When does PMS happen? What is premenstrual syndrome and how to deal with it

Premenstrual syndrome is a complex of symptoms that develop during the luteal phase of the cycle in ovulating women.

Behavioral symptoms include fatigue, irritability, anxiety, depression, emotional lability, insomnia, increased appetite, decreased ability to work. Physical symptoms include bloating, breast tenderness, ankle swelling, and headache.

At least 60% of women suffer from PMS. Most often, the syndrome occurs after 30 years of age, but there are also early cases of its manifestation - in youth, and late cases - before menopause. Although the phenomenon of PMS has been known since antiquity, it was only published in the 1980s. in the magazine “Family Circle”, an article that gave a clear formulation of PMS and emphasized the massive nature of this dysfunction attracted the attention of the general public to it. The press picked up the topic, and after a few months an audience of millions became familiar with the problem, and the definition of PMS entered the everyday lexicon. Feminists have begun an active debate on this issue, arguing that the diagnosis will be used to discriminate against women. Doctors were concerned that this vague diagnosis would become a convenient excuse for women and their families when relationships deteriorate for some unknown reason. At the same time, millions of women received an explanation for their monthly pain and began to seek help from doctors.

It is interesting that professional obstetricians and gynecologists began to discuss the problem of PMS only after publication in the Family Circle, when women began to seek help with this diagnosis, formulated by themselves. But we, doctors, were not ready for this. We were simply not taught how to treat such disorders. By the mid-1980s. The “demand” for the treatment of PMS, formulated by the media and women’s appeals, was so great that 108 the topic began to be discussed at congresses on obstetrics and gynecology, and in medical journals There have been articles on this issue. The same thing happened with natural childbirth, when the desire of the women themselves forced obstetricians to reconsider the traditional approach to the problem. And in the case of PMS, women's need to understand their premenstrual condition has influenced medical practice and shaped a deeper approach to the female body.

Premenstrual syndrome (PMS) - cyclically recurring psychological, behavioral and physical symptoms during the luteal phase menstrual cycle. It begins 2 weeks before menstruation and disappears with its onset. A woman should not have any symptoms between the end of her period and ovulation.

Psychological and somatic disorders are part of the normal physiology of the menstrual cycle, but their excessive severity leads to severe psychological and behavioral disorders. Symptoms include bloating, cramping, breast pain and tenderness, temporary weight gain, and some swelling of the palms and feet. Emotional stress, bad mood, nervousness, irritability, headache, difficulty concentrating, depression and insomnia may be sufficient to alter normal life satisfaction. Some premenstrual symptoms are noted by the majority of women (95%), while a very small number of women (5%) experience no symptoms at all.

In a small group of women (5%), PMS symptoms significantly affect life and sometimes lead to suicide and acts of aggression; it is cited in court as a justification for murder.

Diagnosis of premenstrual syndrome (PMS)

Diagnosis is based on regular daily recording of the frequency and intensity of symptoms over one or two menstrual cycles using a rating scale.

Premenstrual Syndrome Rating Scale

PMS can be accompanied by symptoms of a very different nature. When making a diagnosis, it is important not to describe the woman’s condition before menstruation, but to determine with what cyclicity it recurs. Women who keep a diary of their cycles for at least three months usually see a certain pattern in the occurrence of PMS symptoms. Most women (except for the most difficult cases) have at least three days during their monthly cycle when all unpleasant symptoms are absent. In the second half of the cycle, many chronic diseases worsen - glaucoma, arthritis and depression. This exacerbation cannot be completely identified with PMS, although a connection between them exists. At the moment, more than a hundred symptoms of PMS are known. All of them are likely due to an imbalance of eicosanoids at the cellular level, caused by a complex of psychological, physiological and genetic factors.

Causes of premenstrual syndrome (PMS)

The exact nature of the endocrine changes underlying premenstrual syndrome has not been established. The role of changes in the content of endorphins, prostaglandins and prolactin is shown. Due to the clear connection of symptoms with the luteal phase of the menstrual cycle, the main place in the mechanism of development of this syndrome appears to belong to a violation of progesterone secretion.

The etiology of PMS remains unclear, and therefore therapeutic difficulties arise. The main reason is a combination of imbalance/impaired synthesis of steroids in the ovaries and mediators in the central nervous system. Research has shown that women with PMS have lower concentrations of serotonin in their blood and platelets. Some selective serotonin reuptake inhibitors reduce PMS symptoms. Elimination of cyclic ovarian function leads to complete suppression of all symptoms. Although the trigger for PMS is the cyclic synthesis of steroids in the ovaries, there is no accurate test to distinguish it from other diseases. The origin of symptoms is less important than the time of their onset, so keeping a symptom diary is useful in differentiating between primary and secondary PMS. Secondary PMS is true PMS combined with underlying psychopathology. If symptoms do not follow the pattern described, another diagnosis should be considered.

Symptoms and signs of premenstrual syndrome (PMS)

• Bloating
• Cramping pain in the abdomen
• Accident exposure
• Pimples
• Aggressiveness
• Alcohol intolerance
• Anxiety
• Asthma
• Back pain
• Swelling and pain in the mammary glands
• Contusions (bruises)
• State of Confusion
• Problems with motor coordination
• Depression
• Edema
• Unstable emotional state
• Exacerbation of existing chronic diseases (arthritis, ulcers, skin tuberculosis, etc.)
• Deterioration of vision
• Weakness
• Fatigue
• "Wolf" hunger
• Headaches
• Palpitations
• Haemorrhoids
• Herpes (lichen)
• Insomnia
• Irritability
• Swelling and joint pain
• Apathy
• Migraine
• Nausea
• Salty cravings
• Seizures
• Change in sexual desire
• Fistulas
• Sore throat
• Barley
• Thoughts of suicide
• Sweet cravings
• Problems with urination
• Self-isolation

If left untreated, the syndrome progresses, and its manifestations extend over time. If in the early stages of the disease women complain of pain that occurs a few days before menstruation and abruptly stops with the onset of bleeding, then in an advanced state these symptoms arise one to two weeks before the onset of menstruation. Some women feel a combination of symptoms during the period of ovulation, then feel normal for one week, and feel bad again the last week before their period. Over time, such patients have only two to three days a month when symptoms do not appear. Eventually, the difference between “good” and “bad” days disappears, and the woman actually experiences PMS symptoms all the time.

Some women equate menstrual pain (dysmenorrhea) with PMS, but in reality this is not the case. This distinction is not always clearly defined even by the authors of articles on PMS. Many women with PMS have periods when they experience no pain at all, and conversely, women with severe menstrual pain often do not have PMS at all. Menstrual pain is caused by uterine contractions and spasms that occur from excess PGF2-alpha, a hormone that is produced as the endometrial lining sheds during menstruation. Some studies indicate that prostaglandins also influence PMS. This is why diet, vitamin and mineral supplements, and anti-prostaglandin therapy (usually non-steroidal anti-inflammatory drugs such as Advil) work equally well for both menstrual cramps and PMS.

Although many doctors are still trying to find the “biochemical disorder” that causes PMS, and hundreds of articles have been written on this topic, no one has yet been able to discover the “weak link” or create a magic pill that can relieve unpleasant symptoms. The reductionist approach - the search for the biochemical “cause” of the syndrome and the “medicine” that can suppress it - is futile, since PMS is influenced by a number of factors, so treatment must be carried out comprehensively, taking into account everything: diet, mentality, emotional type, attitude to the world, physical exercise, relationships with other people, heredity and childhood psychological trauma.

All of the above causes hormonal changes that provoke PMS or intensify it, unless treatment is started on time.

About 20-40% of women experience some discomfort during the late luteal phase of the cycle, at the beginning of the menstrual phase and 1-2 days in the middle of the cycle. The pathogenesis of the syndrome has not yet been revealed.

