At what age does PMS begin? Various conditions: what can pregnancy be confused with?

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 area in which the woman lived.

The girl’s condition before her period remained a mystery for a long time. Only in the twentieth century the veil of secrecy was lifted a little.

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

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

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

Why does premenstrual syndrome occur?

Numerous studies have not been able to identify the exact causes of premenstrual syndrome. There are many theories of its occurrence: “water intoxication” (impaired water-salt metabolism), allergic nature (increased sensitivity to endogenous substances), 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, and learning abilities
progesterone - has a sedative effect, which can lead to depressive symptoms in phase 2 of the cycle
androgens - affect libido, increase energy, performance

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

Since the days before menstruation are endocrine unstable, many women experience psycho-vegetative and somatic disorders. In this case, the decisive role is played not so much by the level of hormones (which may 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 fluid retention, swelling, engorgement and tenderness of the mammary glands, cardiovascular disorders, irritability, aggression, tearfulness
hypersecretion - also leads to fluid and sodium retention in the body
excess prostaglandins— , digestive disorders, migraine-like headaches

The most likely factors influencing the development of the syndrome, about which medical opinions do not differ:

Decreased serotonin levels- this is the so-called “hormone of joy”, can 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— a lack of this vitamin is indicated by symptoms such as fatigue, fluid retention in the body, mood swings, and breast hypersensitivity.
Lack of magnesium - magnesium deficiency can cause dizziness, headaches, cravings for chocolate.
Smoking. Women who smoke are twice as likely to experience premenstrual syndrome.
Overweight. Women with a body mass index of over 30 are three times more likely to suffer from PMS symptoms.
Genetic factor— it is possible that the peculiarities of premenstrual syndrome are inherited.
, complicated childbirth, stress, surgical interventions, infections, gynecological pathologies.

Main symptoms and manifestations of premenstrual syndrome

Groups of symptoms for PMS:

Neuropsychiatric disorders: aggression, depression, irritability, tearfulness.
Vegetovascular disorders: changes in blood pressure, headache, vomiting, nausea, dizziness, tachycardia,.
Exchange-endocrine disorders: swelling, increased body temperature, chills, engorgement of the mammary glands, itching, flatulence, shortness of breath, thirst, memory loss, .

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

Neuropsychiatric	Crisis form	Atypical manifestations of PMS
Disturbances in the nervous and emotional spheres: anxiety disorders feeling of unreasonable melancholy depression feeling of fear depression impaired concentration forgetfulness insomnia (see) irritability mood swings decreased or significant increase in libido aggression	attacks of tachycardia blood pressure surges pain in the heart attacks of frequent urination panic attacks Most women have diseases of the cardiovascular system, kidneys, and gastrointestinal tract.	low-grade fever (up to 37.7°C) increased drowsiness bouts of vomiting allergic reactions (ulcerative gingivitis and stomatitis, etc.)
	Edema form	Cephalgic form
	swelling of the face and limbs thirst weight gain itchy skin decreased urine output digestive disorders (constipation, diarrhea, flatulence) headaches joint pain Negative diuresis with fluid retention is noted.	The leading ones are mainly neurological and vegetative-vascular manifestations: migraine, throbbing pain, radiating to the eye area cardialgia (pain in the heart area) vomiting, nausea tachycardia increased sensitivity to smells, sounds in 75% of women, radiography of the skull shows hyperostosis, increased vascular pattern The family history of women with this form is burdened with hypertension, cardiovascular diseases, and gastrointestinal diseases.

PMS occurs differently in every woman, and symptoms vary significantly. According to the results of some studies, women with PMS have the following frequency of manifestation of one or another symptom of PMS:

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

Premenstrual syndrome can aggravate other diseases:

Anemia (see)
(cm. )
Thyroid diseases
Chronic fatigue syndrome
Bronchial asthma
Allergic reactions
Inflammatory diseases of the female genital organs

Diagnostics: what can masquerade as symptoms of PMS?

