Premenstrual syndrome: causes, symptoms and treatment. PMS: symptoms and methods for their relief. How to prevent premenstrual syndrome from ruining your life? Why does PMS happen?

The appearance of unmotivated aggressiveness or the desire to cry after watching a melodrama: which woman has not encountered such feelings? Many people have heard of premenstrual syndrome, but the percentage of people seeking medical help remains low. Unfortunately, some doctors and psychologists consider this condition to be far-fetched and do not take the manifestations of premenstrual syndrome seriously. But the problem exists and requires appropriate treatment.

The term "premenstrual syndrome"

Causes of PMS

There are many theories about the development of this condition, but none fully explains the cause and mechanism of premenstrual syndrome. There are hormonal, allergic theories, the theory of increased aldosterone production, neuropsychic disorders and “water intoxication”. The main etiological factors include:

• violation of the ratio of estrogen and progesterone in the luteal phase (estrogens increase and progesterone levels decrease);
• increased secretion of prolactin (causes transformations in the mammary glands);
• pathological processes in the thyroid gland;
• disorders of water-salt metabolism, the production of aldosterone increases, which leads to the retention of fluid and sodium salts in the body;
• lack of vitamins and microelements (vitamin B6, magnesium, zinc);
• stressful situations.

Predisposing factors for PMS

• living in big cities;
• brainwork;
• late birth;
• psycho-emotional lability;
• a large number of pregnancies (,) or, conversely, their absence;
• surgeries on female genital organs;
• inflammatory processes of the female genital area;
• brain injuries;
• Europeans;
• unbalanced diet;
• CNS infections;
• physical inactivity.

PMS symptoms

Depending on the predominance of certain manifestations, the following forms of premenstrual syndrome are distinguished:

Neuropsychic form of PMS

The woman becomes irritable, whiny, and touchy. Characterized by rapid fatigue, apathy and or uncontrollable rage and aggression. There is sleep disturbance: at night, drowsiness during the day, a tendency to conflict, weakened sexual desire. Also intolerance to smells and sounds or acute perception of them. Possible increased gas formation, constipation, decreased appetite. A certain dependence has been noted: in girls during puberty, aggressiveness and rage predominate; in older women, there is a tendency to depression. The mammary glands become engorged, numbness of the limbs appears.

Edema form of PMS

Retention of sodium and fluid in the body leads to edema. Swelling of the face, legs, fingers, weight gain (up to 500–700 grams), flatulence, increased sweating, and weakness are noted. The classic manifestation of the edematous form is swollen and painful mammary glands. Diuresis decreases.

Cephalgic form of PMS

It is characterized by intolerance to smells and sounds, migraine-type headaches, dizziness, and irritability. Fainting, palpitations, heart pain, diarrhea, irritability, heart pain are common. Nausea and vomiting are possible.

Crisis form of PMS

This form is characterized by sympathoadrenal crises, which are manifested by attacks of arterial hypertension, tachycardia, pain in the heart, behind the sternum, and sudden fear of death. The ECG does not show any abnormalities. The crisis form is often observed in premenopausal women (after 45 years) and in patients suffering from pathologies of the digestive tract, kidneys, and heart.

Atypical forms of PMS

There are 3 subtypes of atypical forms of premenstrual syndrome: hyperthermic, which is characterized by an increase in temperature to 38 degrees before menstruation and a decrease with the onset of menstruation, hypersomnia - irresistible drowsiness in the luteal phase of the cycle, ophthalmoplegic - unilateral ptosis (drooping of the upper eyelid), hemiparesis of the body on the eve of menstruation. Separately, allergic reactions can be distinguished in the form of ulcerative gingivitis and asthmatic syndrome, iridocyclitis, Quincke's edema.

PMS classification

Premenstrual syndrome occurs in mild or severe forms. A mild course of PMS is said to occur when there are 3–4 manifestations, and of these, 1–2 signs predominate. In severe forms of PMS, there are 5–12 manifestations, the leading role among them being occupied by 2–5 symptoms.

Premenstrual syndrome is also classified into stages:

• compensated stage– signs of the disease are mild, there is no tendency to progress, and with the onset of menstruation they disappear;
• subcompensated stage I – the signs of the syndrome are bright, pronounced, the number of symptoms increases, there is a decrease in performance, the longer the disease exists, the more severe the manifestations become, the symptoms do not level out with the onset of menstruation;
• decompensated stage– premenstrual syndrome is severe, symptoms persist during and after the end of menstruation.

