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

General information

premenstrual syndrome, or PMS, are called vegetative-vascular, neuropsychic and metabolic-endocrine disorders that occur during the menstrual cycle (more often in the second phase). Synonyms for this condition, found in the literature, are the concepts of "premenstrual illness", "premenstrual tension syndrome", "cyclic illness". Every second woman over the age of 30 is familiar with premenstrual syndrome firsthand, in women under 30 this condition is somewhat less common - in 20% of cases. In addition, manifestations of premenstrual syndrome are usually companions of emotionally unstable, thin, asthenic body types of women, who are more often involved in the intellectual field of activity.

Causes of premenstrual syndrome

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

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

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

In addition, an indicator of a severe form of the course of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. A decrease in working capacity is usually noted in the neuropsychic form of premenstrual syndrome.

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

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

Diagnosis of premenstrual syndrome

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

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

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

The manifestation of five of the above signs with the obligatory presence of at least one of the first four allows us to speak with confidence about premenstrual syndrome. An important link in the diagnosis is the patient's keeping a diary of self-observation, in which she must note all violations in her state of health for 2-3 cycles.

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

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

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

Treatment of premenstrual syndrome

In the treatment of premenstrual syndrome, drug and non-drug methods are used. Non-drug therapy includes psychotherapeutic treatment, compliance with the regime of work and good rest, physiotherapy exercises, physiotherapy. An important point is the observance of a balanced diet with the use of a sufficient amount of vegetable and animal protein, vegetable fiber, vitamins. In the second half of the menstrual cycle, you should limit the intake of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, and alcoholic beverages.

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

The leading place in the medical treatment of premenstrual syndrome is occupied by specific hormonal therapy with progesterone analogues. It should be remembered that the treatment of premenstrual syndrome is a long process, sometimes continuing throughout the entire reproductive period, requiring a woman's internal discipline and the steady implementation of all doctor's prescriptions.

PMS: forms and signs. How to stop the symptoms of premenstrual syndrome?

The well-established idea of the fragility of the female body is justified: unlike men, the fairer sex does have a more complex physiological organization, which is necessary to perform the reproductive function. An illustration of this is premenstrual syndrome (PMS), a condition that can shake the physical and mental well-being of even the most balanced and healthy young lady. In this article, we'll take a look at the common misconceptions associated with this condition and find out how to alleviate PMS.

Truths and myths about PMS

Many stereotypes are associated with premenstrual syndrome - this is due to the fact that, to date, scientists have not yet fully elucidated the mechanisms for the occurrence of such a phenomenon. In addition, the widespread use of PMS among women has been publicly discussed relatively recently (previously, everything related to the menstrual cycle was a kind of taboo in society). It is not surprising that the representatives of the weaker sex, who were lucky enough to never experience symptoms of discomfort before menstruation, as well as some men, consider this problem far-fetched. According to some sociologists, PMS is a cultural phenomenon: having learned about the existence of this syndrome, women begin to look for signs of psychological instability at a designated time, and every month these days they explain the reasons for their bad mood precisely as premenstrual disorder.

Nevertheless, most experts are inclined to the position that premenstrual syndrome is a complex physiological process that can be characterized by endocrine, psycho-emotional and vegetative-vascular disorders.

According to statistics, manifestations of PMS are observed in half of women of reproductive age, of which, in about 5-10%, the symptoms are so pronounced that they cause disability. It is no coincidence that this condition is included in the international classification of diseases of the World Health Organization: in other words, a diagnosed premenstrual syndrome is a valid reason for receiving a sick leave.

As a rule, the duration of PMS is from two days to a week, while this indicator, like the severity of symptoms, tends to increase with age.

What is the reason for this phenomenon? A few days before the end of the menstrual cycle, the concentration of sex hormones in the blood of a woman significantly decreases: the body understands that pregnancy has not occurred, and is preparing to renew the inner layer of the uterus and the next round of preparation for conception. At the same time, according to one of the theories of the development of PMS, a short-term change in the hormonal background, which also affects the synthesis of biologically active substances in the central nervous system, leads to characteristic symptoms - fluid retention in the body, headache, tightening of the mammary glands and sudden changes in mood. At the same time, with the age of a woman - and, as a result, with an increase in the number of chronic diseases and pathologies of the reproductive system - the manifestations of PMS increase.

