What are the symptoms before menstruation. PMS and its symptoms

Premenstrual syndrome (PMS) - a woman becomes dangerous!

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General information

Premenstrual Syndrome (PMS) also called premenstrual illness or cyclic syndrome - this is a complex of symptoms that appear regularly in women two to ten days before menstruation.
The syndrome is characterized by impaired mood, the work of the autonomic nervous system, vascular and metabolic disorders.
Eight out of ten women experience this ailment. And in a third, the ailments are so serious that they interfere with normal work and rest. Women suffering from this ailment should be aware that if left untreated, the syndrome can develop into an early menopause with a severe course.

According to the joint calculations of doctors and police, most of the accidents that women have happen around the very end of their menstrual cycle.
Almost a third of British female prisoners committed their misdeeds just a few days before the onset of menstruation.
Foreign researchers claim that in the exams taken in the last days of the cycle, the majority of female students receive the worst grades.

Causes

All ailments that appear in the last days of the cycle are primarily associated with a change in the balance between the level of the hormones progesterone and estrogen.
A specific reason for the development of PMS has not been identified to date. However, it is known that this phenomenon is more often observed in women who have had an abortion or several, after infectious diseases, and also in a state of constant stress.
Substances that enter the body with food packed in plastic wrap can disrupt the level of hormones in the body.
Chips and instant noodle lovers, beware!

Another factor contributing to the development of the syndrome is high blood glucose levels. Therefore, women who abuse carbohydrate foods and sweets are more susceptible to the cyclic syndrome.

It is believed that a disease of the kidneys, reproductive organs or digestion can lead to the development of premenstrual syndrome. In addition, there is a genetic predisposition to this disorder.

Symptoms

Most often, the symptoms of this syndrome are observed from the age of 20 or a little later, and by the age of 30 they develop in full force. Most often, of all those listed, there are only two or three symptoms.

• Sleep disturbance
• Lethargy, decreased performance, inattention
• Noise intolerance
• Migraine-like pain, incoordination, fainting
• "goosebumps" on the body or limbs, inhibition of speech
• Discomfort in the breasts
• Nervousness, mood instability, excessive emotionality
• Decreased daily urine volume, weight gain, swelling
• Joint pain, swelling, myalgia, neck pain
• Digestion disorder
• Increased appetite, cravings for sweet or salty foods, aversion to alcohol
• Slight increase in body temperature, bleeding from the nose
• Exacerbation of allergies, asthma, hemorrhoids, other chronic diseases, frequent acute respiratory infections
• Change in libido.

If the set of symptoms in different women is different, then in the same woman from month to month they are the same. Only the degree of their expression differs.

Pain with PMS

Premenstrual syndrome is characterized by dull aching pains in the lower abdomen. They should not be too strong, otherwise they may indicate any diseases of the pelvic organs.
To relieve pain, you can use painkillers based on ibuprofen, paracetamol. Three days before the onset of menstruation, you can take indomethacin at a dosage: one tablet three times a day. You should not use it for a long time, as it does not affect the condition of the stomach too well.

3. Eat less salt, it is advisable to give up nicotine.

Herbal treatment

Such treatment is possible if the symptoms are not too pronounced. If the syndrome is already seriously interfering with normal life, you should consult a doctor and use herbal medicines as ancillary.

2. Foot bath with infusion of rose, lemon balm and marsh cudweed. After the procedure, massage the heels and arches of the feet with fir oil or balm " Golden Star».

3. To normalize sleep and calm: take equal amounts of peony flowers, chamomile, lemon balm, cuff. Mix everything, 1 tbsp. collection, brew with 200 milliliters of boiling water, stand for 10 minutes, pass through a sieve and consume twice or thrice a day. Tea should be prepared immediately before drinking.

4. To soothe, you can make an aromatic pillow. It is advisable to choose plants, guided by personal preferences, for example,

Many girls and women have repeatedly met with such ailments as premenstrual pain. The reason for such phenomena are hormonal fluctuations (the level of estrogen and progesterone in the blood) on certain days of the menstrual cycle, and the individual reaction to these processes of the whole organism. As a rule, pain occurs a week before menstruation and refers to premenstrual syndrome (PMS).

According to statistics, certain symptoms of PMS, in particular, and premenstrual pain, are felt by 95% of the fair sex, in about 5% of them this condition is severe and even leads to loss of working capacity. Girls and women of any age can experience premenstrual pain, but PMS is most common in women over the age of thirty.

Causes of premenstrual pain

Doctors identify the main causes of premenstrual pain:

• genetic predisposition to PMS;
• monthly fluctuations in hormonal levels;
• malnutrition;
• lack of vitamins of groups B, C, calcium, magnesium in the body;
• not well-established sex life;
• stressful conditions, nervous tension;
• diseases of the endocrine system;
• inflammatory processes in the female genital organs;
• frequent pregnancies or their absence, abortions;
• taking hormonal drugs.

