The main signs of PMS before the month: description and assistance


For a long time, the condition of women before menstruation remained a mystery. Back in ancient times, healers tried to understand the interesting behavior and the deterioration of the female state of health. At first, all this was connected with the phase of the moon, then with the terrain and natural conditions in which women lived. Only at the beginning of the last century the curtain opened a little. A change in the mental, emotional and physical condition of women began to be called premenstrual syndrome. Abbreviated designated as the ICP, attributed to a number of complex female diseases that are exacerbated before menstruation. How to distinguish signs of PMS from other diseases?

It should be noted that the true cause of the occurrence of the disease and today is not fully understood. At the same time revealed several forms of the disease. Light, moderate and heavy. Mild PMS symptoms are considered normal and are eliminated by women at home. The disease of moderate severity is treatable with medical drugs, as recommended by the doctor. A severe form of PMS is practically not cured, it requires constant monitoring by specialists, and all the efforts of therapy are aimed at reducing symptoms and normalizing the monthly cycle.

Interesting facts about the signs of PMS

In the analysis of the criminal chronicles, it was found that during the premenstrual syndrome, women commit rash acts, and then can not explain the inappropriate behavior. A murder in the heat of passion is justified by the judges. Manifestations of premenstrual syndrome - shattered nerves, scandals out of the blue, broken dishes, theft, traffic accidents, other crimes. The peak of the unbridled state falls from the 21st day of the menstrual cycle.

According to observations, approximately a few days before the onset of menstruation, a woman turns into a shopaholic. There is a desire to buy everything, and more. And things are not quite necessary. And after the end of menstruation, she does not understand how she could buy them. If you have a sudden craving for shopping, then this is the first symptom of PMS.

Symptoms of premenstrual syndrome are more susceptible to women who are engaged in mental work. A strong load on the nervous system fails, expressed in various forms. In addition to indirect manifestations of PMS, there are direct signs of manifestations.

Symptoms of PMS

The whole body is subject to changes before the menstrual period, but the nervous system, vegetovascular, is more affected. Disruption in the endocrine system, sexual, changes in hormonal balance leads to exacerbation of the symptoms of PMS before menstruation. Most often, women complain of pain in the abdomen, chest, general weakness, nervousness, headache, sleep disturbance. In general, there are more than 100 signs of this disease. The pain in the abdomen, the change in the size of the breast a woman does take, for granted on the eve of menstruation.

Violations of the central nervous system

  • nervousness,
  • irritability,
  • aggressiveness,
  • depression,
  • reduced self-esteem
  • manifestation of pity, sympathy,
  • feeling of fear,
  • tearfulness
  • sleep disturbance,
  • mood swings
  • capriciousness.

Violations in the vascular system

  • headache,
  • weak condition
  • tachycardia,
  • blood pressure drops,
  • vomiting
  • dizziness,
  • pain in the side of the heart
  • memory loss
  • nausea,
  • fatigue

Endocrine Disorders

  • puffiness
  • temperature rise,
  • sweating
  • itching all over or in parts
  • flatulence,
  • bloating
  • dyspnea,
  • chills,
  • breast augmentation
  • breast sensitivity,
  • abdominal pain,
  • blurred vision
  • armpit chest pain
  • thirst.

In addition, there may be pain in the stomach, anus, diarrhea, skin rashes. A woman in front of menstruation observes the appearance of individual acne on the face or a rash of small pimples, an allergy appears in different parts of the body. All this is a consequence of hormonal changes.

Symptoms of PMS are called any negative changes in the condition of the woman before menstruation, which pass on their own immediately after menstruation, then reappear 2 weeks later. Each month, premenstrual syndrome may manifest itself in different ways. Symptoms are influenced by numerous factors. In addition, the symptoms of PMS with symptoms of other diseases that are masked as premenstrual are similar. The severity of PMS is determined by the symptoms of PMS. If there are about 4 or 1, but strongly expressed - there is a light form. If there are about 12 signs or 3-4 pronounced, they say about the severe form.

Differences in PMS symptoms from other diseases

With the symptoms of PMS can be confused diseases of the vascular system, digestive, nervous, endocrine. Premenstrual symptom appears before menstruation, approximately 2 weeks and ends after the end of menstruation or on its first day. Symptoms of other diseases do not have a special cycle. But the approach of menstruation leads to an exacerbation of signs of diseases of internal organs and systems.

  • Migraine,
  • Chronic fatigue syndrome
  • Gastritis
  • Epilepsy,
  • Intestinal dysbiosis,
  • Thyroid disease,
  • Anemia,
  • Bronchial asthma,
  • Allergies,
  • Inflammation of the reproductive organs,
  • Gynecological diseases.

The doctor will help to deal with the symptoms of PMS, other diseases.

The most harmless signs of premenstrual syndrome are abdominal pain, breast augmentation, engorgement of the glands, back pain, nervousness, decreased performance, headache, sleep disturbance. The condition is not critical. To eliminate the negative state before the menstruation, they take painkillers, spasms and sedatives.

Causes of reactions

Why do signs of PMS appear before menstruation? Answer this question definitely can not. Earlier it was assumed that the symptoms occurred due to mental and neurological diseases. Now it is proved otherwise. The manifestation of premenstrual syndrome directly depends on a change in hormonal levels. That is why the symptoms are determined at the same time (before the next monthly).

One cannot answer the question why some women are susceptible to PMS, while others have no idea what it is. A study was conducted: patients with a pronounced manifestation of premenstrual syndrome were given drugs that correct hormones. At the same time, some subjects still had symptoms. This suggests that the cause of PMS lies elsewhere. Often the manifestations are associated with diseases of the thyroid gland, disorders of the circadian rhythm, and psychological diseases.

The timing of the onset of the symptom

At what time a woman may feel signs of PMS (before menstruation)? How many days do they appear? It all depends on the length of the cycle and the individual characteristics of the organism.

Some representatives of the weaker sex say that they feel PMS already 2 weeks before the next bleeding. This means that with the onset of the second phase, the symptoms described below appear. Other patients complain of a five or seven day PMS. At the same time, in all women approximately two days before the onset of menstruation, the manifestations become more acute. Consider what are the signs of PMS before menstruation and find out how to deal with them.

Abdominal pain

For many women, the signs of PMS (before menstruation) are determined by pain. She is pulling, pricking, or cramping. This symptom passes a few days after the onset of menstruation. Some patients easily tolerate such ailment, while others cannot lead a normal life. How can I help in this case?

If immediate recovery is required, then any antispasmodic should be taken. The most popular drugs are "No-Shpa", "Drotaverin", "Papaverin", "Papazol" and so on. They are purchased in pharmacies without a prescription. Also used anesthetic drugs "Spazgan", "Spazmalgon", "Nimulid", "Diclofenac", "Ibuprofen".

Pay attention to the fact that severe pains before menstruation and during it indicate the presence of pathology. A similar symptom occurs in endometriosis, inflammation, myoma and other tumors.

Breast changes

What else are common signs of PMS? Before menstruation, about half of all women of reproductive age complain about their breasts. In the area of ​​the mammary glands arise seals, nodules. They can be easily probed independently. Liquid can also be expelled from the nipple when pressed. The chest slightly increases in volume and hurts.

Only a doctor can help the patient with this symptom. Before the appointment of therapy, you need to undergo an examination, which includes ultrasound diagnosis, the study of hormonal background, and sometimes - mammography. Upon detection of diffuse mastopathy, which has all the above symptoms, treatment is prescribed.

Emotional imbalance

The main symptoms before menstruation (PMS): fatigue, irritability, frequent mood swings. They can be attributed to psycho-emotional manifestations. Most often, such symptoms occur in women who are engaged in mental work, whose work requires concentration. There is also a high risk of psycho-emotional imbalance with general fatigue, weakness. The mood of a woman can change every minute. How can I help?

To begin, all family members need to be patient. Within a few days all the tension will pass. The woman herself needs more rest and a walk. Get positive emotions from your favorite activities, do not wind yourself. In extreme cases, you can take safe sedatives - motherwort and valerian. For more serious antidepressants, see your doctor.

Increased appetite

Before menstruation and a few days after it began, a woman feels an increase in appetite. Note that this is not the case with all the representatives of the weaker sex. Others, on the contrary, refuse to eat for this period. But if you have increased appetite, you want chocolate and dense food, do not deny yourself. But do not lean on fatty, fried, salty. Know the measure. These products intensify other PMS symptoms. A small bar of good dark chocolate will not only hurt you, but also enhance your mood.