Scientists believe that the reason PMS has proved to be an evolutionary advantage is that the condition (often accompanied by irritability and aggressiveness) increases the likelihood of separation from an infertile partner.

How to determine the presence of premenstrual syndrome

How to understand what is the cause of your poor health on the eve of menstruation? Doctors advise every woman, regardless of the presence or absence of signs of PMS, to keep a short diary, reflecting in it any changes in well-being throughout the entire menstrual cycle. For these purposes, you can use one of the many mobile applications. If you notice that a certain "set" of symptoms repeats in a similar form from month to month in the last days before physiological uterine bleeding - most likely, this can be attributed to premenstrual syndrome.

There are four forms of PMS that combine similar types of manifestations:

At neuropsychic form Violations of the emotional sphere come to the fore: a woman becomes whiny, apathetic, irritable, she can be unsettled even by slight physical fatigue or unpleasant news, which on other days would cause only a momentary upset.
Cephalgic form PMS is characterized by a migraine that can go as far as nausea. The pain in this case can be given to the eye area, accompanied by sweating, weakness, numbness of the fingers. Some women, by these signs, guess about the approach of menstruation.
edematous form manifested by fluid retention in the body: a few days before menstruation, a woman notes that her face is swollen or heaviness has appeared in the mammary glands. Edema can also appear on the legs - in the afternoon. At the same time, a woman may feel cravings for salty foods, which indicates a violation of the water-salt metabolism in the body.
At crisis form PMS, which is initially more common in women with a tendency to jumps in blood pressure, the syndrome reveals itself as hypertension in the evenings: the numbers on the tonometer exceed the norm, the pulse quickens and there is a feeling of lack of air.

Often, premenstrual syndrome manifests itself in a mixed form: headache and swelling are combined with irritability, and a general feeling of weakness and weakness - with pressure drops. In severe cases, PMS can be a reason to call the ambulance, especially if a woman over 40 suspects a hypertensive crisis, myocardial infarction or stroke. The opposite situations are not rare either - reassuring herself with the thought that it's just overwork and the typical precursors of menstruation, the patient ignores the alarming symptoms of a serious illness.

There is nothing reprehensible in the fact that with severe PMS, seek the advice of a doctor. Firstly, in order to undergo an examination and make sure that the cause of discomfort is precisely in this phenomenon, and not in a chronic disease that requires special treatment. Secondly, medicine has an arsenal of tools that can significantly alleviate premenstrual syndrome, and in some cases even prevent its onset. At the same time, unfortunately, a universal medicine that allows you to cope with PMS once and for all has not yet been invented - but perhaps such a remedy will one day appear on pharmacy shelves.

Non-drug approaches

If PMS does not cause severe discomfort, then it will probably be possible to do without drugs. Scientists noted that premenstrual discomfort is more often observed in urban women - this may be due to an unhealthy lifestyle and excessive stress, which also negatively affect hormonal levels. Therefore, the first step in solving the problem of PMS is the stabilization of the emotional sphere.

Psychological support involves individual consultations with a psychologist or classes in specialized groups aimed at combating stress. As part of the classes, you will either talk about your experiences and deal with the causes of chronic anxiety, or practice relaxation techniques: breathing exercises, art therapy, etc.
Physiotherapy. Many women report that courses of massage or apparatus procedures (for example, hydrotherapy) lead to a decrease or disappearance of PMS symptoms. This approach is especially useful for those who have other health problems - for example, osteochondrosis, the consequences of surgeries, and so on.
Lifestyle Correction often allows without any auxiliary methods to improve the condition before menstruation. So, proper nutrition and regular exercise help to lose weight, and healthy sleep is the prevention of migraine, even in cases where it is caused by PMS, and not by chronic lack of sleep. It has been proven that in women who follow the daily routine, premenstrual syndrome occurs less frequently and is milder than in others.

Hormone therapy for PMS

Another way to combat premenstrual syndrome is to take sex hormones. Such treatment is carried out exclusively under the supervision of a physician.