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

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

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

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

If a woman feels relatively well in phase 1 of the cycle, then this is 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, studies of hormones are carried out: prolactin, estradiol and progesterone. The doctor may also prescribe additional diagnostic methods, depending on the prevailing complaints:

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

Not only a gynecologist examines women suffering from PMS, but also involves 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 increases in a woman’s body, which also occurs during PMS, so the following symptoms are identical:

fatigue
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 pregnancy:

Symptoms	Pregnancy	Premenstrual syndrome
Breast tenderness	accompanies the entire pregnancy	with the onset of menstruation the pain goes away
Appetite	the attitude towards food changes, you want inedible, salty, beer, things that a woman usually doesn’t like, the sense of smell is greatly heightened, ordinary smells can be very irritating	may crave sweet and salty foods, sensitivity to smells
Back pain	only in later stages	May have lower back pain
Increased fatigue	starts 4-5 weeks after conception	can appear either immediately after ovulation or 2-5 days before menstruation
	mild, short-lived pain	individually in each case
Emotional state	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 is not easy to understand what exactly is happening in a woman’s body and distinguish pregnancy from PMS:

The easiest way to find out what causes poor health is to wait until your period starts.
If the calendar is already late, you should take a pregnancy test. A pharmacy test will give reliable results only if menstruation is delayed. It is sensitive to the pregnancy hormone (hCG) excreted in the urine. If you don’t have the patience and nerves to wait, you can take a blood test for hCG. It shows almost one hundred percent results 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, 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 are of a pronounced nature, treatment cannot be avoided. After a thorough examination, the doctor will prescribe drug therapy and give the necessary recommendations to alleviate 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 her loved ones suffer, are corrected using stabilizing behavioral techniques and psycho-emotional relaxation.
For headaches, lower back and abdominal pain, nonsteroidal anti-inflammatory drugs are prescribed for temporary pain relief (Nimesulide, Ketanov, see).
Diuretics for removing excess fluid from the body during edema (see).
Hormonal therapy is prescribed for insufficiency of the second phase of the cycle, only after functional diagnostic tests, based on the results of identified changes. Progestogens are used - Medroxyprogesterone acetate from 16 to 25 days of the cycle.
prescribed for a variety of neuropsychiatric symptoms (insomnia, nervousness, aggressiveness, anxiety, panic attacks, depression): Amitriptyline, Rudotel, Tazepam, Sonapax, Sertraline, Zoloft, Prozac, etc. in phase 2 of the cycle after 2 days from the onset of symptoms.
In crisis and cephalgic forms, it is possible to prescribe Parlodel in phase 2 of the cycle, or if prolactin is elevated, then in a continuous mode, it has a normalizing effect on the central nervous system.
For cephalgic and edematous forms, antiprostaglandin drugs (Indomethacin, Naprosyn) are recommended in the second phase of the menstrual cycle.
Since women often have elevated levels of histamine and serotonin during 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, Aminolon for 2-3 weeks.
In case of crisis, cephalgic and neuropsychic forms, drugs that normalize neurotransmitter metabolism in the central nervous system are indicated - Peritol, Difenin, the doctor prescribes the drug for a period of 3-6 months.
Homeopathic medicines Remens or Mastodinon.

What can you do?

Full sleep

Try to sleep as long as your body has time to fully rest, usually 8-10 hours (see. Lack of sleep leads to irritability, anxiety and aggression, and negatively affects the functioning of 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 and rose will help normalize the cycle. Lavender and basil effectively fight spasms. Juniper and bergamot improve mood. Start taking baths with aromatic oils two weeks before your period.

Hiking, running, Pilates, bodyflex, yoga, dancing are an excellent way to treat the manifestations of premenstrual syndrome in women. Regular exercise increases endorphin levels, which helps combat depression and insomnia, and also reduces the severity of physical symptoms.

Two weeks before your period, take vitamin B6 and magnesium

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

Nutrition

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

Relaxation practices

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

Regular sex

This helps fight insomnia, stress and bad mood, increases endorphin levels, and strengthens the immune system. At this time, many women's sexual appetite increases - why not surprise your partner and try something new?

Medicinal plants

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

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

If you suddenly find yourself craving a butter sandwich, or burst into tears at the sight of a small child, or you're dying to buy a pair of earrings that you're unlikely to wear, stop for a moment and ask yourself if you're about to get your period. . If soon, your unusual behavior may be caused by premenstrual syndrome or premenstrual tension syndrome (PMS). This is a specific condition that precedes menstruation and, to one degree or another, is characteristic of most women. When PMS hits, just try to calm down and control your actions. When your period starts, you will return to your normal state.

Premenstrual tension syndrome is associated with regular fluctuations in the level of hormones in the blood.

