PMS Flashcards
What is PMS?
Distressing symptoms occurring during luteal phase of cycle, in absence of disease.
What is the aetiology of PMS?
Unknown. Likely due to cyclical effects of OES and PROG on neurotransmission of 5HT/GABA.
What is the epidemiology of PMS?
50-90% of women suffer from some sort of PMS.
What would you find in the history of PMS?
Symptom diary useful. Nature, timing and severity of symptoms.
Mood swings, snziety, headache, poor concentration, lack of energy, change in appetite, disturbed sleep, bloating, breast tenderness.
What investigations would you do for PMS?
Bloods: FBC, TFT (anaemia, hypothyroid)
What is the management of PMS?
Advice: increase exercise, vitamina B6 supplements.
Medical: COCP, SSRI (first line), IUS, GnRH analogues with addback HRT.
Surgical: TAH, BSO if severe cases in last resort.
Other: CBT.
What are the complications/ prognosis of PMS?
Disruption of life. Severe may constitute long term problem with significant psychological morbidity.
