$Unique_ID{BRK00429}
$Pretitle{Genitourinary System}
$Title{Doesn't Anyone Know Anything About Premenstrual Tension?}
$Subject{PMS premenstrual tension}
$Volume{J-23}
$Log{
The Menstrual Cycle*0009101.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Doesn't Anyone Know Anything About Premenstrual Tension?


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QUESTION:  I know that something is wrong, for my life before my period is due
is truly hell.  Yet when I try to get help from my physician, I am left
frustrated and as unhappy as before my visit.  Why is this?  Doesn't anyone
know anything about premenstrual tension?

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ANSWER:  Although much has been written, and many studies conducted to
investigate premenstrual syndrome, the origins and best ways to treat still
defy attempts to classify this disturbing ailment.  It may be that there is no
single syndrome, and that the physical, emotional and behavioral changes that
occur just prior to the menses, may be due to a variety of different factors
that affect each woman in a unique fashion, and with differences in intensity
and timing.  Since the symptoms vary, it is clear that it is important to
document these premenstrual changes (PMC) and to be certain that other
conditions that could cause these problems are not the real reason for the
symptoms.  The symptoms of premenstrual syndrome (that's PMS) are many and
varied, but can be placed into nine categories.  I'll list them for you, and
provide a few samples.  AFFECTIVE symptoms include anxiety and irritability,
while BEHAVIORAL problems include decreased motivation and efficiency.  The
AUTONOMIC nervous systems may provoke diarrhea, nausea and palpitations, while
symptoms from the CENTRAL nervous system include clumsiness, dizziness and
tremors.  DERMATOLOGICAL symptoms include acne and dry hair, while
disturbances in FLUID/ELECTROLYTE balance cause bloating, edema and weight
gain.  COGNITIVE symptoms include indecision, paranoia and even suicidal
thoughts, while the NEUROVEGETATIVE system sees changes in libido, food
cravings and lethargy. PAIN symptoms can cause breast tenderness, headache,
and joint and muscle pain.  Most clinicians agree that to make a diagnosis of
PMC, symptoms should begin during the luteal phase of the menstrual cycle,
which occurs after ovulation, and usually lasts for about 14 days during the
last half of the cycle, the symptoms should disappear shortly after the start
of menstrual flow, and there should be a symptom free period during each cycle
that lasts for at least one week.  Treatment should be attempted when the
symptoms occur during almost every period and when there is some impairment in
normal function.  The symptoms that accompany menstruation are experienced by
almost all women (97% in one study), but are severe in only 2% to 10% of women
of reproductive age.  Getting a handle on a condition as perplexing as this
one requires a thorough history and physical exam as a starting point.  You
may want to keep a symptom diary to aid the physician in understanding the
frequency and severity of each symptom, when they occur, and what may have set
them off.  Daily morning weights are useful in calculating water retention
problems.  A complete record of this type should be kept during a minimum of
two cycles.  Treatment will have to be highly individualized to be effective
and may use both non drug strategies as well as medications.  Relieving stress
by changing life styles, particularly during the second half of the cycle may
be an important first step, while eating nutritionally balanced meals may
help.  These actions may play an important role in overcoming some of the
symptoms, so that consideration of possible medications for the remaining
complaints may become a bit simpler.  Properly used hormones, diuretics,
antidepressants and anti-anxiety agents may offer the relief you are seeking.
It is a long and difficult road, without the knowledge we need, but the
outcome may make it worthwhile.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
