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

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 psycho-vegetative 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 cyclicity. 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.

If suddenly you find yourself craving a butter sandwich, or burst into tears of emotion at the sight of a small child, or you are achingly tempted to buy a pair of earrings that you are unlikely to wear, stop for a while and ask yourself if your period will start soon. . If so, then 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 sets in, try to just 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 as a psychological disease, until researchers proved that this condition has an organic nature, due to changes in the level of hormones 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 tissues and capable of causing depression),
- lower the level (of a substance released in the tissues of the brain and affecting the level of activity and mood).

For some women, PMS is calm, for others it is very violent, but the timing of symptoms is always predictable. This is what distinguishes premenstrual tension syndrome from other diseases. Changes in the emotional and physical state appear 7-10 days before menstruation, and disappear almost immediately after the onset of menstruation. These dates can be set if you keep a menstrual diary for several months, noting in it all the symptoms and the dates of the beginning and end of menstruation.
If symptoms persist throughout the menstrual cycle, PMS may not be the cause. In this case, you should consult a psychiatrist.

Causes of premenstrual syndrome

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

Monthly cyclic fluctuations in the amount of certain substances (neurotransmitters) in the brain, which include endorphins that affect mood,
- malnutrition: symptoms of premenstrual syndrome such as mood swings, fluid retention in the body, breast tenderness, 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 PMS together than fraternal twins. Perhaps there is a genetic predisposition to PMS.

Symptoms of premenstrual syndrome

Physical symptoms:

Increased sensitivity or even soreness of the breast,
- breast augmentation,
- 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,
- intense thirst and frequent urination,
craving for food, especially salty or sweet, intolerance to alcohol,
- lethargy, fatigue or vice versa, energy,
- palpitations and flushing of the face,
- an increase in the number of acne.

Psychological symptoms:

Frequent mood swings
-, spleen, feeling of depression,
- constant tension and irritability,
- insomnia or prolonged sleep,
- distraction and forgetfulness.
Some women may experience more severe symptoms:
- panic
- thoughts of suicide
- aggressiveness, propensity to violence.

What can you do

Do physical exercise. Research has shown that regular exercise reduces the symptoms of PMS, perhaps? this is due to the release of endorphins or other substances in the brain that relieve stress and elevate mood.

Sleep 8-9 hours a day. Lack of sleep exacerbates anxiety and other negative emotions, increases irritability. If you suffer from insomnia, find a way to deal with it. Deep breathing and other simple relaxation techniques before bed are often very effective. Before going to bed, take hot baths and drink a glass of warm milk.

Eat a diet that is low in fat and high in fiber. During PMS, try to eat foods like coffee, cheese, and chocolate as little as possible. They have been linked to migraines and a host of other PMS symptoms, such as anxiety, frequent mood swings, and palpitations.

Do not eat a lot, limit sweets, it is better to take some fruit.

Maintain a constant level of insulin in the blood for this, eat a little about 6 times a day, this is better than eating a large portion once. Try to eat right.

Nutritionists recommend taking vitamin B6 (50-100 mg) and magnesium (250 mg) daily in the form of food supplements. In addition, doctors prescribe calcium supplementation, 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 unless it's bad weather, and get plenty of vitamin C (an antioxidant and immune system booster) as much as possible. Women with PMS are more likely to get sick. Scientists believe that this is a consequence of the weakening of the 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 fully understood, the treatment of PMS focuses on alleviating its symptoms:

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

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

With edema or other signs of fluid retention, diuretics are prescribed, which must be started 5-7 days before the onset of menstruation.

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

Prevention of PMS

Any violation 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 the ability to cope with it, not prevention.

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

The classification of premenstrual syndrome, in addition to dividing by symptomatic manifestations, also implies a compensated and decompensated form. It depends on this when the manifestation of signs of premenstrual syndrome begins:

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

Causes of PMS

The main reason is a change in the concentration of hormones in the blood. What is characteristic, 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 also do not contribute to good health. Both too frequent pregnancies and the inability to get pregnant make it possible to classify a lady as a risk group, as well as 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. The fairer sex, taking combined oral contraceptives, should also be prepared for the fact that unpleasant disturbances in the functioning of the body may manifest themselves to varying degrees a couple of days before menstruation.

If you are not lucky enough to get a head injury or have neuroinfections and endocrine diseases, the risk of the syndrome increases significantly. It has been observed that residents of small towns and villages, as well as representatives of all races except Caucasian, are almost not subject to sharp hormonal surges and have not experienced premenstrual syndrome.