To exclude complications and the development of hidden diseases, in the event of premenstrual pain, it is necessary to consult a physician in order to examine and clarify the diagnosis.

Main symptoms of premenstrual pain

Doctors highlight the main signs, on the basis of which a woman can conclude that it is premenstrual pain that worries her, and nothing else. These are the symptoms:

• aching pain in the lower abdomen, back, muscles and joints;
• the appearance of edema of the extremities, fluid retention in the body;
• frequent urination, intestinal disorders;
• soreness in the mammary glands;
• headache, migraine;
• surge of strength and energy, or their decline;
• the appearance of pimples on the face;
• sleep disorders;
• frequent mood swings;
• aggressiveness.

How to reduce premenstrual pain and other related ailments?

To reduce painful symptoms before the onset of menstruation, doctors recommend following the following general recommendations:

1. Take painkillers such as ibuprofen, no-shpa, panadol, spazgan.
2. Learn to relax, yoga and meditation are useful.
3. Put something warm on the abdomen - a heating pad, a diaper ironed with a hot iron, and lie down for an hour or two in a calm atmosphere.
4. Engage in regular strengthening of the abdominal muscles and the press, Kegel exercises are very useful.
5. Walking and fresh air will help reduce premenstrual pain and abdominal cramps.
6. Follow a healthy diet. The daily menu should contain vegetables, fruits, cereals. During the period of premenstrual pain, it is not recommended to drink alcoholic beverages, coffee, cheese; salt intake should be limited.
7. Observations have shown that with regular exercise, the manifestation of PMS symptoms is significantly reduced, this is due to the production of endorphins, which elevate mood and help relieve stress.
8. It is necessary to observe a sleep schedule, sleep at least eight hours a day, since the lack of sleep increases irritability and exacerbates negative emotions. Insomnia must be fought, deep breathing, other relaxation methods are very effective. Before going to bed, it is advisable to take a relaxing hot bath, drink a glass of warm milk.
9. It is recommended to eat foods low in fat, rich in fiber. Spicy and smoked foods increase premenstrual pain. You should not overeat, lean on sweets, it is better to give preference to fruits. Chocolate interferes with the absorption of vitamin B6, which is important for the female body. Cigarette smoking exacerbates the resulting pain.
10. Tea and coffee can be replaced with decoctions of herbs, chicory. Foods containing carbohydrates (pasta, cereals) contribute to the production of the hormone serotonin, which is responsible for a good mood.
11. To reduce the likelihood of premenstrual pain, it is advisable to take vitamin B6, magnesium, calcium, and iron daily. Bananas, cucumbers, herbs, potatoes, dried fruits are rich in magnesium and potassium.
12. Many women noted that primrose oil, which is a substance containing essential fatty acids, is excellent at fighting PMS.
13. The use of vitamin C has a beneficial effect on the entire body as a whole; it is a powerful antioxidant and immunity stimulant and is necessary during PMS, since at this moment the body is weakened.
14. Do gymnastics. Go to the gym a couple of times a week. In the fight against PMS, an important role is played by the endurance of the body, which is excellently increased by constant sports exercises.
15. Wear loose clothing made from natural fabrics that do not squeeze your chest and stomach.
16. Breathing exercises can help with PMS headaches. You can sit in a comfortable position, relax your body and gently raise your arms up, take a deep breath, hold your breath for a couple of seconds and, slowly lowering your arms, exhale.
17. In the period before menstruation, try not to load yourself with work. Take frequent breaks from work.

Since premenstrual pain has a rather complex mechanism of occurrence and many factors that contribute to it, the treatment of PMS is aimed at alleviating its symptoms:

• to relieve aching pain in the lower abdomen and lower back, migraine, doctors prescribe nonsteroidal drugs, such as ibuprofen;
• if edema occurs, there are signs of fluid retention in the body, a week before the onset of menstruation, it is necessary to drink diuretics;
• in some situations, based on the results of the tests, doctors prescribe progesterone hormones or other hormonal drugs.

Folk remedies for premenstrual pain

Folk remedies will help to cope with the main symptoms of PMS. Let's consider them in detail:

1. Tea made from lemon balm, mint or lavender has a relaxing effect; these herbs relieve painful spasms, fight insomnia and normalize hormonal levels.
2. When taking a bath, you can add a decoction of oregano, wormwood, yarrow, mint to the water, which will help relax the tense muscles of the whole body.
3. Horsetail herb tincture will help eliminate swelling, and motherwort has a beneficial effect on the nervous system.
4. Pain in the lower abdomen and lower back will be relieved by a mixture of jasmine flowers (30 g) and yarrow (40 g), which are poured with hot water and infused for 20 minutes - take 3 glasses a day, a week before menstruation.
5. Symptoms of PMS will be eliminated by tincture of calendula: 10 drops / 3 times a day before meals.
6. 10 days before the onset of menstruation, before eating, to reduce the likelihood of premenstrual pain and swelling, you can take a decoction of dandelion roots, half a cup 2 times a day.