Acne in premenstrual syndrome

Acne vulgaris is one of the most common diseases in dermatologist practice. Open and closed comedones are classified as aseptic lesions, papules and pustules are classified as superficial inflammatory lesions, and cysts and nodules, and sometimes deep pustules, are classified as deep. Most patients simultaneously have several clinical types of acne. In a mild form of the disease, predominantly comedones and papules are formed, as well as single pustules; in a moderate form, papules and pustules are formed; nodules and cysts are characteristic of the severe form.

A mild form of the disease, characterized by the appearance of acne on the face, is observed in 70% of women in the premenstrual period. Perioral dermatitis, which is usually observed in girls, is often cyclical. In addition, premenstrual syndrome can manifest itself as swelling of the hands and feet and, less commonly, patchy pigmentation of the skin.

To treat premenstrual acne, local antiseptic and keratolytic agents (benzoyl peroxide) or antibiotics (1% clindamycin solution) are usually successfully used, but suppression of ovulation and prevention of postovulatory surges in progesterone secretion have a good effect. For women taking oral contraceptives, it is also important to choose the right drug, since some synthetic gestagens (for example, norethisterone, levonorgestrel) worsen the condition of acne-affected skin. For patients prone to acne, combination medications containing gestogen, desogestrel or norgestimate are recommended. These progestins increase SHBG levels, thereby decreasing free testosterone levels with a clinical antiandrogenic effect.

Although progestogens are often prescribed for premenstrual syndrome with suspected progesterone deficiency, this method is not currently used for the treatment of premenstrual acne.

Increased manifestations of dermatosis before menstruation

Many women suffering from dermatosis complain of increased clinical manifestations of the disease in the premenstrual period. Inflammatory skin diseases, especially the facial skin, often worsen before menstruation. In some way, this is due to increased blood flow to the skin under the influence of hormones and its consequences (seborrhea, edema). Examples of such diseases include acne vulgaris, rosacea, and various clinical forms of systemic lupus erythematosus (SLE). Premenstrual exacerbation is also observed with other skin diseases in young women, in particular with psoriasis, atopic eczema, lichen planus, dermatitis herpetiformis, dyshidrosis and urticaria. Gestational pemphigoid (gestational herpes) can persist after childbirth. In such cases, it is accompanied by premenstrual exacerbations. Herpes simplex and aphthosis, despite frequent relapses, usually do not have obvious cyclicity.

Increased blood flow to the skin and more intense metabolism in it before menstruation contribute to the exacerbation of itchy dermatoses (for example, eczema and vulvar itching). In general, the condition of the skin before menstruation in women experiencing premenstrual tension often worsens.

Chronic dermatoses, worsening before menstruation

• Acne vulgaris
• Rosacea
• Systemic lupus erythematosus
• Psoriasis, atopic eczema
• Lichen planus
• Dermatitis herpetiformis
• Dyshidrosis
• Hives
• Polymorphous exudative erythema
• Itching of the vulva
• Gestational pemphigoid

Events associated with the occurrence of premenstrual syndrome (PMS)

• The beginning of menstruation or a year or two before menopause.
• Stop taking oral contraceptives.
• After a period during which there was no menstruation (amenorrhea).
• Childbirth or termination of pregnancy.
• Pregnancy complicated by toxicosis.
• Tubal ligation, especially if it was done in the 1970s, when the now unpractised method of cauterizing most of the fallopian tubes with an electric current (electrocautery) was used.
• Sudden mental trauma, for example, the death of a relative.
• Light deficiency due to the time of year (autumn-winter).

A whole “bouquet” of nutrition-related factors aggravates PMS. Studies of women suffering from the syndrome have revealed what diet they follow and what their physiological characteristics are.

Factors predisposing to premenstrual syndrome (PMS)

• Excessive consumption of dairy products.
• Excessive consumption of caffeine in the form of soft drinks, coffee and chocolate.
• Excessive consumption of refined sugar and insufficient coarse fiber, which is found in fresh vegetables.
• Relatively high levels of estrogen in the blood - either due to the abuse of dairy products and excess weight, or due to poor breakdown of estrogen in the liver. High estrogen levels are associated with a deficiency of B complex vitamins, especially B6 and B12. These vitamins are needed by the liver to inactivate and break down estrogen.
• Relatively low levels of progesterone in the blood. This hormone neutralizes excess estrogen. The level of progesterone is a consequence of either its insufficient production or excessive breakdown of this hormone in the blood. Scientists have differing opinions on this issue.
• A diet that produces high levels of the hormone PGF2 and also increases estrogen levels associated with low progesterone levels. The stool of vegetarians who do not eat fatty foods and consume foods high in fiber contains two to three times more estrogen than the stool of non-vegetarians. A vegetarian's blood plasma contains 50% less unconjugated estrogens (metabolized estrogens) than the blood of people who eat a standard American diet. As a result, the former - vegetarian women - are much less susceptible to PMS. (Please note: In my experience, vegetarians eat far more fruits and vegetables and fewer trans fatty acids than non-vegetarians. There is growing evidence that red meat is not the scary beast we think it is, especially if you eat it in small quantities and together with vegetables, herbs, whole grains, and also eat a lot of fruits and other foods rich in coarse fiber, you need to exclude foods containing a lot of sugar and trans-fatty acids from your diet.)
• Being overweight increases the likelihood of increased estrogen levels and therefore PMS symptoms. Fat deposits produce estrone (one of the estrogens).
• Low levels of vitamins C, E and selenium. Our liver needs them just like B vitamins to properly process estrogen.
• Lack of magnesium. Scientists link the passion for chocolate to low magnesium levels. It (magnesium), just like B vitamins, allows the most productive processing of estrogen.

Seasonal emotional disorder and PMS: shedding light on the connection between these syndromes

Many women suffering from PMS have noticed that their condition worsens in the fall, when the days become shorter. Most of the symptoms of PMS are also characteristic of the so-called seasonal affective disorder (SED). Light nourishes our body. Once on the retina, it, through the hypothalamus and pineal gland (epiphysis, or pineal body), begins to affect the entire neuroendocrine system. In one experiment, patients with PMS responded well to light therapy. After a two-hour evening session, during which the room was flooded with bright light, they stopped gaining weight; depression, constant desire to eat sweets (carbohydrates), isolation, fatigue, irritability disappeared. This is not surprising, because natural light, as well as the consumption of carbohydrates, increases the production of serotonin, which alleviates depression. If you spend most of your time in artificial light, you can get serious cycle dysfunction and PMS.

The connection between PMS and SER reveals the wisdom of feminine nature, “coded” simultaneously in the seasonal and monthly cycles. The period of the month when PMS is most common overlaps with seasonal affective disorder. Natural self-absorption in premenstrual period each month finds a parallel in the autumn “dying” of nature. This is how our body perceives the wisdom of the changing seasons. In autumn and winter, the energy of trees goes into the roots, where the process of life, invisible to us, continues. During the initial phase of the menstrual cycle and subsequent ovulation, our energy goes deep inside and accumulates there so that we have something to draw from in the next phase of development. Since our technogenic culture is far from the natural wisdom of the natural cycle, women are taught to fear menstruation and that time of year when nature requires darkness, solitude and rethinking of existence.

PMS is to the month as SER is to the annual natural cycle of seasons. Both syndromes are treated in approximately the same way and require us to “listen” more deeply and seriously to the wise nature of our body.

We have also been taught to be suspicious of our natural energetic states, resulting in too many women viewing their cycle as a weakness to be overcome or ignored. God forbid you follow the wisdom of your own body and take a time-out for this period!

Treatment of premenstrual syndrome (PMS)

Treatment begins with general health measures: an optimal work and rest schedule, eliminating stressful situations if possible, psychotherapy, regular exercise, limiting the consumption of alcohol, coffee, etc. Limiting sodium in your diet can reduce swelling and bloating.

