PMS symptoms in women are 40 years old. "What is PMS, everything you need to know about premenstrual syndrome." How to get rid of PMS on their own

Most women are familiar with the premenstrual syndrome. Many of them suffer from not so much from the ailments of the menstruation itself, as from the state that precedes her. The cause of everything is hormonal changes occurring in the body on the eve of menstruation. The functioning of various organs, as well as the nervous system, is violated. This leads to the emergence of headaches, depression, irritability. It is necessary to know with what physiological processes they are connected. Then maybe it will be easier to cope with unpleasant symptoms.

After ovulation, the so-called luteinic phase is occurring preceding the beginning of menstruation. Preparation for it begins in the body in advance. Under the influence of hormones, changes occur in the state of the mammary glands, genitals. The hormonal processes react to the brain, the central nervous system.

Most women as a result of this characteristic symptoms arise before monthly. Some are starting 2 days before menstruation, in others - for 10. There are disorders with different degrees of severity. With the onset of critical days, they disappear. Such symptoms are combined under the overall title premenstrual syndrome (PMS). It is observed that PMS is stronger in women who suffer from gynecological or any other diseases.

Work in the night shift, the impact of harmful substances, lack of sleep, improper nutrition, troubles and conflicts - all these are factors that increase their ailments before menstruation.

Note: There is such a theory that the unpleasant feeling before the month is the reaction of the body for the absence of conception, which is the natural conclusion of the physiological processes occurring in the female reproductive system.

Signs of approaching menstruation

The manifestations of PMS can be different from each particular woman. Inheritance, lifestyle, age, health condition affect the nature of manifestations. The most obvious signs of approaching menstruations include the following:

• irritability;
• depressed state, feeling of inexplicable longing, depression;
• fast fatigue, headaches;
• drop in blood pressure;
• the inability to concentrate, worsening attention and memory;
• sleep disturbance;
• constant feeling of hunger;
• painful feelings in the chest;
• the occurrence of edema and an increase in body weight due to a fluid delay in the body;
• violation of digestion, intestinal bloating;
• pulling back pain.

There are a light form of the flow of PMS (the presence of 3-4 symptoms that are disappearing with the onset of menstruation) and a heavy form (the appearance of most symptoms is simultaneously 5-14 days before menstruation). Conduct with severe manifestations of independently a woman is not always under power. Sometimes only hormonal drugs can help.

Varieties of PMS.

Depending on which signs are dominated by a woman before menstruation, the following forms of PMS are distinguished.

Even. In this form, women feel sharper pain in lactic glands, their legs and hands swell, skin itching, hyperships appear.

Cefalgic. Each time before menu, dizziness, nausea, vomiting, headache, giving in the eye appears. Often such symptoms are combined with pain in the heart.

Nervous psychic. Symptoms such as depressive mood, irritability, federation, aggressiveness, intolerance to loud sounds and bright light are dominated.

Crossing. In front of menstruation, crises arise in women: blood pressure increases, pulse is rapidly, the extremities are erupted, pain in the progreded area appears, fear of death arises.

Causes of different symptoms of PMS

The severity of the manifestations of PMS depends mainly on the degree of hormonal changes and the state of the nervous system. An important role is played by a psychological attitude. If a woman is active, engaged in interesting things, it does not feel so acute symptoms of menstruation ones, as a dense pessimist, suffering from one thought about the upcoming malaise. The appearance of each symptom can be found an explanation.

Improving body weight. On the one hand, its reason is to reduce the level of estrogen in the blood in the second phase of the cycle. Accumulating fat fabric capable of separating estrogens, the body fills them with a shortage. There is also a deficiency of glucose in the blood, which leads to an increase in the feeling of hunger. For many women, the use of delicious food is a way to distract from troubles and experiences.

Changes in the mood. The cause of aggressiveness, irritability, anxiety, depression is a shortage in the body of "Hormones of pleasure" (endorphine, serotonin, dopamine), the production of which is reduced during this period.

Nausea. Before the monthly uterus increases slightly due to the growth and breaking of the endometrium. At the same time, it can put pressure on the nervous endings, the irritation of which causes the appearance of a vomit reflex. It can provoke the occurrence of nausea can take hormonal drugs and contraceptive means. If a woman has such a sign in front of the month, then it is possible that this means is contraindicated. It must be replaced with another.

A warning: Nausea before the expected monthly can be a sign of pregnancy. Remembering this, a woman must first make a test and visit the doctor to clarify its condition.

Pain in the abdomen. A weak pulling pain at the bottom of the abdomen is considered before a monthly normal phenomenon, if a woman has no cycle disruptions, there are no pathological discharges and other signs of genital diseases. If the pain is strong, do not subscribe after taking painkillers, then it is necessary to go to the doctor, to undergo a survey to determine the causes of pathology.

Temperature increase. Before menstruation, the temperature may increase 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, other signs of violations arise, forcing the woman to visit the doctor.

The appearance of acne. Such a symptom occurs before monthly as a result of endocrine disorders, intestinal diseases, reducing the body's protective forces, disruption of fat metabolism due to changes in the production of hormones.