The goal of hormone therapy is to eliminate the physical symptoms of PMS. The most common method is the appointment of combined oral contraceptives (COCs), which temporarily “turn off” the functions of the ovaries and take on the task of regulating the menstrual cycle. Due to this, the imbalance of sex hormones, which causes the manifestations of premenstrual syndrome, disappears. In some cases, doctors recommend taking COCs continuously - that is, without interruption for 7 days after the end of each pack of tablets.

In severe cases, when the use of COCs is impossible or ineffective, the patient can be prescribed progestin preparations (based, for example, danazol) or agents from the group of gonadotropin-releasing hormone agonists (goserelin, buserelin). The effectiveness of such treatment reaches 85%, however, long-term use of such drugs sometimes leads to side effects, so they are not prescribed for more than six months.

Medicines given to women to relieve symptoms of PMS

You can cope with PMS without hormones - especially when this condition manifests itself mainly in a neuropsychic form. Drugs from various groups, traditionally used as sedatives and normotonics (mood stabilizers), help relieve irritability and feelings of depression.

Herbal medicines - such as "Fito Novo-sed", "Novo-Passit", "Deprim Forte" reduce feelings of anxiety and fear, and can also help with attacks of melancholy.
Vitamins, homeopathy, dietary supplements : leuzea extract, tincture of ginseng, lemongrass, hawthorn, valerian are natural remedies that increase vitality and eliminate the feeling of depression. The drug "Mastodinon" is a homeopathic remedy designed specifically to combat PMS. Also, doctors often prescribe multivitamin complexes to patients, which normalize metabolism and reduce the somatic manifestations of the syndrome.
OTC and prescription sedatives are medicines used for various indications that may also be effective for PMS. "Afobazol", "Persen", "Fito Novo-Sed" are the most popular over-the-counter drugs, which allows them to be used without consulting a doctor. If your doctor has prescribed you a prescription-only drug, you should be especially careful with dosages and monitor side effects.

Expert opinion: a specialist from the manufacturer of the drug tells about the use of Afobazol during PMS

"Afobazole" is a modern drug aimed at restoring the normal functioning of the nervous system and quickly eliminating the manifestations of increased irritability and anxiety. The effect persists after completion of the course, which allows you to experience relief from PMS for a long time after treatment. "Afobazole" does not cause dependence and does not entail a withdrawal syndrome, so you can use it in those periods of life when it is really necessary. Another plus of "Afobazole" is that it does not enter into drug interactions. This allows it to be used as one of the means of complex drug therapy.

Antipsychotics also called antipsychotic drugs - they are taken to relieve severe emotional disorders, psychosis, severe dementia. In small doses, they have a sedative, anti-anxiety and hypnotic effect, but their long-term use can aggravate the symptoms of PMS.

Since the signs of PMS are individual for each woman, it is not always wise to take the advice of friends or relatives in the treatment of this condition - especially if they endure the last days of the cycle before menstruation easier than you do. Be consistent in your PMS remedies and if lifestyle changes and over-the-counter medications don't improve your condition, be sure to consult your doctor.

Premenstrual syndrome is a complex of symptoms that appear in the second half of the menstrual cycle a few days before the onset of menstruation. Every fifth woman under the age of 30 faces this condition, and every second - after. The symptoms are both physical and mental and can vary greatly from woman to woman.

Causes

Currently, the exact causes of the development of premenstrual syndrome have not been established. There are many theories explaining the occurrence of various symptoms, but none of them covers the whole complex. The hormonal theory is currently considered the most complete, according to which the cause of PMS is a change in the hormonal balance caused by an increase in estrogen levels and a decrease in progesterone levels.

One of the probable factors in the development of premenstrual syndrome is beriberi, in particular the deficiency of vitamins B6, A and trace elements of calcium, magnesium and zinc. The genetic factor is also of great importance, i.e. the nature of the course of PMS can be inherited.

Symptoms of premenstrual syndrome

There are about 150 different symptoms of PMS, which can also occur in different combinations, which greatly complicates the diagnosis. Based on the main symptoms, there are several forms of the syndrome:

neuropsychic;
cephalgic;
edematous;
crisis.