Digestive disorders can also be attributed to the symptoms of premenstrual syndrome. Increasing the level of progesterone has a relaxing effect on the intestines. As a result, constipation worries women. There are women who report diarrhea during PMS. Such a phenomenon is possible. Usually it is a consequence of violation of the diet.

Discharge from the genital tract

What else are symptoms and signs before menstruation? PMS can be attributed to discharge from the genital tract. Normally they are creamy, white or transparent. The mucus is odorless and does not bother a woman.

The manifestation of premenstrual syndrome may be characterized by brown secretions. In most cases, this is a symptom of endometriosis or inflammation. If a woman finds mucus with white streaks, then this indicates cervicitis or cervical erosion. The gynecologist deals with the treatment of these diseases and their diagnosis.

Signs of PMS that are often mistaken for pregnancy

Premenstrual syndrome is often confused with the first symptoms of pregnancy. This usually occurs in women planning to conceive. Indeed, some of the signs are very similar. So, signs of PMS before menstruation or pregnancy? We will understand.

  • Increased appetite. During pregnancy, women change their taste preferences, as before menstruation. If nausea and vomiting additionally appeared, then, most likely, it is toxicosis of pregnant women.
  • Weight gain With pregnancy, the uterus grows, and the weight of the woman becomes larger. Before menstruation is also an increase in weight. However, it is associated with fluid retention in the body. If you find edema (especially in the morning), then wait for your period.
  • Dizziness and headache. Before menstruation and during it, some women drop hemoglobin. Anemia provokes dizziness and general malaise. The same symptoms are present in pregnant women: weakness, fainting, drowsiness.

The test will help you to reliably distinguish PMS from pregnancy. However, many manufacturers recommend conducting research only after a delay. If on the appointed day the bleeding did not start, and all the described signs persist, then pregnancy is possible.

Correction: Assistance

If you are very concerned about the symptoms of PMS, then this condition must be corrected. You can consult a doctor and get a medical prescription. There are also some tips to cope with premenstrual syndrome. How to give yourself help and improve well-being?

For correction of PMS symptoms, gynecologists prescribe the use of progesterone-based drugs. These drugs are used in the second phase of the cycle. These include "Duphaston", "Utrozhestan" "Pradzhisan" and others. If you are not planning a pregnancy in the near future, you may be prescribed oral contraceptives. They relieve PMS symptoms, improve overall well-being and regulate hormone levels. These are the drugs "Logest", "Diane", "Jeanine" and so on. All hormonal agents are taken strictly after examination and consultation with a doctor.

Additional ways to combat PMS: how to help yourself?

To alleviate PMS symptoms, follow these guidelines:

  • sleep at least 7-9 hours a day,
  • play sports or spend a five-minute gymnastics,
  • eat well (increase fiber and limit fats),
  • lead a regular sex life
  • take vitamin complexes rich in iron and substances that stimulate the formation of blood cells,
  • be examined by a doctor and treat existing pathologies in time.


You have learned what are the symptoms of PMS in women. Signs and treatment are presented to your attention. If premenstrual syndrome greatly spoils your life, knocking out of the usual rhythm, you should definitely contact a gynecologist. You will be prescribed the appropriate treatment in accordance with the complaints. Independent use of hormonal drugs is prohibited. With such therapy, you can only hurt yourself and aggravate the course of PMS. Many women report that after the birth of a child, all signs of PMS have disappeared. For others, on the contrary, such a process caused an increase in the described symptoms in the future. Take care of yourself and be healthy!

General information

Doctors have always tried to determine the reasons why poor health and irritability are manifested in women in the days immediately before monthly. In ancient times, this phenomenon was associated with different factors - and with the phases of the moon, and with the health of a woman, and with the peculiarities of the area where she lived. However, the state before the menstruation was a mystery to the doctor. Only in the twentieth century did doctors manage to sort out to some extent what was happening to the ladies.

Speaking of what ICP is - what it is, you should know how ICP stands for - this premenstrual syndromethat means - a manifestation characteristic of women in the days before menstruation. PMS is a complex of symptoms that manifest in women and girls a few days before the onset of menstruation.

What are the causes of such manifestations, and what this syndrome means, scientists are still exploring. Those who are interested in how the ICP is translated should find out in more detail what manifestations are characteristic of this condition. Each transcript of what is PMS in girls, contains a description of all the characteristic symptoms and manifestations.

After all, PMS in women is a whole complex of symptoms, both physical and mental, - their scientists counted about 150. About 75% of women experience premenstrual syndrome in varying degrees.

As a rule, PMS in girls begins to appear about 2-10 days before the day when there are signs of menstruation. After the menstrual period is completed, the menstrual syndrome also completely disappears.

Why is PMS developing?

Until now, all the studies conducted have not made it possible to determine why premenstrual syndrome manifests itself? There are many theories that explain why this condition develops.

  • The so-called "water intoxication" - impaired water-salt metabolism.
  • Allergic nature - high body sensitivity to endogenous progesterone.
  • Psychosomatic - the development of physiological symptoms due to the influence of mental factors.

The most complete and widespread today is the hormonal theory, according to which PMS is explained by a strong hormonal fluctuation in the second phase of the cycle. After all, for the female body to function properly, normal hormonal balance is important:

  • estrogensable to improve health, both physical and mental, activate mental activity, increase vitality,
  • progesteroneprovides a sedative effect that can lead to a depressive state in the second phase,
  • androgensaffect libido, increase efficiency and vitality.

In the second phase of the cycle, the hormonal background of the woman changes. Consequently, the hormonal theory suggests that the body reacts inadequately to such a "storm". Interestingly, the syndrome of premenstrual stress is inherited.

Since in the premenstrual period in the body is noted endocrine instabilityThis leads to the manifestation of somatic and psycho-vegetative disorders. The main reason for this is the fluctuation of sex hormones throughout the monthly cycle and the response of the limbic brain.

  • When the level increases estrogen and first grows, and then the level decreases progesterone, there are swelling, tenderness of the mammary glands, disorders of the heart and blood vessels, pressure jumps, irritability and aggression in women.
  • With increased secretion prolactinfluid is also retained in the body.
  • When content increases prostaglandins, there are violations of the vegetative-vascular nature, digestive disorders - diarrhea, constipationnausea as well as headaches resembling migraine.

Thus, modern physicians identify the following factors determining the development of PMS:

  • Lower level serotonin, which leads to the manifestation of the mental symptoms of premenstrual syndrome: a decrease in this hormone causes sadness, depression, longing.
  • Disadvantage vitamin b6 leads to fluid retention, increased breast sensitivity, mood changes.
  • Lack of magnesium leads to the development of symptoms such as dizziness, tachycardia, headache, desire to eat sweets.
  • Smoking - women who smoke suffer from PMS twice as often.
  • Excess weight - Those with a body mass index greater than 30 are more likely to experience the symptoms of this syndrome.
  • Genetics - the tendency to PMS can be inherited.
  • Difficult childbirth, abortion, gynecological surgery.
  • Stress.

The main symptoms of PMS in women

Speaking about what are the symptoms of PMS, for how many days before menstruation in girls and women, they appear, should take into account the individual characteristics of each organism. The main signs of PMS before menstruation are divided into several different groups. There are such symptoms of premenstrual syndrome (in groups):

  • Neuropsychic: depression, aggression, irritability and tearfulness.
  • Exchange-endocrine: chills, edema due to impaired water-salt metabolism, fever, discomfort in the area of ​​the mammary glands, flatulencebloating dyspnea, blurred vision and memory.
  • Vegeto-vascular: headache, pressure drops, nausea, diarrheavomiting dizziness, tachycardia, pain in the heart.

Speaking about what symptoms before menstruation occur in women, it should be noted that they can be divided into several forms. However, as a rule, they are combined. So, if there are marked psycho-vegetative disorders, the pain threshold is reduced, and the woman is very sensitive to pain - for a week or a few days before the menstruation.

What signs of monthly for a week or a few days can be observed?

  • panic attacks, unreasonable melancholy and depression can develop,
  • anxiety, fear, depression,
  • forgetfulness, deterioration of concentration, mood swings,
  • insomnia, increased or decreased libido,
  • aggression, dizziness.

  • There is tachycardia, pressure drops, heart pain,
  • frequent urination before menstruation, panic.
  • those who are characterized by such a form, as a rule, suffer from heart disease, kidney problems, and poor digestion.
  • The temperature rises to subfebrile indicators,
  • constantly worried drowsiness, allergic manifestations, vomiting.
  • It is characterized by negative diuresis and fluid retention in the body.
  • There are swelling of the limbs and face, itchy skin, thirst, weight gain, lower back pain and joint pain, headache, decreased urination, digestive problems.

