PMS - a large group of physical and psycho-emotional pathological changes in the body of the cyclical nature, closely related to the approaching menstruation.
PMS rightfully belongs to one of the most enigmatic state of the female body.His credible reasons unknown, so to speak of predisposing conditions for its development.
PMS is not a disease, it is a long list of possible pathological symptoms, which can appear in women before menstruation and go without a trace after it.The severity of PMS and the nature of the clinical manifestations of all patients are different, so the syndrome has no specific clinical signs, but it does have one clear diagnostic criteria - the connection with the approaching menstruation.For one or two weeks before the next menstruation women being changed: there are psycho-emotional disorders, peripheral edema of extremities, weight gain, and increase the sensitivity of the mammary glands, vegetative-vascular manifestations, and so on.
Clinical characteristics of PMS consists of a large number (about 150) of potential symptoms, but each of the patients have their own, often unique set of clinical signs.Find two identical women with PMS symptoms virtually impossible.
Have regular clear communication degradation of women on the eve of the next menstrual period indicates the hormonal nature of PMS.PMS is not uncommon among adolescents is obviously connected with the unfinished process of formation of ovarian hormonal function, and the PMS in women menopause is called its natural extinction.
Clinical symptoms of PMS in women expressed differently, and vary widely from mild to severe ailments that breaks the rhythm of life condition.Regardless of the form and severity of pathological symptoms, their appearance in the second phase of the cycle and disappearing first made to correlate with PMS.
Since PMS is accompanied by a large number of symptoms not associated with gynecology, patients often initially turn to other specialists: neurologists, endocrinologists, therapists and others.Unfortunately, before you get to the right specialist, they are often long-term treatment of non-existent diseases.
physiological changes in the body the day before menstruation is always accompanied by changes in health.Recurring mood changes, increased appetite, breast enlargement and other common precursors of menstruation associated with the physiological hormonal changes in the body and are not always symptoms of PMS.In healthy women, these symptoms do not recur on a regular basis before each menstrual period and there occasionally.
About PMS indicates the presence of a certain number of symptoms that are repeated before every menstruation and disappear on their own after its completion.
diagnostic measures include compulsory study of indicators of hormonal function, and a list of other studies depends on the clinical manifestations of PMS.
clear scheme or special treatment for PMS pills do not exist, because its manifestations are individual and very diverse.Used drugs for PMS belong to different groups and are intended for the phased elimination of all existing symptoms and predisposing factors.
success of treatment is determined normal hormonal ovarian function, a two-phase cycle, and the disappearance of pathological symptoms.
Among women, there is a mistaken belief that PMS, especially its mild form, is normal and does not require medical correction.Meanwhile, the ICP over the years may acquire more severe and pathological menopause in women with PMS often develops.
PMS can not be connected with infringement in the same system, as its symptoms are owned virtually the entire organism.Therefore, all existing theories of the ICP explain the development of pathological symptoms in only one system of the body, but can not bind them together.
One of the most significant causes of PMS is considered a hormonal dysfunction.That it explains PMS adolescents during the period of unstability of the ovaries.It may occur with the first menstruation or after a few normal cycles.If the period of the hormonal function in adolescence passed properly, the chances of developing PMS in women is significantly reduced.
Changing the normal ratio of hormones provokes a temporary denial of the whole organism.Therefore PMS in women often occurs after the abortion, abnormal pregnancy, delete, or tubal ligation, as well as on the background of the wrong use of hormonal contraception.
hormonal imbalances, namely the disruption of the normal ratio of estrogen and progesterone, increases the lability of the nervous system and cause psycho-emotional disorders characteristic of PMS.
There is also the assumption that the initial impact of changes in the central nervous system in the development of PMS.It is based on the fact that most often diagnosed in PMS emotional lability patients with high mental stress, frequent stress or against the background of a significant fatigue.Among the residents of megacities owners PMS is much greater than that in rural areas.
change breast the day before the next menstruation is also hormonal reasons.In response to the provoking factor is synthesized in the pituitary gland too much of the hormone prolactin, which is responsible for the state of the mammary glands.On the eve of menstruation, they become sensitive, dense and increasing in volume.