Neuropsychic form characterized by disturbances in the emotional and nervous spheres. It is characterized by emotional instability, tearfulness, irritability, aggression, weakness, fatigue, dizziness, insomnia, apathy, unreasonable longing, depression, suicidal thoughts, olfactory and auditory hallucinations, fear, sexual disturbances, memory loss. There are also disturbances in appetite, bloating, soreness and enlargement of the mammary glands.

At cephalgic form vegetative-vascular and neurotic symptoms predominate: migraine-like, throbbing headaches, often accompanied by nausea or vomiting, swelling of the eyelids, diarrhea. Approximately one third of women experience increased heart rate, pain in the heart area, nervousness, increased sensitivity to smells and sounds. This form is more common in women who have had craniocerebral injuries in the past, frequent stress, infectious diseases of the nervous system.

The main manifestation of premenstrual syndrome with edematous form there is fluid retention in the body and, as a result, swelling of the face, limbs, mammary glands, weight gain, sweating, thirst, decreased urination, skin itching, digestive disorders, constipation, diarrhea, bloating.

In crisis forms there are sympatho-adrenal crises (a condition caused by an increase in the level of adrenaline), which occur with an increase in blood pressure, tachycardia, panic attacks, numbness and coldness of the extremities. There may be pain in the heart without changes on the ECG. As a rule, the end of the attack is accompanied by profuse urination. Overwork and stress can be factors that provoke seizures. This form of premenstrual syndrome is the most severe and requires mandatory medical intervention.

Diagnostics

Due to the variety of symptoms, the diagnosis of premenstrual syndrome can be very difficult. The main diagnostic criterion is the cyclicity of complaints and their disappearance after menstruation. The study of the level of hormones (estrogen, progesterone, prolactin) in the blood helps to establish the form of premenstrual syndrome. It is recommended to undergo an electroencephalography (EEG) procedure.

Treatment of premenstrual syndrome

For the treatment of PMS, pharmacological and non-pharmacological methods are used.

Non-pharmacological methods include, first of all, psychotherapy. A woman must comply with the regimen, avoid excessive stress and have proper rest and sleep.

A diet high in vegetable and animal proteins, fiber and vitamins is recommended. In the second half of the menstrual cycle, it is necessary to limit the use of coffee, chocolate, alcohol, sugar, salt, animal fats and carbohydrates. Regular exercise, therapeutic aerobics, and massages will help alleviate the condition.

Among the drug methods, the main role is given to hormone therapy with drugs - analogs of progesterone. In edematous and cephalgic forms, antiprostaglandin drugs are recommended - indomethacin, naprosin.

Since neuropsychiatric manifestations are present in any form of premenstrual syndrome, in the second phase of the cycle, sedative and psychotropic drugs - tazepam, rudotel, etc.

With edematous form premenstrual syndrome, antihistamines (tavegil, diazolin) are used. Assign veroshpiron 25 mg 2-3 times a day a few days before the onset of symptoms. This drug has a potassium-sparing and diuretic effect, lowers blood pressure.

With cephalgic and crisis forms use drugs that normalize the synthesis of hormones, for example, parlodel (1.25-2.5 mg per day) in the second phase of the cycle. With soreness and engorgement of the mammary glands, the use of progestogel, a gel containing progesterone, is recommended.

A beneficial effect is the use of vitamins E and B6, calcium, potassium, zinc, magnesium, manganese and the amino acid tryptophan. A good effect in the treatment is given by alternative methods - acupressure (acupressure), aromatherapy.

Treatment of premenstrual syndrome is a long process, lasting about 6-9 months, repeated in case of relapse. In rare cases, treatment can last the entire reproductive period. For greater effectiveness, it is necessary to strictly follow the regimen and instructions of the doctor.

Prevention

The basis for the prevention of premenstrual syndrome is the observance of the regime of work and rest, the reduction of psycho-emotional stress. It is important to exclude factors - provocateurs of poor health. It is recommended to limit the consumption of coffee, tea, alcoholic beverages and chocolate, especially at the end of the cycle. Instead, fiber-rich foods, herbal teas, and juices (especially carrot, lemon, and pineapple) are recommended. It is necessary to increase the content of vitamin B6 in the daily diet. It is found in liver, fish, walnuts and soybeans.

