PMS appears. “What is PMS - everything you need to know about premenstrual syndrome”

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. Some of the factors that provoke severe PMS are gynecological operations and injuries, severe stress, infections, and 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.

In addition, the most common causes of 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, with severe PMS, the fair sex’s ability to work is reduced.

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 carrot juice are beneficial for PMS. 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.

Let's consider a group of medications 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. For the first 90 days, a woman is prescribed a therapeutic diet, dietary supplements, a vitamin and 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 spouse begins to feel unwell. Invite her to go to the cinema, chat with friends, or go on vacation at this time.

Premenstrual syndrome is a symptom complex that is characterized by neuropsychic, metabolic-endocrine and vegetative-vascular disorders that occur in the second phase of the menstrual cycle (about 3-10 days) and cease either at the beginning of menstruation or immediately after its completion.

Other names for premenstrual syndrome (PMS) are premenstrual illness, premenstrual tension syndrome, or cyclic illness.

As a rule, PMS is diagnosed in women after 30 years of age (occurs in 50% of the fairer sex), while at a young age it is familiar to only every fifth woman.

Kinds

Depending on the predominance of certain manifestations, 6 forms of premenstrual illness are distinguished:

neuropsychiatric;
edematous;
cephalgic;
atypical;
crisis;
mixed.

Based on the number of manifestations, their duration and intensity, there are 2 forms of PMS:

light. 3-4 signs appear 3-10 days before menstruation, and the most pronounced of them are 1-2;
heavy. 5-12 signs appear 3-14 days before menstruation, and 2-5 of them, or all 12, are maximally expressed.

But, despite the number of symptoms and their duration, in case of decreased performance, they speak of a severe course of PMS.

Stages of PMS:

compensated. Symptoms appear on the eve of menstruation and disappear with their onset, while the symptoms do not intensify over the years;
subcompensated. There is a progression of symptoms (their number, duration and intensity increase);
decompensated. A severe course of PMS is observed; over time, the duration of the “light” intervals decreases.

Causes of premenstrual syndrome

Currently, the causes and mechanism of development of PMS are not well understood.

There are several theories explaining the development of this syndrome, although none of them covers the entire pathogenesis of its occurrence. And if previously it was believed that a cyclic condition is typical for women with an anovulatory cycle, it is now reliably known that patients with regular ovulation also suffer from premenstrual disease.

The decisive role in the occurrence of PMS is played not by the content of sex hormones (this may be normal), but by fluctuations in their levels throughout the cycle, to which the areas of the brain responsible for the emotional state and behavior react.

Hormonal theory

This theory explains PMS by a violation of the proportion of gestagens and estrogens in favor of the latter. Under the influence of estrogens, sodium and fluid are retained in the body (edema), in addition, they provoke the synthesis of aldosterone (fluid retention). Estrogenic hormones accumulate in the brain, which causes neuropsychiatric symptoms; their excess reduces the content of potassium and glucose and contributes to the occurrence of heart pain, fatigue and physical inactivity.

Increased prolactin

Theory of water intoxication

Explains PMS as a disorder of water-salt metabolism.

Among other versions that consider the causes of PMS, one can note the theory of psychosomatic disorders (somatic disorders lead to mental reactions), the theory of hypovitaminosis (lack of vitamin B6) and minerals (magnesium, zinc and calcium) and others.

Predisposing factors for PMS include:

genetic predisposition;
mental disorders in adolescence and the postpartum period;
infectious diseases;
poor nutrition;
stress;
frequent climate change;
emotional and mental lability;
chronic diseases (hypertension, heart disease, thyroid pathology);
alcohol consumption;
childbirth and abortion.

Symptoms

As already mentioned, signs of PMS appear 2-10 days before menstruation and depend on the clinical form of the pathology, that is, on the predominance of certain symptoms.

Neuropsychic form

Characterized by emotional instability:

tearfulness;
unmotivated aggression or melancholy, leading to depression;
sleep disturbance;
irritability;
weakness and fatigue;
periods of fear;
weakening libido;
thoughts of suicide;
forgetfulness;
increased sense of smell;
auditory hallucinations;
and others.

