PMS: symptoms, treatment, causes, difference fromof pregnancy

Update: December 2018

Doctors have long puzzled over the causes of female malaise
before menstruation. Some healers associated it with the phases of the moon, others
– with the locality in which the woman lives.

The condition of the girl before the menstruation for a long time remained a mystery.
Only in the twentieth century the veil of secrecy opened a little.

PMS is a mix of 150 different physical and mental
symptoms. AT той, или иной степени, с проявлениями
about 75% of women face premenstrual syndrome.

How long does PMS in girls? Unpleasant symptoms begin
manifest 2-10 days before the onset of menstruation, and disappear from
the appearance of “red” calendar days.

Interesting facts about PMS

  • Crime Chronicle. PMS is not only shaky nerves and
    broken plates. Most accidents, crimes, thefts committed
    women, occurred from the 21st to the 28th day
    menstrual cycle.
  • Shopping Therapy If you believe the research, for a few
    дней до monthly of womenы наиболее податливы соблазну покупать как
    can be more.
  • Symptoms of PMS are more susceptible to women engaged in mental
    labor and residents of large cities.
  • The term ICP was first used by Robert Frank, an obstetrician-gynecologist from
    Of England.

Why does premenstrual syndrome occur?

Numerous studies have not revealed the exact
causes of premenstrual syndrome. Theories of its occurrence
many: “water intoxication” (violation of water-salt metabolism),
allergic nature (hypersensitivity to endogenous
progesterone), psychosomatic, hormonal, etc.

But the most complete is the hormonal theory explaining the symptoms of PMS.
колебаниями уровня половых гормонов во 2 phase of the menstrual cycle.
For the normal, harmonious functioning of the body of a woman
the balance of sex hormones is very important:

  • estrogens – they improve physical and mental well-being,
    increase the tone, creativity, speed of learning
    information learning ability
  • progesterone – has a sedative effect that can
    cause depressive symptoms in phase 2
  • androgens – affect libido, increase energy,

ATо время второй фазы менструального cycle происходит изменение
hormonal background of a woman. According to this theory, the cause of PMS lies in
�“Inadequate” response of the organism, including the parts of the brain that respond
for behavior and emotions, for cyclic hormonal changes,
which is often inherited.

Since the days before menstruation are unstable in the endocrine
many women have psycho-vegetative and
somatic disorders. The decisive role is not so much
hormone levels (which can be normal), how many fluctuations
содержания половых гормонов в течение менструального cycle и как на
these changes respond to the limbic brain regions responsible for
behavior and emotions:

  • increase in estrogen and first increase and then decrease
    progesterone – hence fluid retention, swelling, engorgement and
    breast tenderness, cardiovascular disorders,
    irritability, aggression, слезливость
  • prolactin hypersecretion – also leads to fluid retention,
    sodium in the body
  • excess prostaglandins – vegetative-vascular disorders,
    indigestion, migraine headaches

The most likely factors affecting the development of the syndrome are
account of which the opinions of physicians do not differ:

  • Снижение уровня серотонина — это  так называемый «гормон
    joy “may be the cause of the development of mental signs
    premenstrual syndrome, since a decrease in its level causes
    sadness, tearfulness, melancholy and depression.
  • Дефицит витамина AT6 — на нехватку этого витамина указывают
    symptoms such as fatigue, fluid retention,
    mood changes, breast hypersensitivity.
  • Magnesium deficiency – magnesium deficiency can cause tachycardia,
    dizziness, headaches, craving for chocolate.
  • Smoking. Women who smoke are twice as likely
    premenstrual syndrome.
  • Overweight. Women whose body mass index is over 30,
    three times more likely to suffer from PMS symptoms.
  • Геnotический фактор — не исключено, что особенности протекания
    premenstrual syndrome is inherited.
  • Abortions (consequences), complicated childbirth, stress, operative
    interventions, infections, gynecological pathologies.

Main symptoms and manifestations of premenstrual syndrome

Symptom groups for PMS:

  • Neuropsychiatric disorders: aggression, depression,
    irritability, tearfulness.
  • ATегетососудистые нарушения: перепады артериального давления,
    headache, vomiting, nausea, dizziness, tachycardia, pain in
    areas of the heart.
  • Exchange-endocrine disorders: swelling, fever
    bodies, chills, hemming of the mammary glands, itching, flatulence, shortness of breath,
    thirst, memory loss, blurred vision.

