PMS

Question 1

What is PMS?

Answer 1

An of a complex of symptoms experiences by some women in the days immediately before menstruation

Question 2

When must the pMS symptoms be present?

Answer 2

Luteal phase

Abate during menstruation followed by symptoms free week

Question 3

Presentation of PMS?

Answer 3

Psychological:

• Depression
• Anxiety
• Loss of confidence
• Mood swings
• Irritability

Physical:

• Bloatedness
• Mastalgia
• Food cravings

Question 4

What isn’t PMS?

Answer 4

-Premenstrual exacerbation of underlying disorder (DM, Depression, epilepsy, asthma, migraine)

Question 5

What causes PMS?

Answer 5

Sensitivity to progesterone

GABA (y aminobytyric acid)

Question 6

Diagnosis of PMS?

Answer 6

Record symptoms prospectively- over 2 cycles

Can use gonadotrophin-releasing hormone (GnRH) analogues to help if diagnosis is inconclusive

Question 7

Primary care management of PMS?

Answer 7

• COC
• Vitamin B6
• SSRIs

Question 8

COCPs used to treat PMS?

Answer 8

Drospirenone-containing

• Yasmin
• ANtimineralocorticoid and anti-androgenic

Estradiol: (patch)

GnRH inhibitor (danazol)

Question 9

Important considerations in PMS managemnet?

Answer 9

Oestrogen stimulates endometrium: hyperplasia/cancer

Question 10

Medciation reserved for women with worst PMS symptoms?

Answer 10

GnRH analogues
Add back hormone therapy if used >6 months
Continuous combined HRT or tibolone