PMS treatment

Therapy for premenstrual syndrome should begin with adjusting your diet and daily routine. If possible, stressful and conflict situations should be excluded or limited, sleep duration should be at least 8 hours a day, physical exercise is useful, which helps to increase the synthesis of enkephalins and endorphins (happiness hormones). In the diet in the luteal phase of the cycle, it is necessary to limit salt, liquid, coffee and strong tea, and chocolate. The diet should contain a sufficient amount of fiber (fresh vegetables and fruits), and sweets should be avoided.

In order to normalize the psycho-emotional state, sedatives (motherwort, valerian, peony tincture) are prescribed; in more serious cases, anti-anxiety drugs (Relanium, Rudotel) and antidepressants (Zoloft, cypramine). To improve blood circulation in the brain, piracetam and picamilon are recommended. Acupuncture, physiotherapy, vitamins (vitamin B6, magnesium preparations) are effective. Progestin drugs (utrozhestan, duphaston) are prescribed in the second phase of the cycle or oral monophasic contraceptives (Zhanin, Marvelon, Yarina) are used. For the edematous form of the disease, diuretics (spironolactone) are prescribed, and for hyperprolactinemia, drugs that inhibit prolactin production (parlodel).

Doctors have always tried to determine the reasons why women feel unwell and irritable in the days immediately before menstruation . In ancient times, this phenomenon was associated with various factors - the phases of the moon, the woman’s health, and the characteristics of the area where she lived. However, the state before menstruation was a mystery to the Aesculapians. Only in the twentieth century were doctors able to understand to some extent what was happening to the ladies.

Speaking about PMS - what it is, you should know how PMS stands for - what it means is a manifestation characteristic of women in the days before menstruation. PMS is a set of symptoms that appear in women and girls a few days before the onset of menstruation.

Scientists are still researching what causes such manifestations and what this syndrome means. Those who are interested in how PMS is translated should learn in more detail what manifestations are characteristic of this condition. Each decoding of what PMS is in girls contains a description of all the characteristic symptoms and manifestations.

After all, PMS in women is a whole complex of symptoms, both physical and mental—scientists have counted about 150 of them. Approximately 75% of women experience premenstrual syndrome to varying degrees.

As a rule, PMS in girls begins to appear approximately 2-10 days before the day when signs of menstruation appear. After menstruation ends, menstrual syndrome also completely disappears.

Why does PMS develop?

So far, all the studies conducted have not made it possible to determine why premenstrual syndrome manifests itself? There are many theories that explain why this condition develops.

• The so-called “water intoxication” is a disrupted water-salt metabolism.
• Allergic nature – high sensitivity of the body to endogenous substances.
• Psychosomatic – the development of physiological symptoms due to the influence of mental factors.

The most complete and broadest theory today is the hormonal theory, according to which PMS is explained by strong hormonal fluctuations in the second phase of the cycle. After all, for the female body to function correctly, normal hormonal balance is important:

• are able to improve well-being, both physical and mental, activate mental activity, increase vitality;
• progesterone provides a sedative effect, which can lead to a depressive state in the second phase;
• affect libido, increase performance and energy.

In the second phase of the cycle, a woman’s hormonal background changes. Consequently, the hormonal theory suggests that the body reacts inadequately to such a “storm”. Interestingly, premenstrual tension syndrome is inherited.

Since during the premenstrual period the body experiences endocrine instability , this leads to the manifestation of somatic and psycho-vegetative disorders. The main reason for this is the fluctuation of sex hormones during the monthly cycle and the reaction of the limbic parts of the brain to this.

• When the level increases estrogen and first increases, and then decreases the level progesterone , swelling, tenderness of the mammary glands, dysfunction of the heart and blood vessels, pressure surges, irritability and aggression in women are noted.
• With increased secretion fluid is also retained in the body.
• When content increases , there are vegetative-vascular disorders, digestive disorders - diarrhea, nausea, as well as headaches reminiscent of.