  • migraine, cardialgia,
  • nausea and vomiting,
  • tachycardia,
  • high sensitivity to smells and sounds.

Approximately 75% of women have increased vascular pattern, hyperostosis. In this form, as a rule, in the family history of hypertension, diseases of the digestive system, diseases of the heart and blood vessels.

Wikipedia and other sources indicate that each lady has PMS in its own way, and the symptoms may vary.

Scientists, conducting a series of studies, and determined the frequency of symptoms of premenstrual syndrome:

In addition, PMS can significantly aggravate the course of other diseases:

What conditions and diseases can be masked as PMS?

To know how many days menstruation begins, each woman must have a calendar or a special notebook and write down the start date of her period, how long her period lasts, and the day of ovulation (to do this, measure the basal temperature). It is also worth noting the manifestation of symptoms before menstruation and well-being during ovulation.

If a woman keeps such records for several cycles, it helps her to establish how often PMS symptoms appear. Also, the diary will help determine whether there is a delay in menstruation, etc.

To establish the diagnosis of "PMS", the doctor determines the presence of at least 4 of the signs listed below:

  • drowsiness, insomnia,
  • loss of attention and memory
  • increased appetite, loss of appetite,
  • severe fatigue, weakness
  • chest pain,
  • headaches,
  • swelling,
  • joint or muscle pain
  • exacerbation of chronic diseases.

You can also diagnose this condition if at least one of these symptoms is noted:

  • conflict, tearfulness, nervousness and irritability, mood swings in women,
  • baseless anxiety, fear, tension,
  • feeling of melancholy without reason, depression,
  • depressed state
  • aggressiveness.

To determine the severity of PMS, it is important to consider the number of manifestations, their severity and duration:

  • Mild form - manifested from 1 to 4 symptoms, if it is 1-2 signs, then they are significantly expressed.
  • Severe form - manifests from 2 to 12 signs, if it is 2-5 symptoms, then they are significantly expressed. Sometimes they can lead to the fact that a woman becomes disabled for a day or a few days before menstruation.

The cyclical manifestation is the main symptom that distinguishes premenstrual syndrome from other diseases. That is, premenstrual syndrome, this condition is when it begins before menstruation (from 2 to 10 days) and completely disappears after menstruation. But if psycho-vegetative symptoms disappear, then physical sensations sometimes turn into painful periods or migraines in the first days of the cycle.

If the sensations of a woman in the first phase of the cycle are relatively good, then it is PMS, and not the exacerbation of chronic diseases - depression, neurosis, fibrocystic mastopathy.

If pain is noted only immediately before menstruation and during menstruation, and is combined with blood secretions in the middle of the cycle, this indicates that the gynecological disease most likely develops in the body. endometritis, endometriosis and etc.

To establish the PMS form, examine hormones: estradiol, prolactin, progesterone.

Additional research methods may also be assigned, depending on which complaints prevail:

  • If you are very worried about headaches, tinnitus, dizziness, fainting, blurred vision, a CT scan or MRI scan is necessary to rule out organic brain diseases.
  • With the predominance of neuropsychiatric symptoms, an EEG is performed to rule out the epileptic syndrome.
  • If you are concerned about edema, the amount of urine per day changes, tests are performed to diagnose kidneys.
  • In the case of significant engorgement of the breast should be an ultrasound of the mammary glands, mammography.

Women who suffer from PMS are examined not only by the gynecologist, but also by other specialists: neurologists, psychiatrists, nephrologists, endocrinologists, cardiologists, therapists.

How to understand - PMS or pregnancy?

Since some of the symptoms during pregnancy are very similar to the signs of PMS, it is important to take into account the differences by which these states can be distinguished.

After conception has occurred, hormone growth occurs in the female body progesterone. As a result, a woman may confuse pregnancy with PMS when it begins to manifest itself: tenderness and swelling of the breast, vomiting, nausea, mood swings, back pain, irritability.

Often, going to one or another thematic forum, you can see the arguments of women about how to distinguish PMS from pregnancy to delay. Of course, if the monthly began in a timely manner, the question is removed by itself. However, even pregnant women sometimes have discharge in the days. When should be monthly. Differences in discharge before menstruation and during pregnancy are - in pregnant women, they are usually more scarce. But still, in order to verify the presence or absence of pregnancy, it is necessary to make a test or conduct tests in honey. institution.

Below is a comparison of the most common signs of pregnancy and PMS.

Since the symptoms of these conditions are actually similar, and in some cases even pregnancy is possible during menstruation (at least, a woman’s impression is formed if discharge occurs), it is important to act correctly.

It is best to wait until menstruation begins. If a woman notes that she already has a delay, it is necessary to conduct a pregnancy test, which reliably determines the pregnancy after a delay. Those who want to immediately verify whether there was a conception can be passed hCG blood test (pregnancy hormone). Such a test on the tenth day after conception accurately determines the pregnancy.

The most correct way in such a situation is to visit a gynecologist, who will help you figure out what the woman actually has - PMS or pregnancy with the help of an examination, an ultrasound scan. Sometimes also the question arises how to distinguish pregnancy from menopause - in this case also need to consult a doctor or do a test.

When should I contact a specialist?

If pain, irritability, increased tearfulness in women, the causes of which are associated with PMS, significantly reduce the quality of life and are very pronounced, you should consult a doctor and conduct their prescribed treatment. Also, the doctor can give effective recommendations on how to alleviate certain unpleasant manifestations.

How is the treatment of PMS

As a rule, symptomatic therapy is prescribed for such manifestations. How to treat PMS, and whether to prescribe any drugs for treatment, the specialist determines, taking into account the shape, symptoms, the course of premenstrual syndrome. The following treatments may be prescribed:

  • When mood swings, depression, irritability prescribe psychotherapy sessions, relaxation techniques, sedative medication.
  • If you are worried about abdominal pain, lower back, headaches, it is recommended to take nonsteroidal anti-inflammatory drugs to relieve pain syndrome (tablets Nimesulide, Ibuprofen, Ketanovand etc.).
  • Also prescribed drugs for the treatment of premenstrual syndrome - diuretics in order to remove excess fluid and eliminate edema.
  • Hormonal treatment is prescribed if there is a failure in the second phase of the cycle, after conducting tests of functional diagnostics, guided by the results of the changes that have been identified. Prescribe progestinsmedroxyprogesterone acetate, Duphaston, they need to be taken from 16 to 25 day of the menstrual cycle.
  • Tranquilizers and antidepressants are prescribed to women who develop numerous neuropsychiatric symptoms before menstruation: aggression, nervousness, panic attacks, insomnia, etc. In such cases, they prescribe Rudotel, Amitriptyline, Tazepam, Zoloft, Sertraline, Prozac, Sonapaks. Drugs should be drunk in the second phase of the cycle, two days after the onset of symptoms.
  • If diagnosed with crisus or cephalgic forms, may be assigned Parlodelin the second phase of the monthly cycle. If prolactin is elevated, then Parlodel should be taken continuously.
  • If a woman develops an edematous or cephalgic form, antiprostaglandin medications are prescribed (Naprosin, Indomethacin) in the second phase of the cycle.
  • Since PMS may increase serotoninand histamine, a specialist may prescribe a second-generation antihistamine treatment. It is necessary to take into account how many days the symptoms begin to appear, and start taking the pills 2 days before the expected development of these symptoms and continue to drink them until the second day of menstruation.
  • To activate blood circulation, apply Nootropil, Grandaxine, Aminolone for about 3 weeks.
  • In the case of the development of cephalgic, crisis and neuropsychiatric forms prescribe drugs that normalize neurotransmitter metabolism in the central nervous system. You need to take money for 3 to 6 months Difenin, Peritol.
  • The doctor may also prescribe homeopathic remedies. Mastodinon, Remens, as well as vitamin-mineral complexes - for example, vitamins for depression for women.

How to ease the condition yourself?

If a woman is worried about PMS (sometimes mistakenly referred to as “postmenstrual syndrome”), then she should use some recommendations to ease the condition.

The use of nonsteroidal anti-inflammatory drugs is recommended.

Fully relax

You need to sleep as much time as the body needs for a good rest. As a rule, it is 8-10 hours. Many women who write on any thematic forum, note that it was the normalization of sleep that made it possible to reduce the severity of unpleasant symptoms. With a lack of sleep can develop anxiety, irritability, aggressiveness, worsens immunity. For those who have insomnia, small evening walks can help.