Every woman should not forget that on certain days of the month her health may worsen and the reason for this is in physiology. Premenstrual pain should be treated calmly and timely measures should be taken to reduce and eliminate it. Subject to the above recommendations, the ailments associated with PMS syndrome will not cause you trouble and discomfort.

During menstruation, the endometrium, the inner layer of the uterus, is shed. This natural process is carried out monthly if pregnancy does not occur. On the first day of menstruation, the uterus begins to contract, trying to piss off excess contents, which often causes pain. In order to get rid of pain during menstruation, it is necessary to understand the cause of the pain.

During menstruation, the uterine tissues secrete the hormone prostaglandin, which provokes uterine contractions. The degree of pain directly depends on the level of the produced hormone. Excess prostaglandin can provoke irregularities in the menstrual cycle and cause pain even after menstruation.

When acute pain in the abdomen, radiating to the pelvic region, worries a woman before the onset of menstruation or during their course, this condition is called dysmenorrhea.

Primary and secondary dysmenorrhea

Signs of primary dysmenorrhea:

• occurs, as a rule, in mature women;
• symptoms may appear a couple of years after the arrival of the first menstruation;
• pain is given to the lower abdomen or back;
• pain occurs a few days before menstruation and lasts up to three days;
• decrease in pain with age, often stop after childbirth;
• menstrual pain is not associated with inflammation and other diseases.

Signs of secondary dysmenorrhea:

• occurs in young women, on average up to 30 years;
• pain can appear with the first menstruation and last more than three days in a row;
• the stomach hurts during menstruation, the pain radiates to the legs and lower back;
• varying degrees of pain - from mild and dull to sharp and throbbing.

Why do menstrual pains occur?

The main reason is too sharp and prolonged uterine contractions caused by a high content of prostaglandin. As a result, blood flow to the uterine walls is significantly reduced.

Another common reason why the stomach hurts during menstruation is profuse discharge with blood clots, which causes a painful expansion of the cervical canal.

Many additional factors can complicate the situation. Among them: smoking, overweight, heredity, stress, low physical activity. Menstrual pain is often accompanied by headache, diarrhea, frequent urination, or constipation.

Secondary dysmenorrhea can be caused by the presence of certain medical conditions. Among them:

• ectopic pregnancy;
• endometriosis;
• uterine polyps, fibroids;
• ovarian cyst;
• inflammatory processes.

What to do when there is pain in the abdomen?

Take a pain reliever

The simplest and most effective way to relieve pain or get rid of it is to take antispasmodics: nosh-pa, analgin, spazmalgon, ibuprofen, etc. Such drugs reduce the level of prostaglandin hormone in the uterus, thereby eliminating pain.

However, experts do not advise frequently resorting to drug anesthesia, as this reduces the reproductive function of a woman.

Take a warm shower or bath

Water procedures can calm the nervous system and relax tense abdominal muscles.

Apply a warm heating pad

Applying a heating pad or hot water bottle to the area where your stomach hurts will help reduce uterine contractions and relax your uterus.

Take oral contraceptives

Monitor body position

When the stomach hurts a lot, it is very important to take the correct position of the body. Usually, if you take the fetal position - lie on your side and curl up - the pain decreases. This happens because the lying position reduces the sensitivity caused by blood flow to the genitals.

Drink herbal tea

Many herbs have excellent pain relieving properties. Teas with mint, oregano, raspberries, ginger will be useful. Milk with the addition of half a teaspoon of cinnamon helps well.

When to see a doctor?

Despite the relative naturalness of pain, in some cases, pain during menstruation may indicate the presence of certain diseases. Be sure to visit a gynecologist when:

1. The stomach hurts and the body temperature is elevated.
2. The pain becomes unbearable.
3. There are suspicions of pregnancy.
4. Painful menstruation lasts more than a week.
5. Menstruation has never been painful before.
6. Pain is accompanied by copious discharge.
7. The woman is sick, severe pain in the lower abdomen.

Often, a woman experiences pain not only during menstruation, but also long before it. Pain in the abdomen before menstruation can be caused by a decrease in the amount of endorphins - the so-called "happiness hormones". Endorphins are produced by the hormones estrogen and progesterone. A week before the onset of menstruation, their sharp jump occurs - first up, then down, which entails a decrease in the level of endorphins.

