Premenstrual Syndrome Disease

DESCRIPTION

Premenstrual syndrome is a constellation of symptoms that occurs prior to menstruation and is severe enough to interfere significantly with the patient's life. DSM-IV diagnosis is premenstrual dysmorphic disorder when the dominant symptoms are emotional.

System(s) affected: Endocrine/Metabolic, Reproductive, Nervous
Genetics: Unknown, probably familial incidence
Incidence/Prevalence in USA: Almost all women have some symptoms prior to menses (this is not PMS). A low percentage have actual PMS.
Predominant age: Childbearing years, worse during late 20's and 30's
Predominant sex: Females only

SIGNS AND SYMPTOMS

Symptoms can involve any organ system but the following are more common:

Depressed mood
Mood swings
Irritability
Difficulty concentrating
Fatigue
Edema
Breast tenderness
Headaches
Sleep disturbances

CAUSES

Unknown, presumed hormonal; perhaps interacting with neurotransmitters

RISK FACTORS

Premenstrual exacerbations can occur with other diseases (i.e., depression)
Caffeine and high fluid intake exacerbate PMS symptoms
Stress may precipitate
PMS increases with age

LABORATORY

There are no laboratory tests which confirm or refute PMS. History and physical may disclose a need for specific laboratory tests.

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

N/A

SPECIAL TESTS

N/A

IMAGING

N/A

DIAGNOSTIC PROCEDURES

Patients complete questionnaires over a minimum of two months to confirm premenstrual exacerbation of symptoms and lack of substantial symptoms in the follicular phase

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

Increase daily exercise
Eat regular, balanced meals
Stop smoking
Get regular sleep
Stress reduction techniques
Individual or couples counseling
Support groups
Light therapy

SURGICAL MEASURES

N/A

ACTIVITY

No restrictions
Exercise is recommended

DIET

Low-salt; low-caffeine; low-fat; frequent, small meals; high complex carbohydrates

PATIENT EDUCATION

Explain PMS and treatment

PREVENTION/AVOIDANCE

N/A

POSSIBLE COMPLICATIONS

N/A

EXPECTED COURSE AND PROGNOSIS

Many patients can have their symptoms adequately controlled. Disappears at menopause.

ASSOCIATED CONDITIONS

N/A

AGE-RELATED FACTORS

Pediatric: N/A
Geriatric: N/A
Others: N/A

PREGNANCY

N/A

OTHER NOTES

Treatment may need to be continued for a long time. PMS sometimes continues after hysterectomy. Effects of long-term hormonal treatment unknown.

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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