more often. In spring and winter, take a vitamin-mineral complex.

The tips listed above will not only ease the symptoms of premenstrual syndrome, but also increase immunity, thereby improving health.

Consultation with a psychotherapist

A professional psychotherapist will help a woman cope with symptoms such as aggression, tearfulness and sudden mood swings. The psychotherapist will tell the fair sex how to alleviate the symptoms of PMS, teach her to relax and forget about the upcoming menstruation.

It is advisable to conduct psychotherapy sessions not only with a woman suffering from PMS, but also with her loved ones, including her husband. Close people will learn to understand the patient’s condition and help her relieve premenstrual tension syndrome.

Drug treatment

If a woman experiences severe symptoms that prevent her from leading a normal lifestyle, she should urgently consult a doctor.

Consider the groups medicines that will help cope with premenstrual syndrome:

If a woman has hyperestrogenism, the doctor may prescribe gestagens (Norkolut, Dufastan or Danazol).
For PMS of the cephalgic form, nootropics can be prescribed that will restore vascular regulation. It is recommended to repeat courses of Aminalon or Nootropil for three months, and then take a break and monitor the patient’s condition.
If an increase in the hormone prolactin is detected in a woman’s blood, she may be prescribed bromocriptine (for ten days).
For severe pain, Diclofenac may be indicated, which suppresses the synthesis of biologically active substances that provoke PMS symptoms.
If a woman suffers from an edematous form of the disease, then potassium-sparing diuretics are indicated for her. Diacarb may also be indicated.
Tranquilizers will help cope with depression. A psychotherapist, after a thorough examination, may prescribe antidepressants or antipsychotics to the patient. It is recommended to take the drugs for three to six months.
Vitamin preparations of groups E and A have a beneficial effect on the female reproductive system. Vitamin B6 and magnesium will help relieve depression and anxiety.

Premenstrual phenomena are treated with cycles. The first 90 days a woman is prescribed therapeutic diet, GPP, vitamin-mineral complex and sedatives. After the treatment course, you need to take a break of six months.

If signs of the disease return again, the doctor adds more powerful medications to the treatment regimen. But you shouldn’t expect an immediate effect from the treatment. Treatment, carried out under the supervision of a doctor, is long-term. At the same time, the patient should not forget to control her lifestyle and monitor her diet.

Treatment of premenstrual syndrome with folk remedies

Blue cornflower. A tablespoon of flowers should be poured into 250 ml of boiling water and left under the lid for half an hour for the infusion to infuse. It is recommended to take the finished infusion ½ glass 2-3 times a day.
Melissa. We will need a glass of boiling water and two tablespoons of herbs. Pour boiling water over the lemon balm and leave to steep for two hours. Then the broth should be strained and drunk instead of tea.
Dandelion. Take the roots of the flower (1 tablespoon) and pour a glass of boiling water over them. Let the broth sit under the lid for several hours. The resulting herbal tea is recommended to be taken 50 ml several times a day.
Lavender and mint tea. Brew the herb with boiling water and can be consumed instead of green tea.
Valerian infusion. It is recommended to drink 20–30 drops per day as a tincture that calms the nerves.
Calendula tincture. It is recommended to take the finished tincture before meals three times a day, 10 drops.
Aromatic oils. Sage, lavender or tea tree oil helps to calm down, relax and forget about PMS symptoms. Light an aroma lamp with oil in the bedroom and leave it for several hours.
Oregano and St. John's wort. It is recommended to add 1/3 tablespoon of oregano and 2/3 tablespoon of St. John's wort to a glass of boiling water. The infusion should stand covered for about an hour. When the herbal tea has cooled, it can be taken half an hour before meals, 50-70 ml. If you want to acidify the drink, you can add a slice of lemon to it.
Blooming Sally. It is recommended to pour a tablespoon of herb into ½ liter of water and place the saucepan with the liquid on low heat. After the broth boils, keep it on the fire for three minutes, and then, after removing it from the stove, wrap it in a towel and leave to infuse for an hour. Strain the finished herbal tea through a strainer and take 50 ml before meals.