Forecast

Assigned symptomatic treatment, as a rule, leads to improvement in the second half of the menstrual cycle.

Many are sure that premenstrual syndrome is another female "whim", a manifestation of character and banal whims. But doctors are quite serious about the phenomenon under consideration - they conduct various kinds of research, select medicines to alleviate the condition of a woman, and develop preventive measures.

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

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

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

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

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

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

Causes of PMS

It is difficult even for modern medicine to name specific reasons for the appearance and development of the premenstrual cycle, but there are highlighted factors that will contribute to the phenomenon in question. These include:

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

Note:the number of artificial abortions, the number of births, and various pathologies of a gynecological nature also affect the appearance of premenstrual syndrome.

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

Vegetovascular disorders- there will be dizziness, sudden "jumps" in blood pressure, headaches, nausea and rare vomiting, heart palpitations.
Neuropsychiatric disorders- characterized by increased irritability, tearfulness, and unmotivated aggression.
Metabolic and endocrine disorders- there is an increase in body temperature and chills, peripheral edema, severe thirst, disturbances in the digestive system (flatulence, diarrhea or constipation), memory loss.

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

neuropsychic

With this form, the condition in question will be manifested by disorders in the mental and emotional sphere. For example, there will be sleep disturbances, a sharp change in mood, irascibility and unmotivated irritability, aggression. In some cases, a woman, on the contrary, develops apathy towards the outside world, lethargy, depression, panic attacks, an enduring feeling of fear and anxiety.

edematous

Crisis

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

Cephalgic

It is imperative that when diagnosing this form of premenstrual syndrome, a woman will have a history of diseases of the gastrointestinal tract, cardiovascular diseases,.

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

Separately, it is worth mentioning that there are atypical manifestations of premenstrual syndrome - fever to subfebrile indications, increased drowsiness, ulcerative gingivitis, stomatitis, allergic manifestations (for example, Quincke's edema), bouts of vomiting.

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

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

How can a doctor help

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

General principles for alleviating the condition of a woman with PMS:

Pay attention to two factors:

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

How to get rid of PMS on your own

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

. In no case should we forget about activity - hypodynamia is recognized by all doctors as a direct path to PMS. You should not immediately set Olympic records - it will be enough to walk more, do exercises, go to the pool, go to the gym, in general, you can choose classes "to your liking."

What it does: Regular exercise raises endorphins, which helps relieve depression and insomnia.

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

What it gives: carbohydrate metabolism remains within the normal range, mood swings and irritability are not provoked by caffeinated products.

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

What it gives: it is a full-fledged sleep that is “responsible” for the strength of immunity, the normal functioning of the central nervous system.

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

What it gives: heart palpitations, unmotivated anxiety and irritability, fatigue and insomnia will either be completely absent or have a low intensity.

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

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

Traditional medicine for PMS

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

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

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

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

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

Speaking of PMS - what it is, you should know how PMS is deciphered - this is what it means - a manifestation that is characteristic of women on the days before menstruation. PMS is a complex of symptoms that appear in women and girls a few days before the onset of menstruation.

What are the causes of such manifestations, and what does this syndrome mean, scientists are still investigating. Those who are interested in how PMS is translated should learn more about what manifestations are characteristic of this condition. Each transcript 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 - their scientists counted about 150. Approximately 75% of women experience premenstrual syndrome to varying degrees.

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

Why does PMS develop?

Until now, 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 disturbed water-salt metabolism.
Allergic nature - high sensitivity of the body to endogenous.
Psychosomatic - the development of physiological symptoms due to the influence of mental factors.

The most complete and broadest to date is the hormonal theory, according to which PMS is explained by a strong hormonal fluctuation in the second phase of the cycle. After all, in order for the female body to function correctly, a 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 efficiency and energy.

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

Since in the premenstrual period in the body there is endocrine instability , this leads to the manifestation of somatic and psychovegetative 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, soreness of the mammary glands, dysfunctions 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 violations of a vegetative-vascular nature, digestive disorders - diarrhea, nausea, as well as headaches resembling.