PMS in women can be divided into several forms, but their
symptoms usually do not appear in isolation, but are combined. With
the presence of psycho-vegetative manifestations, especially depression, in of women
the pain threshold decreases and they perceive pain more acutely.

Crisis form
Atypical manifestations PMS
Disturbances in the nervous and emotional realms:

  • panic attacks
  • anxiety disorders
  • feeling of gratuitous melancholy
  • depression
  • feeling of fear
  • depression
  • concentration disorder
  • forgetfulness
  • insomnia (see how to fall asleep quickly)
  • irritability
  • mood swings
  • decrease or significant increase in libido
  • dizziness (causes)
  • aggression
  • tachycardia
  • blood pressure jumps
  • heartache
  • frequent urination
  • panic attacks

У большинства of women отмечены заболевания, сердечно-сосудистой
system, kidney, gastrointestinal tract.

  • low-grade fever (up to 37.7 ° C)
  • increased sleepiness
  • bouts of vomiting
  • allergic reactions (ulcerative gingivitis and stomatitis, edema
    Quinck, etc.)
Edematous form
 Cephalgic form
  • swelling of face and limbs
  • thirst
  • weight gain
  • pruritus
  • decrease urination
  • indigestion (constipation, diarrhea, flatulence)
  • headaches
  • joint pain

There is a negative diuresis with fluid retention.

Leading mainly neurological and vegetative-vascular

  • migraine, throbbing pain, gives to eye area
  • cardialgia (pain in the heart)
  • vomiting, nausea
  • tachycardia
  • повышенная чувствительность к smells, звукам
  • у 75% of women рентгенография черепа — гиперостоз, усиление
    vascular pattern

Семейный анамнез of women при этой форме отягощен гипертонией,
cardiovascular diseases, gastrointestinal diseases.

ПМС у каждой of womenы протекает по-разному, симптоматика
varies greatly. According to the results of some studies
of womenами с ПМС отмечается следующая частота проявления того или
another sign of PMS:

Symptom frequency%

Hormonal theory of PMS

irritability 94
breast tenderness 87
abdominal distention 75
tearfulness 69
  • depression
  • чувствительность к smells
  • headache
  • puffiness
  • weakness
  • sweating
  • heartbeat
  • aggressiveness
  • dizziness
  • lower abdominal pain
  • nausea
  • pressure increase
  • diarrhea
  • weight gain
vomiting 12
constipation 6
back pain 3

Premenstrual syndrome может усугубить течение других

  • Anemia (see iron supplements for anemia)
  • Epilepsy (symptoms, treatment)
  • Migraine (see triptans for migraine)
  • Thyroid disease
  • Chronic Fatigue Syndrome
  • Bronchial asthma
  • Irritable Bowel Syndrome
  • Allergic reactions
  • ATоспалительные заболевания женских половых органов

Diagnosis: what can be disguised as PMS?

Since dates and deadlines are easily forgotten in order to facilitate yourself
task, you should have a calendar or diary where to write the date
начала и окончания monthly, овуляцию (базальную температуру), вес,
symptoms that bother. ATедение такого дневника на протяжении
2-3 cycles will greatly simplify the diagnosis and allow you to trace
frequency of signs of PMS.

For diagnosis, 4 or more of
following signs:
And at least 1 of the following:
  • Insomnia sleepiness
  • Memory impairment, reduced attention
  • Changes in appetite
  • Слабость, fast fatiguability
  • Breast soreness
  • Edema (see what to do if swollen legs)
  • Headache
  • Muscle or joint pain
  • Deterioration of chronic diseases
  • Unreasonable anxiety, tension and fear
  • Crying, mood swings, conflict,
  • Depressed mood, feeling of inexplicable melancholy
  • Depression
  • Aggressive behavior

The severity of premenstrual syndrome is determined by the amount
duration and intensity of symptoms:

  • Mild: 3-4 symptoms or 1-2 if they are significant
  • Severe: 5-12 symptoms or 2-5, but very pronounced, and
    also regardless of the duration and their number, if they
    приводят к notрудоспособности (обычно нейропсихическая форма)

The main symptom that distinguishes premenstrual syndrome from other
diseases or conditions are cyclical. That is worsening
самочувствия возникает за несколько дней до monthly (от 2 до 10) и
completely disappear with their arrival. However, unlike
psychovegetative, physical discomfort in the first days
следующего cycle могут усиливаться и плавно переходить в такие
disorders like painful menstruation or menstrual

  • Если of womenа относительно хорошо себя чувствует в 1 фаза cycle,
    it is a premenstrual syndrome, not a chronic disease –
    невроз, depression, фиброзно-кистозная мастопатия
  • If pain appears only immediately before menstruation.
    and during it, especially when combined with bleeding in
    середине cycle — это скорее всего не ПМС, а другие гинекологические
    diseases – endometriosis, chronic endometritis, dysmenorrhea
    (painful menstruation) and others.