In addition, there are other signs: numbness of the hands, headaches, decreased appetite, bloating.

Edema form

In this case, the following prevail:

swelling of the face and limbs;
soreness and engorgement of the mammary glands;
sweating;
thirst;
weight gain (and due to hidden edema);
headaches and joint pain;
negative diuresis;
weakness.

Cephalgic form

This form is characterized by a predominance of vegetative-vascular and neurological symptoms. Characteristic:

migraine-type headaches;
nausea and vomiting;
diarrhea (a sign of increased prostaglandins);
palpitations, heart pain;
dizziness;
odor intolerance;
aggressiveness.

Crisis form

It occurs according to the type of sympathoadrenal crises or “psychic attacks”, which differ:

increased blood pressure;
increased heart rate;
heart pain, although there are no changes on the ECG;
sudden attacks of fear.

Atypical form

It occurs as hyperthermic (with an increase in temperature to 38 degrees), hypersomnic (characterized by daytime sleepiness), allergic (the appearance of allergic reactions, not excluding Quincke's edema), ulcerative (gingivitis and stomatitis) and iridocyclic (inflammation of the iris and ciliary body) forms.

Mixed form

It is distinguished by a combination of several described forms of PMS.

Diagnosis of premenstrual syndrome

mental pathology (schizophrenia, endogenous depression and others);
chronic kidney diseases;
brain formations;
inflammation of the spinal cord membranes;
arterial hypertension;
pathology of the thyroid gland.

With all of these diseases, the patient complains regardless of the phase of the menstrual cycle, while with PMS, symptoms occur on the eve of menstruation.

In addition, of course, the manifestations of PMS are in many ways similar to the signs of pregnancy in the early stages. In this case, it is easy to resolve doubts by independently conducting a home pregnancy test or donating blood for hCG.

Diagnosis of premenstrual tension syndrome has some difficulties: not all women turn to a gynecologist with their complaints; most are treated by a neurologist or therapist.

When making an appointment, the doctor must carefully collect anamnesis and study complaints, and during the conversation, establish the connection of the listed symptoms with the end of the second phase of the cycle and confirm their cyclicity. It is equally important to make sure that the patient does not have mental illness.

Then the woman is asked to mark the signs she has from the following list:

emotional instability (crying for no reason, sudden mood changes, irritability);
tendency towards aggression or depression;
feeling of anxiety, fear of death, tension;
low mood, hopelessness, melancholy;
loss of interest in her usual way of life;
increased fatigue, weakness;
inability to concentrate;
increased or decreased appetite, bulimia;
sleep disturbance;
a feeling of engorgement, tenderness of the mammary glands, as well as swelling, headaches, pathological weight gain, pain in muscles or joints.

The diagnosis of “PMS” is established if a specialist ascertains the presence of five signs in the patient, with the obligatory presence of one of the first four listed.

A blood test for prolactin, estradiol and progesterone is required in the second phase of the cycle; based on the results obtained, the expected form of PMS is determined. Thus, the edematous form is characterized by a decrease in progesterone levels. And neuropsychic, cephalgic and crisis forms are characterized by increased prolactin.

Further examinations vary depending on the form of PMS.

Neuropsychiatric

examination by a neurologist and psychiatrist;
radiography of the skull;
electroencephalography (detection of functional disorders in the limbic structures of the brain).

Edema

Shown:

delivery of the BAC;
study of renal excretory function and measurement of diuresis (excreted fluid is 500-600 ml less than consumed);
mammography and ultrasound of the mammary glands in the first phase of the cycle in order to differentiate mastopathy from mastodynia (pain in the mammary glands).

Krizovaya

Necessarily:

Ultrasound of the adrenal glands (to exclude a tumor);
testing for catecholamines (blood and urine);
examination by an ophthalmologist (fundus and visual fields);
X-ray of the skull (signs of increased intracranial pressure);
MRI of the brain (exclude tumor).

It is also necessary to consult a therapist and keep a blood pressure diary (to rule out hypertension).