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

Increased mammary glands. There is an increase in the level of progesterone and the preparation of the body to the possible occurrence of pregnancy. Swipe ducts and slices swell, blood circulation is enhanced. Breast fabrics stretch, which leads to the appearance of stupid pain during touching it.

Video: Why the appetite increases before menstruation

Under what states there are similar manifestations

Often, women are confused by the manifestations of PMS and pregnancy. Nausea, dizziness, increase and painfulness of the mammary glands, White gain is characteristic of both states.

If there are symptoms, and the monthly delayed, then, most likely, a pregnancy has come. To make sure that this is this way, it is recommended to hand over the blood test for the content of chorionic hormone (HCG is formed after the occurrence of pregnancy).

Such symptoms also appear in endocrine diseases, the formation of the tumors of the mammary glands, the use of hormonal drugs.

Symptoms of approaching in adolescent first monthly

Paul ripening begins in girls aged 11-15 years. Their character is finally established only after 1-2 years. Learn about the imminent onset of the first menstruation, the girl can according to characteristic manifestations. Already 1.5-2 years before this event, a teenager girl appears white discharge. Immediately before the appearance of the first menstruation, they are becoming more intense and liquid.

It is possible that the appearance of a weak pulling pain in the ovaries arising from their growth and stretching. PMS is more often manifested sufficiently weakly, but there may be deviations comparable in character with the manifestations of PMS in adult women. One of the characteristic signs of adolescent PMS is the formation of acne on the face. The cause becomes oscillation of the level of sex hormones, the effect of this process on the condition of the skin.

Video: signs of approaching men's men

Manifestations of PMS in women during premanopause

After 40-45 years, women appear the first signs of aging organism and reduce the level of sex hormones. Menstrual disorders arise, the metabolism is slowed down, the chronic diseases of the genital organs are often sharpened. The state of the nervous system is worse. As a result, the manifestation of PMS is even more enhanced.

Many women of this age are observed before monthly severe headaches, dizziness, strengthening, accelerating heartbeat, mood swings, depression state. Often, such manifestations of PMS are so painful that hormonal therapy is prescribed to facilitate the state of the condition, drugs regulating the content in the organism of estrogen, progesterone and other hormones.

Building:

Studies have shown that women suffering from PMS, in the period after ovulation, there is a decrease in serotonin levels. Serotonin is a biologically active substance that plays an important role in the transfer of nerve impulses in the brain.

It is possible that it is the decline in serotonin level that is the cause of such psychological symptoms of PMS as an depression, inexplicable sadness, "depression".

Another possible cause of PMS, according to researchers, may be lack of calcium and magnesium. These minerals, like serotonin, play an important role in the transmission of nerve impulses and in the exchange of substances.

Medicines that increase the level of serotonin and additives with calcium and magnesium are able to greatly facilitate the symptoms of PMS.

As mentioned above, in former times the cause of PMS was considered a hormonal imbalance in the body of a woman (excess estrogen, lack of progesterone, etc.). Some recent studies have shown that women suffering from PMS, the concentration of these hormones in the blood does not really differ from those in healthy women.

As is known during ovulation, physiological (that is, normal) increase the development of progesterone and some decrease in estrogen production (compared to the first half of the menstrual cycle). In this regard, it is assumed that one of the reasons for the appearance of the symptoms of PMS is not a deviation from the "normal" concentration of sex hormones, but the "wrong" body reaction to the physiological changes in the levels of estrogen and progesterone in the blood in the second half of the menstrual cycle.

PMS, smoking and overweight

Some studies have shown that smoking and overweight increases significantly increase the likelihood of the development of PMS symptoms.

In particular, women with BMIs are equal to 30 and above suffer from PMS about 3 times more often than women with normal body weight.

In smoking women, the symptoms of PMS appear almost 2 times more often than in non-smoking women.

As will be shown below in the section with questions about the treatment of PMS, weight loss and smoking refusal are one of the most affordable and sufficiently effective methods for the treatment of this disorder.

PMS and age women

PMS is characteristic only for women who have menstruation. Girls who have no monthly started or women in the period The PMS cannot suffer and all the symptoms similar to the Symptoms of PMS should be considered a sign of some other disease.

As studies show, at certain moments of life, the symptoms of PMS are celebrated from 40 to 90% of women aged from 16-45 years. From this number of women, about 20% note that the symptoms of PMS appear regularly, each month. From 3 to 10% of women suffer from the heavy form of PMS (see below for the symptoms of PMS).

Girls with recently emerged menways suffer from PMS relatively rarely. Nevertheless, as the probability of appearance, the PMS increases. Most often, PMS is observed in women older than 30 years. Women over 40 years old, approaching menopause, are inclined to develop more than severe PMS forms.

At the same time, with the onset of menopause, the symptoms of PMS completely disappear.

I take contraceptive pills and notice the symptoms of PMS. What can it mean?

Despite the fact that during the reception of contraceptive tablets, the ovaries cease to produce eggs and ovulation ceases, many women who take birth control pills are experiencing the symptoms of PMS.

If you notice the symptoms similar to PMS and they are bothering you - talk to your doctor regarding the transition to contraceptives containing a progestic component in the form of dROPRINONA (Examples of such contraceptives of Yarina, Jess). In contrast to conventional contraceptives, contraceptives containing acidware can reduce the intensity of PMS symptoms and are used as the first phase of treatment in young women.