Studies are conducted to establish the form of the syndrome.
hormones: prolactin, estradiol and progesterone. ATрач также может
assign additional diagnostic methods depending on
prevailing complaints:

  • With сильных головных болях, головокружениях, шуме в ушах,
    reduced vision and fainting is assigned computed tomography or
    MRI to exclude organic brain diseases.
  • With an abundance of neuropsychiatric diseases, an EEG is indicated.
    to exclude epileptic syndrome.
  • With pronounced edema, changes in the daily amount of urine
    (diuresis) tests are carried out to diagnose the kidneys (see the causes
    swelling of the legs).
  • When a strong and painful engorgement of the mammary glands is necessary
    perform breast ultrasound and mammography to exclude
    organic pathology.

Conducts a survey of women suffering from PMS, not only
gynecologist, but also involved: psychiatrists, neurologists,
endocrinologists, nephrologists, cardiologists and therapists.

Premenstrual syndrome or pregnancy?

Some symptoms of PMS are similar to the manifestations of pregnancy (see
first signs of pregnancy before a delay). After conception in
the body of a woman increases the content of the hormone progesterone,
what happens during PMS, so the following symptoms
are identical:

  • fast fatiguability
  • breast swelling and tenderness
  • nausea, vomiting
  • irritability, mood swings
  • lower back pain

How to distinguish pregnancy from PMS? Comparison of the most
common symptoms of premenstrual syndrome and

Symptoms Pregnancy Premenstrual syndrome
  • Breast tenderness
accompanies the entire pregnancy with the onset of menstruation the pain goes away
  • Appetite
the attitude to food changes, I want inedible, salty,
beer, the fact that the woman does not like the usual, greatly aggravated
smell, ordinary smells can be very annoying
can pull on sweet and salty, sensitivity to
  • Back pain
only late there may be lower back pain
  • Increased fatigue
starts from 4-5 weeks after conception may appear either immediately after ovulation, or 2-5 days before
  • Lower abdominal pain
soft, short pain individually in each case
  • Emotional condition
frequent mood swings, tearfulness irritability
  • Frequent urination
possibly not
  • Toxicosis
from 4-5 weeks after conception возможна nausea, vomiting

The signs of both conditions are very similar, so understand exactly what
occurs in a woman’s body, and to distinguish between pregnancy and PMS is not

  • The easiest method to find out what caused feeling unwell –
    дождаться начала monthly.
  • If the calendar is already delayed, you should test for
    pregnancy. Pharmaceutical test will give reliable results only when
    delayed menstruation. It is sensitive to pregnancy hormone (hCG),
    excreted in urine. If you do not have enough patience and nerves to wait, you can
    pass a blood test for hCG. It shows almost one hundred percent
    result on the tenth day after conception.
  • The best way to find out what is bothering you is syndrome
    PMS or pregnancy is a visit to the gynecologist. Doctor will evaluate
    condition of the uterus and if you suspect a pregnancy will appoint an ultrasound.

When to see a doctor

If manifestations of premenstrual syndrome significantly reduce
quality of life, affect the ability to work and have a pronounced
nature, without treatment can not do. After a thorough examination,
the doctor will prescribe medication and give the necessary
recommendations for the relief of the syndrome.

How can a doctor help?