Cephalgic

Held:

electroencephalography, which reveals diffuse changes in the electrical activity of the brain (a type of desynchronization of cortical rhythms);
CT scan of the brain;
examination by an ophthalmologist (fundus);
X-ray of the skull and cervical spine.

And for all forms of PMS, consultations with a psychotherapist, endocrinologist and neurologist are necessary.

Treatment of premenstrual syndrome

PMS therapy begins with explaining to the patient her condition, normalizing the regime of work, rest and sleep (at least 8 hours a day), eliminating stressful situations, and, of course, prescribing a diet.

Women with premenstrual tension syndrome should adhere, especially in the second phase of the cycle, to the following diet:

Hot and spicy dishes are excluded:
salt is limited;
a ban is imposed on the consumption of strong coffee, tea and chocolate;
the consumption of fats is reduced, and in some types of PMS, animal proteins are reduced.

The main emphasis of the diet is on the consumption of complex carbohydrates: whole grain cereals, vegetables and fruits, potatoes.

In the case of absolute or relative hyperestrogenism, gestagens (Norkolut, Duphaston, Utrozhestan) are prescribed in the second phase of the cycle.

For neuropsychic signs of PMS, it is recommended to take sedatives and mild tranquilizers 2-3 days before menstruation (Grandaxin, Rudotel, phenazepam, sibazon), as well as antidepressants (fluoxetine, amitriptyline). MagneB6 has a good calming, sleep-normalizing and relaxing effect. Herbal teas, such as “Aesculapius” (daytime) and “Hypnos” (at night), also have a sedative effect.

In order to improve cerebral circulation (cephalgic form), nootropil, piracetam, and aminolon are recommended.

In case of edema, diuretics (spironolactone) and diuretic teas are prescribed.

Antihistamines (teralen, suprastin, diazolin) are indicated for atypical (allergic) and edematous forms of PMS.

Cephalgic and crisis forms of PMS require taking bromocriptine in the second phase of the cycle: this drug reduces prolactin levels. Mastodinon quickly relieves pain and tension in the mammary glands, and Remens normalizes the level of hormones in the body.

For hyperprostaglandinemia, non-steroidal anti-inflammatory drugs (ibuprofen, indomethacin, diclofenac) are indicated, which suppress the production of prostaglandins.

And, of course, indispensable drugs for PMS are combined oral contraceptives from the monophasic group (Jess, Logest, Janine), which suppress the production of their own hormones, thereby leveling the manifestations of the pathological symptom complex.

The average course of treatment for premenstrual tension syndrome is 3-6 months.

Consequences and prognosis

PMS, for which a woman has not been treated, threatens a severe course of menopausal syndrome in the future. The prognosis for premenstrual illness is favorable.

Most women are familiar with the symptoms of premenstrual syndrome. Many of them suffer not so much from the ailments of menstruation itself, but from the condition that precedes it. The reason for this is the hormonal changes that occur in the body on the eve of menstruation. The functioning of various organs, as well as the nervous system, is disrupted. This leads to headaches, depression, and irritability. It is necessary to know what physiological processes they are associated with. Then it may be easier to cope with unpleasant symptoms.

After ovulation, the so-called luteal phase begins, which precedes the onset of menstruation. Preparation for it begins in the body in advance. Under the influence of hormones, changes occur in the condition of the mammary glands and genitals. The brain and central nervous system react to hormonal processes.

Most women experience characteristic pre-menstrual symptoms as a result. For some, they begin 2 days before menstruation, for others – 10. Disorders appear with varying degrees of severity. With the onset of critical days, they disappear. These symptoms are collectively called premenstrual syndrome (PMS). It has been noticed that PMS is stronger in women who suffer from gynecological or other diseases.

Night shift work, exposure to harmful substances, lack of sleep, poor diet, troubles and conflicts are all factors that increase ailments before menstruation.

Note: There is a theory that discomfort before menstruation is the body’s reaction to the lack of conception, which is the natural completion of the physiological processes occurring in the female reproductive system.

