Pre-menstrual syndrome

Question 1

___ are physical and behavioral sx that recur in the luteal phase of the menstrual cycle and interfere w/ some aspects of daily life

The average duration is ___ days/cycle

Answer 1

Premenstrual Syndrome (PMS)

6 days/cycle

Question 2

___ is a severe form of PMS in which sx of ______, _____, and _____ are prominent

Answer 2

Premenstrual dysphoric disorder (PMDD)

anger, irritability and internal tension

Question 3

Premenstrual Syndrome (PMS) is clinically significant in ___-___% of cycling women and ___% of women w/ PMS qualify for PMDD dx

Answer 3

3-8%

2%

Question 4

What are associated risk factors for premenstrual syndrome (PMS)? (x4)

Answer 4

less educated
smoker
anxiety disorder
hx of traumatic event(s)

Question 5

T/F: Women w/ PMS have much higher estrogen levels than women who do not have PMS

Answer 5

F: Women w/ PMS have NO difference in hormone levels (estrogen, progesterone)

Question 6

Abnormal ____ response (_______) to ____ phase hormone changes may be the cause of PMS

Answer 6

neurotransmitter (serotonin)

luteal

Question 7

What are the 2 types of sx of premenstrual syndrome? Provide examples of each type.

Answer 7

BEHAVIORAL
- labile mood, irritability, anxiety, sadness, sensitivity, increased appetite, food cravings, diminished interest in activities

PHYSICAL
- abdominal bloating, extreme fatigue, breast tenderness, HA, dizziness, hot flashes

Question 8

What are some DDx to consider in conjunction w/ PMS?

Answer 8

Mood and anxiety d/o
Perimenopause
Thyroid d/o
Substance abuse

Question 9

How do you manage mild premenstrual syndrome sx?

Answer 9

Exercise
Stress reduction (relaxation techniques)
Avoid stimulants

Question 10

How do you tx moderate-severe PMS sx?

Answer 10

SSRIs (fluoxetine, sertraline, paroxetine, citalopram)

OCP

Question 11

How do you tx refractory PMS sx?

Answer 11

GnRH agonist

Oophorectomy