Thus, modern doctors identify the following factors that determine the development of PMS:

• A decrease in the level, which leads to the manifestation of mental symptoms of premenstrual syndrome: when this hormone decreases, sadness and melancholy are noted.
• Deficiency leads to fluid retention, increased breast sensitivity, and mood changes.
• A lack of magnesium leads to the development of symptoms such as headache, desire to eat sweets.
• Smoking – women who smoke suffer from PMS twice as often.
• – Those with a body mass index greater than 30 are much more likely to experience symptoms of this syndrome.
• Genetics – the tendency to PMS can be inherited.
• Difficult childbirth, abortion, gynecological operations.

The main symptoms of PMS in women

When talking about what PMS symptoms are, how many days before menstruation do they appear in girls and women, we should take into account the individual characteristics of each organism. Doctors divide the main signs of PMS before menstruation into several different groups. The following symptoms of premenstrual syndrome are distinguished (by group):

• Neuropsychiatric : depression, aggression, irritability and tearfulness.
• Exchange-endocrine : chills, swelling due to impaired water-salt metabolism, fever, discomfort in the mammary glands, bloating, blurred vision and memory.
• Vegetative-vascular : headache, pressure changes, nausea, vomiting, tachycardia, heart pain.

Speaking about what symptoms women experience before menstruation, it should be taken into account that they can be conditionally divided into several forms. However, as a rule, they are combined. So, if pronounced psycho-vegetative disorders are observed, the pain threshold decreases, and the woman perceives pain very acutely - a week or a few days before menstruation.

What signs of menstruation can be observed in a week or in a few days?

Wikipedia and other sources indicate that each woman experiences PMS differently, and the symptoms may vary.

Scientists, having conducted a series of studies, determined the frequency of symptoms of premenstrual syndrome:

In addition, PMS can significantly aggravate the course of other diseases:

• anemia ;
• thyroid diseases;
• migraine ;
• chronic fatigue syndrome;
• inflammatory diseases of the female genital area.

What conditions and diseases can masquerade as PMS?

To know how many days before menstruation begins, every woman needs to keep a calendar or a special notebook and write down the start date of menstruation, how long menstruation lasts, as well as the day of ovulation (to do this, just measure your basal temperature). It is also worth noting the manifestation of symptoms before menstruation and how you feel during ovulation.

If a woman keeps such records over several cycles, this helps her determine how often signs of PMS appear. Also, the diary will help determine whether there is a delay in menstruation, etc.

To establish a diagnosis of PMS, the doctor determines the presence of at least 4 signs listed below:

• , insomnia ;
• deterioration of attention and memory;
• increased appetite, decreased appetite;
• severe fatigue, weakness;
• chest pain;
• swelling;
• pain in joints or muscles;
• exacerbation of chronic diseases.

This condition can also be diagnosed if at least one of the following signs is observed:

• conflict, tearfulness, nervousness and irritability, sudden mood swings in women;
• groundless anxiety, fear, tension;
• feeling of melancholy without reason, depression;
• depression;
• aggressiveness.

To determine the severity of PMS, it is important to take into account the number of manifestations, their severity and duration:

• Mild form - manifests itself from 1 to 4 symptoms, if these are 1-2 signs, then they are significantly pronounced.
• Severe form - manifests itself from 2 to 12 signs, if these are 2-5 symptoms, then they are significantly pronounced. Sometimes they can lead to a woman becoming unable to work the day or several days before her period.

The cyclical nature of manifestations is the main feature that distinguishes premenstrual syndrome from other diseases. That is, this condition is premenstrual syndrome when it begins before menstruation (from 2 to 10 days) and completely disappears after menstruation. But if psychovegetative symptoms disappear, then physical sensations sometimes turn into painful periods or migraines in the first days of the cycle.

If a woman’s sensations in the first phase of the cycle are relatively good, then this is precisely PMS, and not an exacerbation of chronic diseases - depression, neurosis, fibrocystic disease.

If pain is observed only immediately before menstruation and during menstruation, and is combined with bleeding in the middle of the cycle, this indicates that, most likely, a gynecological disease is developing in the body - and etc.

To determine the form of PMS, hormones are examined: estradiol , prolactin , progesterone .