Previously, premenstrual syndrome was considered a psychological disease, until researchers proved that this condition is organic in nature, caused by changes in hormone levels in the body.

Increase the production of aldosterone, which causes a lot of changes in the body,
- increase the level of monoamine oxidase (a substance released in brain tissue that can cause depression),
- lower the level of (a substance released in the brain tissues that affects activity levels and mood).

For some women, PMS passes calmly, for others it is very violent, but the time of onset of symptoms is always predictable. This is what makes it possible to distinguish premenstrual tension syndrome from other diseases. Changes in emotional and physical state appear 7-10 days before menstruation, and disappear almost immediately after the start of menstruation. These dates can be established by keeping a menstrual diary for several months, noting in it all the symptoms and dates of the beginning and end of menstruation.
If symptoms persist throughout your menstrual cycle, PMS may not be the cause. In this case, you should contact a psychiatrist.

Causes of premenstrual syndrome

The appearance of premenstrual tension syndrome in some women and its absence in others is associated, first of all, with hormonal fluctuations during the menstrual cycle and the individual reactions of the whole body to them. However, recently scientists have begun to explore other possible causes of this condition (there is no definitive evidence yet):

Monthly cyclical fluctuations in the amount of certain substances (neurotransmitters) in the brain, which include endorphins, which affect mood,
- poor nutrition: symptoms of premenstrual syndrome such as mood swings, fluid retention in the body, increased breast sensitivity, fatigue are associated with B6 deficiency, while headaches, dizziness, palpitations and cravings for chocolate are caused by magnesium deficiency,
- hereditary factor. It has been proven that identical twins are much more likely to suffer from PMS together than fraternal twins. There may be a genetic predisposition to PMS.

Symptoms of premenstrual syndrome

Physical symptoms:

Increased sensitivity or even tenderness of the breasts,
- breast enlargement,
- fluid retention in the body, leading to swelling of the legs and arms and weight gain of about 2 kg,
- headaches, especially migraines,
- nausea, vomiting and dizziness,
- and joints and specific back pain,
- in some cases constipation, diarrhea,
- extreme thirst and frequent urination,
- cravings for food, especially salty or sweet foods, intolerance to alcohol,
- lethargy, fatigue or vice versa, energy,
- palpitations and flushing of the face,
- increase in the number of acne.

Psychological symptoms:

Frequent mood changes
- , blues, feeling of depression,
- constant tension and irritability,
- insomnia or prolonged sleep,
- absent-mindedness and forgetfulness.
Some women may experience more severe symptoms:
- panic
- thoughts of suicide
- aggressiveness, tendency to violence.

What can you do

Exercise. Study Shows Regular Exercise Reduces PMS Symptoms, Perhaps? this is due to the release of endorphins or other substances in the brain that relieve stress and improve mood.

Sleep 8-9 hours a day. Lack of sleep aggravates anxiety and other negative emotions, and increases irritability. If you suffer from insomnia, find a way to combat it. Deep breathing and other simple relaxation techniques before bed can be very effective in many cases. Before going to bed, take a hot bath and drink a glass of warm milk.

Eat a low-fat, high-fiber diet. During PMS, try to limit your intake of foods such as coffee, cheese and chocolate. Their use has been linked to migraines and many other PMS symptoms, such as anxiety, frequent mood swings and palpitations.

Don't eat a lot, limit sweets, it's better to take some fruit.

Maintain a constant level of insulin in the blood by eating small meals about 6 times a day, this is better than eating a large portion once. Try to eat healthy.

Nutritionists recommend taking vitamin B6 (50-100 mg) and magnesium (250 mg) daily in the form of dietary supplements. In addition, doctors prescribe additional calcium intake, which, together with magnesium, eliminates PMS symptoms and protects against osteoporosis, and iron (to fight anemia).

Many women say that primrose oil (a substance rich in important fatty acids) helps them. Check with your doctor about the dosage for you.

Stay away from crowds, don't go outside unnecessarily if the weather is bad, and get plenty of vitamin C (an antioxidant and immune system booster) as possible. Women suffering from PMS get sick more often. Scientists believe that this is a consequence of a weakened immune system before the onset of menstruation, which makes the body vulnerable to viral, bacterial and fungal infections.

What can a doctor do?