In most cases, the treatment is symptomatic. AT
depending on the shape, course and symptoms of premenstrual
syndrome, a woman needs:

  • Психотерапия — перепады настроения, irritability,
    depression, which affects both women and loved ones, are corrected
    methods of stabilizing behavioral techniques and psycho-emotional
    relaxation, sedatives.
  • For headaches, lower back pain and abdominal pain
    nonsteroidal anti-inflammatory drugs for temporary withdrawal
    pain syndrome (Ibuprofen, Nimesulide, Ketanov see pills and
    pain shots).
  • Diuretics for removing excess fluid from the body during edema
    (see herbal diuretics).
  • Hormone therapy prescribed for failure of the second phase
    cycle, only after tests of functional diagnostics, based on
    results of identified changes. Withменяют гестагены  —
    Duphaston, Medroxyprogesterone Acetate from the 16th to the 25th day of the cycle.
  • Antidepressants and tranquilizers are prescribed for multiple
    neuropsychiatric symptoms (insomnia, nervousness, aggressiveness,
    anxiety, panic attacks, depression): Amitriptyline, Rudotel,
    Tazepam, Sonapaks, Sertralin, Zoloft, Prozac, etc. in phase 2 of the cycle
    after 2 days from the onset of symptoms.
  • With кризовой и цефалгической  формах possibly назначение
    Parlodel in phase 2 of the cycle or if prolactin is elevated, then in
    continuous mode, it has a normalizing effect on 
  • Cephalgic and edematous forms are recommended.
    antiprostaglandin preparations (Indomethacin, Naprosin) in the second
    phase of the menstrual cycle.
  • Since women often have PMS with elevated levels of histamine and
    serotonin doctor may prescribe antihistamines 2
    generations (see pills for allergies) 2 days before the intended
    deterioration at night before the 2nd day of menstruation.
  • For improvement кровообращения в ЦНС possibly использование
    Grandaxine, Nootropil, Aminolone for 2-3 weeks.
  • With кризовой, цефалгической и нейропсихической форме
    drugs normalizing neurotransmitter metabolism are shown in
    central nervous system – Peritol, Difenin, the doctor prescribes
    drug for a period of 3-6 months.
  • Homeopathic remedies Remens or Mastodinon.

What can you do?

Some simple guidelines for alleviating PMS symptoms:

  • Full sleep

Try to sleep as much as your body can.
rest fully, usually it is 8-10 hours (see all about sleep and light
falling asleep). Lack of sleep leads to irritability,
anxiety and aggression, adversely affects the work of the immune
system. If you are suffering from insomnia, try walking before
sleep breathing techniques.

  • Aromatherapy

In the absence of allergy composition specially selected
Aromatic oils are a good weapon against PMS symptoms. Geranium,
rose and sage will help normalize the cycle. Lavender and basil
effectively fighting spasms. Juniper and bergamot boost
mood. ATанны с ароматическими маслами начните принимать за две
недели до monthly.

  • Exercise stress

Hiking, running, pilates, body flex, yoga, dancing – great
A way to treat the manifestations of premenstrual syndrome in women.
Regular exercise increases the level of endorphins, which allows
overcome depression and insomnia, and also reduce the severity
physical symptoms.

  • За две недели до monthly принимайте витамин AT6 и магний

Магне AT6, Магнерот, а также витамины Е и А — это позволит
It is much more effective to deal with such manifestations of PMS as:
heart palpitations, heart pain, fatigue, insomnia,
тревога и irritability.

  • Nutrition

Eat more fruits and vegetables, high foods.
fiber content, and include foods rich in
calcium. ATременно ограничьте употребление кофе, шоколада, колы,
поскольку кофеин усиливает смену настроений, irritability,
anxiety. Daily ration should include 10% fat, 15%
protein and 75% carbohydrates. Fat intake should be reduced as well
limit the use of beef, some species of which contain
artificial estrogens. Herbal teas, fresh juices,
especially carrot and lemon. Better not to drink alcohol, he
истощает запасы минеральных солей и витаминов группы AT, нарушает
carbohydrate metabolism, reduces the ability of the liver to utilize

  • Relaxation practices

Avoid stress, try not to overwork and keep
positive mood and thinking, relaxation helps
practices – yoga, meditation.

  • Regular sex

It helps fight insomnia, stress and bad
mood, increase the level of endorphins, strengthen the immune system. AT
This time, many women have increased sexual appetite – why
would not surprise your partner and try anything

  • Medicinal plants

It may also help relieve the symptoms of premenstrual
синдрома: ATитекс — снимает тяжесть и боль в молочных железах,
Primrose (evening primrose) – for headaches and edema, St. John’s wort
– Excellent antidepressant, normalizes libido, improves
well-being and reduces fatigue.

Balanced nutrition, adequate exercise,
vitamin supplements, healthy sleep, regular sex,
a positive attitude towards life will help ease the psychological and
physical manifestations of premenstrual syndrome.

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