Spironolactone is a potassium-sparing drug.

Naproxen (syn.: naprosynr) and ibuprofen are effective for symptoms such as headaches, cramps, back and muscle pain, and in some patients, increased irritability and depression. These drugs are taken until menstruation occurs.

Danazol, tamoxifen (an antiestrogen) and bromocriptine (Parlodel, a dopamine receptor agonist) are effective for breast pain. Danazol, given at the onset of symptoms and before the onset of menstruation, significantly reduces the severity of symptoms without affecting ovulation. Bromocriptine in these cases is prescribed in the premenstrual period.

Alprazolam (a tranquilizer) is used when irritability dominates the clinical picture of the syndrome.

Fluoxetine (an antidepressant) is effective for depression. Note that in case of severe mental disorders, the patient should be consulted by a psychiatrist, as well as before prescribing psychotropic drugs.

A placebo has been shown to provide short-term improvement in half of those suffering from premenstrual syndrome. At the same time, previously recommended treatment with pyridoxine, vitamin E, and progesterone is no more effective than placebo.

When symptoms bother the patient for more than a week or premenstrual syndrome is severe, you can try to suppress ovulation. Patients with ovulation suppressed by danazol, a GnRH analogue, medroxyprogesterone, or estrogen implantation may not experience symptoms for some time (about a year) even after stopping such treatment. However, if symptoms recur or do not resolve, some patients may be offered oophorectomy. In a patient with documented premenstrual syndrome that resolves with anovulation induced by a GnRH analogue, danazol, or estrogens, and in whom severe manifestations of the syndrome do not allow treatment normal life, oophorectomy may be the most rational treatment option if the woman is willing to accept premature ovarian failure.

Relief scheme for premenstrual syndrome (PMS) symptoms

• A diet that helps regulate eicosanoid imbalance.
• Multivitamin and mineral supplements. They should contain 400 to 800 mg of magnesium (magnesium deficiency is often characteristic of women with PMS) and 50-100 mg of B complex vitamins. All women should take these medications daily (not just before menstruation) for the entire month.
• Exclusion from the list of refined sugar, flour products made from finely ground flour, as well as saturated fatty acids.
• Elimination of caffeine from the diet. Simply giving up caffeine, even if the woman previously drank just one cup of coffee or one can of cola a day, significantly reduced PMS symptoms.
• Consume sufficient amounts of essential fatty acids. These substances are found in raw nuts and grains, cold-water fish (salmon, sardines) and many plants. An excellent source of fatty acids is sesame oil, as well as vegetable oil, safflower oil and walnut oil. You can also take dietary supplements, available over the counter from pharmacies and organic food stores. 500 mg of fish oil three to four times a day is usually sufficient. Flaxseed oil is also suitable - three to four doses of 500 mg per day. For optimal absorption of essential fatty acids, the body requires adequate amounts of magnesium, vitamin C, zinc, vitamins B3 and B6.
• Reducing stress and restoring the body's energy balance. Women who practice meditation and other deep relaxation techniques can significantly mitigate PMS on their own. Many relaxation techniques reduce the levels of cortisol and adrenaline (epinephrine) in the blood, which helps balance the body's biochemical processes, including eicosanoids. The most useful various types meditation. Every woman should find what suits her and include such activities in her daily routine. For example, relaxation according to Dr. Herbert Benson's scheme is carried out for 15-20 minutes twice a day and includes the following: first you need to sit quietly in a comfortable position with your eyes closed; then deeply relax all the muscles, starting from the face and ending with the feet; breathe through your nose, concentrating on each inhalation and exhalation; With each exhalation, mentally say the word “one.” One study found that three months of regular exercise following this regimen provided significant relief from PMS symptoms.
• Reflexology. Therapy that uses pressure on specific points on the ear, hand, and foot has been shown to relieve PMS symptoms. Typically, the course is eight weeks under the guidance of a qualified reflexologist (one half-hour session per week).
• At least three twenty-minute sessions of aerobics or similar exercise per week. Just brisk walking will do as well. Such exercises that maintain physical fitness are very effective - they help against many manifestations of PMS. They also increase the level of endorphins (produced naturally substances that help the body cope with depression and physical pain). It is estimated that more than half of cases of depression are treated with exercise alone.
• Full day light. Spend two hours in the morning and evening near a light source (2500-10000 lux; lux is a unit of measurement of light intensity). This can be natural daylight or an artificial light lamp. A gloomy day, typical of Northern Europe, produces 10,000 lux. A sunny day somewhere near the equator is 80,000 lux.
• If necessary, progesterone therapy. Taking natural progesterone in combination with lifestyle changes often produces significant benefits in treating PMS. As neurotransmitters, estrogen and progesterone have obvious effects on mood swings. Estrogen not balanced by progesterone irritates the nervous system. In contrast, progesterone is associated with a state of rest and relaxes the central nervous system. It is possible that progesterone, which is beneficial for relieving PMS syndrome, acts precisely by calming the central nervous system.

Natural progesterone is not at all the same as synthetic progestins, for example medroxyprogesterone acetate - Provera. When treated with natural progesterone in standard doses, there are almost no serious side effects. Only sometimes there are delays in menstruation. Dysfunction usually disappears after two months of use. Very large doses, much larger, cause a state of euphoria and, in rare cases, sporadic dizziness. Oral natural progesterone can be purchased in pharmacies with a doctor's prescription. It is also available in the form of skin creams. Note that although natural progesterone is obtained from wild Mexican yams, creams containing only yam extract may help some women, but do not compare with similar amounts of natural oral progesterone. Not all pharmacies prepare natural progesterone, and not all doctors know where to get it.

To apply to the skin, you can use one of several natural progesterone creams that are available over the counter, or ask your doctor to order it from a pharmacy that specializes in making custom medications. 2% cream protest. The natural progesterone content of the 2% cream is at least 400 mg per ounce. Applying a quarter to a half teaspoon of cream to the skin once or twice a day produces physiological levels of progesterone almost similar to those produced naturally during the normal luteal phase of the cycle.

It is usually prescribed to apply a quarter teaspoon of cream (approximately 20 mg) to soft areas of the skin (chest, lower abdomen, neck, face, inner arms or hands) in the morning and evening. Areas of skin that are lubricated with cream must be alternated. It is best to apply it from the fourteenth to the twenty-eighth day of the menstrual cycle, for at least three months. However, the dosage and time of application are individual for each patient. It is only important to include progesterone in your metabolic process until the moment when mood decline occurs. You should apply the cream a day or two before you ovulate, or a day or two before you usually experience PMS symptoms. For some it is the twenty-first day of the cycle, for others it is the twelfth or thirteenth. Continue using the cream on the first day monthly bleeding(first day of the cycle). This can completely prevent PMS symptoms or significantly reduce their intensity. There is no point in waiting for symptoms to appear: in this case, therapy will not work. Increase or decrease dosage depending on severity of symptoms; Most women have to experiment to find the right amount of the drug for them. It is quite safe to use these creams for two or more weeks of each cycle, as long as you take at least one break of 12 hours or more once a month.

Unlike natural progesterone, synthetic progestins have many side effects, such as abdominal engorgement, headaches, and weight gain. Unfortunately, they try to convince many women that natural progesterone and progestins are the same thing. But in fact, synthetic progestins can even provoke PMS symptoms because taking them reduces the natural level of progesterone in the blood.

Progesterone therapy is very helpful for women who experience sudden mood swings after ovulation that last until menstrual bleeding begins. They describe their condition as follows: “I just felt great, but suddenly dark clouds are gathering over my head.” When menstruation begins, there is a feeling that “light has shone on you.” This is a very accurate description of the biochemical changes occurring in the body, which really occur and have nothing to do with simulation or fiction.