Provided that the woman does not suffer from the manifestations of allergy, you can practice aromatherapy, choosing a special composition of aroma oils. It is recommended to use lavender, basil, sage, geranium, rose, juniper, bergamot oil. It is necessary to start taking baths with aroma oils two weeks before the menstruation.

Physical exercise

Any reasonable loads - running, dancing, yoga, bodyflex, etc. - have a positive effect on the body. If you train fully and regularly, your body’s content increases endorphins. And this allows to overcome depression and insomnia, to reduce the severity of physical symptoms.

Vitamins and Minerals

To reduce the severity of symptoms, two weeks before menstruation, you need to take magnesium and vitamin b6. It is also recommended to drink vitamins E and BUT. This will help reduce the severity of a number of symptoms: palpitations, insomnia, anxiety, fatigue, irritability.

It is important to include in the diet as much as possible vegetables and fruits, as well as products containing calcium and fiber. It is worth reducing the amount of consumed coffee, cola, chocolate, as caffeine provokes anxiety and mood swings. It is important to reduce the amount of fat in the diet.

It is also not recommended to eat beef, which may contain artificial estrogen. You should drink herbal teas, lemon and carrot juices. Alcohol is better to exclude or limit, because under its influence depleted reserves of minerals and vitamins, and the liver is worse in utilizing hormones.

Often women are interested in why you want salt before menstruation. The fact is that the fluctuation of appetite is a normal phenomenon during the period of PMS, and sometimes you just need to “satisfy the requirements” of the organism in order to feel better.

Regular sex

Sex also has a beneficial effect on health - it helps to sleep better, overcome stress, cope with bad emotions, strengthen the immune system and increase the content of endorphins. In addition, in the period before menstruation, a woman often increases libido, which contributes to an active sex life.

Medicinal herbs

With the help of herbal teas, you can significantly alleviate the condition of PMS. The main thing - to choose the right grass. Tea can be made from Hypericum, primrose, as well as other herbs that the doctor will recommend.

Thus, premenstrual syndrome is a serious condition, which sometimes becomes a barrier for a woman to a full life and work capacity. According to studies, the most often pronounced symptoms of PMS are manifested in residents of large cities and women who are engaged in mental work.

However, with the help of specialists, as well as practicing proper nutrition, regular exercise, taking vitamins and minerals, this condition can be greatly alleviated.

What is PMS in women

A complex of symptoms appears in a certain part of the female population several days before the onset of menstruation. How is the PMS translated? The term is revealed as premenstrual syndrome - this is what this abbreviation stands for. Signs of approaching menstruation, according to physicians, may appear long before they begin, because the duration of PMS varies from 2 to 12 days.At this time, some systems in the female body fail, and normal functioning is restored only with the arrival of critical days or even after their completion.

How the abbreviation PMS stands for puts everything in its place, explaining the strange behavior of women by a physiologically determined process. The reason for hormonal changes. The nervous system is regulated by female hormones, which accumulate in large quantities during PMS. In most cases, bright, noticeable symptoms begin to be felt a week before menstruation.

Uniform changes would not lead to negative phenomena. There is a suppression of one hormone by another: progesterone by estrogen, which causes poor health in this phase of the cycle. There is a theory that women who are sensitive to their own hormones are susceptible to PMS. Proponents of this hypothesis call the system of symptoms of the syndrome a simple allergy to estrogen.

Signs of PMS

According to medical statistics, there are about 150 species of common premenstrual symptoms, and they may have various combinations. For convenience, the symptoms before menstruation are divided into groups. The first one is neuropsychic. It reflects the emotional state and leads to changes in behavior. Here are some signs of menstruation that are approaching, characteristic of this form:

  • depressed mood
  • aggressive attitude
  • irritability to others,
  • abrupt change of aggression on tearfulness,
  • fever,
  • drowsiness, general weakness.

The second form is edematous, with such unpleasant symptoms as:

  • breast tenderness
  • swelling of the mammary glands,
  • swelling of the feet, hands and even the face
  • excessive sweating
  • heightened odor sensitivity.

The third form of PMS is called cephalgic. It is expressed in the following symptoms:

  • the sensitivity of the eyeballs, the feeling of pulsation in them,
  • headache, dizziness,
  • feeling nauseous with possible vomiting.

The last form of PMS is manifested in adrenaline crises, therefore it is called crisis. It is provoked by additional stressful experiences, infection and overwork. The most severe PMS has the following symptoms:

  • blood pressure surges,
  • squeezing sensation under the breast,
  • cardiopalmus,
  • frightened state, the appearance of the fear of dying,
  • shaking limbs, there is a feeling of numbness in the arms and legs,
  • fainting
  • frequent urination.

How to distinguish PMS from pregnancy to delay

Symptoms of PMS are often confused with signs of pregnancy, but if you understand the nuances, these two states are easily separated. The first thing a girl pays attention to is “I started eating a lot.” Then immediately comes the conclusion - “pregnant”, but increased appetite and a change in taste preferences are characteristic of both pregnancy and PMS. If you look, then toxicosis begins after a delay, and does not manifest itself before. It turns out that there is nothing to worry about because of the desire to eat chocolate, if there has not yet been a delay.

There are other factors that can separate the signs of PMS before menstruation from pregnancy:

  1. Backache. It occurs more often at a later stage of pregnancy. If you do not have a decent tummy yet, this is a symptom of PMS.
  2. Emotional condition. Pregnancy causes mood swings, i.e. it can be bad and then improve dramatically. Premenstrual syndrome causes only depression and depression.
  3. Lower abdominal pain. During pregnancy, it is unobtrusive and short-term, while with PMS it is stronger and can last for one day or throughout menstruation.
  4. Menstrual cycle. If you celebrate it regularly, you will be able to determine the next beginning of your period. A delay of one to two days is allowed and does not yet indicate pregnancy.
  5. Highlight. If the blood is released in the period long before the onset of menstruation and in scant amounts - this indicates a possible pregnancy. The egg cell digs into the body of the uterus, which causes the appearance of several pinkish drops of blood.
  6. Basal temperature. In the period of ovulation, it increases. What basal temperature should be before menstruation? It falls from 37.1 to 36.7 ° C. If the temperature does not go down - this may indicate pregnancy or inflammation of the cervix.
  7. Already with a delay, due to the progesterone produced, thick secretions may appear, with the passage of time they become watery - a characteristic symptom for the state of pregnancy.
  8. A pregnancy test is the most effective method. Buy in a pharmacy and, following the instructions, make a test to know the result with accuracy.

Premenstrual syndrome

Premenstrual syndrome, or PMS, are called vascular, neuropsychiatric and metabolic-endocrine disorders arising during the menstrual cycle (usually in the second phase). The synonyms of this condition occurring in the literature are the concepts of "premenstrual disease", "premenstrual tension syndrome", "cyclic disease". Every second woman at the age after 30 years is familiar with premenstrual syndrome, this condition is less common in women under 30 years old - in 20% of cases. In addition, the manifestations of premenstrual syndrome are usually companions of emotionally unstable, thin, asthenic body type of women, most often engaged in the intellectual sphere of activity.

Causes of premenstrual syndrome

So far, gynecology as a science cannot unambiguously tell which factors and causes underlie the development of premenstrual syndrome. It is believed that earlier severe stresses, neuroinfections, surgical abortion, injuries and operations, as well as various gynecological and somatic diseases that create the background for the manifestations of premenstrual syndrome, contribute to the emergence and more severe course of PMS.

The most common is the opinion that the causes of the development of premenstrual syndrome are hormonal fluctuations that occur in the female body during the menstrual cycle. These observations underlie hormonal theories of the origin of premenstrual syndrome.

One of the theories considers as a fundamental cause of premenstrual syndrome - a change in the ratio of hormones of progesterone and estrogen in the second half of the menstrual cycle. Excess production of estrogen leads to fluid retention in tissues, edema, swelling of the mammary glands, cardiovascular disorders. The effect of estrogens on brain structures causes neuroemission disorders — depression or aggression, irritability, tearfulness, etc. Another hormonal theory links premenstrual syndrome with hypersecretion of the hormone prolactin, which causes water and sodium retention and changes in the mammary glands.

In the development of premenstrual syndrome, a certain role of prostaglandins is also proved - hormone-like substances produced in the tissues of the body and participating in the regulation of many physiological processes. Excess prostaglandins cause migraine-like headaches, digestive disorders, vegetative-vascular reactions.

