Premenstrual syndrome

Question 1

What is premenstrual syndrome (PMS) (aetiology, RF)

Answer 1

Distressing symptoms- occuring during luteal phase of menstrual cycle (without pathology)
Unkown cause - cyclical effects of oestradiol/progesterone on brain

RF- obesity, lack of exercise, diet, smoke
affects up to 90% of women

Question 2

Sx and Ix of Pre-menstrual Syndrome (PMS)

Answer 2

Sx-
mood sweings, anxiety, headache, poor concentration
lack of energy, change in appetite (up and down), sleep issues, bloat, breast tenderness

Diagnosis requires sx diary over 2 cycles
no Ix

Question 3

Mx of Pre-menstrual syndrome

Answer 3

for all PMS- conservative life measures and painkillers
Regular meals, exercise, sleep, reduce stress, smoke, alcohol
painkillers- NSAID, paracetamol

Moderate-impact life - COCP
+ referal for CBT

severe - called prementrual dysphoric disorder -
withdraw from life-unable to function-
SSRI (continuous or only luteal phase)
+CBT