Signs of approaching period

Manifestations of PMS may vary for each individual woman. The nature of the manifestations is influenced by heredity, lifestyle, age, and health status. The most obvious signs that your period is approaching include the following:

irritability;
depressed state, feeling of inexplicable melancholy, depression;
fatigue, headaches;
drop in blood pressure;
inability to concentrate, deterioration of attention and memory;
sleep disturbance;
constant feeling of hunger;
painful sensations in the chest;
the occurrence of edema and weight gain due to fluid retention in the body;
indigestion, bloating;
nagging pain in the lower back.

There is a mild form of PMS (the presence of 3-4 symptoms that disappear with the onset of menstruation) and a severe form (the appearance of most symptoms simultaneously 5-14 days before menstruation). It is not always possible for a woman to cope with severe symptoms on her own. Sometimes only hormonal medications can help.

Types of PMS

Depending on what signs predominate in a woman before her period, the following forms of PMS are distinguished.

Edema. With this form, women feel pain in the mammary glands more acutely, their legs and arms swell, skin itching, and increased sweating appear.

Cephalgic. Every time before menstruation, dizziness, nausea, vomiting, and a headache radiating to the eyes appear. Often such symptoms are combined with heart pain.

Neuropsychic. Symptoms such as depressed mood, irritability, tearfulness, aggressiveness, and intolerance to loud sounds and bright lights predominate.

Krizovaya. Before menstruation, women experience crises: blood pressure rises, pulse quickens, limbs go numb, pain appears in the chest area, and fear of death arises.

Causes of various PMS symptoms

The severity of PMS manifestations depends mainly on the degree of hormonal changes and the state of the nervous system. The psychological attitude plays an important role. If a woman is active and busy with interesting things, then she does not feel the symptoms of menstruation as acutely as a suspicious pessimist, suffering from the mere thought of upcoming ailments. Every symptom can have an explanation.

Increased body weight. On the one hand, its cause is a decrease in the level of estrogen in the blood in the second phase of the cycle. By accumulating adipose tissue capable of secreting estrogens, the body compensates for their deficiency. There is also a deficiency of glucose in the blood, which leads to an increased feeling of hunger. For many women, eating delicious food is a way to distract themselves from troubles and worries.

Changes in mood. The cause of aggressiveness, irritability, anxiety, and depression is the lack of “pleasure hormones” in the body (endorphin, serotonin, dopamine), the production of which decreases during this period.

Nausea. Before menstruation, the uterus enlarges slightly due to the growth and loosening of the endometrium. At the same time, it can put pressure on the nerve endings, the irritation of which causes the gag reflex. Nausea can be caused by taking hormonal medications and contraceptives. If a woman constantly experiences this symptom before her period, then this remedy may be contraindicated for her. It needs to be replaced with something else.

Warning: Nausea before your expected period can be a sign of pregnancy. With this in mind, a woman should first of all do a test and visit a doctor to clarify her condition.

Pain in the lower abdomen. A slight nagging pain in the lower abdomen is considered normal before menstruation if the woman does not have cycle disorders, there are no pathological discharge or other signs of genital diseases. If the pain is severe and does not subside after taking painkillers, then you must definitely go to the doctor and undergo an examination to find out the causes of the pathology.

Temperature increase. Before menstruation, the temperature can normally rise to 37°-37.4°. The appearance of a higher temperature becomes a sign of the presence of an inflammatory process in the uterus or ovaries. As a rule, there are other signs of disturbances that force the woman to visit a doctor.

The appearance of acne. This symptom occurs before menstruation as a result of endocrine disorders, intestinal diseases, decreased body defenses, and impaired fat metabolism due to changes in hormone production.

The appearance of edema. Hormonal changes cause a slowdown in the process of water-salt metabolism in the body, which leads to fluid retention in the tissues.

Enlargement of the mammary glands. Progesterone levels increase and the body prepares for the possible onset of pregnancy. The ducts and lobules swell, blood circulation increases. The breast tissue is stretched, which leads to a dull pain when you touch it.

Video: Why does your appetite increase before your period?

Under what conditions do similar manifestations occur?