Such an imbalance negatively affects the entire female body: in some, the chest begins to hurt, in others, the stomach, depressions, headaches, drowsiness, lethargy, etc. are noted. This condition is called PMS - premenstrual syndrome.

The causes of PMS are:

• insufficient period between the release of the egg and the onset of menstruation;
• high concentration of prostaglandins;
• inadequate functioning of the endometrium;
• low pain threshold;
• fibroids, cysts;
• inflammatory processes;
• disruption of the endocrine system;
• congenital pathologies of the structure and placement of the uterus.

Menstruation is the rejection of the functional layer of the endometrium lining the inner surface of the uterus, which has a certain cyclicity. Another name for menstruation is regula (from the word "regular"). The first day of menstruation is considered the beginning of the menstrual cycle - the period during which changes occur in the work of the reproductive organs, aimed at the possibility of conception. In a healthy woman, the cycle duration is usually 28-30 days. These numbers are the classic norm, but for many women they can fluctuate depending on individual characteristics. Gynecologists consider the duration of the menstrual cycle from 25 to 34 days to be acceptable.

A few days before the start of the regulation, a woman may feel worse. Many complain of increased weakness during this period, decreased performance, constant drowsiness. Physiological sensations are also possible, for example, headaches, a slight increase in body temperature, increased sweating. The most common complaint at the end of the menstrual cycle in most women is pain in the lower abdomen. This symptom is observed in almost 60% of women of reproductive age. To understand whether this is a norm or a pathology, it is necessary to know the possible causes of the pain syndrome.

Every month, processes take place in a woman’s body that prepare the body for a possible conception and create conditions for the fertilization of a mature egg. During the period of ovulation, which occurs on days 14-16 of the cycle, the membranes of the dominant follicle rupture to release the egg ready for fertilization into the cavity of the fallopian tube, where it can meet with the sperm. From the fallopian tube, the egg moves into the body of the uterus, a pear-shaped muscular organ whose main task is to carry the fetus.

In the uterus, the egg is attached to the mucous membrane (endometrium). If conception does not occur, the unfertilized egg is rejected by the uterine walls along with the functional mucous surface. An open bleeding wound forms on the surface of the uterus, which heals a few days after the end of menstruation. All these processes can cause moderate nagging pain in the lower abdomen, where the uterus is located, and usually do not require pain medication.

Pain in the lower abdomen a few days before the onset of regulation is considered normal if accompanied by the following characteristics:

• the general health of the woman remains normal;
• body temperature is within the normal range or at the lower border of subfebrile condition (no more than 37.4 °);
• after the onset of menstruation, there are no signs of heavy uterine bleeding.

Note! Menstrual fluid is not just blood, it contains endometrial tissue as well as mucus secreted by the glands of the vagina and cervix. Menstrual blood does not clot and is darker in color than the blood circulating through the blood vessels due to the high amount of enzymes. This is the main sign that allows you to distinguish menstruation from breakthrough bleeding.

Premenstrual syndrome: norm or pathology?

Premenstrual syndrome is a complex of symptoms that occur 3-5 days before the start of the regular period. It has a psychosomatic nature and is associated mainly with emotional disturbances and changes. Many women during this period become irritable, tearful. Unreasonable aggression, anxiety, signs of depression, insomnia may appear. In about 30% of women, the signs of PMS include physiological symptoms, for example:

• headache (in women with neurological disorders, migraine attacks may worsen);
• severe pain of a pulling nature in the lower abdomen;
• nausea, aversion to certain foods;
• soreness in the mammary glands;
• increased sweating.

Despite the fact that many women suffer from premenstrual syndrome, gynecologists do not consider it a normal condition. In most cases, the pathology is caused by insufficient synthesis of endorphins - “pleasure hormones”, which are natural analgesic substances. Lack of this hormone can lead to a serious complication - menstrual psychosis. The disease is considered very serious and may require medical correction in a hospital, therefore, with frequently recurring signs of PMS, it is necessary to consult a doctor and check the functioning of the endocrine system and the functioning of the pituitary gland of the brain, which is responsible for the synthesis of endorphins.

Pain of high intensity 3-5 days before menstruation

If the pain syndrome is of high intensity, and the woman cannot perform her usual activities, it is necessary to consult with the observing gynecologist. Such a symptom may indicate hidden inflammatory processes and other pathologies of the genitourinary system and reproductive organs, which worsen before the onset of regulation due to a decrease in immunity caused by natural physiological changes in the body.

Fibroids are the second most common female benign tumor, second only to breast fibroadenoma. The formation is of a benign nature and consists of the muscle tissue of the myometrium - a layer consisting of myocytes intertwined with each other, which are constantly contracting in an arbitrary order and rhythm.

Myoma usually looks like a small nodule. It can be single or multiple, and also differ in the localization of tumor nodes.

