PMS and PMDD Overview

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Questions and Answers

What percentage range of women experience PMS symptoms severe enough to interfere with daily activities?

  • 5% to 10%
  • 20% to 40% (correct)
  • 50% to 70%
  • 80% to 95%

Which of the following conditions is PMS often misdiagnosed as, due to overlapping psychological symptoms?

  • Anxiety disorder (correct)
  • Bipolar disorder
  • Schizophrenia
  • Obsessive-compulsive disorder

Women with PMDD have a differential response to normal hormonal fluctuations that may involve which of the following?

  • Altered brain circuitry involving emotional and cognitive functions. (correct)
  • Enhanced dopamine sensitivity.
  • Reduced blood sugar levels.
  • Increased estrogen production.

Which of the following hormonal imbalances is theorized as a potential etiology of PMS?

<p>Progesterone deficiency (D)</p> Signup and view all the answers

Disordered aldosterone function, potentially contributing to PMS, is associated with an excess of:

<p>Estrogens and aldosterone. (C)</p> Signup and view all the answers

According to the information presented, what effect does caffeine have on premenstrual symptoms?

<p>It can lower blood sugar. (B)</p> Signup and view all the answers

According to research, how does a high-sugar diet potentially affect estrogen levels and metabolism?

<p>It raises the production of estrogen, impairing its metabolism. (D)</p> Signup and view all the answers

Which dietary modification has shown promise in reducing estrogen levels in women?

<p>Reducing fat and increasing fiber intake. (C)</p> Signup and view all the answers

According to research, how does eating carbohydrates affect tryptophan and serotonin levels?

<p>Carbohydrates increase the brain uptake of tryptophan which increases serotonin synthesis. (B)</p> Signup and view all the answers

What is the potential benefit of exercise for women experiencing PMS?

<p>Elevates endorphin levels. (D)</p> Signup and view all the answers

According to presented insights, regular exercise is associated with a reduced likelihood of experiencing PMS:

<p>Less often as women who do not exercise. (B)</p> Signup and view all the answers

What is the primary role of Pyridoxine (Vitamin B6) in the body?

<p>A cofactor for more than 100 enzyme reactions. (A)</p> Signup and view all the answers

Prolactin secretion is linked to what other mineral?

<p>Lower levels of zinc. (A)</p> Signup and view all the answers

When suggesting dosages for taking Vitamin B6 for helping treat PMS systems, what it the safe upper limit to reduce long term side effects?

<p>Do not go above 200 mg/day. (B)</p> Signup and view all the answers

Which of the following statements is true regarding Vitamin E?

<p>It can improve symptoms for patients with PMS. (C)</p> Signup and view all the answers

When should L-tryptophan supplementation be avoided or used with caution?

<p>Avoided in MAOIs and used in caution with SSRIs or amitriptyline. (A)</p> Signup and view all the answers

A double-blind study revealed that what can be helpful with PMS symptoms?

<p>1,000mg of calcium daily. (A)</p> Signup and view all the answers

Low levels of this mineral has been shown in clinical trials to be low in patients with PMS.

<p>Zinc (D)</p> Signup and view all the answers

Abnormalities of prostaglandin metabolism have been revealed with which of the following?

<p>Women with PMS. (D)</p> Signup and view all the answers

According to studies, what potential benefit has been observed using Ginkgo biloba for PMS?

<p>Helping with PMS symptoms. (B)</p> Signup and view all the answers

What symptoms have used Lavender effectively for to treat PMS?

<p>Anxiety, Irritability, Insomnia and Depression. (B)</p> Signup and view all the answers

What is a key consideration for treating PMS with thyroid replacement?

<p>Low thyroid function is common in women with PMS so thyroid replacement may be needed. (B)</p> Signup and view all the answers

Describe the optimal administration method for progesterone when treating PMS.

<p>Transdermally on days 14-25 of cycle. (B)</p> Signup and view all the answers

An "anti-Candida" program has shown to help alleviate which of the following?

<p>Symptoms of PMS. (D)</p> Signup and view all the answers

What focus is used in cognitive-behavioral therapy to resolve PMS symptoms?

<p>Correction of unsettled thoughts, behaviors, and emotions. (B)</p> Signup and view all the answers

What is often used in treating the different categories of PMS?

<p>Anti-aging and personalized medicine therapies. (B)</p> Signup and view all the answers

Name the category for PMS that deals mostly with the symptom of anxiety.

<p>PMS-A (A)</p> Signup and view all the answers

What symptom is commonly associated with category PMS-C?

<p>Carbohydrate Cravings (C)</p> Signup and view all the answers

In the PMS category, PMS-D, what is the imbalance that is the source leading increased neurotransmitter degradation?

<p>Estrogen imbalance (C)</p> Signup and view all the answers

Which main symptom is related to PMS-H category?

<p>Hyperhydration (B)</p> Signup and view all the answers

When headaches have their onset after first taking contraceptives, what is the general headache category?

