What is PMS and what it is not
Symptoms of PMS appear in the second phase of the cycle, after ovulation, increase towards the end of the cycle and disappear with the onset of menstruation or in its first days. Between the end of menstruation and the next ovulation there must be a period of complete well-being - this is a prerequisite for diagnosis.
If anxiety, irritability or depression are present in the first half of the cycle, and only intensify before menstruation, we are not talking about PMS, but about another condition - for example, an anxiety disorder or depression, which worsens during this period. This is fundamentally important because the treatment will be different.
- PMS - moderately severe symptoms that affect well-being
- PMDD (premenstrual dysphoric disorder) is a severe form with severe emotional symptoms that seriously disrupt life; requires active treatment
- Premenstrual exacerbation of existing diseases - migraine, depression, anxiety disorder, asthma, epilepsy
Symptoms
- Emotional: irritability, tearfulness, anxiety, depression, mood swings, feelings of tension
- Decreased concentration and performance
- Sleep disorders: insomnia or, conversely, drowsiness
- Changes in appetite, cravings for sweets and salty foods
- Breast engorgement and tenderness
- Bloating, swelling, weight gain due to fluid retention
- Headache, migraine
- Pain in muscles and joints
- Fatigue
- Acne
- Decreased sex drive
Why is this happening
The reason is not “excess” or “deficiency” of any hormone: women with PMS usually have normal hormone levels. The point is the individual sensitivity of the nervous system to their natural fluctuations in the second phase of the cycle.
- The influence of progesterone metabolic products on brain receptors
- Changes in serotonin metabolism
- Fluid retention due to hormonal fluctuations
- Individual and probably hereditary sensitivity
- Exacerbating factors: chronic stress, lack of sleep, lack of physical activity, smoking, excess caffeine and alcohol
This leads to a practical conclusion: hormone tests for typical PMS are usually unnecessary and do not help in diagnosis. They are prescribed to rule out other causes, such as thyroid disease or anemia.
Diagnostics: diary instead of tests
- Ведение дневника симптомов ежедневно в течение двух-трёх циклов — main метод
- Отмечаются симптомы, их выраженность по шкале и дни цикла
- Диагноз подтверждается, если симптомы приходятся на вторую фазу и полностью исчезают после менструации
- Осмотр гинеколога и УЗИ для исключения гинекологической патологии
- ТТГ — исключение заболеваний щитовидной железы
- Общий анализ крови и ферритин — исключение анемии как причины утомляемости
- Оценка симптомов депрессии и тревоги при выраженных эмоциональных проявлениях
What helps
- Regular aerobic physical activity is one of the most proven non-drug methods
- Adequate and regular sleep
- Diet with limited salt, caffeine and alcohol in the second phase of the cycle, split meals
- Stress reduction, relaxation techniques, breathing practices
- Quitting smoking
- Calcium and magnesium supplements - as recommended by a doctor
- Combined hormonal contraceptives, especially in continuous mode, suppress ovulation and associated fluctuations
- Non-steroidal anti-inflammatory drugs for pain symptoms
- Drugs that affect serotonin metabolism are the treatment of choice for PMDD; prescribed by a doctor, sometimes only in the second phase of the cycle
- Cognitive behavioral psychotherapy - effective for severe emotional symptoms
- Treatment of associated conditions: anemia, hypothyroidism, migraine
When you definitely need help
- Symptoms interfere with work, school, or relationships
- Severe depression and hopelessness before menstruation
- Thoughts of harming yourself - require immediate attention
- Symptoms do not go away with the onset of menstruation
- The condition worsens from cycle to cycle
- Self-help measures do not bring relief
PMDD is not a “bad character” or an exaggeration. It is a condition with an understandable mechanism and effective treatment, and it is as appropriate to see a doctor as you would any other health problem.
Where to get help in Tashkent
Consultation with a gynecologist, exclusion of other causes of symptoms and selection of therapy are required, and in case of pronounced emotional manifestations, the participation of a psychotherapist.
In Tashkent, such consultation and examination can be obtained at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
Starting with a symptom diary for two to three cycles is the most helpful thing you can do before your appointment. It turns vague complaints into a concrete picture and significantly speeds up the selection of treatment. Clinic contacts are below.
