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Questions and Answers
What is premenstrual tension syndrome characterized by?
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?
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?
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?
What is the ovarian hormone hypothesis of premenstrual tension syndrome?
What is the purpose of diet modification in managing premenstrual tension syndrome?
What is the purpose of diet modification in managing premenstrual tension syndrome?
Which of the following foods is recommended in the diet of women with premenstrual tension syndrome?
Which of the following foods is recommended in the diet of women with premenstrual tension syndrome?
Which of the following medications is used to treat premenstrual tension syndrome?
Which of the following medications is used to treat premenstrual tension syndrome?
What is the goal of non-pharmacologic treatment of premenstrual tension syndrome?
What is the goal of non-pharmacologic treatment of premenstrual tension syndrome?
Why is it important to exclude organic disease in the diagnosis of premenstrual tension syndrome?
Why is it important to exclude organic disease in the diagnosis of premenstrual tension syndrome?
What is one of the differential diagnoses of premenstrual tension syndrome?
What is one of the differential diagnoses of premenstrual tension syndrome?
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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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