What could be the symptoms and signs of PMS?

PMS can manifest themselves as a number of psychological and physical symptoms.

Depression, irritability, "depression", aggressiveness, feeling of anxiety, restless sleep

Many women suffering from PMS describe their condition as follows:

« i strongly nervous, I can upset, shout on someone or praise almost no reason" or " on the days of the PMS, even minor problems bring me out of themselves, children are nervous, it is nervous to work or housework" or

« i feel some kind of severe deep sadness" or " in the days of PMS, I am pursued by a sense of selflessness, it is difficult for me to concentrate at work, I am very scattered, I have no strength to take up the case" or " in the days of the PMS, I am constantly covered by some kind of inexplicable inner anxiety, the feeling of something will soon have something bad, for which I can not affect" or " i have a very restless sleep; Because of this, after I wake up I feel tired».

Indeed, many women in the days of PMS there is an extremely unstable psychological state. Attacks of anger, strong irritability and aggression can suddenly replace the state of apathy, strong depression and "depression."

Regarding mental symptoms of PMS, you need two important comments:

A. In general, a number of cases, psychological symptoms that women are "written off" on PMS in fact are a sign of not premenstrual syndrome, but a certain psychological disorder. Most often with PMS confession and anxiety disorder. Above, describing the symptoms characteristic of PMS, we took the word "depression" in quotes as contrary to popular conviction is not a temporary and easy mood violation, but a very difficult psychological disease. Unlike sadness and depression with PMS, which are without a trace pass within a few days, this depression can flow for a long time (weeks or months) and represents a serious threat to the health and life of a sick person. Anxious disorder is a very common disorder characteristic and for men and for women, in which a person feels inexplicable and anxious, "hidden approximation of danger." And this depression and alarming disorder may become more explicit during the period of approaching menstruation and, especially, in the days of the menstruation themselves. This is exactly why women with these diseases often consider their symptoms of the symptoms of PMS. However, in contrast to the symptoms of PMS, sadness, depression, anxiety and other psychologically symptoms are characteristic of depression or anxiety disorder, do not pass simultaneously with the onset of menstruation and persist in the days of the menstruation themselves and on days after them. To understand if psychological symptoms can not be connected with PMS, but with some other disease, see our recommendations below in the question What can mean if the symptoms of PMS appear not only before monthly, but also on other days? B. In cases where psychological symptoms are really associated with PMS, they cannot be considered a sign of a bad nature, infantile behavior or "psychopathicness" of women. As already mentioned above in the section on The causes of PMS.This disorder arises due to the violation of some biochemical processes in the brain. In this regard, from women suffering from PMS, it is impossible to demand or expect complete control and overcoming psychological symptoms. It should be understood that during the PMS, a woman behaves "in this way," because it is so at that time her brain works.

Chest pain (in lactic glands) and nipples

«… shortly before the menstruation, I have a strange sense of "gravity", stress, soreness or tingling in both breasts and nipples. Sometimes it prevents me from working or worrying during sex. On the Internet often write that chest pain can mean cancer ...».

Despite the fact that tensions and soreness in breasts with PMS are usually not very strong, many women with PMS pay special attention to this symptom, as they consider it a possible symptom of breast cancer.

In fact, the soreness of the breast with PMS has no connection with cancer and it should not be afraid of this symptom.

Tensions and increase in breast size with PMS are associated with water delay in the body of a woman.

How to find out exactly what it is not cancer?

In order to finally make sure that the pain in the breasts in your case are not related to the development of the tumor:

• Tell your gynecologist about them. The doctor will examine the chest.
• If a doctor notices something unusual (for example, a seal in one breast), it will appoint you additional surveys that will help you accurately determine the nature of changes in the chest. Detailed recommendations on this occasion you will find in our article. The health of the mammary glands in women of all ages and in children. Explanation of possible changes, symptoms and problems.

Increase body weight

« ... quite often shortly before the occurrence of menstruation it seems to me that I "recovered." If I weighed at such moments, then I really see that we have 1-2 kg more than usual. I can not understand where this weight is taken from. It is very sad for me, since I try to follow the figure ... "

A sudden increase in body weight, which is observed in women suffering from PMS is not associated with the accumulation of adipose tissue, but is a manifestation of the time delay of water in the body of a woman, which, in turn, is associated with some changes in the water-salt balance of the body during this period. As a rule, during the first few days after the start of the monthly, the excess water is derived from the body and "extra kilograms" disappear.

Appearance of edema

«… sometimes a few days before the start of the month, I notice, swelling on the legs ... »

Like weight gain and breast increase, swelling on the legs associated with PMS are a consequence of water delay in the body of a woman and should not be considered a sign of the kidney disease, varicose veins or other diseases.

According to statistical data, which means PMS, more than 80% of all girls and women in the world know. Most often, the manifestation of the syndrome occurs in the age range from 20 to 40 years. In rare cases, the harbingers of menstruation show themselves in severe form, so the representatives of weak gender usually do not turn to the gynecologist with complaints. But the aggravation of the symptoms of PMS in women from month to a month forces consult with a doctor, because it may be a sign of health problems.

