A Family Doctor's Tale - PREMENSTRUAL TENSION

DOC I HAVE PREMENSTRUAL SYNDROME

Premenstrual syndrome is a condition occurring seven to ten days before menses more common in women over the age of 30.

Premenstrual Syndrome may manifested itself as a period of irritability, abdominal discomfort, headache and other various symptoms for the patient presenting just before the menses.

The cause of Premenstrual Syndrome is still not known.
There are a few theories:
1.Fluctuation in estrogen and progesterone hormonal concentration may affect the body's function and emotions

2.The fluid retention action of estrogen may cause abdominal discomfort, irritability of the brain, and weight gain

3.changes in the other glands such as the adrenal gland may also be involved

4.Stress aggravates the symptoms of excessive hormones before the menses.

Symptoms of Premenstrual syndrome may consists of:
1.feeling of fullness in lower abdomen


2.Bloated abdomen and ankle edema(swelling due to fluid retention)


3.Weight gain during the second half of menstrual cycle due to fluid retention which is reversed after the onset of menses


4.Low back pain


5.headache and exacerbation of migraine,


6.painful breasts,


7.depression, anxiety, irritabilty


8.emotional instabilty and mood changes


9.interpersonal problems and social unhappiness

Treatment for premenstrual Syndrome are as follows:


Mild premenstrual Syndrome symptoms:
reassurance without other treatment

More severe Premenstrual syndrome symptoms:
1.ankle edema may require diuretics to pass out fluids or decreased salt intake

2.Tranquillizer or antidepressant for anxiety or depression

3.Analgesics or Muscle relaxant for headaches and back pain

4.breast support with properly fitting brassieres for painful breasts

Very severe symptoms:
a course of low combination female hormones may help

Family counseling may be indicated

Prognosis of Premenstrual syndrome:
It may improve spontaneously over years or it may recur on and off until menopause.