Other numerous theories consider as disorders of water-salt metabolism (the theory of water intoxication), vitamin deficiency (vitamin A, B6) and trace elements (calcium, magnesium, zinc), genetic factor, hypothalamic disorders as causes of premenstrual syndrome. A number of researchers believe that premenstrual syndrome is caused by a whole complex of reasons that are individual in each clinical case. Therefore, the diagnosis of premenstrual syndrome has its own specifics and certain difficulties.

Symptoms of premenstrual syndrome

Based on the leading symptoms accompanying premenstrual syndrome, the following forms of disorders are distinguished: neuropsychiatric, cephalgic, edematous, crisp, atypical. Often, these forms of premenstrual syndrome do not exist in isolation, so PMS treatment is usually symptomatic.

The neuropsychiatric form of premenstrual syndrome is characterized by disturbances in the emotional and nervous spheres: insomnia, weakness, instability of mood, irritability, tearfulness, aggression, fatigue, causeless melancholy, depression (up to suicidal thoughts), unreasonable feelings of fear, sexual disorders, auditory and olfactory disorders , dizziness. Against the background of neuropsychiatric disorders, there are also disorders in appetite, flatulence (abdominal distension), tenderness and engorgement of the mammary glands.

The clinical picture of the cephalgic form of premenstrual syndrome is dominated by vegetative-vascular and neurological symptoms: migraine-like headaches, diarrhea, palpitations, pain in the region of the heart, hypersensitivity to odors and sounds, nervousness, insomnia. Characteristic is a headache, throbbing in the temples, accompanied by swelling of the eyelids, nausea and vomiting. Cephalgic form of premenstrual syndrome often develops in women with a history of history, who have suffered head injuries, neuroinfections, and severe stress. Of the accompanying pathologies, these women usually suffer from cardiovascular pathology, hypertension, and gastrointestinal diseases.

In the edematous form of premenstrual syndrome, interstitial fluid retention and the associated swelling of the face and extremities, weight gain, thirst, and decreased urine output become the leading manifestation. In addition, breast engorgement, itchy skin, indigestion (flatulence, constipation, diarrhea), headaches and joint pain, etc. are noted.

The course of the premenstrual syndrome crisis form is manifested by sympathetic-adrenal crises characterized by bouts of high blood pressure, tachycardia, heart pain without abnormalities on the ECG, panic fear. The end of the crisis, as a rule, accompanies plentiful urination. Often the attacks are triggered by stress and overwork. The critical form of premenstrual syndrome may develop from untreated cephalgic, neuropsychiatric or edematous forms and usually manifests after 40 years. Diseases of the heart, blood vessels, kidneys, and the digestive tract serve as a backdrop for the occurrence of the crisp form of PMS.

The cyclic manifestations of atypical forms of premenstrual syndrome include: an increase in body temperature (in the second phase of the cycle to 37.5 ° C), hypersomnia (drowsiness), ophthalmoplegic migraine (headaches with oculomotor disturbances), allergic reactions (ulcerative stomatitis and ulcerative gingivitis, asthma syndrome, uncontrollable vomiting, iridocyclitis, angioedema, etc.).

When determining the severity of the premenstrual syndrome, the number of symptomatic manifestations is based on, highlighting the mild and severe form of premenstrual syndrome. The mild form of premenstrual syndrome manifests itself with 3-4 characteristic symptoms that appear 2-10 days before the onset of menstruation, or 1-2 significant symptoms. In severe premenstrual syndrome, the number of symptoms increases to 5-12, they appear 3-14 days before the onset of menstruation. At the same time, all of them or several symptoms are expressed significantly.

In addition, an indicator of severe forms of premenstrual syndrome is always a disability, regardless of the severity and number of other manifestations. A decrease in the ability to work is usually noted in the neuropsychiatric form of premenstrual syndrome.

It is customary to distinguish three stages in the development of premenstrual syndrome:

  1. compensation stage - symptoms appear in the second phase of the menstrual cycle and pass with the onset of menstruation, the course of premenstrual syndrome does not progress over the years
  2. stage of subcompensation - the number of symptoms increases, their severity worsens, PMS symptoms accompany all menstruation, the course of premenstrual syndrome becomes heavier with age
  3. decompensation stage - early onset and late cessation of the symptoms of premenstrual syndrome with slight "light" intervals, severe PMS.

Diagnosis of premenstrual syndrome

The main diagnostic criterion for premenstrual syndrome is cyclicity, the periodic nature of complaints arising on the eve of menstruation and their disappearance after menstruation.

The diagnosis of premenstrual syndrome can be made on the basis of the following symptoms:

  • State of aggression or depression.
  • Emotional imbalance: mood swings, tearfulness, irritability, conflict.
  • Bad mood, feeling of melancholy and hopelessness.
  • State of anxiety and fear.
  • Decreased emotional tone and interest in current events.
  • Increased fatigue and weakness.
  • Decreased attention, memory loss.
  • Changes in appetite and taste preferences, signs of bulimia, weight gain.
  • Insomnia or drowsiness.
  • Breast pain, swelling
  • Headache, muscle or joint pain.
  • Worsening of chronic extragenital pathology.

The manifestation of five of the above symptoms with the mandatory presence of at least one of the first four allows you to speak with confidence about premenstrual syndrome. An important part of the diagnosis is to keep a diary of self-observation by the patient, in which she should note all disturbances in her state of health for 2-3 cycles.

The study of hormones in the blood (estradiol, progesterone and prolactin) allows you to establish the form of premenstrual syndrome. It is known that the edematous form is accompanied by a decrease in the level of progesterone in the second half of the menstrual cycle. Cephalgic, neuropsychiatric and crisis forms of premenstrual syndrome are characterized by an increase in blood levels of prolactin. The appointment of additional diagnostic methods is dictated by the form of premenstrual syndrome and leading complaints.

A pronounced manifestation of cerebral symptoms (headaches, fainting, dizziness) is an indication for an MRI or CT scan of the brain to rule out its focal lesions. Indicative of the neuropsychiatric, edematous, cephalgic and crisis forms of the premenstrual cycle are the results of EEG. In the diagnosis of the edematous form of premenstrual syndrome, an important role is played by the measurement of daily diuresis, taking into account the amount of fluid consumed, and conducting tests to study the excretory function of the kidneys (for example, Zimnitsky test, Reberg test). With painful engorgement of the mammary glands, an ultrasound of the mammary glands or mammography is necessary to exclude organic pathology.

Examination of women suffering from some form of premenstrual syndrome is carried out with the participation of doctors of various specialties: a neurologist, a therapist, a cardiologist, an endocrinologist, a psychiatrist, etc. The prescribed symptomatic treatment usually leads to an improvement in health in the second half of the menstrual cycle.

Treatment of premenstrual syndrome

Drug and non-drug methods are used in the treatment of premenstrual syndrome. Non-drug therapy includes psychotherapeutic treatment, adherence to work and a good rest, physical therapy, physiotherapy. An important point is the observance of a balanced diet with the use of a sufficient amount of plant and animal protein, plant fiber, vitamins. In the second half of the menstrual cycle, you should limit the consumption of carbohydrates, animal fats, sugar, salt, caffeine, chocolate, alcoholic beverages.

Drug treatment is prescribed by a medical specialist, taking into account the leading manifestations of premenstrual syndrome. Since neuropsychiatric manifestations are expressed in all forms of premenstrual syndrome, almost all patients are shown to take sedatives (sedatives) drugs several days before the expected onset of symptoms. Symptomatic treatment of premenstrual syndrome involves the use of painkillers, diuretics, antiallergic drugs.

The leading place in the drug treatment of premenstrual syndrome is specific hormone therapy with progesterone analogues. It should be remembered that the treatment of premenstrual syndrome is a long, sometimes continuing throughout the reproductive period process, requiring the woman to internal discipline and the steady implementation of all doctor's orders.

Which means

How is PMS decrypted and what is this phenomenon? Waiting for the answer to these questions, it is worth remembering that nature has placed the mission of the birth of a new life on a woman. This feature is associated with the monthly rejection of the upper layer of the mucous membrane of the uterus in the form of menstrual bleeding. The process is governed by a change in the concentration of hormones in the body, which are guilty of PMS.

What causes premenstrual syndrome in the first place?

Было время, когда специалисты считали, что пмс у женщин связан исключительно с их душевным состоянием и лежит в плоскости психологии. С развитием медицинской науки было обнаружено, что этот синдром имеет органическое обоснование. Установлено, что в этот период снижается количество эстрогена и прогестерона, что провоцирует:

  • An increase in aldosterone, which retains fluid in the body, affects the overall well-being and functioning of the nervous system,
  • Increasing the concentration of monoamine oxidase in the brain tissue that can cause depression,
  • Reduction of the “hormone of joy” serotonin, which gives a clear understanding of what PMS is for girls, not only for themselves, but also for their loved ones.