Theory of origin

Specialists from the field of medicine for a long time led the research that could not help identify the cause of the appearance of premenstrual syndrome. There are many theories of its occurrence. Among them:

1. Hormonal.
2. Violation of the water-salt balance.
3. Psychosomatic.
4. Allergic reaction to endogenous progesterone.

If you believe hormonal theory, then the manifestation of signs of the premenstrual period occurs due to changes in the level of sex hormones in the blood of a woman in the second phase of the cycle. For the normal functioning of the body, the patient requires a stable hormonal background, which includes:

After ovulation, that is, in the second phase of the cycle, the change in the hormonal background in the female organism occurs. Therefore, the supporters of the theory believe that the cause of the occurrence of PMS is improperly reaction of the brain departments that are responsible for the change of emotional mood and behavior, on natural changes in the concentration of genital hormones. Such a feature is hereditary predisposition.

Somatic and pillagetative disorders before the onset of critical days occur due to the unstable state of the endocrine system. At the same time, the level of hormones, which may be normal, is not a decisive factor. Responsible for the change in mood and behavior are considered:

Features and Stages

As a rule, over the years, the risk of increasing PMS is that in translation means PremenStrual Syndrome, only increases. The appearance of the syndrome resident of large cities is prone stronger than rural women. About 90% of female girls notice a number of minor changes in the body and the body. They begin to appear before the onset of critical days. This is usually happening 7-10 days before the start of bloody secretions.

Some symptoms are manifested in a weak form without affecting the usual life. Light flowing of PMS does not require the intervention of the doctor and the appointment of treatment. Others with difficulty tolerate the symptoms that occur in severe form. Such a state requires compulsory contacting a medical facility for professional assistance. The cyclic feature of the emergence of a number of symptoms makes it possible to understand that it is PMS, and not some kind of disease.

Heavy phenomena in the physical and emotional state of women who are observed before the occurrence of menstruation immediately stop with the beginning of blood secretions. If unpleasant symptoms are preserved during the entire menstruation cycle, then it is necessary to contact the gynecologist. The fact is that this may be a sign of the flow of serious pathology in the reproductive system. With a heavy emotional state, it is recommended to turn to a psychotherapist.

Experts share PMS for 3 stages:

In most cases, PMS is considered a natural phenomenon, so women do not appeal to their doctor. Feelings before monthly and at the beginning of pregnancy are very similar, so girls are often confused. Strong pain and reluctance to go to the hospital make them take not only painkillers, but also antidepressants without consultation with a specialist. Drugs such a group really help to remove pain syndrome, but without the necessary PMS therapy can go to a more heavy stage - decompensated.

The manifestation of signs of premenstrual syndrome seizes all the women's body systems, so they are often confused with the flow of other diseases. This leads to the fact that the girls are asking for help not to those experts, for example, to a neurologist or therapist, and do not receive proper treatment. It is possible to understand the exact cause of deterioration of the state only with a professional inspection and full examination.

Symptoms of manifestation

Each woman, PMS proceeds in its own way. This is due to the fact that any organism has its own individual features. The symptoms of the premenstrual syndrome are divided into such groups:

1. Vegeta. Racing blood pressure, vomiting, severe headache, nausea, tachycardia, dizziness and pain in the heart area.
2. Nervous psychic. Depressive condition, plasticity, aggression and irritability.
3. Exchange and endocrine. Edema, temperature rise, chills, breast pain, itching, thirst, shortness of breath, violation, reducing memory.

Conditionally premenstrual syndrome is divided into several forms, but at the same time its signs proceed not isolated, but in combination. So, with the depressive state of the pain threshold, women significantly decreases, and it begins to feel more spasms and pain.

PMS form:

Women most often before starting menstruation suffer from irritability, pain in the dairy glands, the bloating, plasticity, headache, and ethnicity. Weakness, pain in the abdomen, dizziness, nausea, vomiting and an increase in body weight are significantly less.

It is worth remembering that PMS is able to exacerbate the following diseases:

Frequent reasons

There are many factors that can affect the development of PMS. Unfortunately, gynecologists and endocrinologists could not come to the general opinion. Frequent causes of unpleasant symptoms are considered:

Differences from pregnancy

Some signs of PMS are very similar to the first symptoms of pregnancy, which arise before the delay. The fact is that from the moment of conception in the blood, the level of sex hormone increases. The same process is observed before the start of menstruation. That is why these states are confused. Similar symptoms:

• the rapid appearance of fatigue;
• back pain;
• an increase in the sensitivity and swelling of the mammary glands;
• mood swings;
• irritability;
• vomiting;
• nausea.

It is recommended to compare their character over the causes of the appearance of unpleasant symptoms. So, with PMS discomfort in the chest passes with the onset of menstruation, and during pregnancy continues to disturb until the very end. In an interesting position for girls inherent in the desire to eat inedible things, drink beer with salty fish. In addition, they exacerbate the smell and they begin to sick from the usual smells. In the syndrome, sensitivity to flavors also appears, but there are no special addictions in food, it just rises appetite.