Since the causes of the disease are not completely clear, treatment for PMS focuses on mitigating its symptoms:

For anxiety, insomnia, and other psychological symptoms, your doctor may prescribe tranquilizers or sedatives. However, long-term use of these medications is undesirable due to the fact that they are addictive. Newer antidepressants have shown to be effective for PMS, but they must be taken under medical supervision.

For migraines associated with PMS, your doctor may prescribe special therapy aimed at preventing headache attacks. To relieve pain, most doctors prescribe non-steroidal anti-inflammatory drugs such as.

For swelling or other signs of fluid retention, diuretics are prescribed, which must be started 5-7 days before the start of menstruation.

In some cases, the doctor may prescribe progesterone and other hormones for PMS.

Prevention of PMS

Any disorder in the body, the causes of which are not clear, is difficult to prevent. At the moment, the best way to control this situation is to cope with it, and not to prevent it.

Many women experience far from pleasant symptoms of PMS caused by changes in the concentration of hormones in the blood. For some it goes almost unnoticed, while for others it prevents them from leading a full life. And although in most cases they understand what exactly is the reason for their poor health, not everyone knows how many days before their period PMS begins.

The classification of premenstrual syndrome, in addition to dividing according to symptomatic manifestations, also implies a compensated and decompensated form. This is what determines when the symptoms of premenstrual syndrome begin to appear:

On average, the answer to the question of how many days before menstruation PMS symptoms begin to appear is seven to ten days.

Causes of PMS

The main reason is a change in the concentration of hormones in the blood. What is characteristic is that the hormonal surge occurs very abruptly, and not gradually. Stress and fast city life contribute to the manifestation of symptoms; a sedentary lifestyle and intense intellectual work will also not contribute to good health. Both too frequent pregnancies and the inability to become pregnant allow a woman to be classified as a risk group, as do previous gynecological diseases and operations.

You should not abuse sweets and overeat in general, but it is better to get rid of bad habits - they disrupt the normal functioning of the body. Representatives of the fairer sex who take combined oral contraceptives should also be prepared for the fact that unpleasant disturbances in the functioning of the body may appear to varying degrees a couple of days before menstruation.

If you are unlucky enough to receive a head injury or have neuroinfections and endocrine diseases, the risk of developing the syndrome increases significantly. It was noted that residents of small towns and villages, as well as representatives of all races except Caucasian, are almost not subject to sudden hormonal surges and have not encountered premenstrual syndrome.

PMS symptoms

The symptoms of premenstrual syndrome in girls vary individually, but it is still possible to identify those manifestations of PMS that are characteristic of the majority:

In addition, we can distinguish types of manifestation of the syndrome before menstruation, which are characterized by certain symptoms:

The neuropsychic form is characterized by mood swings and appears when PMS begins before menstruation - several days before. Girls most often show depression and sad thoughts, while older women show aggressiveness and severe irritability.
The crisis form is characterized by a paroxysmal nature, blood pressure rises, the heartbeat quickens, and a constricting sensation is felt in the chest and heart. This form appears mainly at night and stops in the morning.
The edematous form is the most common. Pain occurs in the mammary glands, arms and legs swell, and sensitivity to odors may increase.
The cephalgic form of PMS is associated with headaches. Frequent and prolonged migraines occur, but blood pressure does not increase or decrease. Limbs may also go numb and there may be a stabbing sensation in the heart. Sweating often occurs.
The atypical form is characterized by the manifestation of symptoms characteristic of several forms at once. In addition, the temperature may rise, despite the absence of infectious diseases and colds. With the onset of menstruation, it gradually begins to decrease.

How to get rid of premenstrual syndrome?

Do not think that this syndrome is a death sentence. You need to know how many days before your period signs of PMS will begin to appear, and monitor your condition. Increasing physical activity and walking in the fresh air will help you cope well with this.

Do not overindulge in sweet foods, unhealthy soda, chips and fast food. Controlling your weight will help not only increase self-esteem, but also reduce the symptoms of premenstrual syndrome. It is important to be able to distract yourself from mood swings and everyday problems; it is advisable to go out of town or walk in quiet places, admiring nature. Then the syndrome will not be able to interfere with active daily life both before and during menstruation.

Premenstrual syndrome (PMS) is a complex of symptoms that occurs several days (from 2 to 10) before the onset of menstruation and disappears in its first days. At other times, there are no symptoms of PMS.