Thus, modern physicians distinguish 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: with a decrease in this hormone, sadness and longing are noted.
Deficiency leads to fluid retention, breast tenderness, mood changes.
A lack of magnesium leads to the development of symptoms such as headache, desire to eat sweets.
Smoking – women who smoke are twice as likely to suffer from PMS.
- those with a body mass index greater than 30 are much more likely to experience the symptoms of this syndrome.
Genetics - the tendency to PMS can be inherited.
Difficult childbirth, abortion, gynecological operations.

The main symptoms of PMS in women

Speaking about what are the symptoms of PMS, how many days before menstruation in girls and women they appear, one should take into account the individual characteristics of each organism. The main signs of PMS before menstruation are divided into several different groups by doctors. There are such symptoms of premenstrual syndrome (in groups):

neuro-psychic : 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 drops, nausea, vomiting, tachycardia, pain in the heart.

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

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

Neuropsychic form		Disturbances in the emotional and nervous spheres are manifested: panic attacks, causeless longing and depression may develop; anxiety, feeling of fear, depression; forgetfulness, impaired concentration, mood swings; insomnia, activation or decrease in libido; aggression, dizziness.
crisis form		There is tachycardia, pressure drops, pain in the heart; frequent urination before menstruation, panic. those who are characterized by this form, as a rule, have heart disease, kidney disease, and poor digestion.
Atypical manifestations		The temperature rises to subfebrile indicators; constantly worried about drowsiness, allergic manifestations, vomiting.
edematous form		Characterized by negative diuresis and fluid retention in the body. There are swelling of the limbs and face, itching of the skin, thirst, weight gain, pain in the lower back and joints, headache, decreased urination, and digestive problems.
Cephalgic form		Most show vegetative-vascular and neurological symptoms: migraine, cardialgia; nausea and vomiting; tachycardia; high sensitivity to smells and sounds. Approximately 75% of women have an increase in the vascular pattern, hyperostosis. With this form, as a rule, a family history includes hypertension, diseases of the digestive system, diseases of the heart and blood vessels.

Wikipedia and other sources indicate that every woman has PMS in her own way, and the symptoms may vary.

Scientists, after conducting a series of studies, determined the frequency of manifestations of symptoms of premenstrual syndrome:

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

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

What conditions and diseases can masquerade as PMS?

To know how many days menstruation begins, every woman must have a calendar or a special notebook and write down the date of the beginning of menstruation, how long menstruation lasts, and also the day of ovulation (for this, it is enough to measure basal temperature). It is also worth noting the manifestation of symptoms before menstruation and well-being during ovulation.

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

To establish the diagnosis of PMS, the doctor determines the presence of at least 4 signs of the following:

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

You can also diagnose this condition if at least one of the following signs is noted:

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

To determine the severity of PMS, it is important to consider 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 the fact that a woman becomes disabled a day or a few days before menstruation.

The cyclicity 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 the psychovegetative symptoms disappear, then physical sensations sometimes turn into painful periods or migraines in the first days of the cycle.

If a woman feels relatively good in the first phase of the cycle, then this is PMS, and not an exacerbation of chronic diseases - depression, neurosis, fibrocystic.

If soreness is noted only immediately before menstruation and during menstruation, and is combined with blood secretions in the middle of the cycle, then this indicates that, most likely, a gynecological disease develops in the body -, and etc.

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

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

If you are concerned about very severe headaches, tinnitus, dizziness, fainting, visual impairment, it is necessary to conduct a CT scan or MRI to rule out organic brain diseases.
With the predominance of neuropsychic symptoms, an EEG is performed to rule out an epileptic syndrome.
If edema is of concern, the amount of urine per day changes, tests are carried out 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 understand - PMS or pregnancy?

Since some symptoms during pregnancy are very similar to those of PMS, it is important to consider the differences by which these conditions can be distinguished.

After the conception has occurred, the growth of the hormone occurs in the female body progesterone . As a result, a woman can confuse pregnancy with PMS when they begin to appear: breast tenderness and swelling, vomiting, nausea, mood swings, lower back pain, irritability.