Types of fibroids depending on location

Pathology has two characteristic features: pain in the lower abdomen and uterine bleeding, which can be manifested by menorrhagia (heavy menstruation lasting more than 7 days) or breakthrough uterine bleeding. Almost always, with fibroids, a woman feels a pulling pain in the lower abdomen, which intensifies before the start of the regular period and in the middle of the menstrual cycle.

For conservative treatment of fibroids, tranexamic acid preparations, as well as drugs that suppress the production of pituitary gonadotropic hormones, can be used. In the absence of a therapeutic effect, the doctor may decide to remove the tumor surgically.

Important! The risk group for the development of fibroids includes women taking oral contraceptives and women over 40 years of age. This category of patients is recommended to undergo a routine examination by a gynecologist at least once a year.

Violations in the functioning of the endometrium

One of the most common causes of pain in the lower abdomen before menstruation is endometrial disease. Most often, women experience excessive growth of the mucosal layer, which is called endometrial hyperplasia. If the cells of the mucosal membrane begin to go beyond the mucous layer, the woman is diagnosed with endometriosis.

Both pathologies have the same symptoms and often occur simultaneously. For diagnosis, the method of ultrasonic transvaginal examination or hysteroscopy (introduction of a special optical device into the uterine cavity) is used. Equally important is the collection of medical history. With pathologies of the endometrium, women complain of the following symptoms:

• severe pain in the lower abdomen that occurs monthly and increases in the middle and end of the menstrual cycle;
• abundant regulation lasting more than one week;
• irradiation of pain in the lumbar region, coccyx, sacrum, buttocks and thighs;
• pain during intercourse;
• intermenstrual bleeding.

In most cases, breakthrough bleeding can only be stopped surgically using vacuum aspiration or curettage. After the operation, the woman is prescribed antibiotic therapy with broad-spectrum drugs (" Metronidazole”) and hormonal treatment with progesterone and estrogen-based agents (“ Yarina», « Janine», « Diana-35»).

Important! If signs of endometriosis appear, you should immediately contact a gynecologist, even if the general state of health remains normal. If treatment is not needed on time, serious complications can occur, for example, inflammation of the endometrium (endometritis). Endometritis often occurs against the background of purulent infectious processes and can lead to blood poisoning. In 20% of women, purulent endometritis causes infertility.

Diseases of the urogenital area

Cystitis (inflammation of the bladder) is considered one of the most common diseases in women. The cause of the pathology is a decrease in immunity as a result of hypothermia, colds, alcohol abuse and smoking. When bacteria or fungi enter the mucous membranes of the urogenital tract and bladder, an inflammatory process develops, which manifests itself with pronounced symptoms.

Signs of acute cystitis include:

• temperature increase (above 38 °);
• sharp pains of high intensity in the lower abdomen, which can radiate to the lumbar region;
• severe burning when trying to empty the bladder;
• frequent (most of them false) urge to urinate;
• sharp pain after urination.

If a woman has not treated acute cystitis in time, the pathology can become chronic. In this case, there may be no pronounced symptoms, and a sluggish inflammatory process will be manifested by minor abdominal pain and discomfort during urination. Before menstruation, symptoms increase due to a decrease in the activity of the immune system.

Note! In some cases, pain in the lower abdomen may indicate inflammation in the kidneys. Despite the fact that the renal system is located in the lateral parts of the abdomen, the pain syndrome can radiate to the central and lower part. This clinical picture occurs mainly with glomerulonephritis.

Severe pain occurs every month

If the stomach hurts regularly before menstruation, while there are no other symptoms, you should consult a doctor. Such a picture can be observed with malignant tumors of the uterus and vagina, if the pathology is at an early stage. Indirectly, other signs can also indicate cancerous diseases of the uterus, which can only be considered as symptoms of oncological processes in the aggregate.

These include:

• weight loss (usually rapid);
• periodic increase in temperature (including basal indicators);
• arching pain in the lower abdomen during sexual intercourse;
• voluminous mucous secretions between the regulation;
• spotting or bleeding of varying intensity between periods;
• itching of the genitals.

Important! These signs of cancer do not always appear. In some cases, there may be no symptoms at all, so regular abdominal pain that worsens on the eve of menstruation is a reason for an examination.

Video - Why does my stomach hurt before menstruation?

Stomach hurts before menstruation, but menstruation has not come

The most likely cause of pain during this period in the absence of further menstruation is pregnancy. To diagnose pregnancy, you can use home tests in the form of strips with a reagent applied to them or laboratory methods (determining the level of hCG in the blood and urine). A doctor can diagnose pregnancy using a transvaginal ultrasound, but you should know that this method is quite traumatic and can cause an abortion in the early stages.