As for pain in the lower back, the pregnant women are not always boring at the beginning of the term. Fatigue appears from 4 weeks of to wear. It is then that the toxicosis occurs. The stomach can pull a little, but it lasts not very long.

Before the monthly, the back is beginning to root or immediately after ovulation, or a few days before the start of the selection. The discomfort at the bottom of the belly is far from everyone, because this symptom is very individual. Frequent urination cannot be a harbinger of critical days. But nausea and even vomiting are common enough.

Of course, it is difficult to determine exactly what is happening in the body. Often in very early time, when a new life is only originated, it is not possible to determine the pregnancy without even an experienced gynecologist when inspection on the chair. In such cases, he assigns ultrasound for more accurate check. If there is no possibility to visit the specialist, it is recommended to wait for the delay and conduct a pregnancy test or pass the blood test on hCG.

Diagnostic methods

Remember the start date and end of menstruation is not easy, it is quickly forgotten. To facilitate the task, it is recommended to keep a diary or calendar, where it will be necessary to record not only the flow of menstruation, but also indicators of basal temperature, symptoms and changes in weight. Such an approach should be followed for 2-3 cycles to simplify the diagnosis and treatment of PMS.

It is possible to determine the severity of the premenstrual period by the duration of the signs and their intensity:

1. Lightweight. There are maximum 4 symptoms of weak severity or 2 signs strong.
2. Heavy shape. From 2 to 5 intense symptoms. It is also diagnosed if at least one sign deprives a female performance.

Cyclicity distinguishes PMS from pathological manifestations of other sexual diseases. Well-being worsens 2-10 days before menstruation. Unpleasant symptoms do not always pass with the onset of bloody secretions. Often they flow into menstrual migraine or painful critical days. You can distinguish PMS from pathology according to the following signs:

1. If the girl feels good in the first half of the cycle, then diseases such as fibrous-cystic, neurosis and depression are excluded.
2. Endometriosis, dysmenorrhea and chronic endometritis are manifested by intermenstrual bloody discharges and pains at the end of the cycle.

Gynecologists to establish the degree of sub-syndrome, conduct hormonal analysis to progesterone, and estradiol. In addition, the specialist appoints an additional examination of the patient. Depending on the complaints, the following procedures may be spelled out:

To the diagnosis of patients who suffer from the heavy flow of PMS, neurologists, psychiatrists, endocrinologists, therapists and cardiologists are also connected.

Therapeutic approaches

It is possible to achieve improvement in well-being possible with complex treatment of premenstrual syndrome. It is selected individually for a variety of parameters. So, for stream, form and symptoms PMS woman can assign the following:

Preventive measures

If the PMS does not quietly live, depriving performance, then, of course, without conducting therapy. But this is sometimes not enough. After the end of the course of treatment, it is necessary to follow certain prophylactic measures. These include:

Balanced diet, reception of vitamins and minerals, physical activity, sex sessions and strong sleep bring a positive mood and good well-being, which is preserved even before the start of menstruation.

Premenstrual syndrome (PMS) - a set of features arising in a few days (from 2 to 10) before menstruation and disappearing in the first days. At another time, the symptoms of PMS are missing.

The condition includes neuropsychiatric violations, vegetative-vascular and metabolic manifestations. Almost every woman ever experienced signs of PMS. However, it takes only every tenth patient.

How and why premenstrual syndrome occurs

In the middle of the menstrual cycle in the ovary there is an ovulation - an egg flow from the ripe follicle. It begins to move along the abdominal cavity to the uterine tube to meet with sperm and fertilization. A yellow body is formed on the site of the follicle - formation with high hormonal activity. Some women in response to such endocrine "bursts" react the brain departments responsible for emotions, vascular reactions, the regulation of metabolism. Often such an individual response feature is inherited from Mother to her daughter.

Previously, it was believed that PMS occurs more often in women with a disturbed hormonal background. Now doctors are confident that such patients have a regular ovulatory cycle, and in all other relations they are healthy.

PMS development theory:

• hormonal;
• water intoxication;
• dysfunction of the renin angiotensin-aldosterone system;
• lack of vitamins and fatty acids in nutrition;
• hyperprolactinemia;
• allergy;
• psychosomatic disorders.

At PMS, the relative content of estrogen increases with a relative reduction in the level of the Gestagennes. Estrogens detain sodium and liquid in the body, causing edema, meteorism, headache appears, chest hurts. Estrogens activate the renin-angiotensin-aldosterone system, causing additional fluid delay. These sex hormones directly affect the brain zone responsible for the formation of emotions (limbic system). Also reduced the level of potassium and glucose in the blood, which causes weakness, heart pain, reduced activity.

The level of the gestagenov depends on how many days before the menstruation will come PMS. These hormones pushed the occurrence of menstruation. They determine how much premenstrual syndrome lasts.

As a result of the violation of the activity of the renin-angiotensin-aldosterone system, a fluid is delayed, which causes the edema of the intestinal wall. There is a bloating, nausea, constipation.

The development of PMS contributes to the lack of vitamins, magnesium and unsaturated fatty acids in food. Some scientists believe that as a result, depression arises, chest pain, irritability, elevated body temperature.