Additional research methods may also be prescribed, depending on which complaints predominate:

• If you are concerned about very severe headaches, tinnitus, dizziness, fainting, or blurred vision, it is necessary to perform a CT or MRI to exclude organic diseases of the brain.
• If neuropsychiatric symptoms predominate, an EEG is performed to exclude epileptic syndrome.
• If swelling is a concern, the amount of urine per day changes, tests are performed to diagnose the kidneys.
• In case of significant breast engorgement, an ultrasound of the mammary glands should be performed, .

Women who suffer from PMS are examined not only by a gynecologist, but also by other specialists: neurologists, psychiatrists, nephrologists, endocrinologists, cardiologists, and therapists.

How to figure it out - PMS or pregnancy?

Since some symptoms during pregnancy are very similar to signs of PMS, it is important to take into account the differences that can distinguish between these conditions.

After conception occurs, the hormone increases in the female body progesterone . As a result, a woman may confuse pregnancy with PMS when the following symptoms begin to appear: breast tenderness and swelling, vomiting, nausea, mood swings, lower back pain, irritability.

Often, when you go to one or another thematic forum, you can see women’s arguments about how to distinguish PMS from pregnancy before a delay. Of course, if your periods started on time, then the issue goes away by itself. However, even pregnant women sometimes experience discharge during the day. When should your period be? There are differences between discharge before menstruation and during pregnancy - in pregnant women it is usually more scanty. But still, in order to verify the presence or absence of pregnancy, it is worth doing a test or conducting tests at the medical center. institution.

Below is a comparison of the most common symptoms during pregnancy and PMS.

Since the symptoms for these conditions are actually similar, and in some cases it is even possible to become pregnant during your period (at least that is the impression a woman gets if discharge appears), it is important to act correctly.

It is best to wait until your period begins. If a woman notes that she is already experiencing a delay, it is imperative to conduct a pregnancy test, which reliably determines pregnancy after a delay. For those who want to immediately verify whether conception has occurred, you can take (pregnancy hormone). Such a test accurately determines pregnancy already on the tenth day after conception.

The most appropriate thing to do in such a situation is to visit a gynecologist who will help you figure out what a woman actually has - PMS or pregnancy through an examination and an ultrasound. Sometimes the question also arises of how to distinguish pregnancy from – in this case, you also need to consult a doctor or do a test.

When should you contact a specialist?

If pain, irritability, and increased tearfulness in women, the causes of which are associated with PMS, significantly reduce the quality of life and are very pronounced, you should consult a doctor and carry out the treatment prescribed by him. The doctor can also give effective recommendations on how to alleviate certain unpleasant symptoms.

As a rule, with such manifestations, symptomatic therapy is prescribed. How to treat PMS, and whether it is worth prescribing any drugs for treatment, the specialist determines, taking into account the form, symptoms, and course of premenstrual syndrome. The following treatment methods may be prescribed:

• For mood swings, depression, and irritability, psychotherapy sessions, relaxation techniques, and sedatives are prescribed.
• If you are worried about pain in the abdomen, lower back, or headaches, it is recommended to take non-steroidal anti-inflammatory drugs to relieve pain (tablets, and etc.).
• Drugs are also prescribed for the treatment of premenstrual syndrome - diuretics to remove excess fluid and eliminate swelling.
• Hormonal treatment is prescribed if there is insufficiency in the second phase of the cycle, after conducting functional diagnostic tests, guided by the results of the changes that have been identified. Assign gestagens — medroxyprogesterone acetate , they should be taken from the 16th to 25th day of the menstrual cycle.
• Tranquilizers and antidepressants are prescribed to women who develop numerous neuropsychiatric symptoms before menstruation: aggressiveness, nervousness, panic attacks, insomnia, etc. In such cases, they are prescribed,

  

  Have a good rest

  You need to sleep as much time as your body needs for proper rest. As a rule, this is 8-10 hours. Many women who write on any thematic forum note that it was the normalization of sleep that made it possible to reduce the severity of unpleasant symptoms. With a lack of sleep, anxiety, irritability, aggressiveness may develop, and worsen. For those who suffer from insomnia, taking short evening walks can help.

  Aromatherapy

  Provided that the woman does not suffer from allergies, you can practice aromatherapy by selecting a special composition of aromatic oils. It is recommended to use lavender, basil, sage, geranium, rose, juniper, and bergamot oils. It is worth starting to take baths with aromatic oils two weeks before menstruation.