Other reasons

The processes occurring in the female body during this period are all the same. But the first signs of menstruation are manifested differently due to the individual response to hormonal fluctuations. Some perceive them sharper, others have it more smoothly and smoothed out. The reason for this may also be some circumstances:

  • "Jumping" indicators of endorphins in the brain and blood that affect the endocrine system and are responsible for reducing sensitivity to physical and mental pain,
  • Errors in nutrition. Lack of vitamin B provokes swelling of tissues, which causes excessive sensitivity of the mammary glands, increased fatigue. Magnesium deficiency causes palpitations, dizziness,
  • Genetic predisposition. As a rule, women from the same family experience similar sensations before menstruation. This applies not only to mothers and daughters, but also twin sisters,
  • Stressful situations, abrupt changes in climatic conditions of life exacerbate the syndrome and its manifestations.

Physiological manifestations

Symptoms of PMS are more pronounced in some, and less pronounced in others. Even if a woman has forgotten about the beginning of a new cycle, they will remind you of the imminent arrival of the monthly:

  • Drawing pain in abdomen and lower back
  • Swelling of limbs, puffiness of face,
  • Weight gain for a couple of kilograms
  • Swelling of the mammary glands, aching pain in them,
  • Head cramps, in severe cases of migraine,
  • Feeling nauseous, sometimes vomiting,
  • "Twisting" pain in the joints and spine,
  • Errors in the bowels (constipation or diarrhea),
  • Changes in eating habits (increased cravings for sweet or salty),
  • Thirst and frequent urination,
  • Quick fatigue or unnatural vigor,
  • Increased skin greasiness and rash on it.

How much does a girl’s PM last depends largely on her immunity, physical health and lifestyle. Usually these symptoms disappear with the onset of menstruation, but they may also linger for a couple of days.

Emotional signs

Often they are transferred heavier than physiological, because they cause bewilderment of others and the woman herself. It is the psychological inadequacy associated with PMS that causes car accidents, undelivered examinations and damaged relationships:

  • Mood swings from heavy gloom to wild fun,
  • An increased emotional reaction to stimuli, in severe cases, can turn into aggressiveness,
  • Drowsiness or, on the contrary, overexcitement and associated insomnia,
  • Inability to concentrate
  • Unreasonable fears, panic.

To exclude mental illness, it is worth knowing for how many days ICP begins. This usually occurs 7-10 days before the month. If this condition accompanies a woman the whole cycle or a significant part of it, you need to look for another cause of the disease along with a specialist. To avoid doubts about your own mental health when ICP begins, you can follow the calendar.

PMS or pregnancy

According to the description, the symptoms before menstruation are difficult to distinguish from the first signs of pregnancy. Especially when it comes to an inexperienced girl. And yet, it’s really possible to do it yourself:

  • Discharge during pregnancy notice in the interval between 6 and 12 days after ovulation, they are short and have a pink-brown color. Pms bleeds bright red and more profuse,
  • Pain in the mammary glands accompanies the entire pregnancy. Areas of the nipples become brighter, darker. With PMS, this does not happen, and breast sensitivity goes to the onset of menstruation,
  • The pains before the menstruation lasts until the beginning of the blood discharge, they are localized in the lumbar region and pelvis. The initial stage of pregnancy gives short, slack cramps for a couple of days,
  • Increasing the temperature, if it happens, with PMC does not linger longer than ovulation occurs. Pregnancy can cause this symptom for 18 days,
  • Nausea with PMS occurs regardless of the time of day. Pregnancy is accompanied by this symptom and vomiting mainly in the morning, complemented by aversion to certain foods and their flavor, an irresistible desire to eat something, sometimes unfit for food. Precursors of menstruation are characterized by an abnormal appetite for any food, but there is no rejection of other dishes and cravings for the inedible.

On the basis of the listed signs, it is possible to determine that this is PMS or pregnancy. The differences of both states are clearly visible with the help of a pharmacy test. More precisely, they will identify the gynecologist with palpation and ultrasound.

Even knowing what PMS is in women and young girls, and the temporary limitation of this condition is not easy to endure. The consolation is that it is characteristic of the majority of the representatives of the beautiful half of the population. There are also drug and other ways to reduce the effect of premenstrual syndrome on the well-being and life of a woman.

The clinical picture of the syndrome includes a number of symptoms:

  1. Neuropsychiatric (these include: irritability, tearfulness, depression, aggression)
  2. Symptoms associated with disorders of the vascular system (these include: headache, pain in the heart, vomiting, nausea, migraine, dizziness)
  3. Symptoms associated with disorders in the endocrine system (these include: swelling, itching, fever, swelling of the chest, sometimes chest pain).

Depending on the symptoms of PMS, the clinical form of the disease is divided into the following types:

In this form of the syndrome, symptoms such as depression, aggression, excessive irritability, tearfulness, general weakness prevail, sensitivity to smells and sounds is increased. This form of PMS is one of the common ones. 43.3% of women experience neuropsychiatric symptoms. The average age of women with such symptoms is from 27 to 37 years. Girls in transitional age are dominated by aggression, and young women often become depressed with PMS.

This form is characterized by headache, dizziness, vomiting, nausea, irritability, depression, pain in the region of the heart, chest engorgement, swelling, and great sensitivity to odors. With this disease, the headache begins in the temporal part and becomes pulsating. 20% of women suffer from cephalgic premenstrual syndrome. It occurs mainly in women of early reproductive age (about 32%) and late age for reproduction (20%).

With this form, swelling of the face and extremities occurs, itching and rash, sweating, pain in the mammary glands. There may also be bloating and general weakness. This form occurs mainly in women in early reproductive age and is 46%. During active reproductive age, symptoms of edematous form occur in only 6% of women.

In this form, panic disorder is observed, starting with an increase in blood pressure, a feeling of squeezing of the chest, there is a fear of death, an unpredictable feeling of anxiety, sweating, shortness of breath. Symptom adrenal crises usually occur in the evening or at night and end in very heavy urination. The crisis form is the hardest, but it is extremely rare in women. Such crises can occur due to prolonged stress, constant fatigue, any infections. In early reproductive age, this form occurs in 4% of women. In active age - 12.5% ​​and 20% in the late.

Symptoms of PMS are very diverse, they number about 200.

The most common symptoms are:

After the onset of menstrual symptoms disappear almost immediately. But if the symptoms do not go away during the menstrual cycle, you should consult a doctor. Since the cause may be some kind of disease, not PMS.

How much continues PMS depends on a woman’s lifestyle, her health and immunity. Some women have PMS more ardently expressed, others less.

Many people think that the causes of the syndrome are related to the woman’s psyche and mental state. But in fact, the cause is a change in the hormonal background of the woman during the menstrual cycle. The syndrome is caused by a violation of the ratio of estrogen and progesterone hormone in the luteal phase of a woman’s cycle. Signs of PMS before menstruation speak of their imminent onset.

The syndrome can not occur in the following cases:

The development of the syndrome occurs not only from a lack of the hormone progesterone, but also depending on the characteristics of the metabolism of progesterone in the central nervous system.

One of the new theories is psychosomatic, where diseases of somatics occupy the original place, and mental disorders appear as a result of hormonal disturbances.

The risk of premenstrual syndrome increases with age. Women living in big cities are more prone to the syndrome than women in villages and villages.

Diagnosis of cyclic syndrome in women

It is difficult to diagnose the disease, due to the large number of symptoms.

To diagnose the syndrome, the main point is the cyclical PMS symptoms that occur before menstruation.

To make a diagnosis, the doctor prescribes blood tests for hormones in two phases of the menstruation cycle. The doctor is studying the history, asking about the complaints of the woman.

Then the doctor performs additional procedures: MRI, mammography, pressure is controlled, an electroencephalogram and rheoencephalography of the brain vessels are necessary.

The state of the central nervous system, the level of brain damage using X-rays are evaluated depending on the age of the patient and the severity of the disease.

In the form of neuropsychiatry, it is necessary to additionally visit a neuropathologist and a psychiatrist, who may prescribe an EEG, craniography, and REG.

For edematous form, you need to monitor the amount of fluid you drink 3-4 days before menstruation and during them. In the normal state of the body fluid is allocated more than 400 ml than it was drunk. A doctor will examine the renal excretory function and may prescribe a mammogram.

When cephalgic - a change in the bones of the cranial vault occurs, so X-rays, EEG, REG are performed, the fundus of the eye looks. In this form, consultation of a neurologist, allergist and oculist is recommended.