Pain in the lower abdomen before menstruation is a fairly common problem that almost all women face. In most cases, the pain syndrome is the result of physiological processes that occur in the body during the menstrual cycle, but sometimes serious illnesses can cause such symptoms, therefore, with regular pain during this period, you should not postpone a visit to the gynecologist.

Doctors have long puzzled over the causes of women's malaise before menstruation. Some healers associated it with the phases of the moon, others with the area in which the woman lives.

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

PMS is a mix of 150 different physical and mental symptoms. To one degree or another, about 75% of women experience manifestations of premenstrual syndrome.

How long does PMS last for girls? Unpleasant symptoms begin to appear 2-10 days before the onset of menstruation, and disappear with the advent of the "red" days of the calendar.

• Crime chronicle. PMS is not only shattered nerves and broken plates. Most traffic accidents, crimes, thefts committed by women occurred between the 21st and 28th days of the menstrual cycle.
• Shopping therapy. According to research, a few days before menstruation, women are most susceptible to the temptation to buy as much as possible.
• PMS symptoms are more prone to women engaged in mental work and residents of large cities.
• The term PMS was first used by Robert Frank, an obstetrician-gynecologist from England.

Why does premenstrual syndrome occur?

Numerous studies do not allow to identify the exact causes of premenstrual syndrome. There are many theories of its occurrence: “water intoxication” (violation of water-salt metabolism), allergic nature (increased sensitivity to endogenous), psychosomatic, hormonal, etc.

But the most complete is the hormonal theory, which explains the symptoms of PMS by fluctuations in the level of sex hormones in the 2nd phase of the menstrual cycle. For the normal, harmonious functioning of a woman's body, the balance of sex hormones is very important:

• - they improve physical and mental well-being, increase tone, creativity, speed of assimilation of information, learning abilities
• progesterone - has a sedative effect, which can lead to depressive symptoms in the 2nd phase of the cycle
• androgens - affect libido, increase energy, performance

During the second phase of the menstrual cycle, a woman's hormonal levels change. According to this theory, the cause of PMS lies in the “inadequate” reaction of the body, including the brain regions responsible for behavior and emotions, to cyclic changes in hormonal levels, which is often inherited.

Since the days before menstruation are endocrine unstable, many women experience psychovegetative and somatic disorders. In this case, the decisive role is played not so much by the level of hormones (which can be normal), but by fluctuations in the content of sex hormones during the menstrual cycle and how the limbic parts of the brain responsible for behavior and emotions react to these changes:

• an increase in estrogen and first an increase, and then a decrease in progesterone- hence the retention of fluids, swelling, engorgement and soreness of the mammary glands, cardiovascular disorders, irritability, aggression, tearfulness
• hypersecretion - also leads to fluid retention, sodium in the body
• excess prostaglandins- , digestive disorders, migraine-like headaches

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

• Decreased serotonin levels- this is the so-called "hormone of joy", may be the cause of the development of mental signs of premenstrual syndrome, since a decrease in its level causes sadness, tearfulness, melancholy and depression.
• Vitamin B6 deficiency- Symptoms such as fatigue, fluid retention in the body, mood changes, and breast hypersensitivity indicate a lack of this vitamin.
• Magnesium deficiency – Magnesium deficiency can cause dizziness, headaches, cravings for chocolate.
• Smoking. Women who smoke are twice as likely to get premenstrual syndrome.
• Overweight . Women with a body mass index over 30 are three times more likely to suffer from PMS symptoms.
• genetic factor- it is possible that the features of the course of premenstrual syndrome are inherited.
• , complicated childbirth, stress, surgical interventions, infections, gynecological pathologies.

The main symptoms and manifestations of premenstrual syndrome

Groups of symptoms in PMS:

• Neuropsychiatric disorders: aggression, depression, irritability, tearfulness.
• Vegetovascular disorders: changes in blood pressure, headache, vomiting, nausea, dizziness, tachycardia,.
• Metabolic and endocrine disorders: swelling, fever, chills, breast engorgement, itching, flatulence, shortness of breath, thirst, memory loss,.

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

neuropsychic	crisis form	Atypical manifestations of PMS
Violations in the nervous and emotional spheres: anxiety disorders feeling of unreasonable sadness depression feeling of fear depression impaired concentration forgetfulness insomnia (see) irritability mood swings decrease or significant increase in libido aggression	tachycardia attacks jumps in blood pressure heartache frequent urination episodes panic attacks Most women have diseases of the cardiovascular system, kidneys, and gastrointestinal tract.	subfebrile temperature (up to 37.7 ° C) increased drowsiness bouts of vomiting allergic reactions (ulcerative gingivitis and stomatitis, etc.)
	edematous form	Cephalgic form
	swelling of the face and limbs thirst weight gain pruritus decreased urination indigestion (constipation, diarrhea, flatulence) headache joint pain There is a negative diuresis with fluid retention.	Leading mainly neurological and vegetative-vascular manifestations: migraine, throbbing pain, radiates to the eye area cardialgia (pain in the heart area) vomiting, nausea tachycardia hypersensitivity to smells, sounds in 75% of women, x-ray of the skull - hyperostosis, increased vascular pattern The family history of women with this form is aggravated by hypertension, cardiovascular diseases, and gastrointestinal diseases.