PMS symptoms

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

In addition, it is possible to distinguish the 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 - a few days before. Girls most often manifest depression and sad thoughts, older women - aggressiveness and severe irritability.
The crisis form is characterized by a paroxysmal nature, blood pressure rises, the heartbeat quickens, 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. There is pain in the mammary glands, the arms and legs swell, and susceptibility to odors may increase.
The cephalgic form of PMS is associated with headaches. There are frequent and prolonged migraines, while blood pressure does not rise or fall. Limbs can also go numb and prick in the heart. Often there is sweating.
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 decline.

How to get rid of premenstrual syndrome?

Do not think that this syndrome is a sentence. Need to know how many days before menstruation signs of PMS will begin to appear, and monitor your condition. An increase in physical activity and walks in the fresh air will help to cope well with this.

Do not abuse sweet foods, harmful soda, chips and fast food. Controlling your weight will help not only increase self-esteem, but also reduce the manifestations of premenstrual syndrome. It is important to be able to distract from mood swings and everyday problems, it is advisable to leave the city or walk in quiet places, admiring nature. Then the syndrome will not be able to interfere with the conduct of an active daily life both before and during menstruation.

In contact with

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

The condition includes neuropsychiatric disorders, vegetative-vascular and metabolic manifestations. Almost every woman has experienced the symptoms 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 with the sperm and fertilization. In place of the bursting 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 is inherited from mother to daughter.

Previously, it was believed that PMS occurs more often in women with disturbed hormonal levels. Now doctors are sure that such patients have a regular ovulatory cycle, and in all other respects they are healthy.

Theories for the development of PMS:

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, a headache, 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, pain in the heart, decreased activity.

It depends on the level of gestagens 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 a violation of the activity of the renin-angiotensin-aldosterone system, fluid retention occurs, which causes swelling of the intestinal wall. There is bloating, nausea, constipation.

The development of PMS contributes to the 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 the level of prolactin in the second half of the cycle, an allergy to internal progesterone, as well as interconnected bodily (somatic) and mental (mental) changes.

Clinical picture

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

neuropsychiatric disorders: tearfulness, depression, irritability;
vegetative-vascular changes: nausea and vomiting, headache and dizziness, palpitations, pain in the heart area, increased pressure;
metabolic disorders: breast enlargement, swelling, bloating, thirst and shortness of breath, itching, chills, fever, pain in the lower abdomen.

An aggravating factor in the course of PMS is depression. With her, women feel more pain and other unpleasant sensations, which can smoothly turn into painful menstruation and migraines.

Forms of premenstrual syndrome

PMS can occur in the following clinical forms:

neuro-psychic;
edematous;
cephalgic;
crisis.

The neuropsychic form is accompanied by emotional disturbances. Young women have a reduced mood background. In adulthood, aggressiveness and irritability become the leading sign.

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

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

The crisis form is manifested by sympathoadrenal attacks: blood pressure suddenly rises, pressing pain in the chest appears, fear of death. At the same time, a strong heartbeat, a feeling of numbness and coldness of the hands and feet are disturbing. The crisis usually occurs late in the day, 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, 2-10 days before menstruation, three to four signs appear, 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 in all patients is different. For some, symptoms appear at the same time and stop with the onset of menstruation. In other patients, more and more signs are recorded over the years. The condition is normalized only after the end of menstrual bleeding. In the most severe cases, the symptoms persist even after the cessation of menstruation, and the period without complaints is gradually reduced. In such a situation, a woman may even lose her ability to work. In some patients, cyclic ailments continue after the onset of menopause. There is a so-called transformed PMS.

The 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, the signs of this condition affect family life, working capacity, conflicts with others may appear. In severe cases, especially during a crisis course, a woman cannot work and needs to issue a certificate of incapacity for work.

Diagnostics

PMS is a clinical diagnosis based on the analysis of symptoms, their severity, and the cyclical occurrence. An examination by a gynecologist is prescribed, 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, if necessary - a psychiatrist, ophthalmologist, endocrinologist. She may be assigned to such studies as electroencephalography, computed tomography of the brain, ultrasound of the kidneys,.

Only after a comprehensive examination and observation, the gynecologist makes such a diagnosis and prescribes treatment.

PMS treatment

How to relieve premenstrual syndrome? To this end, the following scheme is recommended:

psychotherapy;
proper nutrition;
physiotherapy;
physiotherapy;
treatment of premenstrual syndrome drugs.