In case of a crisis one, diuresis is measured (the volume of urine that is formed within a certain period of time. The pressure and the volume of the fluid consumed are also measured. EEG, craniography and REG are indicated.

The main treatments for PMS are:

To prevent the syndrome, you need to change your normal lifestyle and start taking vitamins. Try to avoid stress, a dramatic climate change. It is highly undesirable to use combined oral contraceptives. Abortions also have a negative effect on the woman’s body, so you should try to avoid them. For the prevention of PMS you need to regularly engage in sports, yoga. Excessive use of alcohol and caffeine detrimental to the body.

When irritability is recommended to take vitamin B6 at a dose of 100 mg, magnesium - 400 mg, calcium - 1000 mg. Reception of vitamins is carried out by a course, you should not abuse them as it can lead to side effects.

What is PMS and what are its symptoms 3

Many women are familiar with strange and unpleasant feelings before regular menstruation. During this period, the most cheerful and balanced personages can turn into furies or monstrous crybaby. To an inadequate psychological state, purely physical, rather uncomfortable sensations are added. Every woman has experienced this condition to a greater or lesser extent at least once in her life. And those who endure it regularly expect with fear not the coming of menstruation, but these few days waiting for them. To get rid of the feeling of helplessness before nature it is worth understanding what PMS is in girls and what causes it.

How is PMS decrypted and what is this phenomenon? Waiting for the answer to these questions, it is worth remembering that nature has placed the mission of the birth of a new life on a woman. This feature is associated with the monthly rejection of the upper layer of the mucous membrane of the uterus in the form of menstrual bleeding. The process is governed by a change in the concentration of hormones in the body, which are guilty of PMS.

Causes and symptoms of premenstrual syndrome in women

A woman’s life is cyclical in everything: the development of the female reproductive system, maturity is the realization of reproductive function, and its extinction is the perimenopausal period. Fertile period: after the formation of the monthly cycle, the possibility of the occurrence of the first pregnancy appears, which ends with childbirth, lactation, the restoration of menstruation and again possible pregnancy.

The menstrual ("lunar") cycle - every (on average) 30 days, the "reproductive life" of a woman begins with a clean slate, with a "clean endometrium." In order to understand what is premenstrual syndrome (PMS) and why it occurs, let us examine the processes occurring during the "lunar cycle".

The menstrual cycle is the time interval from the first day of the subsequent menstruation to the first day, during which numerous hormone-controlled changes occur in the woman's body, aimed at the possibility of the occurrence and preservation of pregnancy.

The key point in the monthly cycle is the maturation and release of the egg into the fallopian tubes and uterus for possible fertilization - ovulation, which divides the MC into “before and after” (phase I and II).

All changes in the reproductive system “before” (i.e., in phase I) are aimed at the maturation of the egg in the ovaries and preparing the endometrium for a possible pregnancy, and “after” (phase II) for the implementation of implantation and preservation of gestation. MC is regulated by a variety of hormones, each of which has its predominant influence in its phase.

Figure 1 - The menstrual cycle (source Pinterest). To view, click on the picture.

In the first phase - the predominant influence of estrogen (secreted by growing follicles under the guidance of follicle-stimulating hormone). The formation of the maximum threshold level of estrogen in the blood is accompanied by the release of luteinizing hormone, which coincides with ovulation.

In phase II - the predominant effect of progesterone. After ovulation at the site of the ruptured dominant follicle, a corpus luteum is formed, which begins to secrete progesterone (a hormone that supports pregnancy). Progesterone causes proliferation of the endometrium, promotes implantation, reduces the effect of FSH.

In the absence of pregnancy, the yellow body gradually begins to "fade away", degrade and the level of gestagens decreases. The second phase ends with menstrual bleeding. Against this background, follicle growth and estrogen secretion is resumed. The loop closes.

1. What is premenstrual syndrome?

Premenstrual syndrome is a combination of various neurological and somatic symptoms that occur only in the second phase of the menstrual cycle and are associated with a change in the dominant effect of estrogen and progesterone.

As a rule, PMS begins to bother 2-10 days before menstruation and passes from the first day of her, but the duration may increase with severe and medium-severe course.

1.2. What is the mechanism of premenstrual syndrome?

In medicine, there are many theories of the pathogenesis of this syndrome. Consider some of them:

  • Hormonal theory. The most well-known theory of hormonal imbalance, proposed by Robert Frank back in 1931 in his treatise on “premenstrual tension,” explains the occurrence of symptoms by an insufficient level of progesterone in the body against the background of a relative excess of estrogen. This condition is observed both in disorders of the ovarian-menstrual cycle (irregular menstruation, an increase in the cycle duration of more than 35-40 days), for example, insufficiency of the luteal phase of the cycle, chronic anovulation, and during its normal course.
  • "Theory of water intoxication" If we consider the pathogenesis in detail, then the key figure from the point of view of this theory is the hormone aldosterone.

    Against the background of relative hyperestrogenem, there is an increase in the secretion of angiotensinogen in the liver, which then transforms into angiotensin-2. Increasing the level of the latter leads to increased production of adenocorticotropic hormone (ACTH) by the anterior pituitary gland.

    On the other hand, an increase in the secretion of ACTH (as a stimulator of catecholamine production - stress hormones) occurs under the influence of stress and a small amount of serotonin, which is also observed in the premenstrual period.

    Progesterone itself acts as an antagonist of antidiuretic hormone (ADH, vasopressin), therefore, against the background of its lack in the premenstrual phase, the production of ADH increases. The goal of ADH is to increase the volume of circulating blood due to the retention of sodium and water in the body, which it achieves by stimulating ACTH.

    Свободные фракции эстрогенов в крови женщины оказывают влияние на подвластные дофамину реакции в центральной нервной и других системах. Изменение активности дофамина в свою очередь также повышают выработку АКТГ.

    As a result, all the ways lead to the fact that the level of an increased amount of adenocorticotropic hormone by the pituitary gland stimulates the adrenal cortex and its production of aldosterone.

    So what is aldosterone responsible for? Aldosterone is a member of the renin-angiotensin-aldosterone system that regulates the exchange of fluid in the body. As a result, tubular reabsorption is inhibited and cellular filtration increases - excessive fluid retention and tissue swelling occur.

    Symptoms are formed from general and local edema: there is an unreasonable temporary increase in body weight by 1-2 kg, swelling of the stroma of the mammary glands gives mastalgia, swelling caused by headaches and flatulence.

    This theory has its supporters and opponents, the pathogenesis is not fully understood, but such a mechanism has the right to be on a par with the rest.

  • Psychosomatic theory. Explains the emergence of mental and then somatic symptoms by the influence of steroid hormones (many estrogens and little progesterone) on the level of dopamine, beta endorphins, melatonin. And they, in turn, contribute to a change in mood and metabolic processes.
  • Allergic Theory - Hypersensitivity to its own steroid hormones - both estrogen and progesterone and fluctuations in their levels. This in some cases explains the connection of the phase of the menstrual cycle with the exacerbation of allergic reactivity - there may be urticaria, pruritus, allergic rhinitis, etc.
  • Prolactin theory. There is a slight increase in the level of prolactin in the second phase of the menstrual cycle or hypersensitivity at its normal concentration. Prolactin modulates the action of many hormones, including aldosterone and vasopressin, contributing to fluid retention and the emergence of appropriate clinical symptoms.
  • Prostaglandin theory. Some symptoms of PMS can be associated with impaired synthesis of prostaglandins E1 and E2, the production of which is subject to estrogen-gestagennymi fluctuations. The production of prostaglandins occurs in many organs and tissues: the brain, mammary glands, the intestinal wall, the glands of the gastrointestinal tract, the kidneys - therefore, a change in their activity affects different systems of the body. Pg E1 deficiency contributes to neuropsychiatric disorders - depression, irritability, nervousness, up to affective disorders. Maintaining Pg E1 levels is helped by eating foods rich in unsaturated fatty acids, magnesium, and B vitamins (especially B6). The deficiency of Pg E2 leads to impaired coordination of the vascular tone of the brain: narrowing of the intracranial and expansion of the extracranial vessels. This is associated with the occurrence of migraine headaches and neurological symptoms.
  • Effect of melanostimulating hormone. Melanocyte-stimulating hormone is produced by the anterior pituitary gland, whose activity falls under the influence of estrogen-progesterone imbalance. The level of melatonin is associated with the amount of endorphins and serotonin (hormones of happiness and pleasure), on which the mood, behavior and human needs depend. And also affects the exchange of prostaglandins, the result of the violation of which is described above.