The balance between the levels of estrogen, progesterone and other hormones associated with PMS appears to be unstable, fluctuating in nature, which cannot be recorded using currently available methods and tests. Even minor hormonal imbalances can cause dysfunction and emotional breakdown. The latter, in turn, increases the level of the hormone ACTH (corticotropin), which ultimately leads to a non-ovulatory cycle (when no egg is released). It is characterized by inadequate levels of progesterone.

Over time, taking natural progesterone normalizes the balance of estrogen and progesterone. If you take progesterone therapy regularly over several months, PMS symptoms become easier with each cycle. Many women reduce their dosage as pain relief and mood improve (although this drug has so many positive effects that some women continue to take it even after PMS symptoms have completely disappeared). However, it is most effective to start with high doses and continue this for several months.

Ultimately, women who are able to understand the psychological causes of PMS can restore their hormonal balance naturally, without the use of additional hormones. As emotional and physiological stress decreases, all biochemical processes in the body change.

PMS and codependency relationships

There is a direct correlation between PMS and growing up in a dysfunctional family, where parents or grandparents are alcoholics. When a girl grows up with a constant feeling that she has to sacrifice herself to other people's desires and indulge adults, the risk of PMS is very high. In many families where alcoholism is passed down the male line, women very often suffer from PMS. Children of drinking parents have a 40% chance of becoming alcoholics, not only because of genetic predisposition, but because they see alcohol as a means of dulling their negative emotions. Women from drinking families often experience PMS as a result of the constant need to suppress their negative emotions.

Men usually consider changes in a woman's character from time to time to be a whim. And women are trying with all their might to hide from others that they are overtaken by mood swings, increased sensitivity and irritability, changes in food preferences, although this happens with enviable frequency - once a month. It is not surprising that the fair sex rarely takes any action to combat this scourge, since for centuries the consequences of hormonal changes during the menstrual cycle have been the norm. Many people to this day are sure that “this is the fate of a woman - you have to endure it, since there is no cure for PMS.” However, doctors have been quite effective in helping “sufferers” cope with the manifestations of PMS for many years.

PMS: who is at risk?

The risk group includes women aged 20 to 40 years, mostly urban residents, overly emotional, socially active, who have had an abortion or childbirth, and who are often exposed to stress. The influence of hereditary factors and chronic diseases (especially diseases of the central nervous system and cardiovascular system, as well as the gastrointestinal tract) was also determined.

Determining the cause of PMS

Where do the roots come from, so to speak? Oddly enough, medicine has not yet determined the exact cause of PMS. However, the overall picture is clear: changes in hormone levels in female body during the menstrual cycle. The intensity of premenstrual syndrome also depends on other factors, for example, lifestyle, in particular, bad habits, physical activity, excess weight, stress at work and even the amount of coffee drunk during the day. Also, PMS tends to run in families, so if the mother suffered from its manifestations, then it is likely that the daughter will also suffer. Most likely, siblings will also have a similar problem, although perhaps with different manifestations.

For some, premenstrual syndrome is just abdominal pain and headaches, for others it is increased irritability, and still others are ready to eat all the chocolate in the candy store, throw away the entire old wardrobe and tear off the wallpaper in the room just because “I’m tired of it all.” Some people don’t pay attention to weight changes, while others complain about swelling, swelling and soreness of the mammary glands, skin rashes and a feeling of complete uselessness. In general, there are many options, since nature has endowed each woman with her own premenstrual syndrome, one and only – the same as the woman herself. Premenstrual syndrome is a kind of other side of the personality that prevails a couple of days a month due to hormonal changes. And approximately 75% of European women suffer from this. And 75% of men - after all, they are in these unfavorable days near.

PMS symptoms

Today, more than 150 symptoms of PMS are known. Scientists have even developed a classification of forms of PMS, each of which includes corresponding symptoms. Typically, representatives of the fair sex experience a mixture of several forms at once, as well as a set of symptoms peculiar only to it. Thus, treatment in each case must be individualized.

Neuropsychic form - increased irritability, tearfulness, depression, anxiety, fatigue, etc.;

Edema form – enlargement and tenderness of the mammary glands, swelling of the face, sweating, swelling of the extremities, bloating, etc.;

Cephalgic form – migraine attacks, headache, suffocation, heart pain, numbness of fingertips, dizziness, etc.;

Crisis form - increased blood pressure, increased heart rate, feeling of compression behind the sternum, cold extremities, fear of death, etc.;

An atypical form is an increase in body temperature up to 38 degrees, vomiting, asthma attacks, drowsiness, allergic reactions, etc.

To treat PMS or not

So, we get to the most important question: is it possible to cure PMS? Or rather, is it possible to get rid of it? Premenstrual syndrome is possible, and most importantly it needs to be controlled. As long as a woman attaches importance to this issue and takes certain measures, the symptoms either disappear completely or become almost invisible. You should try to overcome the manifestations of PMS not only because they ruin the life of both the woman herself and her close friends and colleagues, but also because an imbalance in the hormonal sphere leads to health problems, and is even a precursor to pathological menopause.

Although, those who are far from this are more concerned about the issue of getting rid of the emerging symptoms. How to turn critical days into ordinary ones? First of all, you need to learn to relax. We are not talking about visiting a cafe on Friday evening with friends, but about the daily global ability to relieve stress. Secondly, you should consume caffeinated drinks in moderation. Thirdly, you need good sleep - at least 8 hours, a healthy diet containing sufficient proteins, carbohydrates and fiber. And the fourth rule is that you need physical activity: regular yoga, fitness or other physical activity. There is also a prerequisite: you must consume a sufficient amount of liquid. And pay attention to the fact that all this should be done constantly, that is, throughout life, and not just when a migraine begins, you want to cry for no apparent reason, or your jeans suddenly begin to tighten.

Doctor's help

Be prepared to carefully describe all the symptoms that recur every month. To do this, it's best to write them all down over a period of two to three months to make sure they're consistent.

The doctor prescribes a blood test for hormones and, if an imbalance is determined, prescribes hormonal medications.

It is possible that additional research and consultation with other specialists will be required, since PMS symptoms cover almost all systems and organs of the human body.

Do not be surprised if you are suddenly prescribed medications that are not related to the disease - antiallergic, sedative, homeopathic, vitamin, painkillers. Your doctor may also prescribe exercise therapy and physical therapy.

How to help yourself

Diet.

Oddly enough, a reduction in PMS symptoms can be achieved by eliminating or adding certain foods to your diet. During this period, it is better to avoid consuming large quantities of salt, fats, protein foods (all this causes fluid retention in the body and leads to edema, increasing the load on the liver), coffee and energy drinks (excessive stimulation of the central nervous system causes even greater irritability, which can lead to to insomnia), alcoholic beverages (we will discuss them in more detail later).

It is recommended to supplement your diet with foods containing fiber - fruits, vegetables, nuts, seeds, cereals, legumes and omega-3 fatty acids (fatty fish). For sweets, it is better to give preference to dark chocolate and dried fruits, and for drinks, you should opt for natural juices and herbal teas. These products are rich in vitamins and antioxidants, which normalize digestion and remove excess fluid from the body.

You should eat in small portions, but often throughout the day.

Sport

The body always needs physical activity. There is no need to give them up during PMS, but you should still reduce the load.

Light jogging, walking, yoga, cycling, gymnastics, rollerblading are recommended - all this helps relieve psychological stress and improves mood. But before you start exercising, it is better to consult a doctor, since it is possible that exercise is generally contraindicated for you.

Fight bad habits.

Start listening to yourself. No study or doctor can provide as much information as your body. Try to give up what is unpleasant to you. You can pamper yourself by thinking only about good things - and then your body will calm down or become less bothered.

Smoking leads to vascular spasms and depresses the respiratory system, which can quickly increase the severity of certain PMS symptoms (headaches, dizziness, pain in the lower abdomen, numbness in the fingers, etc.) and provoke the development of diseases.