PMS is different for every woman, and the symptoms vary greatly. According to the results of some studies, women with PMS have the following frequency of manifestation of one or another sign of PMS:

Symptom	frequency %	Hormonal theory of PMS
irritability	94
soreness of the mammary glands	87
bloating	75
tearfulness	69
depression sensitivity to odors headache	56
puffiness weakness sweating	50
heartbeat aggressiveness	44
dizziness pain in the lower abdomen nausea	37
pressure increase diarrhea weight gain	19
vomit	12
constipation	6
back pain	3

Premenstrual syndrome can aggravate the course of other diseases:

• Anemia (see)
• (cm. )
• Thyroid diseases
• chronic fatigue syndrome
• Bronchial asthma
• allergic reactions
• Inflammatory diseases of the female genital organs

Diagnosis: what can masquerade as manifestations of PMS?

Since dates and dates are easily forgotten, in order to make it easier for yourself, you should keep a calendar or diary where you write down the start and end dates of your period, ovulation (basal temperature), weight, and symptoms that bother you. Keeping such a diary for 2-3 cycles will greatly simplify the diagnosis and allow you to trace the frequency of PMS symptoms.

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

• Mild: 3-4 symptoms, or 1-2 if severe
• Severe form: 5-12 symptoms or 2-5, but very pronounced, and also regardless of the duration and their number, if they lead to disability (usually neuropsychic form)

The main feature that distinguishes premenstrual syndrome from other diseases or conditions is cyclicality. That is, a deterioration in well-being occurs a few days before menstruation (from 2 to 10) and completely disappears with their arrival. However, unlike psycho-vegetative, physical discomfort in the first days of the next cycle can intensify and smoothly turn into disorders such as menstrual migraine.

• If a woman feels relatively well in the 1st phase of the cycle, then this is a premenstrual syndrome, and not a chronic disease - neurosis, depression,
• If pain appears only immediately before and during menstruation, especially when combined with - this is most likely not PMS, but other gynecological diseases - chronic endometritis, dysmenorrhea (painful menstruation) and others.

To establish the form of the syndrome, hormone studies are carried out: prolactin, estradiol and progesterone. The doctor may also prescribe additional diagnostic methods, depending on the prevailing complaints:

• With severe headaches, dizziness, decreased vision and fainting, computed tomography or MRI is prescribed to exclude organic brain diseases.
• With an abundance of neuropsychiatric diseases, an EEG is indicated to exclude the epileptic syndrome.
• With severe edema, changes in the daily amount of urine (diuresis), tests are performed to diagnose the kidneys (see).
• With severe and painful engorgement of the mammary glands, it is necessary to conduct an ultrasound of the mammary glands and mammography to exclude organic pathology.

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

Premenstrual syndrome or pregnancy?

Some symptoms of PMS are similar to those of pregnancy (see). After conception, the content of the hormone progesterone in a woman’s body increases, which also happens during PMS, so the following symptoms are identical:

• fast fatiguability
• swelling and soreness of the breast
• nausea, vomiting
• irritability, mood swings
• lower back pain

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

Symptoms	Pregnancy	Premenstrual syndrome
Soreness of the mammary glands	accompanies the entire pregnancy	Pain goes away with menstruation
Appetite	the attitude to food changes, you want inedible, salty, beer, something that a woman usually does not like, the sense of smell is greatly aggravated, ordinary smells can be very annoying	can crave sweet and savory, sensitivity to odors
Back pain	only late	may have back pain
Fatigue	starts 4-5 weeks after conception	can appear both immediately after ovulation, and 2-5 days before menstruation
	mild, short-term pain	individually in each case
Emotional condition	frequent mood swings, tearfulness	irritability
Frequent urination	Maybe	No
Toxicosis	from 4-5 weeks after conception	possible nausea, vomiting

The signs of both conditions are very similar, so it’s not easy to understand what exactly happens in a woman’s body and distinguish pregnancy from PMS:

• The easiest way to find out what caused poor health is to wait for the onset of menstruation.
• If the calendar is already late, you should take a pregnancy test. A pharmacy test will give reliable results only with a delay in menstruation. It is sensitive to the pregnancy hormone (hCG) excreted in the urine. If you do not have enough patience and nerves to wait, you can take a blood test for hCG. It shows almost one hundred percent result on the tenth day after conception.
• The best option to find out what is bothering you - PMS syndrome or pregnancy - is to visit a gynecologist. The doctor will assess the condition of the uterus and, if pregnancy is suspected, will prescribe an ultrasound.