The condition includes neuropsychic disorders, vegetative-vascular and metabolic manifestations. Almost every woman has experienced signs of PMS at some point. However, it is severe only in every tenth patient.

How and why premenstrual syndrome occurs

In the middle of the menstrual cycle, ovulation occurs in the ovary - an egg is released from a mature follicle. She begins to move through the abdominal cavity to the fallopian tube to meet the sperm and fertilize. In place of the burst follicle, a corpus luteum is formed - a formation with high hormonal activity. In some women, in response to such endocrine “bursts,” the parts of the brain responsible for emotions, vascular reactions, and metabolic regulation react. Often this individual response feature is inherited from mother to daughter.

Previously, it was believed that PMS occurs more often in women with disrupted hormonal levels. Doctors are now confident that such patients have a regular ovulatory cycle and are otherwise healthy.

Theories of PMS development:

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

With PMS, the relative content of estrogens increases with a relative decrease in the level of gestagens. Estrogens retain sodium and fluid in the body, causing swelling, flatulence, headaches, and chest pain. Estrogens activate the renin-angiotensin-aldosterone system, causing additional fluid retention. These sex hormones directly affect the area of the brain responsible for the formation of emotions (the limbic system). The level of potassium and glucose in the blood also decreases, which causes weakness, heart pain, and decreased activity.

The level of gestagens determines how many days before menstruation PMS occurs. These hormones delay the onset of menstruation. They also determine how long premenstrual syndrome lasts.

As a result of disruption of the activity of the renin-angiotensin-aldosterone system, fluid retention occurs, which causes swelling of the intestinal wall. Abdominal bloating, nausea, and constipation occur.

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

Of particular importance in the mechanism of development of PMS is an increase in prolactin levels in the second half of the cycle, an allergy to internal progesterone, as well as interrelated bodily (somatic) and mental (mental) changes.

Clinical picture

There are three groups of main symptoms that determine the severity of the condition:

neuropsychic disorders: tearfulness, depression, irritability;
vegetative-vascular changes: nausea and vomiting, headache and dizziness, palpitations, pain in the heart, increased blood pressure;
metabolic disorders: enlarged mammary glands, swelling, bloating, thirst and shortness of breath, itching, chills, increased body temperature, pain in the lower abdomen.

An aggravating factor in PMS is depression. With it, women feel more pain and other unpleasant sensations, which can gradually turn into painful menstruation and migraines.

Forms of premenstrual syndrome

PMS can occur in the following clinical forms:

neuropsychic;
edematous;
cephalgic;
crisis.

The neuropsychic form is accompanied by emotional disturbances. Young women experience low mood levels. In adulthood, aggressiveness and irritability become the leading symptom.

The edematous form is accompanied by swelling of the legs, face, and eyelids. Shoes become tight and rings don’t fit well. Sensitivity to odors increases, bloating and skin itching appear. Due to fluid retention, weight increases (by 500-1000 g).

In the cephalgic form, the main symptom is headache in the temples spreading to the orbit. It has a twitching, pulsating character, accompanied by dizziness, nausea and vomiting. Most of these women show changes in the pituitary gland.

The crisis form is manifested by sympathoadrenal attacks: blood pressure suddenly rises, pressing pain in the chest appears, and fear of death appears. At the same time, there is a strong heartbeat, a feeling of numbness and coldness in the hands and feet. The crisis usually occurs late in the day and ends with the release of urine in a large volume. This form is more often observed as an outcome of untreated previous variants.

Flow

When does PMS start? With a mild course, three to four signs appear 2-10 days before menstruation, one or two of which are most pronounced. In severe cases, symptoms appear 3-14 days before menstruation. There are more than five of them, and at least two are pronounced.

The course of PMS is different for all patients. For some, symptoms appear at the same time and stop with the onset of menstruation. Other patients develop more and more symptoms over the years. The condition normalizes only after the end of menstrual bleeding. In the most severe cases, symptoms persist even after the cessation of menstruation, and the interval without complaints gradually decreases. In such a situation, a woman may even lose her ability to work. In some patients, cyclical ailments continue after menopause. The so-called transformed PMS occurs.

A mild course of PMS is accompanied by the appearance of a small number of symptoms, mild malaise, without limiting the normal rhythm of life. In more severe situations, signs of this condition affect family life, performance, and conflicts with others may arise. In severe cases, especially during a crisis, a woman cannot work and needs to be issued a certificate of incapacity for work.