Drinking alcoholic beverages during the premenstrual period puts a serious burden on the liver, thereby preventing it from processing estrogen circulating in the blood and disrupting the already unstable hormonal estrogen.

Relaxation.

Try not to make responsible decisions, not do important things, and put off active communications. It is better not to draw special attention to your person and try to relax a little.

Loose clothes made of natural fabric and comfortable shoes

Before going to bed, you need to take a warm bath with salt and aromatic oils (mint, lavender, myrrh, rose are very effective), you can drop orange oil into the aroma lamp so that its smell improves your mood.

SPA treatments and massage help restore blood circulation, relieve psychological stress and relax muscles.

Try to get enough sleep and sleep at least 8 hours a day. You need to give your body the opportunity to recover and manage metabolic processes while you sleep.

Wedge with wedge...

However, sometimes even all this does not give the expected result. The reason is probably that the recommendations are not followed responsibly, or that the hormonal fluctuations in the body are too significant. In this case, there is also an effective method based on hormonal contraception. Yes, you read that right, and this is not a joke. Modern hormonal contraception is not just a means of protecting against unwanted pregnancy. Therapeutic effects drugs appeared after the discovery of the ability to combine two female sex hormones. Moreover, taking the pill on different days of the cycle, the female body is filled with different doses of hormones. This approach makes it possible to “smooth out” natural fluctuations in the hormonal sphere, which lead to the occurrence of PMS symptoms. One of these contraceptive drugs with the “24+4” regimen contains the hormone drospirenone, due to which fluid is not retained in the body, that is, the possibility of gaining extra pounds due to taking a contraceptive is eliminated. This same hormone has special properties and helps get rid of skin rashes caused by hormonal disorders(acne), as well as symptoms of premenstrual syndrome. By taking this drug, the menstrual cycle becomes regular, completely predictable, and becomes less painful. However, for those suffering from PMS, the main thing remains that the unpleasant symptoms that are characteristic of individual days of the cycle disappear and are maximally alleviated: headache, swelling of the mammary glands, swelling, tearfulness, irritability, uncontrollable cravings for sweets, excessive impressionability...

Of course, we must not forget that hormonal contraceptives are medications and cannot be taken without consulting a specialist. If you need to decide on a contraceptive method, you can do this taking into account the additional properties of the drug for PMS, acne and hirsutism (hair growth where there should not be hair). But we must not forget that certain contraceptives can be used, first of all, as medicine, if necessary. Therefore, tell your doctor your complaints and he will help you choose hormonal drug, effective for you. And don’t be embarrassed if you were prescribed a contraceptive to treat the symptoms of premenstrual syndrome, since doctors have not yet come up with a more effective way to combat the unpleasant manifestations of “critical days.”

Does PMS depend on age?

The fact that the unpleasant sensations that appeared before the first menstruation in adolescence finally disappear by the age of 20-22 is a real myth. The syndrome can occur at any time during the reproductive years, but it has been proven that it appears more often between 20-35 years of age. If symptoms appeared already during puberty, then it is likely that PMS will manifest itself with varying intensity until menopause.

How to eat during PMS?

In many cases, proper nutrition leads to a noticeable reduction in pain. The main thing is that the diet should not include too much salt, and preference should be given to foods rich in magnesium, calcium, vitamins A, D, E and B6. It is also necessary to reduce or even completely abandon the consumption of sweets, coffee and alcohol.

Does smoking affect PMS?

According to a study conducted by Yale University researchers in 2008, 85% of all women who smoke have more irregular and painful periods than non-smokers. Women who smoke more than 4 cigarettes a day are twice as likely to experience worsening symptoms such as headaches, acne, breast swelling and tenderness.

What medications can relieve discomfort?

As a rule, the use of painkillers such as spasmalgon is justified only in the most severe cases. Medium-intensity pain can also be eliminated by diuretics - mild diuretics. They prevent fluid retention and reduce the feeling of swelling in the abdomen and thighs. If the symptoms do not subside, it is possible to use antidepressants, whose action is aimed at producing additional doses of serotonin.
Can they hormonal contraceptives cause PMS symptoms?

No. This has been proven by numerous studies. Vice versa, birth control pills used to treat premenstrual syndrome. Due to hormonal changes in the ovaries, these drugs reduce the amount of estrogen and progesterone in the body.

Improving your diet

And it matters not only what exactly you should eat, but also how it should be done. Try to eat at regular intervals to prevent sudden spikes in your blood sugar. Before undergoing treatment, it is better to change your eating habits. This will minimize the risk of side effects.

More activities

Exercise can help relieve the emotional and physical symptoms of PMS. Although women often complain not about a lack of energy, they need to overcome themselves and do some exercises.

You should choose a workout program that gets your heart rate up and gives you pleasure. Sessions should last about 2 hours 30 minutes for moderate activity or 1 hour 15 minutes for vigorous activity, or a combination of both, plus a couple of muscle-strengthening exercises.

Explore herbal remedies

Herbal remedies are not well studied and are less regulated by law than prescription drugs. Among herbal remedies, there are some that are effective in relieving menstrual symptoms (especially mood swings and cramps). Use black cohosh, chasteberry, ginger, evening primrose oil, raspberry leaves, dandelion leaves and natural creams containing progesterone.

Consult your gynecologist, who will probably know more about the research and beneficial properties herbal remedies. It is possible that your doctor will advise you on what and when exactly you should take.

Taking birth control medications

If you haven't found it yet contraceptive, which would completely suit you, then you should try taking small doses oral contraceptives, which suppress premenstrual syndrome. They regulate the amount of hormones during the cycle. Some representatives of the fair sex use them constantly to avoid menstruation and PMS, but this often causes breakthrough bleeding.

After thirty, premenstrual syndrome has become a real problem

I know that my problem is as old as the hills, a lot has been written about it and nothing new can be said, but it seems to me that every woman experiences this in her own way. In my youth, periods did not particularly bother me. My mood dropped, irritability appeared, after two or three days everything went away, and I again became cheerful and cheerful, not thinking that in twenty-eight days everything would repeat itself. After thirty, premenstrual syndrome became a real problem.

Now it’s not just a bad mood, but rather depression, with thoughts that my youth is gone, that no one needs me, and that family and work are sucking all the juices out. At the same time, I don’t feel well. My husband says that I’m becoming more aggressive, I’m lashing out, and I’m taking every word with hostility. In general, everything is not so scary, after all, I’m not the first. That's just my work in new position Not at all designed for my PMS. I have to communicate with people often, persuade them, find an approach to everyone. My salary depends on it. Give me some kind of mood so that I can be distracted at least while working. Thanks in advance.

Elena Zapolskaya,
g, Tula

You are right in saying that PMS is not the end of the world. If you feel unwell or irritable, look at your calendar - perhaps your critical days are approaching soon. This will help you gather your strength and meet the enemy fully armed. During this period, to reduce irritability, it is very important to get enough sleep. Your already overexcited nervous system needs additional rest.

At any job, at any time, you need to restrain your emotions and behave decently. And if you value your work, you will still have to do this. By the way, going headlong into the work cycle helps alleviate the condition.

Well, to better relax and relieve stress, try the simplest meditative technique called “Conscious Breathing.” Try to devote at least fifteen minutes a day to this exercise. Choose a place where no one will disturb you. Sit comfortably on a chair or armchair, but keep your back straight. The hands rest freely on the knees. Concentrate on your breathing, describe and observe it.

“I breathe slowly, my stomach sticks out, my chest expands.” Pause. Now exhale. Don't interfere with your breathing process, don't try to change your breathing, just watch it, go with the flow. Pay attention to pauses. If some extraneous thought wanders into your head, there is no need to fight it - let it in, come up with some kind of designation for it, figuratively speaking, hang a tag on it and put this thought on the shelf, where you can find it after meditation if you wish.