  Physical exercise

  Any reasonable load has a positive effect on the body - running, dancing, yoga, bodyflex, etc. If you train fully and regularly, the body’s content increases. endorphins . And this allows you to overcome depression and insomnia, and reduce the severity of physical symptoms.

  Vitamins and minerals

  To reduce the severity of symptoms, two weeks before menstruation you need to take magnesium and. It is also recommended to drink and. This will help reduce the severity of a number of symptoms: palpitations, insomnia, anxiety, fatigue, irritability.

  Nutrition

  It is important to include as many vegetables and fruits as possible in your diet, as well as foods containing calcium and fiber. It is worth reducing the amount of coffee, cola, and chocolate consumed, as caffeine provokes anxiety and mood swings. It is important to reduce the amount of fat in your diet.

  It is also not recommended to eat beef, which may contain artificial estrogens. You should drink herbal teas, lemon and carrot juices. It is better to exclude or limit alcohol, since under its influence reserves of minerals and vitamins are depleted, and the liver utilizes hormones worse.

  Women often wonder why they crave salty foods before menstruation. The fact is that fluctuations in appetite are normal during PMS, and sometimes you just need to “satisfy the demands” of the body in order to feel better.

  Relaxation

  You need to try to avoid stressful situations, not overwork and think positively. To do this, it is recommended to practice yoga and meditation.

  Regular sex

  Sex also has a beneficial effect on health - it helps you sleep better, overcome stress, cope with bad emotions, strengthen your immune system and increase endorphins. In addition, in the period before menstruation, a woman’s libido often increases, which contributes to an active sex life.

  Medicinal herbs

  With the help of herbal teas, you can significantly alleviate the condition of PMS. The main thing is to choose the right herbs. Tea can be made from St. John's wort, primrose, and other herbs that your doctor recommends.

  conclusions

  Thus, premenstrual syndrome is a serious condition, which sometimes becomes an obstacle for a woman to a full life and ability to work. According to research, the most severe symptoms of PMS occur in residents of large cities and women who engage in mental work.

  However, with the help of specialists, as well as by practicing proper nutrition, regular exercise, and taking vitamins and minerals, this condition can be significantly alleviated.

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.

Premenstrual syndrome (PMS) is a complex of interrelated symptoms characteristic of the premenstrual period. These symptoms can manifest themselves in both the psychoemotional and physiological spheres.

The difficulty in describing and diagnosing PMS lies in the fact that, as a rule, every woman experiences certain changes in well-being before menstruation. And assessing the severity and degree of these manifestations largely has to be subjective. Sometimes you have to come across the opinion that PMS - due to its widespread prevalence, cyclicality and variety of manifestations - is not a pathology and, therefore, does not require serious attention either from the woman herself or from her doctor. This is a deep misconception. Think about it: the first signs of PMS appear on average at the age of 25 and then they only get worse, smoothly flowing into menopausal syndrome already at the age of 45-50 years. That is, the most active years of a woman’s life pass “under the sign of PMS,” significantly reducing the quality of life and bringing her both physical and moral suffering. Modern gynecology clearly states that premenstrual syndrome is a good reason to consult a doctor and receive a set of therapeutic prescriptions.

We can talk about four forms of PMS.

1. Neuropsychiatric. Characterized by vivid manifestations in the psycho-emotional sphere. The woman becomes irritable, experiences unreasonable anxiety and excitement, and finds it difficult to control her emotions. She becomes insecure, and the “offense threshold” also rises - a woman may react inadequately to completely neutral statements addressed to her, and show causeless aggression. A very common manifestation of the neuropsychic form of PMS is a depressive state.
2. Edema. It is characterized by swelling (of the arms, legs, face), mastalgia (painful sensations in the mammary glands), abdominal pain, and a feeling of bloating. During the period before menstruation, weight increases, and familiar and favorite clothes become uncomfortable.
3. Cephalgic - with severe headaches.
4. Krizovaya. Manifests itself in the form of attacks of unmotivated panic and fear; accompanied by a sharp release of adrenaline into the blood.

The most difficult symptoms to bear, both for the woman herself and for the people around her, are those related to the psycho-emotional sphere. From the outside, a woman’s behavior may seem inadequate and emotionally unstable. Of course, this entails complications in relationships, especially with those people to whom it is impossible to explain the true reason for such changes in behavior.