Psychotherapy

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

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

Lifestyle and nutrition

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

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

You should abandon the excess of salt, spices, limit the consumption of chocolate and meat. Alcoholic beverages should not be consumed, as they reduce the body's content of B vitamins, minerals, and change the metabolism of carbohydrates. The work of the liver suffers, which can lead to a violation of estrogen metabolism and an increase in the severity of the condition.

You do not need to take many drinks with caffeine (tea, coffee, Coca-Cola) during PMS. Caffeine causes fluid retention, disrupts sleep, and contributes to neuropsychiatric disorders. In addition, it enhances the engorgement of the mammary glands.

Preparations for the treatment of PMS

If you have symptoms of PMS, you should consult a doctor. He will tell you how to deal with his symptoms using medications. Consider the main groups of drugs for the treatment of premenstrual syndrome.

After examination by a gynecologist, if an increased content of estrogens (absolute or relative hyperestrogenism) is detected, gestagens are prescribed. These include Duphaston, Norkolut and others. Gonadotropin-releasing factor agonists, in particular, Danazol, also have an antiestrogenic effect.
Antihistamines are prescribed in connection with an increase in the level 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 the 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 they take a break.
If, after determining the level of hormones, an increase in the level of prolactin is detected, Parlodel (bromocriptine) is prescribed, starting two days before the expected onset of PMS, for 10 days.
In the presence of pronounced edema, the appointment of a diuretic with a potassium-sparing effect of Veroshpiron, which is an aldosterone antagonist, is indicated. Assign it 4 days before the deterioration of health and stop taking it with the onset of menstruation. If the edematous syndrome is manifested by a headache, visual impairment, it is recommended to use Diakarb.
In the presence of pain, the main means for the treatment of PMS are non-steroidal anti-inflammatory drugs, in particular, Diclofenac. It is prescribed two days before the deterioration of health. These drugs inhibit the synthesis of prostaglandins, biologically active substances that cause many of the symptoms of PMS. Course treatment is carried out for three months. The effect of such a course lasts up to four months after its termination. Then PMS symptoms return, but are usually less intense.
Excessive emotionality, depressive disorders, neurosis may be an indication for the appointment of tranquilizers. There are special "day" drugs that do not suppress normal activity, in particular, Grandaxin and Afobazol. Antipsychotics and antidepressants may be used. These drugs are prescribed by a psychiatrist. They need to 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 injected intramuscularly for a month, alternating with each other. With the appearance of anxiety and depressive disorders in the second half of the cycle, magnesium preparations and vitamin B6 are prescribed.

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

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

What is PMS in girls (women)

How PMS stands for

The abbreviation PMS has a fairly simple decoding - 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 about half of the women feel some changes in their bodies during this period.

What does PMS mean

As already mentioned, PMS is characterized by some manifestations, and now we will consider them in more detail.

Anger and irritability for no particular reason.Frequent mood swings - from complete depression to aggression.Unreasonable anxiety.Loss of interest in the usual daily activities.Increased fatigue.Sleep problems (may be drowsiness or insomnia).Headache pain, swelling, pain in the abdomen. Increased appetite. Exacerbation of infectious processes and allergic reactions of the body. If you observe at least half of these symptoms in yourself shortly before the onset of "menstruation", then we can say that you are dealing with PMS.

At what age does PMS start?

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

How many days before menstruation does PMS start?

The beginning of PMS in each woman proceeds individually. Mostly, its signs begin to appear 2-3 days before the period of menstruation begins. However, it is worth noting that some girls are "lucky" much less - they begin to feel irritability, anger and other symptoms much earlier - about a week, or even ten days before the "menses" come. However, the number of days each time may vary.

How many days does PMS last for women

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

How to know if you have PMS

mood swings One of the first signs of PMS that has begun is sudden mood swings. In such cases, a woman may suddenly feel anxiety and depression against the background of general well-being. Also, she can be unbalanced and brought to an aggressive state by some completely minor troubles, which at other times she would most likely not pay much attention to. Of course, not only a woman experiencing PMS often suffers from such mood swings, but also people who happened to contact her during this period. Physiological changes in the body The onset of PMS, most often, is characterized not only by changes in the psychological state of a woman, but also by some physiological changes. Let us consider in more detail some forms of the syndrome

This form is characterized by high blood pressure, pressing pains in the chest area, palpitations. There is also a very high level of anxiety. Symptoms usually appear at night, during a special activity of the autonomic nervous system. Women who suffer from this form of PMS may periodically experience tremors throughout the night during this period. As a rule, the described symptoms stop in the morning.

What to do when you have PMS

Advice from a gynecologist

Psychologist's advice