PMS

Question 1

What does PMS stand for? PMDD? PMM?

Answer 1

• PMS (Premenstrual Syndrome)
• PMDD (Premenstrual Dysphoric Disorder)
• PMM (Premenstrual Magnification)

Question 2

What is the prevalence of PMS?
__-__% of menstruating women report having some degree of premenstrual symptoms
__% will actually have severe PMS sxs
__-__% will meet diagnostic criteria for PMDD

Answer 2

50-80% of menstruating women report having some degree of premenstrual symptoms
30% will actually have severe PMS sxs
3-9% will meet diagnostic criteria for PMDD

Question 3

PMS includes a Monthly recurrence of mood, cognitive or physical symptoms during the _______ phase

Symptoms remit with _____

Symptoms (are or are not?) an exacerbation of an
underlying disorder

Answer 3

Lateal (Symptoms peak prior to or with onset of flow - about 3-4 days prior)

Menses

Are not

Question 4

PMS is Confirmed w/ > ___ cycles of prospective charting

90% will say sxs are PMS (pre-menses) when actually only 40% will present with true PMS

Answer 4

2

Question 5

What is PMDD

Answer 5

Psychosocial impairment: Interferes with work, school, relationships or social activities
- NOT an exacerbation of an underlying disorder

Question 6

PMMD is most prominent during _____ phase

Answer 6

The last week of luteal phase

Begins to remit with menses
Absent in a week post-menses

Question 7

PMDD must include 5 of the following and at east 1 of the first 4

Answer 7

1. Depressed mood, hopelessness, self-deprecation
2. Marked anxiety or tension
3. Marked affective lability
4. Anger or irritability
5. Decreased interest in usual activities
6. Difficulty concentrating
7. Decreased energy
8. Marked change in appetite
9. Sleep disturbance
10. Sense of being overwhelmed or out of control
11. Physical symptoms generally associated with changes in
    the menstrual cycle

Question 8

What is PMM

Answer 8

Distressing physical or affective symptoms
THROUGHOUT the cycle
- Symptoms worsen during the luteal phase
- Symptoms NEVER completely remit

May be an exacerbation of an underlying condition
ie: affective disorder, depression, endometriosis, substance
abuse, migraines, seizure disorder, asthma, chronic fatigue,
allergies or irritable bowel syndrome

Question 9

What nutritional deficiencies may be present with PMS?

Answer 9

• Vitamin B6, B3, C, E
• Calcium
• Magnesium
• EPO (linoleic acid/ GLA)
• Zinc
• Linoleic acid (help to syntheisis PGE-1)
• Excessive sugar, caffeine, alcohol

Question 10

The withdrawal of progesterone releases and initiates the synthesis of _______ (pro-inflammatory)

Answer 10

PGE2-a

Question 11

How is serotonin related to PMS

Answer 11

In PMS pts serotonin levels were found to be lower 10 days prior to menses, while PMDD patients had lower serotonin levels all month long.