Women often confuse the symptoms of PMS and pregnancy. Nausea, dizziness, enlargement and tenderness of the mammary glands, and increased leucorrhoea are characteristic of both conditions.

If there are symptoms and your periods are late, then you are most likely pregnant. To make sure that this is exactly the case, it is recommended to take a blood test for human chorionic hormone levels (hCG is formed after pregnancy).

Similar symptoms also appear with endocrine diseases, the formation of mammary gland tumors, and the use of hormonal drugs.

Symptoms of approaching first menstruation in adolescents

Puberty begins in girls aged 11-15 years. Their character is finally established only after 1-2 years. A girl can find out about the imminent onset of her first menstruation by characteristic manifestations. Already 1.5-2 years before the onset of this event, a teenage girl begins to develop white discharge. Immediately before the appearance of the first menstruation, leucorrhoea becomes more intense and thin.

A slight nagging pain in the ovaries may occur due to their growth and stretching. PMS often manifests itself quite weakly, but there may also be deviations comparable in nature to the manifestations of PMS in adult women. One of the characteristic signs of teenage PMS is the formation of acne on the face. The reason is fluctuations in the level of sex hormones, the influence of this process on the condition of the skin.

Video: Signs of approaching menstruation in girls

Manifestations of PMS in premenopausal women

After 40-45 years, women experience the first signs of aging and a decrease in the level of sex hormones. Menstrual irregularities occur, metabolism slows down, and chronic diseases of the genital organs often worsen. The condition of the nervous system worsens. As a result, the manifestations of PMS intensify even more.

Many women of this age experience severe headaches, dizziness, increased sweating, increased heart rate, mood swings, and depression before menstruation. Often, such manifestations of PMS are so painful that to alleviate the condition, hormonal therapy is prescribed with drugs that regulate the content of estrogen, progesterone and other hormones in the body.

Many are sure that premenstrual syndrome is just another female “whim,” a manifestation of character and banal whims. But doctors take this phenomenon quite seriously - they conduct various types of research, select medications to alleviate the woman’s condition, and develop preventive measures.

You urgently wanted to buy yourself a ring, you burst into tears at the sight of your neighbor’s baby, do you think that your feelings for your husband have passed? Don’t make hasty conclusions, but try to quickly figure out how soon your period should start. Such strange, unmotivated behavior is most often explained by premenstrual syndrome. Surprisingly, at the beginning of the 20th century, such deviations were considered a sign of the development of a mental illness, and only after research did doctors and scientists make an unambiguous conclusion - the condition in question is directly related to fluctuations in the level of hormones in the blood, which are considered natural.

For example, if the level of estrogen and/or progesterone decreases, this can provoke:

increased levels of monoamine oxidase - this substance is produced by brain tissue, its increased level causes depression;
decreased serotonin levels - the substance is also released by brain tissue, but it affects mood and activity;
increased production of aldosterone - it provokes various changes in the body, from taste preferences to a feeling of fatigue.

Premenstrual syndrome can occur in different ways: for some women, this condition practically does not change their usual lifestyle, but some representatives of the fair sex literally suffer from their own irritability, mood swings and even hysterics. The only thing that will always indicate the manifestation of premenstrual syndrome is its cyclicity. Remember one simple fact - if any deviations in behavior and well-being appear on specific days of the menstrual cycle, and disappear with the arrival of menstruation or immediately after them, then this is clearly premenstrual syndrome.

Note:if the symptoms characteristic of PMS do not disappear even after menstruation and appear in the middle of the menstrual cycle, then this is a reason to seek help from a therapist and psychiatrist.

In order not to make a mistake in diagnosis, it is worth keeping a diary in which you need to record all changes in health, pathological manifestations according to the dates of onset - this way you can determine the cyclical occurrence of symptoms. The best option is to immediately contact a specialist for an accurate diagnosis.

Causes of PMS

Even modern medicine finds it difficult to name specific reasons for the appearance and development of the premenstrual cycle, but there are identified factors that will contribute to the phenomenon in question. These include:

lack of vitamin B6;
genetic predisposition;
decrease in serotonin levels.