In some cases, other symptoms may be observed, in particular:

• slight increase in body temperature;
• ophthalmoplegic migraine is a headache associated with various disorders in the eye area. This may be a violation of the movement of the eyelids, strabismus, dilated pupils, blurred vision;
• cyclic iridocyclitis - inflammation of the iris;
• hypersomnia - increased sleepiness;
• allergy;
• gingivitis (gum inflammation), stomatitis;
• cyclic bronchial asthma;
• cyclic vomiting.

Obviously, such severe manifestations of PMS are a serious burden on the body and require adjustment. In addition, it has been proven that women suffering from PMS have a much more difficult time during menopause. Therefore, you should not be shy and try to cope with this problem yourself. Be sure to consult a doctor.

How does premenstrual syndrome manifest?

The female body is not a static substance. Naturally, during his life he undergoes various changes, and his reactions to various events and phenomena also change.

In relation to PMS, we can say that its first signs are observed at the age of 20-25 years. As a rule, the syndrome is mild, and a young and healthy body can easily tolerate it. Therefore, women see no reason to see a doctor.

However, PMS tends to intensify and become more pronounced over time. And at the time of going to the doctor (the most common age for this is 30-35 years), premenstrual manifestations are already causing the woman some anxiety, they become clearly expressed and are quite difficult to tolerate. Moreover, the forms of PMS change with age. It has been proven that at the age of 27-28 years the neuropsychic form is more often observed, at 30-31 years - the edematous form, at 33-34 years - the cephalgic form.

It is safe to say that each woman experiences her own “individual” PMS, in which, to varying degrees, there are changes in general well-being, emotional disturbances and somatic symptoms (physical sensations). When formulating complaints, the average woman identifies 3 symptoms that cause her the greatest inconvenience and anxiety. During the conversation with the doctor, 4 more symptoms are revealed. If you try to rank all the symptoms according to the frequency of complaints about them, you will get the following picture.

1. Rapid and severe fatigue, a feeling of constant tiredness, which often occurs in the morning and gradually increases in the evening.
2. Difficulty concentrating, absent-mindedness, memory loss. If a woman’s work involves such actions as calculations, calculations, comparative analysis and decision-making, then during the premenstrual period she may experience serious difficulties in carrying out her professional activities.
3. Depression. Depressed mood, disappointment in life, heightened perception of even the slightest difficulties and problems are very often premenstrual syndromes. This condition is very accurately described by the phrase “Nothing in life makes you happy.” This is explained by the fact that the level of the neurotransmitter hormones serotonin and dopamine in the blood decreases.
4. Changing the diet due to the needs of the body. Many women note that in the days leading up to menstruation, their appetite increases and their taste preferences change. The need for salt and sugar changes quite often.
5. Painful sensations in the chest, increased sensitivity, engorgement in the nipple area, mastalgia. Numerous studies have shown that the stronger the pain, the shorter its duration. However, this symptom must be treated very carefully. The fact is that it feels similar to the initial manifestations of mastopathy. And because of the familiarity of the sensations, a woman may postpone a preventive visit to the gynecologist in order to check the condition of the mammary glands. We remind you that such a visit should be carried out once a year, and it is also advisable to conduct an independent breast examination once a month. It is advisable to do this on the same day of the menstrual cycle.
6. Edema. Swelling during PMS can be expressed in different ways. For some, it manifests itself as fluid retention in the arms, legs, abdomen, and waist. The oval of the face also changes. There are also local manifestations - only in the abdomen, upper or lower extremities.

Treatment of premenstrual syndrome

The first group of measures that can be distinguished consists of drug-free methods of PMS correction. They are primarily aimed at adjusting the regime and lifestyle. It may be enough for a woman to pay more attention to her diet, set aside time for proper sleep and moderate physical activity - and the manifestation of PMS symptoms will significantly decrease or disappear altogether.

Of course, the emotional background and the overall load on the body are very important - and these two factors are directly related to the situation in the family and at work. It is not always possible to completely correct them, but, nevertheless, it is necessary to try to eliminate overload, mental fatigue, and try to avoid stressful situations. Rest in the evening and a peaceful bedtime are very important. Sleep duration should be 7-8 hours.