Diagnostics

PMS is a clinical diagnosis based on an analysis of symptoms, their severity, and cyclical occurrence. An examination by a gynecologist is prescribed, and the genital organs are performed. For proper hormonal therapy, it is necessary to determine the level of sex and other hormones in the blood.

The patient is consulted by a neurologist, and, if necessary, by a psychiatrist, ophthalmologist, and endocrinologist. She may be prescribed tests such as electroencephalography, computed tomography of the brain, ultrasound of the kidneys, etc.

Only after a comprehensive examination and observation does a gynecologist make such a diagnosis and prescribe treatment.

PMS treatment

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

psychotherapy;
proper nutrition;
physical therapy;
physiotherapy;
treatment of premenstrual syndrome with drugs.

Psychotherapy

Rational psychotherapy helps to get rid of such unpleasant symptoms as excessive emotionality, mood swings, tearfulness or aggressiveness. For this purpose, psycho-emotional relaxation techniques that stabilize behavioral techniques are used. A woman is taught how to relieve PMS and is helped to cope with the fear of menstruation.

It is very useful to conduct psychotherapeutic sessions not only with a woman, but also with her loved ones. Relatives learn to better understand the patient’s condition. Conversations with the patient’s immediate circle improve the microclimate in the family. Through psychosomatic mechanisms, it is possible to improve the patient’s physical condition and alleviate the objective manifestations of premenstrual syndrome.

Lifestyle and nutrition

It is necessary to increase the content of plant fiber in the diet. It normalizes intestinal function and removes excess fluid from the body. The daily diet should consist of 75% carbohydrates (mostly complex), 15% proteins and only 10% fats. The consumption of fats must be limited, as they affect the participation of the liver in estrogen metabolism. It is better to avoid beef, as it often contains small doses of artificially introduced hormones. Thus, the most useful source of protein for PMS will be fermented milk products.

It is useful to increase the consumption of juice, in particular carrot juice with the addition of lemon. Herbal teas with the addition of mint, lemon balm, and valerian are recommended. Herbal sedative for PMS helps cope with emotional disorders, improve sleep and overall well-being.

You should avoid excess salt and spices, and limit your consumption of chocolate and meat. You should not drink alcoholic beverages, as they reduce the content of B vitamins and minerals in the body, and change the metabolism of carbohydrates. Liver function suffers, which can lead to disruption of estrogen metabolism and increased severity of the condition.

There is no need to take a lot of caffeinated drinks (tea, coffee, Coca-Cola) during PMS. Caffeine causes fluid retention, disrupts sleep, and contributes to neuropsychiatric disorders. In addition, it increases engorgement of the mammary glands.

Drugs for the treatment of PMS

If you have severe symptoms of PMS, you should consult a doctor. He will tell you how to deal with its symptoms using medications. Let's consider the main groups of drugs for the treatment of premenstrual syndrome.

After examination by a gynecologist, if an increased level of estrogen is detected (absolute or relative hyperestrogenism), gestagens are prescribed. These include Duphaston, Norkolut and others. Gonadotropin-releasing factor agonists, in particular Danazol, also have an antiestrogenic effect.
Antihistamines are prescribed due to increased levels of histamine and serotonin in such patients. Tavegil, Suprastin are usually used at night, starting two days before the expected onset of PMS and ending with the first day of menstruation.
To normalize the functioning of brain structures responsible for vascular regulation and mental disorders, nootropics are prescribed - Nootropil, Aminalon, starting from the first day of menstruation for two weeks. Such courses are repeated for three months in a row, then take a break.
If, after determining hormone levels, an increase in prolactin levels is detected, Parlodel (bromocriptine) is prescribed, starting two days before the expected onset of PMS, for 10 days.
In the presence of severe edema, the prescription of a diuretic with a potassium-sparing effect, Veroshpiron, which is an aldosterone antagonist, is indicated. Prescribe it 4 days before the deterioration of health and stop taking it with the onset of menstruation. If edema syndrome manifests itself as headache, blurred vision, it is recommended to use Diacarb.
In the presence of pain, the main means for treating PMS are non-steroidal anti-inflammatory drugs, in particular Diclofenac. It is prescribed two days before your health worsens. These drugs suppress the synthesis of prostaglandins, biologically active substances that cause many symptoms of PMS. Course treatment is carried out over three months. The effect of this course lasts up to four months after its termination. PMS symptoms then return, but are usually less intense.
Excessive emotionality, depressive disorders, and neuroses may be an indication for the prescription of tranquilizers. There are special “daytime” drugs that do not suppress normal activity, in particular, Grandaxin and Afobazol. Antipsychotics and antidepressants may be used. Such drugs are prescribed by a psychiatrist. They must be taken continuously for 3-6 months.
Vitamins A and E have a beneficial effect on the female reproductive system, including reducing the severity of premenstrual syndrome. They are taken orally or administered intramuscularly for a month, alternating with each other. If anxiety and depressive disorders appear in the second half of the cycle, magnesium and vitamin B6 are prescribed.