Recommendations for representatives of the stronger sex if a woman has signs of PMS

If his wife begins to experience PMS, the man must understand that she is not to blame for her bad mood. This is a real disease that affects most of the fairer sex.

During a crisis, a man should try to help his lady in his life at home and in the kitchen.

It is advisable to determine for yourself the days when your wife begins to feel unwell. Invite her to go to the cinema, chat with friends, or go on vacation at this time.

Premenstrual syndrome (PMS) (also called premenstrual tension, cyclic or premenstrual illness) is a complex of physical and mental symptoms that are cyclical and occur several 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 has been revealed that the risk of developing PMS increases over the years. According to statistics, city residents are more susceptible to this disease than rural ones. About ninety percent of women of reproductive age experience some changes in their 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 daily life(mild form of PMS), accordingly, do not require treatment, but in others (about 3-8%), the symptoms manifest themselves in a severe form, requiring mandatory medical intervention. The fact that certain symptoms manifest themselves cyclically makes it possible to distinguish PMS from other diseases.

Changes of an emotional and physical nature in a woman’s state before menstruation pass almost immediately after their onset. 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 a more serious illness. IN in this case Consultation with a psychiatrist is recommended.

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

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, overly concerned about their health).
Hormonal imbalances, namely, disturbances in the levels of the hormones estrogen and progesterone in the second phase of the menstrual cycle (the level of estrogen increases with insufficient function corpus luteum with a decrease in progesterone levels, which affects the nervous and emotional state of a woman).
Increased secretion of the hormone prolactin, against the background of which changes occur in the mammary glands.
Various thyroid diseases.
Inadequate nutrition: lack of vitamin B6, as well as zinc, magnesium, calcium.
Cyclic fluctuations in the levels of certain substances (neurotransmitters) in the brain (particularly endorphins) that affect mood.

Symptoms of premenstrual syndrome.
As mentioned earlier, with the onset of menstruation, PMS symptoms completely disappear or are significantly reduced. There are several main forms of PMS that have pronounced symptoms:

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

Taking into account the number of symptoms of premenstrual syndrome, diseases are distinguished into mild and severe forms:

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

Impaired ability of a woman to work during menstruation indicates a severe course of PMS, which in this case is often accompanied by mental disorders.

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 a woman’s ability to work, and over the years the manifestations of PMS only get worse;
decompensated stage, expressed in severe symptoms that persist for several days after the end of menstruation.

In most cases, women with premenstrual syndrome do not seek medical help, considering it a natural phenomenon. The symptoms of PMS are very similar to those during short term pregnancy, so many women confuse them. Some people try to cope with the symptoms of PMS on their own, taking painkillers and often antidepressants without a doctor’s prescription. Most often, the use of this kind of medication helps to temporarily weaken the manifestations of PMS, but a long absence of proper treatment leads to the transition of the disease to the decompensated stage, so you should not delay visiting a gynecologist.

Since the symptoms of premenstrual syndrome are quite extensive, some women confuse it with other diseases, often turning to the wrong specialists (therapist, neurologist, psychiatrist) for help. 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 medical history and listens to any existing complaints. The cyclical nature of attacks is the first sign of PMS.

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

After this, taking into account the patient’s form and complaints, additional studies are carried out (mammography, MRI, blood pressure control, electroencephalography, measurements of daily diuresis, etc.) with the involvement of other specialists (endocrinologist, neurologist, 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 write down their complaints in detail every day in a kind of diary.

Treatment of premenstrual syndrome.
Treatment is carried out comprehensively, regardless of the form of the disease.

To eliminate psycho-emotional manifestations, psychotropic and sedatives: sedatives Seduxen, Rudotel and antidepressants Tsipramine, Coaxil. It is recommended to take these medications for two months in both phases of the menstrual cycle.