When choosing a type of exercise, it is recommended to pay attention to swimming, walking, light jogging and cycling. During exercise, the brain produces endorphins - compounds that have the ability to reduce pain and improve mood. It is only important to correctly determine the intensity of the load and not get carried away with increasing it. Otherwise, exercise will lead to severe fatigue and can only worsen PMS.

As for nutrition, the following recommendations can be given. In general, it is advisable to adhere to a carbohydrate diet; the percentage of carbohydrates in the diet should be at least 70%. It is better if it is complex carbohydrates: cereals, vegetables, legumes. Pay attention to green vegetables, they have an extremely beneficial effect on the body. Broccoli, for example, reduces chest pain, spinach and zucchini help cope with depression, and avocados and green peppers can influence causeless mood swings. By the way, doctors from the University of Texas say that green vegetables and fruits contain the largest amount of vitamins, and including these foods in your daily diet helps maintain health for many years.

The protein portion of the diet consists of nuts and lean meats.

It is very important to monitor the water-salt balance. The amount of salt should be reduced so as not to provoke swelling; it is also necessary to exclude canned food, smoked foods, seasonings with monosodium glutamate, and chips from the menu. For drinks, freshly squeezed juices, still water, and green tea are preferable. But it is better to refrain from drinking coffee - caffeine can only aggravate emotional instability and sensitivity of the mammary glands. The total volume of fluid consumed per day should be about 1.5-2 liters.

Treatment with medications can be divided into two large groups: non-hormonal therapy and hormonal therapy.

Non-hormonal drugs primarily include vitamins and minerals. For severe pain in the chest area, vitamin E helps well, and B vitamins help cope with mood swings and depression. Very often, magnesium orotate and calcium carbonate are recommended for PMS, which prevent swelling. Calcium carbonate also helps regulate the psycho-emotional state.

In addition to vitamins and minerals, for manifestations of premenstrual syndrome, a woman may be prescribed various diuretics, selective serotonin reuptake inhibitors and dopamine agonists. Don't be afraid of these complicated names - in fact, the essence and principle of action of all drugs is quite easy to understand.

Diuretics are diuretics. They remove fluids from tissues and increase the amount of urine produced. Their use is justified if a woman’s PMS is accompanied by severe swelling. Recommended diuretics, in particular veroshpiron, act in a complex manner, promoting the removal of not only excess fluid, but also sodium salts. They are also potassium-sparing drugs and regulate the acid-base balance of the blood.

Selective serotonin reuptake inhibitors (SSRIs) help cope with unmotivated worries, anxiety, and depression. These drugs, which belong to the latest generation of antidepressants, act very gently and are well tolerated. When taken correctly, they do not cause addiction or sedative effects, and gradually level out the emotional background. The most common medications are fluoxetine (Prozac), sertraline (Zoloft), and citalopram (Cipramil). They are taken in two-week intermittent courses, starting 14 days before the date of expected menstruation. Please note: all SSRI drugs should only be used as prescribed by a doctor.

Dopamine agonists are medications that reduce prolactin levels in the blood. They cope well with symptoms of PMS such as mastalgia and swelling. The most commonly prescribed drug is bromocriptine.

Hormone therapy

Very often, combined oral contraceptives (COCs) are used to treat premenstrual syndrome. The logic here is very simple: COCs suppress ovulation, and with it the symptoms of PMS. However, recent research in this area shows that this is not the case. Yes, many women noted that while taking oral contraceptives, their symptoms of PMS decreased. But at the same time, the percentage of those women in whom the severity of PMS symptoms not only did not decrease, but also increased, turned out to be quite high. This can be explained by the fact that COCs contain gestagens, which cause side effects with symptoms similar to PMS.

If we talk about other hormonal drugs that are not contraceptives, then for PMS, utrozhestan, duphaston, danazol, zoladex, buserelin can also be prescribed. Each drug has pronounced side effects and contraindications.

To summarize, we can unequivocally state that premenstrual syndrome is a chronic disease that affects a woman’s mental and physical health, definitely reducing her quality of life. To treat PMS, complex therapy should be used, which combines medications, correction of work and rest schedules, moderate physical activity, and a balanced diet with a number of restrictions. The experience that has been accumulated in the study of this syndrome allows us to say with confidence that each woman can choose her own individual treatment schedule. It is individual, because PMS manifests itself differently in every woman. Remember this and do not self-medicate.