Note:The appearance of premenstrual syndrome is influenced by the number of artificial abortions, the number of births, and various gynecological pathologies.

In medicine, it is customary to classify PMS symptoms into groups:

Vegetovascular disorders– dizziness, sudden “jumps” in blood pressure, headaches, nausea and rare vomiting, and rapid heartbeat will be present.
Neuropsychiatric disorders– characterized by increased irritability, tearfulness, and unmotivated aggression.
Exchange-endocrine disorders– there is an increase in body temperature and chills, peripheral edema, severe thirst, disturbances in the digestive system (flatulence, diarrhea or constipation), and decreased memory.

In addition, premenstrual syndrome in a woman can manifest itself in various forms:

Neuropsychiatric

In this form, the condition in question will manifest itself as disturbances in the mental and emotional sphere. For example, there will be sleep disturbances, sudden mood swings, short temper and unmotivated irritability, and aggression. In some cases, a woman, on the contrary, develops apathy towards the world around her, lethargy, depression, panic attacks, and a persistent feeling of fear and anxiety.

Edema

Krizovaya

With the development of this form of PMS, women are usually diagnosed with diseases of varying severity of the kidneys, gastrointestinal tract, and cardiovascular system. And the syndrome in question will manifest itself as pain in the heart, “jumps” in blood pressure, attacks of rapid heartbeat and feelings of fear/panic, and frequent urination.

Cephalgic

When diagnosing this form of premenstrual syndrome, it is imperative that a woman have a history of diseases of the gastrointestinal tract, cardiovascular diseases, etc.

The cephalgic form of PMS is manifested by pain in the heart area, increased sensitivity to previously familiar aromas and sounds, nausea and vomiting.

It is worth mentioning separately that there are atypical manifestations of premenstrual syndrome - an increase in temperature to subfebrile readings, increased drowsiness, ulcerative gingivitis, stomatitis, allergic manifestations (for example, Quincke's edema), attacks of vomiting.

Note:The described disorders can manifest themselves in women to varying degrees - for example, increased irritability, chest pain, and weakness are most often noted. Other manifestations may either be completely absent or be too mild.

Many women try to solve the problem of premenstrual syndrome on their own - they use some sedatives, painkillers, take out sick leave to avoid problems at work, and try to communicate less with relatives and friends. But modern medicine offers every woman clear measures to ease her well-being with the syndrome in question. You just need to seek help from a gynecologist, and he, in tandem with other specialists, will select an effective treatment for PMS.

How can a doctor help?

Usually, specialists select symptomatic treatment, so first the woman will be fully examined and interviewed - you need to clearly understand how premenstrual syndrome manifests itself in a particular patient.

General principles for alleviating a woman’s condition with PMS:

Please note two factors:

Antidepressants and tranquilizers are prescribed only in the presence of many neuropsychiatric symptoms - such drugs include Tazepam, Zoloft, Rudotel and others.
Hormone therapy will be appropriate only after the woman has been assessed for the condition her hormonal system.

How to get rid of PMS on your own

There are a number of measures that will help a woman alleviate her condition and reduce the intensity of the manifestations of the premenstrual cycle. They are quite simple, but no less effective. Women should follow the following recommendations:

. In no case should we forget about activity - physical inactivity is recognized by all doctors as a direct path to PMS. You don’t need to set Olympic records right away - it will be enough to walk more, do exercises, visit the pool, go to the gym, in general, you can choose activities “to your liking.”

What it does: regular physical activity increases the level of endorphins, and this helps get rid of depression and insomnia.

Nutrition correction. A week before the expected start of the premenstrual cycle, a woman should limit the consumption of coffee, chocolate, and give up alcoholic beverages. It is necessary to reduce the amount of fatty foods consumed, but increase the amount of foods in the diet that are high in calcium in the body.

What this gives: carbohydrate metabolism remains within normal limits, mood swings and irritability are not provoked by caffeine-containing products.

A good night's rest. We are talking about sleep - it should be deep and long enough (at least 8 hours). If a woman cannot fall asleep quickly, then she is recommended to take walks in the fresh air in the evenings, drink a glass of warm milk before bed and take a honey bath.