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

gestagens (Utrozhestan and Duphaston) during the second phase of the menstrual cycle;
monophasic combined oral contraceptives (Zhanine, 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) in the presence of severe pain in the mammary glands;
premenopausal women are prescribed GnRH agonists (gonadotropin-releasing hormone agonists) - Zoladex, Buserelin, which block the process of ovarian functioning, excluding ovulation, thereby eliminating the symptoms of PMS.

If there is excessive secretion of prolactin in the second phase of the menstrual cycle, dopamine agonists (Parlodel, Dostinex) are prescribed. To eliminate edema, diuretics (Spironolactone) are prescribed, and for high blood pressure, antihypertensive drugs are prescribed.

Symptomatic therapy is carried out in the form of additional treatment 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.

For the treatment of premenstrual syndrome, homeopathic medications are often prescribed, in particular Mastodinon and Remens are herbal non-hormonal remedies, 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 of a psychological nature (irritability, feelings of anxiety and fear, tearfulness). Mastodinon is often recommended for the edematous form of the disease, including chest pain. It is prescribed to be taken twice a day, thirty drops, diluted with water, for three months. If the drug is in tablet form, then take one tablet twice a day. The drug Remens is also taken for three months, ten drops, or one tablet three times a day. Both drugs have virtually 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 is a lack of B vitamins and magnesium, then vitamins of this group (Magne B6), as well as calcium to prevent osteoporosis and iron to combat 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 recovery process, as well as 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 PMS manifestations such as migraines), include fish, rice, dairy products, legumes, vegetables, fruits, and herbs in the diet. To maintain insulin levels in the blood, it is recommended to eat at least five to six times a day in small portions.
Exercising two to three times a week helps increase the level of endorphins that improve your mood. However, you should not overuse exercise, as excessive amounts only aggravate the symptoms of PMS.
It is necessary to monitor your emotional state, try not to be nervous, avoid stressful situations, get enough sleep (at least eight to nine hours of full 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.
It is recommended to take as much vitamin C as possible. It has been proven that women with PMS get sick more often, this is due to weakening immune system before menstruation, making her vulnerable to viral and bacterial infections.

Complication of PMS.
Lack of timely treatment threatens the transition of the disease to the decompensated stage, characterized by severe depressive disorders, cardiovascular complications (high blood pressure, rapid heartbeat, heart pain). In addition, the number of symptom-free days between cycles decreases over time.

Prevention of PMS.

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

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What is PMS (premenstrual syndrome)

Premenstrual syndrome (abbreviated as PMS, or as it is sometimes mistakenly called “postmenstrual syndrome”) is a complex set of negative symptoms that occurs in women in the days leading up to menstruation. Premenstrual syndrome (PMS) can manifest itself in a number of neuropsychic, metabolic-endocrine or vegetative-vascular disorders, and the symptoms of PMS are individual for each patient.

According to statistics, premenstrual syndrome (PMS) affects, according to various sources, from 50 to 80% of all women on the planet. Many of them are in a fairly mild form, in which there is no need to see a doctor. However, you need to know that over time and under the right circumstances, PMS can progress, so if you experience any pain or nervous disorders before menstruation, try to prevent the situation from worsening.

It happens that changes in a woman’s well-being or behavior occur after the onset of menstruation. Since this happens after 2-3 weeks, many people mistakenly call it postmenstrual syndrome.

In general, according to the doctors of our medical center, women aged 20 to 40 years most often suffer from PMS; cases of premenstrual syndrome occurring together with the onset of menarche are less common, and even less common in the premenopausal period.

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Symptoms of PMS (premenstrual syndrome)

Gynecologists and specialists in this field say that there are about 150 symptoms of premenstrual syndrome (PMS), which, moreover, occur in different combinations. However, the most common of them are the following: slight weight gain, pain in the lower back and pelvic organs, bloating, nausea, hardening and tenderness of the mammary glands, increased fatigue, irritability, insomnia or, in some cases, on the contrary, excessive drowsiness.