The increase in the level of prolactin in the second half of the cycle, allergic to the internal progesterone, as well as interrelated bodily (somatic) and mental (mental changes), has a certain value in the ICP development mechanism.

Clinical picture

There are three groups of basic symptoms that determine the severity of the status:

• neriva-mental disorders: plasticity, depression, irritability;
• vegetative-vascular changes: nausea and vomiting, headache and dizziness, heartbeat, pain in the field of heart, increase pressure;
• violations of metabolism: an increase in the mammary glands, swelling, bloating, thirst and shortness of breath, itching, chills, an increase in body temperature, pain at the bottom of the abdomen.

The aggravating factor of the PMS flow is depression. With her, women feel more pain and other unpleasant sensations that can smoothly move into painful menstruation and migraine.

Forms of premenstrual syndrome

PMS can occur in the following clinical forms:

• nervous psychic;
• edema;
• cephalgic;
• crossing.

The neuropsychic form is accompanied by emotional disorders. Young women have a reduced mood background. In adulthood, aggressiveness and irritability becomes the leading sign.

The edema is accompanied by edema legs, face, eyelids. It becomes close shoes, the rings are poorly put on. Increased sensitivity to smells, the abdomen appears, skin itch. Due to the fluid delay, weight increases (by 500-1000 g).

With cephalgic form, the main symptom becomes headache in the temples with spread to the eyeboard. It has a tweaking, pulsating character, accompanied by dizziness, nausea and vomiting. Most of these women detect changes in the pituitary.

The curriculum is manifested by sympathoadrenal attacks: the blood pressure suddenly increases, the graceful pain in the chest appears, the fear of death. At the same time, there is a strong heartbeat, a feeling of numbness and cooling hands and legs. Crisis usually occurs in the later time of the day, ends in a large amount of urine. This form is more often observed as the outcome of the untreated previous options.

Flow

When does the PMS begins? With a slight month 2-10 days before menstruation, three - four features arise, one or two of which are expressed most. With severe flow, symptoms appear 3-14 days before menstruation. There are more than five, and at least two are sharply expressed.

The PMS current in all patients is different. Someone symptoms appear at the same time and stop with the occurrence of menstruation. Other patients over the years are registered more and more signs. The condition is normalized only after the end of menstrual bleeding. In the most difficult cases, symptoms are preserved and after stopping menstruation, and the gap without complaints is gradually decreasing. In such a situation, a woman can even lose disability. In some patients, cyclical ailments continue and after the onset of menopause. There is a so-called transformed PMS.

The lightest flow of PMS is accompanied by the appearance of a small number of symptoms, easy malaise, without limiting the normal rhythm of life. In more severe situations, signs of this state affect family life, performance, conflicts with others may appear. In severe cases, especially with the crisal of the course, a woman cannot work and needs to be issued a sheet of disability.

Diagnostics

PMS is a clinical diagnosis based on the analysis of symptoms, their severity, cyclicity of occurrence. An inspection of the gynecologist is assigned, genital organs are carried out. For proper hormone therapy, it is necessary to determine the level of genital and other hormones in the blood.

The patient advises a neurologist, if necessary, a psychiatrist, an ophthalmologist, an endocrinologist. It can be appointed such research as electroencephalography, computed tomography of the brain, ultrasound of the kidneys,.

Only after a comprehensive examination and observation, the gynecologist puts such a diagnosis and prescribes treatment.

Treatment of PMS.

How to facilitate premenstrual syndrome? For this purpose, the following scheme is recommended:

• psychotherapy;
• proper nutrition;
• physiotherapy;
• physiotherapy;
• treatment of premenstrual syndrome drugs.

Psychotherapy

Rational psychotherapy helps to get rid of such unpleasant symptoms as excessive emotionality, mood swings, fiscaliness or aggressiveness. For this purpose, psycho-emotional relaxation techniques are used, stabilizing behavioral techniques. A woman is taught how to facilitate PMS, help to cope with fear before the onset of menstruation.

It is very useful to carry out psychotherapeutic classes not only with a woman, but also with her loved ones. Native learn to better understand the condition of the patient. Conversations with close surroundings of the patient improve the microclimate in the family. Through psychosomatic mechanisms, it is possible to improve the physical condition of the patient, facilitate the objective manifestations of the premenstrual syndrome.

Lifestyle and food

In the diet, it is necessary to increase the content of plant fiber. It normalizes the intestinal job, removes the excess fluid from the body. The daily diet should consist of carbohydrates (mostly complex), by 15% of proteins and only 10% of fats. Use of fats must be limited, as they affect the participation of the liver in the exchange of estrogen. It is better to refuse from beef, since it often contains small doses of artificially entered hormones. Thus, the most useful source of protein with PMS will be fermented dairy products.

It is useful to increase the use of juice, in particular, carrot with the addition of lemon. Herbal teas are recommended with adding mint, Melissa, Valerians. Vegetable sedative with PMS helps to cope with emotional disorders, improve sleep and general well-being.

It should be abandoned from excess salt, spices, limit the use of chocolate and meat. Alcoholic beverages should not be used, as they reduce the content in the body of vitamins of the group B, minerals, change the exchange of carbohydrates. The work of the liver suffers, which can lead to impaired estrogen exchange and strengthening the severity of the state.