What does this give: it is proper sleep that is “responsible” for the strength of the immune system and the normal functioning of the central nervous system.

Taking vitamin B6 and magnesium supplements. This should be done 10-14 days before the start of menstruation, but only under the supervision of a doctor - by the way, he will competently select specific complexes. Often a woman is prescribed Magnerot, Magne B6.

What this gives: rapid heartbeat, unmotivated anxiety and irritability, fatigue and insomnia will either be completely absent or of low intensity.

Aromatherapy. If a woman is not allergic to essential oils, then it will be useful to use juniper or bergamot oil for taking warm baths. Moreover, aromatherapy sessions should begin 10 days before the start of menstruation.

What it gives: the aroma of bergamot and juniper improves mood and stabilizes the psycho-emotional background.

Traditional medicine for PMS

There are a number of recommendations from the “traditional medicine” series that will help get rid of the manifestations of premenstrual syndrome or, at least, reduce their intensity. Of course, you should first consult with a gynecologist and get approval for such a solution to the problem.

The most popular, effective and safe folk remedies for alleviating the manifestations of premenstrual syndrome are:

Premenstrual syndrome is not a whim or a “whim” of a woman, but a rather serious health disorder. And you need to take PMS seriously - in some cases, ignoring the symptoms of the phenomenon in question can lead to problems in psycho-emotional terms. Just don’t try to alleviate your condition on your own - every woman with premenstrual syndrome should undergo an examination and receive competent recommendations from a specialist.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category

– a cyclically recurring symptom complex observed in the second half of the menstrual cycle (3-12 days before menstruation). It has an individual course and can be characterized by headache, severe irritability or depression, tearfulness, nausea, vomiting, skin itching, swelling, pain in the abdomen and in the heart area, palpitations, etc. Swelling, skin rashes, flatulence, painful engorgement of the mammary glands. In severe cases, neurosis may develop.

General information

Premenstrual syndrome, or PMS, are called vegetative-vascular, neuropsychic and metabolic-endocrine disorders that occur during the menstrual cycle (usually in the second phase). Synonyms for this condition found in the literature are the concepts of “premenstrual illness”, “premenstrual tension syndrome”, “cyclic illness”. Every second woman over the age of 30 is familiar with premenstrual syndrome firsthand; in women under 30, this condition occurs somewhat less frequently - in 20% of cases. In addition, manifestations of premenstrual syndrome are usually associated with emotionally unstable, thin, asthenic women who are more often engaged in intellectual activities.

Causes of premenstrual syndrome

The course of the crisis form of premenstrual syndrome is manifested by sympatho-adrenal crises, characterized by attacks of rising blood pressure, tachycardia, heart pain without abnormalities on the ECG, and panic. The end of a crisis is usually accompanied by copious urination. Often attacks are provoked by stress and overwork. The crisis form of premenstrual syndrome can develop from untreated cephalgic, neuropsychic or edematous forms and usually manifests itself after 40 years. The background for the crisis form of premenstrual syndrome is diseases of the heart, blood vessels, kidneys, and digestive tract.

Cyclic manifestations of atypical forms of premenstrual syndrome include: increased body temperature (in the second phase of the cycle up to 37.5 ° C), hypersomnia (drowsiness), ophthalmoplegic migraine (headaches with oculomotor disorders), allergic reactions (ulcerative stomatitis and ulcerative gingivitis, asthmatic syndrome, uncontrollable vomiting, iridocyclitis, Quincke's edema, etc.).

When determining the severity of premenstrual syndrome, they proceed from the number of symptomatic manifestations, distinguishing between mild and severe forms of premenstrual syndrome. A mild form of premenstrual syndrome is manifested by 3-4 characteristic symptoms that appear 2-10 days before the onset of menstruation, or by the presence of 1-2 significantly pronounced symptoms. In severe forms of premenstrual syndrome, the number of symptoms increases to 5-12; they appear 3-14 days before the onset of menstruation. Moreover, all of them or several symptoms are significantly expressed.

In addition, an indicator of a severe form of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. Decreased ability to work is usually observed in the neuropsychic form of premenstrual syndrome.

