$Unique_ID{BRK01581}
$Pretitle{Genitourinary System}
$Title{Understanding About Premenstrual Syndrome}
$Subject{premenstrual symptoms syndrome disorder}
$Volume{J-14}
$Log{
The Menstrual Cycle*0009101.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


Understanding About Premenstrual Syndrome


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QUESTION:  Can you provide me with some understanding about the premenstrual
syndrome?  It seems that this sad situation is discussed whenever I sit down
with my friends for a chat.  There are only two things that we seem sure of,
everyone has symptoms, and no one seems to know just what to do about them.
Can you help us?  Thank you.

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ANSWER:  Your group seems no different from many others around the country
where such matters come up for discussion, usually with a hope that some new
information can be gained.  It might be helpful to divide the problems into
four categories.
     1:  Premenstrual Symptoms.  These cover a wide range of complaints,
enough to fill a page.  They may range from difficulty in concentrating to
nausea, mood swings, loss of appetite crying, fatigue and backache.  More than
150 symptoms have been described as being associated with PMS but a listing of
some 21 items can be used to evaluate the severity of the problem.  The fact
is that as many as 95 percent of women experience premenstrual symptoms at
some point, but less than 5 percent have a true premenstrual disorder.
     2:  Premenstrual Syndrome.  The true PMS consists of two or three
symptoms, usually mild in nature, and not sufficiently severe to interfere
with daily functioning.
     3: Premenstrual Disorder.  As defined by the American Psychiatric
Association, the patient must have five or more symptoms, including one which
involves mood ("irritability" as an example) and which are severe enough to
interfere with a woman's ability to care on the daily activity of life.
     In addition there is another category, 4: Premenstrual worsening of a
chronic condition.  Both medical conditions ("asthma" or "allergy" as
examples) as well as emotional problems ("depression" as an example) may
become more severe during the premenstrual period.
     A diagnosis is possible when the same symptoms occur over a two month
period.  In order to deal with these situations correctly, a proper work up is
indicated.  While the history is most important, some other disease must be
ruled out, such as thyroid problems or other medical conditions that may cause
chronic fatigue.  A thorough gynecological evaluation is in order as well as
some laboratory tests.  While there is no specific test for PMS, the
laboratory results are useful in detecting other problems that may be confused
with this syndrome.  As with any good medical therapy, the treatment should be
dictated by the cause.  Many types of symptoms associated with PMS may be
diminished and controlled by appropriate medications.  When moods are
affected, specific medications with mood altering properties may be used.  In
some cases, recognizing the difficulties and attending PMS support groups may
be enough to achieve significant improvement.
     Of greatest interest (at least to me) was discovering articles in the
literature that indicate that aerobic exercise is most useful in reducing the
severity of the symptoms, perhaps because it is also a useful tool in reducing
stress.  Once a regular program has been set up, changing other factors such
as diet, smoking and alcohol may be addressed as well.  Actually the odds are
all on your side.  Of all woman complaining of PMS only 20 percent are
actually found to have it when proper analysis is undertaken, and 80 percent
of these achieve significant improvement when treatments are undertaken.

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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.
