PREMENSTRUAL TENSIONS SYMDROMES (SIGNS AND SYMPTOMS (• Depressed mood,…
PREMENSTRUAL TENSIONS SYMDROMES
Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding.
Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:
• Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.
• Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that's thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.
• Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.
SIGNS AND SYMPTOMS
• Depressed mood
• Crying spells
• Mood swings and irritability or anger
• Appetite changes and food cravings
• Trouble falling asleep (insomnia)
• Social withdrawal
• Poor concentration
• Change in libido
Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) — which include fluoxetine (Prozac, Sarafem), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and others — have been successful in reducing mood symptoms. SSRIs are the first line treatment for severe PMS or PMDD. These medications are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.
Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking water pills (diuretics) can help your body shed excess fluid through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.
Hormonal contraceptives. These prescription medications stop ovulation, which may bring relief from PMS symptoms.
The woman's chief complaint is one or more of the emotional symptoms associated with PMS (most typically irritability, tension, or unhappiness).
Symptoms appear predictably during the luteal (premenstrual) phase, reduce or disappear predictably shortly before or during menstruation, and remain absent during the follicular (preovulatory) phase.
The symptoms must be severe enough to interfere with the woman's everyday life
Hormonal contraception is commonly used; common forms include the combined oral contraceptive pill and the contraceptive patch. This class of medication may cause PMS-related symptoms in some women, and may reduce physical symptoms in other women. They do not relieve emotional symptoms.
Progesterone support has been used for many years but evidence of its efficacy is inadequate.
Gonadotropin-releasing hormone agonists can be useful in severe forms of PMS but have their own set of significant potential side effects.