Premenstrual Syndrome (PMS) and Dysmenorrhea

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Questions and Answers

What is premenstrual tension syndrome characterized by?

  • A group of disorders and symptoms caused by genetic defects
  • A group of disorders and symptoms cyclically recurring in relation to premenstrual period (correct)
  • A group of disorders and symptoms occurring at random times
  • A group of disorders and symptoms caused by hormonal imbalance

What is one of the emotional symptoms of premenstrual tension syndrome?

  • Irritability (correct)
  • Appetite loss
  • Anxiety
  • Insomnia

Which of the following is a behavioral symptom of premenstrual tension syndrome?

  • Increased appetite
  • Increased energy
  • Absenteeism (correct)
  • Excessive sleepiness

What is the ovarian hormone hypothesis of premenstrual tension syndrome?

<p>Deficiency of progesterone (C)</p> Signup and view all the answers

What is the purpose of diet modification in managing premenstrual tension syndrome?

<p>To reduce symptoms of PMS (A)</p> Signup and view all the answers

Which of the following foods is recommended in the diet of women with premenstrual tension syndrome?

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

Which of the following medications is used to treat premenstrual tension syndrome?

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

What is the goal of non-pharmacologic treatment of premenstrual tension syndrome?

<p>To improve quality of life (A)</p> Signup and view all the answers

Why is it important to exclude organic disease in the diagnosis of premenstrual tension syndrome?

<p>To rule out other conditions with similar symptoms (C)</p> Signup and view all the answers

What is one of the differential diagnoses of premenstrual tension syndrome?

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

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Study Notes

Premenstrual Tension Syndrome (PMS)

  • A group of disorders and symptoms that cyclically recur in relation to the premenstrual period
  • Symptoms can be severe enough to interfere with a patient's regular lifestyle

Manifestations of PMS

  • Emotional symptoms:
    • Irritability
    • Depression
    • Mood swings
  • Fluid retention symptoms:
    • Breast pain
    • Weight gain
    • Bloating
  • Behavioral symptoms:
    • Absenteeism
    • Aggressive behavior
    • Suicide
  • Musculoskeletal symptoms:
    • Headache
    • Tiredness
    • Ache

Pathogenesis

  • Ovarian hormone hypothesis:
    • Progesterone deficiency
    • Progesterone receptor insensitivity
  • Serotonin hypothesis:
    • Serotonin deficiency
    • Serotonin receptor insensitivity
  • Psychological hypothesis:
    • Unconscious conflicts
    • Maladaptive coping

Diagnosis

  • Exclude organic disease
  • Explore underlying psychological troubles
  • Helpful diagnostic points:
    • Positive family history on the female side
    • Symptoms start early but worsen with age

Differential Diagnosis

  • Premenstrual syndrome
  • Major depression
  • Dysmenorrhea
  • Substance abuse
  • Perimenopausal symptoms
  • Sexual dysfunction
  • Fibromyalgia

Management

  • Non-pharmacologic treatment:
    • Reassurance
    • Lifestyle changes
      • Leisure time (stress reduction)
      • Exercise
      • Avoiding bad habits
    • Psychotherapy
    • Diet
  • Diet and PMS:
    • Frequent small meals
    • Avoid salty and sweet diet
    • Protein intake
    • Complex carbohydrates
    • Foods containing 5HT (e.g., oatmeal, bananas)
  • Drug therapy:
    • Diuretics
    • Laxatives
    • Vitamins
    • PUFA (primrose)
    • Pain killers
    • Mood elevators (SSRI, e.g., Fluoxetine)
    • Agnucaston
    • GABA (gamma amino butyric acid)
    • OCP (oral contraceptive pills)
    • Calcium, vitamin B6, B12
    • Long-acting GnRH agonist

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