PMS treatment is carried out in cycles. In the first three months, diet, herbal sedatives, vitamins, and non-steroidal anti-inflammatory drugs are used. Then they take a break from treatment for 3-6 months. When PMS symptoms return, other drugs with more serious effects are added to treatment. Don't expect a quick effect. Therapy should be long-term and accompanied by modifications of diet and lifestyle.

PMS is a very common syndrome among women and girls, and often its manifestations affect not only its owners, but also their close circle. Some believe that by explaining their unsightly behavior with this syndrome, representatives of the fair sex are simply looking for an excuse for their bad temper, but in reality this, of course, is not the case. You can find out how to alleviate the unpleasant symptoms of PMS in this article.

What is PMS in girls (women)

How does PMS stand for?

The abbreviation PMS has a fairly simple definition - we are talking about premenstrual syndrome. This phenomenon is characterized by a set of symptoms that manifests itself in a girl shortly before the onset of menstruation. Of course, we are not talking about a separate disease, but approximately half of women feel some changes in their body during this period.

What does PMS mean?

As already mentioned, PMS is characterized by several manifestations, and now we will look at them in more detail.

Anger and irritability for no particular reason. Frequent mood swings - from complete depression to aggression. Anxiety that has no basis. Loss of interest in usual daily activities. Increased fatigue. Problems with sleep (can be expressed by drowsiness or insomnia). Headache pain, swelling, abdominal pain. Increased appetite. Exacerbation of infectious processes and allergic reactions of the body. If you observe at least half of these symptoms shortly before the onset of your period, then we can say that you are dealing with PMS.

At what age does PMS begin?

Since PMS is a phenomenon that occurs shortly before menstruation, it can be diagnosed in a girl already from her first menstruation. Although, of course, each organism is individual, and if you did not observe any signs of this syndrome in your early youth, then it is quite possible that they will appear in adulthood. However, it is worth noting that most often women between the ages of 20 and 40 experience concerns about this.

How many days before your period does PMS start?

The onset of PMS occurs individually for each woman. Mostly its symptoms begin to appear 2-3 days before the menstruation period begins. However, it is worth noting that some girls are much less “lucky” - they begin to feel irritability, anger and other symptoms much earlier - about a week, or even ten days before their period arrives. However, the number of days may vary each time.

How many days does PMS last in women?

Even if your PMS began a week before menstruation or even ten days, it is not at all necessary that its syndromes will manifest themselves throughout this period. Just a couple of days before your period, aggression, apathy, anxiety and other “charms” of PMS may stop. At the same time, of course, there are also frequent cases when the syndrome lasts until menstruation.

How to tell if you have PMS

Mood swings One of the first signs of the onset of PMS is sudden mood swings. In such cases, a woman may suddenly feel anxious and depressed against the background of general well-being. She can also be thrown off balance and brought to an aggressive state by some completely insignificant troubles, to which at other times she most likely would not have paid much attention. Of course, such mood swings often affect not only the woman experiencing PMS, but also the people who happened to come into contact with her during this period. Physiological changes in the body The onset of PMS is most often characterized by changes not only in the psychological state of a woman, but also by some physiological changes. Let's take a closer look at some forms of the syndrome

This form is characterized by high blood pressure, pressing pain in the chest area, and rapid heartbeat. There is also very high anxiety. Symptoms usually appear at night, when the autonomic nervous system is particularly active. Women suffering from this form of PMS may periodically feel body tremors throughout the night during this period. As a rule, in the morning the described symptoms stop.

What to do when you have PMS

Advice from a gynecologist

Psychologist's advice