Some distracting thoughts will be extremely tempting, don't fall for it. Gently bring your thoughts back to controlling your breathing.

Rice will relieve stress before menstruation

And he replied that many women have problems before their periods, and they begin to find fault with everyone. And even during menstruation, due to pain and swelling, you feel bad and irritability increases.

He gave me advice that I have been using for years and it helps me. Simply, I began to do a fasting day two or three days before the onset of the critical week, eating only rice. It's so simple, but it helps so much! No pain for you, no swelling anywhere. All unpleasant days pass quietly and peacefully.

And for this day you only need to have a glass of rice and fresh herbs. I personally prefer dill, but parsley can also be useful.

And there is also an important point - less salt and sugar, no coffee or black tea, and definitely more clean water.

I boil 1 cup of rice, divide it into three parts and eat it in three portions. I don’t use salt when cooking, as it retains fluid in the body and increases swelling, and this can make the stomach hurt more.

And if I get nervous during my period, I just eat two tangerines or one banana. The doctor said that tangerines contain essential oils for stress, and during menstruation it is useful to calm down in this natural way. And bananas, it turns out, contain sedatives, but I didn’t know. I don’t throw away the tangerine peels right away, but periodically inhale their aroma for about an hour. It takes me back to childhood and calms me down. I even bought tangerine oil and now I smell it at every opportunity so as not to be nervous.

In addition to fruit, on critical days I always carry a bag of nuts (but only unsalted, and it should not be peanuts) or seeds in my purse. They contain many vitamins that are beneficial for women.

Instead of black tea, I drink all sorts of soothing herbs. I brew motherwort, oregano, mint, and lemon balm. I take what I can find, mix herbs or use one herb. Such a simple change in diet, and nervousness disappears instantly. Previously, I tried to treat my nerves by gorging myself on sweets, but now, on the contrary, I am successfully treated by its absence.

And the pain during women's days has passed, and I am no longer angry with my friends, and I am less nervous at work. I noticed that tangerines and bananas calm me down on ordinary days. That's why I always carry some of these fruits with me.

Galina Lubina,
Kirov

Scientists about PMS

To date, scientists know 200 manifestations of PMS, mainly bad mood, irritability, sleep disturbances, mood swings, changes in libido, fatigue, and increased fatigue. Experts from Brazil have determined that daily intake of vitamin E and unsaturated fatty acids helps cope with these symptoms.

Before menstruation, health begins to deteriorate in 85% of women, and in 2-5% significant deterioration is noted, sometimes to the point of temporary disability.

Experts from the Federal University of Pernambuco treated PMS in 120 women. 80 representatives of the fair sex received capsules containing a mixture of linoleic, oleic, linolenic and other saturated acids and vitamin E. The remaining women were offered a placebo.

As a result, it turned out that this dietary supplement has a stronger effect than a placebo. This effect depended on the duration of administration and dosage. Women who took the highest amounts of vitamin E and fatty acids saw a reduction in the severity of PMS symptoms by two-thirds. Experts have not identified any pronounced side effects.

Proper nutrition will ease PMS

90% of the fair sex of reproductive age suffer monthly from PMS, which is expressed by irritability, depression, dissatisfaction with oneself, headaches and nagging pain in the lower abdomen. Scientists tried to find a way that could alleviate the situation. And they succeeded!

American experts believe that the severity of symptoms and pain during menstrual periods is significantly reduced if a woman’s diet includes many foods containing B vitamins. These can be dairy and grain products, some vegetables (for example, spinach), lean fish and meat. In general, representatives of the fair sex should eat porridge with milk during such periods, and they will certainly feel better. It should also be noted that none of the vitamin supplements in the form medicinal product may not have the same effect as these products.

Scientists claim that they have been able to document cases of existence between PMS symptoms and diet. And that by following an appropriate diet, the risk of PMS can be reduced by an average of 25%.

PMS is closely related to nutrition. And you shouldn’t beat yourself up for eating a whole chocolate bar during your lunch break. “Forbidden” foods during this period are simply necessary, because high levels of progesterone are responsible for the body’s need for carbohydrates. In addition, chocolate is responsible for good mood, promoting the production of endorphin in the body - the hormone of joy. However, it is better if during this period you focus on soft sucrose products, for example, honey or, in extreme cases, jam. If you are worried about insomnia during this period, you should dissolve a teaspoon of honey in the juice of half a lemon and drink it 30 minutes before bedtime.

Nutrition at this time should be as gentle as possible. So, you should exclude salty, smoked and spicy foods, alcoholic drinks and coffee, soda and lemonade from the menu. Reduce your consumption of meat, milk, and eggs as much as possible. Carbohydrates should be a priority in the diet during this period, but it is better to postpone food rich in proteins and protein for later. It’s worth introducing more variety into the menu fresh vegetables and fruits, which are rich in a variety of vitamins. Drinks should be preferred herbal teas and mineral water without gas. It is better to eat food more often, optimally - up to 6 times a day, but little by little. Note that this diet is recommended during the period of hormonal attack, primarily because it significantly reduces the load on the digestive organs and, accordingly, has a positive effect on overall well-being.

B vitamins - a remedy for PMS

Premenstrual tension (premenstrual syndrome) is a rather unpleasant condition for every woman. A number of symptoms of this syndrome are very frustrating and upsetting for women trying to lose weight and dieting. Such symptoms include sudden mood changes, the desire to eat something sweet, rapid weight gain, etc.

But don't despair! According to many American experts, the signs of premenstrual syndrome can be eliminated by consuming foods high in B vitamins. Those women who include in their diet many foods containing sufficient amounts of water-soluble vitamins B1 (thiamine) and B2 (lactoflavin) tolerate premenstrual syndrome much easier. syndrome.

During the experiments, which were aimed at identifying the connection between premenstrual syndrome and the consumption of foods containing B vitamins, American scientists involved more than three thousand women, about a thousand of whom complained of the syndrome. It turned out that with an increase in the amount of foods consumed with vitamins B1 and B2, the risk of negative PMS symptoms decreases by approximately 35 percent.

Sources of large amounts of thiamine are: potatoes, black rye bread, millet, pork loin. Vitamin B2 (lactoflavin) is found in large quantities in spinach, coarsely ground bread, rose hips, cheese, cottage cheese, fresh milk, and meat. In pork liver and kidneys, as well as in all legumes, buckwheat and oat seeds, both vitamins described above are present.

Contents:

Studies have shown that women suffering from PMS, in the period after ovulation, experience a decrease in serotonin levels. Serotonin is a biologically active substance that plays an important role in the transmission of nerve impulses in the brain.

It is quite possible that a decrease in serotonin levels is the cause of such psychological symptoms of PMS as depression, inexplicable sadness, and “depression.”

Another possible reason PMS, according to researchers, may be a lack of calcium and magnesium. These minerals, like serotonin, play an important role in the transmission of nerve impulses and metabolism.

Medications that increase serotonin levels and calcium and magnesium supplements can significantly relieve PMS symptoms.

As mentioned above, in the past, the cause of PMS was considered to be a hormonal imbalance in a woman’s body (excess estrogen, lack of progesterone, etc.). Some recent studies have shown that in women suffering from PMS, the concentration of these hormones in the blood is actually no different from that of healthy women.

As you know, during ovulation there is a physiological (that is, normal) increase in progesterone production and a slight decrease in estrogen production (compared to the first half of the menstrual cycle). In this regard, it is assumed that one of the reasons for the appearance of PMS symptoms is not a deviation from the “normal” concentration of sex hormones, but an “incorrect” reaction of the woman’s body to physiological changes in the levels of estrogen and progesterone in the blood in the second half of the menstrual cycle.

PMS, smoking and excess weight

Some studies have shown that smoking and being overweight significantly increase the likelihood of developing PMS symptoms.