<p>Hormonally related migraines (D)</p> Signup and view all the answers

If a patient experiences an increase in severity of headaches after each pregnancy, what kind of headache is that categorized as?

<p>Hormonally related migraines (C)</p> Signup and view all the answers

List a cause of hormonally related headaches related to increase binding of salt.

<p>Estrogen (C)</p> Signup and view all the answers

The increase of which hormones at the time of ovulation can precipitate headaches?

<p>Estrogen (B)</p> Signup and view all the answers

List a standard blood test that may be ordered for patients with PMS/PMDD.

<p>Complete thyroid studies (D)</p> Signup and view all the answers

According to AKH Inc., how are conflicts of interest managed to ensure integrity in its continuing education activities?

<p>They are mitigated by AKH prior to accreditation of the activity. (C)</p> Signup and view all the answers

SSRIs are very effective to treat both physical and psychological symptoms of PMS/PMDD. When should they generally be considered?

<p>Should be considered after all metabolic approaches have failed. (A)</p> Signup and view all the answers

A medical trial revealed women, in taking Vitamin A, had help relieving what symptoms caused by PMS?

<p>Stress and Fatigue (B)</p> Signup and view all the answers

What has one trial where patients with PMS were given magnesium shown as the results?

<p>Decreased breast tenderness in 96% (A)</p> Signup and view all the answers

Flashcards

PMS Definition

A hormonal disorder with recurring monthly physical/psychological symptoms, subsiding with flow onset.

Estimated PMS prevalence

70% to 90% of women.

PMDD Definition

Emotional, physical symptoms, functional impairment, severe end premenstrual symptoms.

PMS Treatment success

Better than 90% success rate.

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PMS Diagnosis

No definitive test exists.

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PMS clear course

Interference with pituitary-ovarian feedback loop decreases progesterone supply.

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Abnormal Hormone Levels

Estrogen dominance, progesterone deficiency, thyroid disorders.

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Fluid/Electrolyte Abnormalities

Excess aldosterone from excess estrogens.

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Hormone Imbalance

Estrogen levels suboptimal, progesterone levels low, increased prolactin sensitivity.

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Neurotransmitter Dysfunction

Serotonin/NE Deficiency

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Nutrient Deficiencies

Vitamin B6, E, A, Calcium, Magnesium, Potassium, Trace minerals, Zinc.

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PMS Factors

Hysterectomy, age.

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Estrogen's Neurotransmitter Effect

Increases serotonin, dopamine, noradrenaline production; decreases MAO activity

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Progesterone Neurotransmitter effect

Reduces serotonin, dopamine, noradrenaline production; increases MAO activity.

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Clinical Neurotransmitter Study

Serotonin precursors increased days 7-11, 17-19. PMS linked to mood through estrogen-serotonin regulation.

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Serotonergic System

Altered serotonin levels and transmission.

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Stress Response

Blunted cortisol, adrenal response, decreased adrenal ACTH receptors.

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Hormone Level Changes

Phase change, not steady levels, triggers PMDD symptoms in a recent trial.

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PMS-A

Patterns of anxiety.

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PMS-C

Patterns of carbohydrate cravings.

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PMS-D

Patterns of depression.

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PMS-H

Patterns of hyperhydration.

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PMS-A Symptoms

Estrogen excess, diminished stress response, neurotransmitter effects, anxiety, insomnia, irritability.

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PMS-C Symptoms

Enhanced insulin,sugar cravings, increased appetite, headache, hypoglycemia, heart palpitations.

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PMS-D

Imbalance and lead to degradation. Depression, despair, hopelessness, fatigue, insomnia, apathy, low libido.

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PMS-H symtoms

Increased aldosterone, edema, weight gain, bloating, clothes fit tighter.

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Headaches at ovulation

The time of ovulation

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PMS/PMDD Work-Up

Low blood sugar, fasting insulin, complete thyroid studies, prolactin, FSH, LH.

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SSRIs

SSRIs are very effective to treat both physical and psychological symptoms of PMS.

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Personalized Medicine Therapies

Diet, sleep, supplements, exercise, thyroid, herbals, progesterone.

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Dietary Factors

Avoiding refined carbohydrates, processed foods, excess dairy, and simple sugars.

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Hygiene good sleep

Healthy sleeping habits.

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Nutritional Supplements

Magnesium, Vitamin B6, Vitamin E

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Excercise

Helps with PMS symtoms.

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Black Cohosh

Having balancing effect on estrogen, relax, and sedative.

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Chasteberry

Very effective herb for PMS.

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Johns Wort

Caps TID (standardized to contain 990 mcg hypericins, 9 mg hyperforin).

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MG daily

80-160

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Saffron

Is when is a serotoninergic.

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Mood

Very effective to relieve.

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Dandelion

Can be use to reduce from premenstrual syndrome.

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