PMS vary normal levels of water-salt balance.Sodium and fluid retention in the kidney leads to the appearance of edema.
significant role in the formation of PMS belongs tissue hormones prostaglandins, which are synthesized by almost all organs and tissues.It is noted that some PMS symptoms are similar to those with an excess of prostaglandins: migraine headaches, disturbance of bowel movements, dizziness, nausea or vomiting, and a variety of behavioral change.Also prostaglandins responsible for vegetative and vascular disorders in the premenstrual period.
Among the causes of PMS are also present: lack of zinc, magnesium, calcium and vitamin B6;underweight or depletion;endocrine disorders;neuroinfection and thyroid disease.Established a genetic predisposition to the emergence of PMS.
thus leading place among the causes of PMS occupy functional disorders in the central nervous system and the hormonal ovarian dysfunction congenital or acquired nature.
Signs and symptoms of PMS
Clinical characteristics of PMS encompasses numerous cyclically recurring lesions in almost all body systems.However, each woman has a unique set of symptoms.Depending on the prevalence of various clinical symptoms of PMS are four basic forms of its course:
- neuropsychiatric (sometimes referred to as psychovegetative) form of PMS.Severe violations differ from the emotional sphere, and changes in the nervous system.On the eve of menstruation changes mood: patients become depressed, irritable, you may be tearfulness, insomnia, depression.In addition to mood changes occur headaches and dizziness, changes in appetite, fatigue, heart pain and other neurological symptoms.In adult women in the clinic prevalent depressive disorders and PMS symptoms in adolescents differs excessive aggressiveness.
- edematous form of PMS is associated with a predominance of a violation of water-salt balance and is associated with fluid retention in the tissues.The main symptom - swelling of varying severity that occur on the face, legs and hands.Fluid retention in the tissues leads to an increase in mammary and morbidity (mammalgia), as well as weight gain.Appears thirst, itching, joint pain, changes in bowel habits.
- cephalgic form of PMS occurs with severe vegetovascular disorders.The leading symptom is headaches like migraine pain.Typically, these pains are characteristic sided localization in the temple and are characterized by the patient as jerking or pulsating.They are often accompanied by nausea, vomiting, uncontrollable diarrhea and dizziness.Women with PMS cephalgic form usually have a history of cardiovascular disease, hypertension, a disease of the stomach and intestines and psychological trauma.
- krizovoe recalls the undulating form of PMS "panic attacks."Suddenly, often in the evening or at night, the patient having bouts of palpitations, breathlessness and unmotivated fear.Krizovoe form of PMS is inherent in premenopausal, so often present in patients after 45 years.
isolated form of PMS is conditional and does not mean that the patient can simultaneously be only one form of characteristic symptoms of PMS.When mixed forms of PMS is more common combination of psycho-vegetative and edematous forms.
clinical picture of PMS do not always fit into the designated box, sometimes atypical PMS.Before menstruation and during the symptoms of asthma, fever, inflammation of the mucous membranes of the mouth, vomiting.Any unusual symptoms, regular appearance which has a clear connection with menstruation, belongs to the atypical form of PMS.
number of symptoms and their severity determines how hard proceeds PMS.Availability 3-4 clinical signs of which are severe, only one or two, talk about light during PMS.Severe characterized by severe symptoms from 2-5 5-12 available.
If PMS symptoms manifested by small and for many years does not progress, it is considered to be compensated.As a rule, all of its manifestations take place in the beginning of the next menstruation.
subcompensated stage of PMS differs gradual increase in clinical manifestations and disrupts the rhythm of life of the patient.
Severe PMS symptomatic, violation of disability indicate decompensated process.His symptoms disappear a few days after menstruation.