Most young women say that in the days leading up to menstruation, they often experience not only physical, but also emotional and psychological discomfort. Many experience attacks of unreasonable aggression; inappropriate behavioral reactions, tearfulness, and rapid mood swings may be observed. At the same time, it has been noticed that some women unconsciously experience fear of the onset of PMS and menstruation, and therefore become even more irritable and withdrawn, even before the onset of this period.

At one time, studies were conducted aimed at clarifying the effect of PMS on a woman’s activity and ability to work. Their results turned out to be very disappointing. Thus, the last few days of the menstrual cycle account for about 33% of cases of acute appendicitis, 31% of acute viral infections and respiratory diseases, about 25% of women are hospitalized during this period. 27% of women during postmenstrual syndrome begin to take tranquilizers or some other drugs that affect the neuropsychic state, which also negatively affects both their future health and ability to work.

As Fyodor Nikolaevich Usatenko, a gynecologist at our medical center Euromedprestige, notes, in clinical practice there are four most common forms of premenstrual syndrome. The first form of postmenstrual syndrome is neuropsychic, characterized by weakness, tearfulness, depression or, conversely, excessive and unreasonable irritability and aggression. Moreover, the latter, as a rule, predominates among young girls, while slightly older women are more often susceptible to depression and melancholy.

The edematous form of PMS is characterized by hardening, swelling and tenderness of the mammary glands, swelling of the face, legs and hands, and sweating. With this form of PMS, sensitivity to smells is sharply expressed, and a change in taste sensations is possible. Many women suffering from this type of premenstrual syndrome believe that the cause of such conditions is respiratory or viral infections and seek help from a therapist. Meanwhile, gynecologists at our medical center recommend that you carefully monitor yourself and, if symptoms occur exclusively before the onset of menstruation, visit a gynecologist. In this case, only he will be able to prescribe the appropriate treatment for you.

The third form of PMS is called cephalgic. With this form of PMS, a woman experiences headaches, nausea, sometimes vomiting, and dizziness. About a third experience heart pain and a depressed psychological state. If a cranial x-ray is performed in this situation, you can see an increase in the vascular pattern in combination with hyperostosis (overgrowth of the bone layer). In addition, the amount of calcium in a woman’s body changes, which can lead to fragility and brittle bones.

And finally, the last, so-called crisis form of postmenstrual syndrome (PMS), manifests itself in the appearance of adrenaline crises, which begin with a feeling of squeezing under the chest and are accompanied by a significantly increased heart rate, numbness and coldness of the arms and legs. Frequent and copious urination may occur. In addition, half of the women say that during such crises they experience a very heightened fear of death, which negatively affects their mental and emotional state.

As noted by specialists from our medical center, the crisis form of PMS is the most severe and requires mandatory medical intervention. Moreover, it does not arise on its own, but is a consequence of the untreated previous three forms. Therefore, for any negative symptoms and deterioration in general health in the days preceding menstruation, it is best to consult a gynecologist, since only he will be able to determine how serious the situation is and prescribe the necessary treatment.

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Causes of PMS (premenstrual syndrome)

For several decades, medical scientists have been trying to figure out the causes and factors that lead to the occurrence of premenstrual syndrome. Today, there are several theories, but none of them can explain all the symptoms that accompany PMS.

The most complete theory so far is considered to be the hormonal theory, according to which premenstrual syndrome is a consequence of an imbalance of estrogen< и прогестерона в организме женщины. Наиболее обоснованной в рамках этой теории является точка зрения, говорящая о гиперэстрогении (избытке эстрогенов). Действие этих гормонов таково, что в большом количестве они способствуют задержке жидкости в организме, что, в свою очередь, вызывает отеки, набухание и болезненность молочных желез, головную боль, обострение сердечно-сосудистых проблем. Кроме того, эстрогены могут скапливаться в лимбической системе организма, влияющей на нервно-эмоциональное состояние женщины. Отсюда — депрессивные или агрессивные состояния, раздражительность и т.п.