No need to take a lot of drinks with caffeine (tea, coffee, coca-cola) with PMS. Caffeine causes a fluid delay, breaks a dream, contributes to neuropsychiatric disorders. In addition, it enhances the heat of the mammary glands.

Preparations for the treatment of PMS

With pronounced signs of PMS, it is necessary to consult a doctor. He will tell how to deal with his symptoms, applying drugs. Consider the main groups of drugs for therapy of premenstrual syndrome.

1. After the survey in the gynecologist, gestagens are prescribed in the detection of an increased level of estrogen (absolute or relative hyper estrogenation). These include Duphaston, Norcut and others. Anti-estrogenic action and agonists of gonadotropin-rilizing factors, in particular, Danazole are possessed.
2. Antihistamines are prescribed due to the increase in histamine and serotonin levels in such patients. TAVEGIL, Supratine is usually applied on the night since two days before the expected attack of PMS and ending with the first day of menstruation.
3. To normalize the work of the brain structures responsible for vascular regulation and mental disorders, novotropy are prescribed - nootropyl, aminal, starting from the first day of menstruation within two weeks. Such courses repeat three months in a row, then take a break.
4. If, after determining the level of hormones, the level of prolactin is detected, pairlook is assigned (bromocriptine), starting two days before the intended occurrence of PMS, within 10 days.
5. In the presence of pronounced edema, the appointment of a diuretic with the potassium-saving effect of Veroshpiron, which is an aldosterone antagonist. Assign it 4 days before the deterioration of well-being and cease reception with the onset of menstruation. If the sweeping syndrome is manifested by a headache, violation of vision, it is recommended to use diakarb.
6. In the presence of pain, fixed assets for the treatment of PMS are non-steroidal anti-inflammatory drugs, in particular, diclofenac. He is prescribed two days before the deterioration of well-being. These drugs suppress the synthesis of prostaglandins - biologically active substances causing many signs of PMS. Curriculum treatment is carried out within three months. The effect of such a course lasts up to four months after its termination. Then the symptoms of PMS are resumed, but are usually less intense.
7. Excessive emotionality, depressive disorders, neurosis may be an indication for the purpose of tranquilizers. There are special "daytime" drugs that do not suppress normal activity, in particular, Grandaxin and Afobazol. Neuroleptics and antidepressants can be used. Such drugs appoint a psychiatrist. They need to be taken continuously for 3-6 months.
8. Vitamins A and E have a beneficial effect on the female sexual system, including reducing the severity of the premenstrual syndrome. They are taken inside or introduced intramuscularly for a month, alternating among themselves. When anxious-depressive disorders appear in the second half of the cycle, magnesium and vitamin B6 are prescribed.

PMS treatment is carried out by cycles. In the first three months, diets, vegetable sedatives, vitamins, nonsteroidal anti-inflammatory drugs are used. Then make a break in treatment for 3-6 months. When the signs of PMS, other drugs with more serious effects are added to the treatment. Do not expect a quick effect. Therapy should be carried out for a long time, accompanied by modification of nutrition and lifestyle.

Premenstrual syndrome (PMS, premenstrual voltage syndrome, premenstrual disease) - pathological symptom complex, manifested by neuropsychic, vegetative-vascular and exchange-endocrine disorders in the second phase of the menstrual cycle.

The frequency is variable and depends on the age of a woman. At the age of 30 years, the frequency is 20%, after 30 years of PMS occurs approximately every second woman. In addition, it is more often observed in emotionally labile women of asthenic physique with a body weight deficit. More often observed in women of intellectual labor.

The factors that contribute to the emergence include stressful situations, neuroinfection, complicated childbirth and abortions, various injuries and operational interventions.

There are many development theories, each of which explains the pathogenesis of the occurrence of various symptoms: hormonal, theory of "water intoxication", psychosomatic disorders, allergic, etc.

An important role in the pathogenesis is given a hormone prolactin. In addition to the physiological increase, the hypersensitivity of target tissues to prolactin in the second phase of the cycle is noted.

The role of prostaglandins in pathogenesis is shown. Since prostaglandins are universal tissue hormones, which are synthesized in almost all organs and tissues, the synthesis of prostaglandins can manifest itself a variety of different symptoms. The synthesis of synthesis and metabolism of prostaglandins explains the occurrence of such symptoms as headaches according to migraine, nausea, vomiting, bloating, diarrhea and various behavioral reactions. Prostaglandins are also responsible for the manifestation of various vegetative-vascular reactions.

The variety of clinical manifestations indicates the involvement in the pathological process of central structures responsible for the regulation of all metabolic processes in the body, as well as behavioral reactions, so at present the main role in the pathogenesis is given to the violation of the exchange of neuropeptides and the associated peripheral neuroendocrine processes.

Thus, development can be explained by the functional disorders of the CNS as a result of the impact of adverse factors against the background of the innate or acquired lability of the hypothalamic-pituitary system.

Depending on the prevalence of certain symptoms in the clinical picture, allocate four forms of PMS. :

● neuropsychic;

● Overall;

● Cefalgic;

● Currency.