Often patients do not know whether and how to distinguish pregnancy from PMS in the case of similar symptoms.Indeed, small-term pregnancy and PMS can have similar symptoms: fatigue, changes in appetite and weight, and an increase in breast tenderness, swelling, and other psycho-emotional changes.Usually, the doctor is able to distinguish between these states, having studied history and the results of blood tests on HCG - "pregnancy hormone."However, before the onset of menstruation delay, this method is not always reliable.
So how to distinguish pregnancy from PMS in anticipation of the next menstruation?Closely watching the change in the state of his body, the woman herself may come to the correct conclusion.On small pregnancy might think if:
- just you had unprotected sexual intercourse;
- these symptoms do not recur on a monthly basis you before menstruation;
- your condition is not associated with disease neginekologicheskim: colds, intestinal infections, stress, climate change and others.
If pregnancy small life is not ruled out in the next menstruation period will not come.In case of a delay can make rapid - test and then consult a doctor.
Typically, a patient with symptoms of PMS initially turn to endocrinologists, internists and neurologists according to the form of PMS, but pursued their therapy does not give the desired result, so the treatment of a non-existent illness may last for years.
If a woman fails to notice a clear connection with the deterioration of the approaching menstruation, PMS diagnosis begins in a timely manner.Since PMS does not have a clear set of clinical signs, its primary diagnosis relies on two diagnostic criteria: a clear link the symptoms to the menstrual cycle and the lack of mental disorders in patients.
Based on analysis of the most common forms of PMS compiled a list of symptoms, allowing the correct diagnosis.He is considered reliable only if the patient has at least five of the following clinical signs in the obligatory presence of the first four:
- aggression or depression, depression;
- feeling unmotivated anxiety and stress;
- a feeling of hopelessness and despair, in a bad mood;
- indifferent attitude to the surrounding people and events;
- fatigue and physical weakness;
- loss of memory, inability to concentrate;
- poor appetite, tendency to bulimia;
- change the habitual rhythm of sleep - insomnia or drowsiness;
- expressed headaches, breast tenderness, swelling of the face and extremities, weight gain, pain in muscles and joints.
definitive diagnosis is made after seeing the condition of the patient for several menstrual cycles.She is invited to regularly capture premenstrual symptoms in a special diary.After 3-4 cycles contained in the diary data are analyzed.If during the period of observation records reflect the regularity of pathological symptoms and their clear connection with menstruation, PMS diagnosis is obvious.
diagnosis of PMS involves compulsory study of the hormonal status of the patient.It determines the nature of the changes in hormones (prolactin, estradiol and progesterone) in different phases of the cycle.At various forms of PMS, these changes are not equivalent.Thus, reduction of the normal indicators of the level of progesterone in the second phase of the cycle is observed in the edematous form of PMS, and other things there is an increase in prolactin levels.
Additional surveys are conducted in order to avoid extragenital masquerading as ICP.When neuropsychic and cephalgic form of PMS is obligatory consultation neurologist and psychiatrist.To exclude space-occupying lesions in the brain when expressed headaches, impaired vision and hearing may be conducted CT or MRI.
EEG in patients with PMS fixed cyclic disturbances of the electrical activity of the brain.
When mastodynia after visiting the patient passes mammalogy breast ultrasound or mammogram to rule out mastitis.
edematous form of PMS requires the study of kidney function, and to exclude the presence of cardiovascular disease, patients with a form of PMS krizovoe undergo examination by a physician.
Self Test PMS unacceptable.Availability of ill health on the eve of menstruation has many causes and not always means ICP.
PMS Treatment of PMS is a very difficult task, because this condition affects almost all important system.The close connection with PMS hormonal ovarian function explains the complete disappearance of all its manifestations after the cessation of menses.Young women with preserved menstrual function complete relief from PMS is possible only in mild forms of the disease.
Since the only valid reasons established by ICP, therapy aimed at eliminating abnormal menstrual symptoms.Correct symptomatic therapy for PMS can make it easier to return the work capacity and improve quality of life.
Unfortunately, not all patients are turning to the doctor, many people choose medications for PMS themselves.Self-medication can reduce symptoms of the disease, but does not guarantee its recovery.