Another theory, the theory of water intoxication, suggests that PMS symptoms appear when there are disturbances in the water-salt metabolism of fluids in the body. In addition, there is an opinion that PMS is a consequence of vitamin deficiency, in particular, a lack of vitamins B6, A, magnesium, calcium, and zinc. However, this has not yet been fully tested in practice, although in some cases vitamin therapy gives a positive result in the treatment of PMS. Also, some doctors talk about a genetic factor in the development of premenstrual syndrome.

At our medical center "Euromedprestige", gynecologists and gynecological endocrinologists are of the opinion that the basis of premenstrual syndrome is not one reason, but a combination of them, and for each woman they can be individual. Therefore, before prescribing treatment, our doctors conduct a comprehensive mini-examination in order to make the most accurate diagnosis.

Treatment of PMS (premenstrual syndrome)

The direction of treatment for premenstrual syndrome (PMS) is largely determined by individual characteristics female body and the symptoms that the patient experiences. Common to all forms of PMS is the advice to keep a menstrual calendar, and, if possible, write down your feelings in the days before menstruation. This clearly shows whether a woman has PMS or whether the causes of the malaise lie in another, non-gynecological disorder.

Doctors practice in our medical center complex treatment premenstrual syndrome, including the use of sex hormones, vitamins, and other medicines as needed, as well as special diet and physical therapy. The last two methods are recommended in any case, whatever the symptoms. Drug therapy is prescribed by the doctor at his own discretion.

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Hormonal theory of PMS

Let's talk a little about what medications are prescribed to women suffering from premenstrual syndrome (PMS). Firstly, these are synthetic analogues of natural gestagen hormones, which help restore hormonal balance and eliminate the manifestations of PMS. They have been used for quite a long time, since about the 50s of the twentieth century, and remain popular to this day, as they are effective in most cases. Rarely, but still there are situations in which gestagens are not recommended to be used due to the individual characteristics of a woman’s hormonal system. Therefore, before prescribing treatment, specialists at our Euromedprestige medical center first conduct a study using functional diagnostic tests, and also examine the level of hormones in the patient’s blood. All this allows us to draw a conclusion about the possibility of using gestagens for the treatment of PMS. If there are contraindications, the doctor selects another treatment using other medications.

Treatment of PMS with vitamin preparations usually includes the use of vitamins A and E in combination. A series of approximately 15 injections is performed. In addition, at the discretion of the specialist and on the basis of analysis, magnesium, calcium or vitamin B6 may be prescribed for the treatment of PMS, which activates estrogen metabolism and prevents their accumulation.

Diet also takes important place in the treatment of premenstrual syndrome. It is based on the fact that a woman should consume food that contains a sufficiently large amount of fiber. The approximate ratio of proteins, fats and carbohydrates should be 15%, 10% and 75%. It is worth limiting beef, as some types contain artificial estrogens, and reducing the amount of fat consumed due to the fact that they can negatively affect the liver and cause fluid retention in the body. Excess proteins are also not recommended, as they increase the body's need for mineral salts, due to which the water-salt exchange may be disrupted.

The theory of water intoxication in postmenstrual syndrome

In addition to foods rich in fiber, a woman suffering from PMS can be advised to eat more vegetables, fruits, and drink herbal teas and juices, especially carrot and lemon. But drinks containing caffeine should be avoided, as this component can increase irritability, anxiety and sleep disturbances. The same applies to alcohol, but its effect is even more negative, since it directly affects the liver, reducing its ability to process hormones, and thus estrogens accumulate in the body.

Physiotherapy is also quite effective for premenstrual syndrome (PMS). The woman is offered therapeutic aerobics or special hydrotherapy< в сочетании с массажем. Доказано, что physical exercise can relieve stress and balance the hormonal system. However, you should not get involved in sports such as weightlifting, boxing, etc. Too strong physical exercise not only do they not treat, but also aggravate the course of premenstrual syndrome (PMS). Gynecologists at our medical center recommend that women suffering from PMS engage in sports such as jogging, walking, and cycling on level ground at low speed. First, of course, you should consult a doctor who will select the best exercise regimen.