In particular, women with a BMI of 30 or higher suffer from PMS approximately 3 times more often than women with normal body weight.

Women who smoke experience symptoms of PMS almost 2 times more often than women who do not smoke.

As will be discussed below in the section on questions about the treatment of PMS, weight loss and smoking cessation are among the most accessible and fairly effective methods of treating this disorder.

PMS and woman's age

PMS is typical only for women who are menstruating. Girls whose periods have not yet started or women who are cannot suffer from PMS and all symptoms similar to PMS symptoms in them should be considered a sign of some other disease.

Research shows that at certain points in life, 40 to 90% of women aged 16-45 experience symptoms of PMS. Of this number of women, approximately 20% note that PMS symptoms appear regularly, every month. Between 3 and 10% of women suffer from severe PMS (see section below on PMS symptoms).

Girls who have recently started their periods suffer from PMS relatively rarely. However, as they get older, they are more likely to experience PMS. Most often, PMS occurs in women over 30 years of age. Women over 40 who are approaching menopause are more likely to develop more severe forms of PMS.

Along with the onset of menopause, PMS symptoms completely disappear.

I'm taking birth control pills and I'm noticing PMS symptoms. What could this mean?

Although the ovaries stop producing eggs and ovulation stops while taking birth control pills, many women who take birth control pills experience PMS symptoms.

If you notice symptoms similar to PMS and they bother you, talk to your doctor about switching to contraceptives containing a progestin component in the form drospirinone(examples of such contraceptives Yarina, Jess). Unlike conventional contraceptives, contraceptives containing drospirinone can reduce the intensity of PMS symptoms and are used as the first stage of treatment in young women.

What are the symptoms and signs of PMS?

PMS can present with a range of psychological and physical symptoms.

Depression, irritability, depression, aggressiveness, anxiety, restless sleep

Many women suffering from PMS describe their condition something like this:

« I get very nervous, I can get upset, yell at someone or cry for almost no reason" or " on PMS days, even minor problems make me angry, children make me nervous, work or housework makes me nervous" or

« I feel some kind of strong deep sadness" or " on PMS days I am haunted by a feeling of worthlessness, it is difficult for me to concentrate on work, I am very absent-minded, I do not have the strength to get down to business" or " on PMS days, I am constantly gripped by some inexplicable internal anxiety, a feeling that something bad may happen soon, which I cannot influence" or " I have very restless sleep; because of this, after I wake up I feel tired».

Indeed, many women experience an extremely unstable psychological state during PMS days. Attacks of anger, severe irritability and aggression can suddenly give way to a state of apathy, severe depression and “depression”.

There are two important points to make regarding the mental symptoms of PMS:

Pain in the chest (mammary glands) and nipples

«… Shortly before my period, I have a strange sensation of “heaviness,” tension, soreness, or tingling in both breasts and nipples. Sometimes it interferes with my work or bothers me during sex. People often write on the Internet that chest pain can mean cancer...».

Although tightness and tenderness in the breasts with PMS are usually not very severe, many women with PMS pay special attention to this symptom, as they consider it a possible symptom of breast cancer.

In fact, breast tenderness during PMS has no connection with cancer and you should not be afraid of this symptom.

Tension and increase in breast size during PMS are associated with water retention in a woman’s body.

How do you know for sure that it is not cancer?

In order to finally make sure that breast pain in your case is not associated with the development of a tumor:

• Tell your gynecologist about them. The doctor will examine your breasts.
• If your doctor notices something unusual (for example, a lump in one breast), he or she will order additional tests to help determine the exact nature of the changes in your breasts. You will find detailed recommendations on this matter in our article. Breast health in women of all ages and children. Explanation of possible changes, symptoms and problems.

Weight gain

« ...quite often, shortly before the onset of my period, it seems to me that I have “gained weight.” If at such moments I weigh myself, I really see that I weigh 1-2 kg more than usual. I can't figure out where this weight comes from. This upsets me very much, as I try to watch my figure..."

The sudden increase in body weight that is observed in women suffering from PMS is not associated with the accumulation of adipose tissue, but is a manifestation of temporary water retention in the woman’s body, which, in turn, is associated with some changes in the water-salt balance of the body during this period. As a rule, within the first few days after the start of menstruation, excess water is removed from the body and the “extra pounds” disappear.

The appearance of edema

«… sometimes a few days before the start of my period I notice swelling in my legs... »

Like weight gain and breast enlargement, swelling in the legs associated with PMS is a consequence of water retention in a woman's body and should not be considered a sign of kidney disease, varicose veins or other diseases.

During this period, the most cheerful and balanced individuals are capable of turning into furies or monstrous crybabies. In addition to an inadequate psychological state, purely physical and rather uncomfortable sensations are added. Every woman has experienced this condition to a greater or lesser extent at least once in her life. And those who endure it regularly, fearfully await not the arrival of their periods, but these few days in anticipation of them. To get rid of the feeling of helplessness in front of nature, it is worth understanding what PMS is in girls and what causes it.

How is PMS deciphered and what is this phenomenon? While waiting for an answer to these questions, it is worth remembering that nature entrusted the mission of giving birth to a new life to a woman. It is this feature that is associated with the monthly rejection of the upper layer of the uterine mucosa in the form of menstrual bleeding. The process is regulated by changes in concentration in the body, which are responsible for PMS.

The decoding of all this is nothing more than premenstrual syndrome, that is, a combination of those same physical and psychological sensations early signs menstruation, which can bring a woman to a hospital bed.

What causes premenstrual syndrome in the first place?

There was a time when experts believed that PMS in women was associated exclusively with their state of mind and lies in the plane of psychology. With the development of medical science, it was discovered that this syndrome has an organic basis. It has been established that during this period the amount of estrogen and progesterone decreases, which provokes:

• An increase in aldosterone, which retains fluid in the body, affects the overall well-being and functioning of the nervous system;
• Increased concentration of monoamine oxidase in brain tissue, which can cause depression;
• A decrease in the “hormone of joy” serotonin, which gives a clear understanding of what PMS is in girls, not only for themselves, but also for their loved ones.

Other reasons

The processes occurring in the female body during this period are the same for everyone. But the first signs of menstruation appear differently due to individual reactions to hormonal fluctuations. Some perceive them more sharply, while for others everything goes more smoothly and smoothly. There may also be some other reasons for this:

• “Jumping” levels of endorphins in the brain and blood, which affect the functioning of the endocrine system and are responsible for reducing sensitivity to physical and mental pain;
• Errors in nutrition. A lack of vitamin B provokes tissue swelling, which causes excessive sensitivity of the mammary glands and increased fatigue. A deficiency of magnesium in the body causes frequent dizziness;
• Genetic predisposition. As a rule, women from the same family experience similar sensations before menstruation. This applies not only to mothers and daughters, but also to twin sisters;
• Stressful situations and sudden changes in climatic living conditions aggravate the syndrome and its manifestations.

Physiological manifestations

PMS symptoms are more pronounced in some people, less pronounced in others. Even if a woman has forgotten about the beginning of a new cycle, she will be reminded of the imminent arrival of her period:

• Nagging pain in the abdomen and lower back;
• Swelling of the limbs, puffiness of the face;
• Increase in body weight by a couple of kilograms;
• Swelling of the mammary glands, aching pain in them;
• , in severe cases, migraine;
• Sensation, sometimes vomiting;
• “Twisting” pain in the joints and spine;
• Errors in bowel function (constipation or diarrhea);
• (increased cravings for sweet or salty foods);
• Thirst and;
• Quick fatigue or unnatural vigor;
• Increased skin greasiness and...

How long a girl’s PMS lasts largely depends on her immunity, physical health and lifestyle. Usually these symptoms disappear with the onset of menstruation, but they may linger for a couple of days.