Depending on the number of symptoms, their duration and severity, they allocate a lung and heavy form:

Light form of pms - The appearance of 3-4 symptoms 2-10 days before menstruation with significant severity of 1-2 symptoms.

Heavy form of pms - The appearance of 5-12 symptoms 3-14 days before menstruation, of which 2-5 or all are significantly expressed.

Disruption of disability regardless of the number and duration of symptoms indicates a heavy course and is often combined with a neuropsychic form.

PMS Stages

Compensated Stage: The appearance of symptoms in the premenstrual period, with the beginning of menstruation symptoms pass. Over the years, the manifestations of PMS are not progressing.

Subcompensated Stage: Over the years, the severity of the PMS flow progresses, the duration, the number and severity of symptoms increases.

Decompensated stage: The difficult course of PMS, "light" gaps are gradually reduced.

Neuropsychic form of PMS It is characterized by the following symptoms: emotional lability, irritability, plasticity, insomnia, aggressiveness, apathy to the surrounding, depressive state, weakness, fast fatigue, olfactory and auditory hallucinations, memory weakening, feeling of fear, longing, unfortunate laughter or crying, sexual disorders, suicidal thoughts . In addition to neuropsychic reactions, which appear on the fore, in the clinical picture there may be other symptoms: headaches, dizziness, disruption of appetite, diseases of dairy glazes, bloating.

Overall form of PMS. It is distinguished by prevailing in the clinical picture of the following symptoms: the edema of the face, the legs, the fingers of the hands, heat and painfulness of dairy glasses (medium), skin itching, sweating, thirst, weight gain, violation of the gastrointestinal tract (constipation, flatulence, diarrhea), pain in Sustaines, headaches, irritability, etc. In the overwhelming majority of patients with an oscillator form of PMS in the second phase of the cycle, a fluid delay in the body is noted.

Cefalgic form of PMS. It is characterized by vegetative-vascular and neurological symptoms: headaches in terms of migraine with nausea, vomiting and diarrhea, dizziness, heartbeat, heart pain, insomnia, irritability, increased sensitivity to smells, aggressiveness. The headache is of a specific character (twirling, pulsating in the area of \u200b\u200bthe temple with a century edema) and is accompanied by nausea, vomiting. In history, these women are often noted neuroinfection, cunning injuries, mental stresses. Family history of patients with cephalgic form is often burdened by cardiovascular diseases, hypertensive disease and the pathology of the gastrointestinal tract.

For crisis form of PMS. In the clinical picture, crises predominate, accompanied by an increase in blood pressure, tachycardia, pain in the heart, a sense of fear without changes in the electrocardiogram. The attacks often end with abundant urinary. As a rule, crises arise after overwork, stressful situations. The crime flow may be the outcome of an unheld neuropsychic, ethimous or cofalgic form at the stage of decompensation and manifest after 40 years. The overwhelming majority of patients with crisis form of PMS marked kidney diseases, a cardiovascular system and a ventricular tract.

TO atypical forms of PMS. there are myocardiopathy, migraines, "cyclic" allergic reactions (ulcerative gingivitis, stomatitis, bronchial asthma, iridocyclitis, etc.).

Diagnostics Presents certain difficulties, since patients often turn to the therapist, a neuropathologist or other specialists depending on the form.

Given the variety of symptoms, the following clinical diagnostic criteria are proposed:

● A clear connection of symptoms with a menstrual cycle - the emergence of clinical manifestations for 7-14 days before and their termination after menstruation.

The diagnosis is established in the presence of at least 5 of the following symptoms with a binding manifestation of one of the first four:

● Emotional lability: irritability, fiscalness, fast mood change.

● Aggressive or depressive condition.

● Feeling alarm and voltage.

● Mood deterioration, hopelessness.

● Reducing interest in the usual way of life.

● Fast fatigue, weakness.

● The inability to concentrate.

● Changes in appetite, tendency to bulimia.

● drowsiness or insomnia.

● Burning and painfulness of dairy glasses, headaches, edema, articular or muscle pain, body weight gain.

It is advisable to keep a diary for at least 2-3 menstrual cycles, in which all the symptoms are noted.

Hormonal studies are used to form a diagnosis, depending on the form, additional examination methods are prescribed (CT, MRI, electroencephalography, mammography). For a survey of patients with PMS, adjacent specialists are involved: neuropathologist, psychiatrist, therapist, endocrinologist.

Treatment

The first stage of treatment is psychotherapy with an explanation of the essence of the disease. Mandatory normalization of the regime of labor and recreation. Very relieved state regular. The food must be in compliance with the diet in the second phase of the cycle, excluding coffee, chocolate, sharp and salty dishes, as well as a liquid limitation. Food should be rich in vitamins; Animal fats, carbohydrates are recommended to limit. Since PMS accompanies ovulatory cycles, the most effective drugs are COC.

Considering the presence of neuropsychic manifestations in varying degrees of severity in any form, sedative and psychotropic drugs are recommended.

Preparations are prescribed in the second phase of the cycle 2-3 days before the symptoms manifest.

Antihistamine action preparations are effective in the FM formal form, allergic manifestations.

Effectively use drugs that improve blood circulation in the central nervous system.

Since it is manifested by many symptoms, preparations are prescribed depending on these manifestations.