When to See a Doctor

If the manifestations of premenstrual syndrome significantly reduce the quality of life, affect the ability to work and have a pronounced character, treatment is indispensable. After a thorough examination, the doctor will prescribe drug therapy and give the necessary recommendations to alleviate the course of the syndrome.

How can a doctor help?

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

• Psychotherapy - mood swings, irritability, depression, from which both the woman and loved ones suffer, are corrected by the methods of stabilizing behavioral techniques and psycho-emotional relaxation,.
• For headaches, pain in the lower back and abdomen, non-steroidal anti-inflammatory drugs are prescribed for the temporary relief of pain (, Nimesulide, Ketanov, see).
• Diuretics for removing excess fluid from the body with edema (see).
• Hormone therapy is prescribed for insufficiency of the second phase of the cycle, only after tests of functional diagnostics, based on the results of the identified changes. Apply gestagens - Medroxyprogesterone acetate from 16 to 25 days of the cycle.
• are prescribed for many neuropsychic symptoms (insomnia, nervousness, aggressiveness, anxiety, panic attacks, depression): Amitriptyline, Rudotel, Tazepam, Sonapax, Sertraline, Zoloft, Prozac, etc. in the 2nd phase of the cycle after 2 days from the onset of symptoms.
• With crisis and cephalgic forms, it is possible to prescribe Parlodel in the 2nd phase of the cycle, or if prolactin is elevated, then in a continuous mode, it has a normalizing effect on the central nervous system.
• With cephalgic and edematous forms, antiprostaglandin drugs are recommended (Indomethacin, Naprosin) in the second phase of the menstrual cycle.
• Since women often have elevated levels of histamine and serotonin with PMS, the doctor may prescribe 2nd generation antihistamines (see) 2 days before the expected worsening of the condition at night before the 2nd day of menstruation.
• To improve blood circulation in the central nervous system, it is possible to use Grandaxin, Nootropil, Aminolone for 2-3 weeks.
• In the crisis, cephalgic and neuropsychic form, drugs are indicated that normalize the neurotransmitter metabolism in the central nervous system - Peritol, Difenin, the doctor prescribes the drug for a period of 3-6 months.
• Homeopathic preparations Remens or Mastodinone.

What can you do?

• Full sleep

Try to sleep as much as your body has time to fully rest, usually 8-10 hours (see. Lack of sleep leads to irritability, anxiety and aggression, negatively affects the immune system. If you suffer from insomnia, try walking before bed, breathing technology.

• aromatherapy

In the absence of allergies, compositions of specially selected aromatic oils are a good weapon against PMS symptoms. Geranium, rose and will help normalize the cycle. Lavender and basil effectively fight spasms. Juniper and bergamot are uplifting. Start taking baths with aromatic oils two weeks before your period.

Hiking, running, Pilates, body flex, yoga, dancing are a great way to treat symptoms of premenstrual syndrome in women. Regular exercise increases endorphin levels, which can help fight depression and insomnia, as well as reduce the severity of physical symptoms.

• Take vitamin B6 and magnesium two weeks before your period

Magne B6, Magnerot, as well as vitamins E and A - this will make it much more effective to deal with such manifestations of PMS as: heart palpitations, heart pain, fatigue, insomnia, anxiety and irritability.

• Nutrition

Eat more fruits and vegetables, high-fiber foods, and include calcium-rich foods in your diet. Temporarily limit the use of coffee, chocolate, cola, as caffeine increases mood swings, irritability, anxiety. The daily diet should include 10% fat, 15% protein and 75% carbohydrates. Fat intake should be reduced, as well as beef, some types of which contain artificial estrogens. Useful herbal teas, freshly squeezed juices, especially carrot and lemon. It is better not to drink alcohol, it depletes the reserves of mineral salts and B vitamins, disrupts the metabolism of carbohydrates, and reduces the ability of the liver to utilize hormones.

• Relaxation practices

Avoid stress, try not to overwork and maintain a positive mood and thinking, relaxation practices such as yoga and meditation help with this.

• Regular sex

It helps fight insomnia, stress and bad mood, increase the level of endorphins, strengthen the immune system. At this time, many women increase their sexual appetite - why not surprise your partner and try something new?

• medicinal plants

They can also help alleviate the symptoms of premenstrual syndrome: Vitex - relieves heaviness and pain in the mammary glands, Primrose (evening primrose) - from headaches and swelling, - an excellent antidepressant, normalizes libido, improves well-being and reduces fatigue.

A balanced diet, adequate exercise, vitamin supplements, healthy sleep, regular sex, a positive attitude towards life will help alleviate the psychological and physical manifestations of premenstrual syndrome.