Emotional Signs

They are often more difficult to tolerate than physiological ones, since they cause bewilderment among others and the woman herself. It is the psychological inadequacy associated with PMS that causes car accidents, failed exams and damaged relationships:

• Mood swings from severe despondency to wild joy;
• Increased emotional reaction to stimuli, in severe cases can turn into aggressiveness;
• Drowsiness or, on the contrary, overexcitation and associated insomnia;
• Inability to concentrate;
• Unreasonable fears, panic.

To rule out mental illness, it is worth knowing how many days before PMS begins. This usually happens 7-10 days before menstruation. If such a condition accompanies a woman throughout the entire cycle or a significant part of it, you need to look for another cause of the disease together with a specialist. To avoid doubts about your own mental health, when PMS begins, you can track it on the calendar.

PMS or pregnancy

According to the description, the symptoms before menstruation are difficult to distinguish from the first signs of pregnancy. Especially if we are talking about an inexperienced girl. And yet it’s really possible to do it yourself:

• Discharge during pregnancy is noticed between 6 and 12 days after pregnancy, it is short-lived and has a pink-brown color. PMS produces bleeding that is bright red and more profuse;
• Pain in the mammary glands accompanies the entire pregnancy. The nipple areas become brighter and darker. With PMS, this does not happen, and breast sensitivity goes away by the beginning of menstruation;
• last until blood begins to flow; they are localized in the lumbar and pelvic areas. The initial stage of pregnancy gives short, mild cramps for a couple of days;
• An increase in temperature, if it occurs, with PMS does not last longer than ovulation occurs. Pregnancy can cause this symptom at 18 days;
• Nausea during PMS occurs regardless of the time of day. Pregnancy is accompanied by this symptom and vomiting mainly in the morning, complemented by an aversion to certain foods and their aroma, an irresistible desire to eat something, sometimes unfit for food. Precursors of menstruation are characterized by an abnormal appetite for some food, but there is no rejection of other dishes and no craving for inedible things.

Based on the listed signs, it is possible to determine whether it is PMS or. The differences between both conditions are clearly visible using a pharmacy test. A gynecologist will identify them even more accurately using palpation and ultrasound.

Even knowing what PMS syndrome is in women and young girls, and the temporary limitations of this condition, it can be difficult to endure it. The consolation can be that it is characteristic of the majority of representatives of the fair half of the population. There are also medications and other ways to reduce the impact of premenstrual syndrome on a woman’s well-being and life.

– a cyclically recurring symptom complex observed in the second half of the menstrual cycle (3-12 days before menstruation). It has an individual course and can be characterized by headache, severe irritability or depression, tearfulness, nausea, vomiting, skin itching, swelling, pain in the abdomen and in the heart area, palpitations, etc. Swelling, skin rashes, flatulence, painful engorgement of the mammary glands. In severe cases, neurosis may develop.

The course of the crisis form of premenstrual syndrome is manifested by sympatho-adrenal crises, characterized by attacks of increased blood pressure, tachycardia, heart pain without abnormalities on the ECG, and panic. The end of a crisis is usually accompanied by copious urination. Often attacks are provoked by stress and overwork. The crisis form of premenstrual syndrome can develop from untreated cephalgic, neuropsychic or edematous forms and usually manifests itself after 40 years. The background for the crisis form of premenstrual syndrome is diseases of the heart, blood vessels, kidneys, and digestive tract.

Cyclic manifestations of atypical forms of premenstrual syndrome include: increased body temperature (in the second phase of the cycle up to 37.5 ° C), hypersomnia (drowsiness), ophthalmoplegic migraine (headaches with oculomotor disorders), allergic reactions (ulcerative stomatitis and ulcerative gingivitis, asthmatic syndrome, uncontrollable vomiting, iridocyclitis, Quincke's edema, etc.).

When determining the severity of premenstrual syndrome, they proceed from the number of symptomatic manifestations, distinguishing between mild and severe forms of premenstrual syndrome. A mild form of premenstrual syndrome is manifested by 3-4 characteristic symptoms that appear 2-10 days before the onset of menstruation, or by the presence of 1-2 significantly pronounced symptoms. In severe forms of premenstrual syndrome, the number of symptoms increases to 5-12, they appear 3-14 days before the onset of menstruation. Moreover, all of them or several symptoms are significantly expressed.

In addition, an indicator of a severe form of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. Decreased ability to work is usually observed in the neuropsychic form of premenstrual syndrome.

It is customary to distinguish three stages in the development of premenstrual syndrome:

1. compensation stage - symptoms appear in the second phase of the menstrual cycle and disappear with the onset of menstruation; the course of premenstrual syndrome does not progress over the years
2. subcompensation stage - the number of symptoms increases, their severity worsens, manifestations of PMS accompany the entire menstruation; Premenstrual syndrome becomes more severe with age
3. stage of decompensation - early onset and late cessation of symptoms of premenstrual syndrome with minor “light” intervals, severe PMS.

Diagnosis of premenstrual syndrome

The main diagnostic criterion for premenstrual syndrome is cyclicality, the periodic nature of complaints that arise on the eve of menstruation and their disappearance after menstruation.

The diagnosis of premenstrual syndrome can be made based on the following signs:

• State of aggression or depression.
• Emotional imbalance: mood swings, tearfulness, irritability, conflict.
• Bad mood, feeling of melancholy and hopelessness.
• State of anxiety and fear.
• Decreased emotional tone and interest in current events.
• Increased fatigue and weakness.
• Decreased attention, memory impairment.
• Changes in appetite and taste preferences, signs of bulimia, weight gain.
• Insomnia or drowsiness.
• Painful tension in the mammary glands, swelling
• Headaches, muscle or joint pain.
• Worsening of the course of chronic extragenital pathology.

The manifestation of five of the above signs with the obligatory presence of at least one of the first four allows us to speak with confidence about premenstrual syndrome. An important part of the diagnosis is the patient’s keeping a self-observation diary, in which she must note all disturbances in her well-being over the course of 2-3 cycles.

A study of hormones (estradiol, progesterone and prolactin) in the blood allows us to determine the form of premenstrual syndrome. It is known that the edematous form is accompanied by a decrease in progesterone levels in the second half of the menstrual cycle. Cephalgic, neuropsychic and crisis forms of premenstrual syndrome are characterized by an increase in the level of prolactin in the blood. The prescription of additional diagnostic methods is dictated by the form of premenstrual syndrome and leading complaints. to exclude organic pathology.

An examination of women suffering from one or another form of premenstrual syndrome is carried out with the participation of doctors of various specialties: neurologist, therapist, cardiologist, endocrinologist, psychiatrist, etc. Prescribed symptomatic treatment, as a rule, leads to an improvement in well-being in the second half of the menstrual cycle.

Treatment of premenstrual syndrome

In the treatment of premenstrual syndrome, drug and non-drug methods are used. Non-drug therapy includes psychotherapeutic treatment, adherence to work and proper rest, physical therapy, and physiotherapy. An important point is to maintain a balanced diet with sufficient amounts of plant and animal protein, plant fiber, and vitamins. In the second half of the menstrual cycle, you should limit the consumption of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, and alcoholic beverages.

Drug treatment is prescribed by a medical specialist, taking into account the leading manifestations of premenstrual syndrome. Since neuropsychic manifestations are expressed in all forms of premenstrual syndrome, almost all patients are advised to take sedative (sedative) drugs several days before the expected onset of symptoms. Symptomatic treatment of premenstrual syndrome involves the use of painkillers, diuretics, and antiallergic drugs.

The leading place in the drug treatment of premenstrual syndrome is occupied by specific hormonal therapy with progesterone analogues. It should be remembered that the treatment of premenstrual syndrome is a long process, sometimes continuing throughout the entire reproductive period, requiring internal discipline from the woman and strict compliance with all doctor’s instructions.