Often, going to one or another thematic forum, you can see the reasoning of women about how to distinguish PMS from pregnancy before delay. Of course, if menstruation began on time, then the issue is removed by itself. However, even pregnant women sometimes have discharge during the days. When should you have your period. There are differences in discharge before menstruation and during pregnancy - in pregnant women, they are usually more scarce. But still, in order to verify the presence or absence of pregnancy, it is worth doing a test or conducting tests in honey. institution.

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

Symptom	During pregnancy	For premenstrual syndrome
Chest pain	Occurs during pregnancy	Disappears with the onset of menstruation
Appetite	Taste preferences change, sense of smell sharpens, habitual smells irritate	May crave sweet, salty, sensitivity to odors, possibly increased appetite
Backache	Anxiety in the last trimester	Possible lower back pain
Fatigue	Appears about a month after conception.	Possible both after ovulation and a few days before menstruation
Pain in the lower abdomen	Intermittent, mild pain	Manifested individually
Emotional condition	Mood changes frequently	Irritability, tearfulness appear
Frequent urination	May be	Not
Toxicosis	Begins to develop approximately 4-5 weeks after conception	May have nausea, vomiting

Since the symptoms of these conditions are actually similar, and in some cases even pregnancy during menstruation is possible (at least, this is the impression a woman gets if there is a discharge), it is important to act correctly.

It is best to wait until the menstruation begins. If a woman notes that she already has a delay, it is imperative to conduct a pregnancy test that reliably determines pregnancy after a delay. Those who want to immediately verify whether there was a conception can take (pregnancy hormone). Such a test already on the tenth day after conception accurately determines pregnancy.

It is most correct in such a situation to visit a gynecologist who will help you figure out what a woman really has - PMS or pregnancy through examination, ultrasound. Sometimes the question also arises, 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, 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. Also, the doctor can give effective recommendations on how to alleviate certain unpleasant manifestations.

As a rule, symptomatic therapy is prescribed for such manifestations. 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 treatments may be prescribed:

With mood swings, depression, irritability, psychotherapy sessions, a relaxation technique, and a sedative are prescribed.
If you are concerned about pain in the abdomen, lower back, headaches, it is recommended to take non-steroidal anti-inflammatory drugs to relieve pain (pills, and etc.).
Also prescribe drugs for the treatment of premenstrual syndrome - diuretics in order to remove excess fluid and eliminate edema.
Hormonal treatment is prescribed if there is an insufficiency of the second phase of the cycle, after carrying out tests of functional diagnostics, guided by the results of the changes that have been identified. Appoint gestagens — medroxyprogesterone acetate , they need to be taken from the 16th to the 25th day of the menstrual cycle.
Tranquilizers and antidepressants are prescribed to women who develop numerous neuropsychic 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 the body needs for proper rest. As a rule, it is 8-10 hours. Many women who write to 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 can develop, worsens. For those who have insomnia, small evening walks can help.

aromatherapy

Provided that a woman does not suffer from allergies, aromatherapy can be practiced by choosing a special composition of aroma oils. It is recommended to use oil of lavender, basil, sage, geranium, rose, juniper, bergamot. 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, body flex, etc. If you train fully and regularly, the content of endorphins . And this allows you to overcome depression and insomnia, reduce the severity of physical symptoms.

Vitamins and minerals

To reduce the severity of symptoms, magnesium should be taken two weeks before menstruation 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 in the diet as many vegetables and fruits as possible, as well as foods containing calcium and fiber. It is worth reducing the amount of coffee, cola, chocolate consumed, as caffeine provokes anxiety and mood swings. It is important to reduce the amount of fat in the 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 the reserves of minerals and vitamins are depleted, and the liver utilizes hormones worse.

Often women are interested in why they want salt before menstruation. The fact is that appetite fluctuations are normal during PMS, and sometimes you just need to “meet the requirements” 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, meditation.

regular sex

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

Medicinal herbs

With the help of herbal teas, you can significantly alleviate the condition with PMS. The main thing is to choose the right herbs. Tea can be made from St. John's wort, primrose, as well as other herbs recommended by the doctor.

conclusions

Thus, premenstrual syndrome is a serious condition that sometimes becomes an obstacle for a woman to a full life and ability to work. According to studies, the most common symptoms of PMS occur in residents of large cities and women who are engaged in mental work.

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