It is customary to distinguish three stages in the development of premenstrual syndrome:

compensation stage - symptoms appear in the second phase of the menstrual cycle and disappear with the onset of menstruation; the course of premenstrual syndrome does not progress over the years
subcompensation stage - the number of symptoms increases, their severity worsens, manifestations of PMS accompany the entire menstruation; Premenstrual syndrome becomes more severe with age
stage of decompensation - early onset and late cessation of symptoms of premenstrual syndrome with minor “light” intervals, severe PMS.

Diagnosis of premenstrual syndrome

The main diagnostic criterion for premenstrual syndrome is cyclicality, the periodic nature of complaints that arise on the eve of menstruation and their disappearance after menstruation.

The diagnosis of premenstrual syndrome can be made based on the following signs:

State of aggression or depression.
Emotional imbalance: mood swings, tearfulness, irritability, conflict.
Bad mood, feeling of melancholy and hopelessness.
State of anxiety and fear.
Decreased emotional tone and interest in current events.
Increased fatigue and weakness.
Decreased attention, memory impairment.
Changes in appetite and taste preferences, signs of bulimia, weight gain.
Insomnia or drowsiness.
Painful tension in the mammary glands, swelling
Headaches, muscle or joint pain.
Worsening of the course of chronic extragenital pathology.

The manifestation of five of the above signs with the obligatory presence of at least one of the first four allows us to speak with confidence about premenstrual syndrome. An important part of the diagnosis is the patient’s keeping a self-observation diary, in which she should note all disturbances in her well-being over the course of 2-3 cycles.

A study of hormones (estradiol, progesterone and prolactin) in the blood allows us to determine the form of premenstrual syndrome. It is known that the edematous form is accompanied by a decrease in progesterone levels in the second half of the menstrual cycle. Cephalgic, neuropsychic and crisis forms of premenstrual syndrome are characterized by an increase in the level of prolactin in the blood. The prescription of additional diagnostic methods is dictated by the form of premenstrual syndrome and leading complaints.

Severe manifestation of cerebral symptoms (headaches, fainting, dizziness) is an indication for an MRI or CT scan of the brain to exclude focal lesions. EEG results are indicative for neuropsychic, edematous, cephalgic and crisis forms of the premenstrual cycle. In the diagnosis of the edematous form of premenstrual syndrome, an important role is played by measuring daily diuresis, recording the amount of fluid drunk, and conducting tests to study the excretory function of the kidneys (for example, Zimnitsky's test, Rehberg's test). In case of painful engorgement of the mammary glands, an ultrasound of the mammary glands or mammography is necessary to exclude organic pathology.

An examination of women suffering from one or another form of premenstrual syndrome is carried out with the participation of doctors of various specialties: neurologist, therapist, cardiologist, endocrinologist, psychiatrist, etc. Prescribed symptomatic treatment, as a rule, leads to an improvement in well-being in the second half of the menstrual cycle.

Treatment of premenstrual syndrome

In the treatment of premenstrual syndrome, drug and non-drug methods are used. Non-drug therapy includes psychotherapeutic treatment, adherence to work and proper rest, physical therapy, and physiotherapy. An important point is to maintain a balanced diet with sufficient amounts of plant and animal protein, plant fiber, and vitamins. In the second half of the menstrual cycle, you should limit the consumption of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, and alcoholic beverages.

Drug treatment is prescribed by a medical specialist, taking into account the leading manifestations of premenstrual syndrome. Since neuropsychic manifestations are expressed in all forms of premenstrual syndrome, almost all patients are advised to take sedative (sedative) drugs several days before the expected onset of symptoms. Symptomatic treatment of premenstrual syndrome involves the use of painkillers, diuretics, and antiallergic drugs.

The leading place in the drug treatment of premenstrual syndrome is occupied by specific hormonal therapy with progesterone analogues. It should be remembered that the treatment of premenstrual syndrome is a long process, sometimes continuing throughout the entire reproductive period, requiring internal discipline from the woman and strict compliance with all doctor’s instructions.