    So, the pathogenesis of premenstrual syndrome is the result of a multitude of neuro-endocrine disorders in the body, which result from an imbalance of estrogens and progesterone in the second phase of the menstrual cycle, and lead to changes in the secretion of neuropeptides, dopamine, endorphins, prostaglandins, disrupting the vital activity of individual organ systems.

    PMS is caused by dysfunction of some parts of the central nervous system and many organs and systems subject to it, resulting from a combination of a hereditary predisposition to the occurrence of the syndrome - the inferiority of the hypothalamic-pituitary system - with the action of adverse stress factors and an imbalance of sex hormones.

    The presence of various clinical forms of premenstrual syndrome is explained by the fact that each individual organism is characterized by the predominance of one or another mechanism of pathogenesis:

  • 1 In edematous form - activation of the aldosterone mechanism of fluid retention, often determined by a reduced level of progesterone.
  • 2 In the neuropsychiatric form - a violation of the adaptation of the hypothalamic-pituitary system.
  • 3 With cephalgic form - increased reactivity of the adrenal cortex and the influence of catecholamines.

    Common to all forms is the relative or absolute increase in estrogen concentration.

    Some authors, based on the study of electroencephalograms (electrical activity of various parts of the brain), are of the opinion that in the occurrence of the syndrome, neurohormonal disorders at the level of the hypothalamic-pituitary system are primary, which then trigger the rest of the mechanisms through the propagation of signals through the reticular formation to other parts of the brain.

    PMS in women - what is it, why does it occur? Symptoms and treatments

    Many women know firsthand what PMS is in women, its interpretation, symptoms and treatment. Men under this abbreviation often mean the menstruation itself, which is fundamentally wrong. What is behind this name and whether to treat it?

    PMS (stands for “premenstrual syndrome”) - This is a whole set of changes in the woman's body, which is manifested by a change in physical condition and emotional background. It begins to appear on average one week before the onset of menstruation, but a more accurate period is 2-10 days. During this period, changes in the hormonal background occur in the woman’s body, there is an imbalance in the trace elements, which leads to a change in mood and discomfort.

    Premenstrual syndrome (PMS) is a combination of changes in a woman’s body.

    Decoding PMS can be in such variations:

  • premenstrual syndrome,
  • cyclic syndrome
  • premenstrual tension syndrome.

    According to statistics, the symptoms of PMS women are exposed differently in certain age periods. For example, only 1/5 of women under the age of 30 face PMS manifestations. Among the fair sex at the age of 30 to 40 years, signs of PMS occur in almost half. In the later reproductive period, about 60% of them experience it. It is noticed that women are most often exposed to the manifestations of the syndrome, who suffer from underweight and are subject to intellectual stress. It is also found mainly in women of the Caucasians.

    Most often, how many days before menstrual ICP begins, depends on age - it gradually begins to appear in earlier periods and is difficult. It is proved that girls who have only begun monthly, do not face PMS manifestations at all. Exceptions occur in extremely rare cases.

    It is noted that during this period the woman becomes more irritable, she is subject to frequent changes of mood. There may be slight pain in the abdomen and engorgement of the mammary glands. Many girls cannot understand whether PMS or pregnancy manifests itself in a similar way, but usually with age they learn to recognize the signals of their body.


    When women have PMS, the symptoms gradually increase and completely end with the onset of menstruation. Doctors paid attention to this pattern even in times of ancient medicine. Even then, Galen noticed a correlation between the approaching beginning of a new cycle and the state of a woman.

    More accurate studies were conducted in the middle of the twentieth century. It was found that it is the progesterone level and its relationship with the level of estrogen in the body that affects the onset of PMS symptoms. It was also noted that during this period women are deficient in vitamin B9 and magnesium.

    Doctors still do not know the cause of PMS

    There are no exact reasons why the PMS occurs and what causes PMS. It is noticed that this state can become the reason for committing rash actions and impulsive decisions. During this period, the fair sex may feel a kind of malaise, which sometimes causes them to doubt - PMS or pregnancy becomes the cause of this condition.

    Doctors distinguish such aspects as provoking factors:

  • lowering the level of the hormone of happiness - serotonin,
  • pyridoxine deficiency (vitamin b6),
  • magnesium deficiency
  • weight disorders - both its deficiency and excess,
  • heredity,
  • frequent hormonal surges: COC reception, abortions,
  • smoking.
  • Interesting fact:According to the theory of the Australian biologist Michael Gillings, the appearance of PMS has an evolutionary background. During this period, hormonal changes are changing so that a woman can diverge from that male whose fertility is low.

    A distinctive feature of this condition is the fact that during PMS the symptoms always differ quite brightly. Some doctors identify up to 150 different symptoms of the syndrome. It is believed that normally there are up to 4 signs. If the indicator is from 4 to 10, these are manifestations of PMS of moderate severity, and over 10 is already a severe syndrome, which usually leads to disability of the woman. Knowing the specific signs, you can easily navigate how to distinguish PMS from pregnancy.

    Vegeto-vascular manifestations

    During PMS, a large number of signs of the cardiovascular system begin to appear in women. This is due to the fact that an excessive amount of prostaglandins is formed in the body, which provoke such states:

  • sudden jumps in blood pressure
  • migraine,
  • dizziness,
  • nausea,
  • vomiting
  • heart rhythm disorders
  • may start to hurt the heart.

    Such symptoms are quite rare, but with age, the probability of their occurrence increases.

    Psycho-emotional manifestations

    The most common "herald" of the beginning of a new cycle is the engorgement of the mammary glands: with PMS, the breast of most girls hurts. But no less rare are changes in the emotional background, which are much more noticeable to others than chest pains.

  • Quick mood swings. It is during this period that the frequency of drops can be very large. Knowing what PMS is in girls, one can easily distinguish this period just for the indicated symptom.
  • Depression and depression.
  • Increased irritability, which often causes impulsive action.
  • Sleep disturbances - both its absence and excessively long “hibernation”.
  • Distraction during this period is more acute than ever. Some doctors even compare this condition with pregnancy and find a relationship between the increase in progesterone level and forgetfulness.
  • Panic attacks. This feature is extremely rare and often indicates a crisis form of the syndrome.
  • Increased aggressiveness.
  • The emergence of suicidal tendencies. Thoughts of suicide can appear up to several times a day - women face this extremely rarely, but this symptom also occurs.

    Important!PMS delay, as well as its too early appearance, can be a cause of hormonal disturbances. If a woman is systematically confronted with manifestations of the syndrome, but they suddenly ceased, it is necessary to consult a doctor.

    PMS in women can take place in several forms:

  • Neuropsychic form. In this case, violations from the emotional sphere most often occur.
  • Cephalgic form. It is characterized by strong and prolonged migraines.
  • Edematous form. Caused by violations of water-salt balance and leads to the accumulation of fluid in the tissues. Frequent thirst also occurs and blood pressure may increase.
  • Crisis form. It is considered one of the most difficult. Accompanied by strong pressure surges and loss of efficiency during this period.

    A woman’s mood during PMS may change frequently

    When PMS occurs, treatment is carried out only in cases where the syndrome interferes with daily life. Deciphering the ICP shows that with the onset of menstruation, the signs disappear on their own. But in some cases, when the syndrome is prolonged in time and leads to serious disruption of work, specialized treatment is carried out to alleviate its symptoms.

    Drug treatment

    In the presence of psycho-emotional disorders, a woman is prescribed antidepressants or tranquilizers. For mild symptoms, sedatives may be prescribed. But their reception should be strictly controlled by a doctor. Which group of drugs will be prescribed, it is the doctor who decides on the basis of how clearly the symptoms appear.

    In the presence of migraines, it is recommended to use ibuprofen-based anesthetics. Such drugs quickly eliminate unpleasant symptoms. Increased edema will be the reason for receiving diuretics, which should be started several days before the onset of PMS.

    Home Treatment

    More often home treatment is given, which helps to get rid of the lung manifestations of the syndrome:

  • Exercise increases the level of endorphin in the blood and helps to overcome depression.
  • A good sleep will help normalize the nervous system and soften mood swings.
  • It is necessary to limit the intake of caffeine and sweets for this period. This will help avoid weight gain, rash and facilitate metabolism.
  • Take vitamins. Vitamins of group B and vitamin C help especially well. Their regular use helps to keep working capacity.


    Prevention of PMS in women should be done every month a few days before the start. Usually, the above recommendations about home treatment methods are sufficient - they help to normalize the functioning of the nervous system and relieve unpleasant symptoms. Knowing what to do with PMS, it is much easier to transfer this period both independently and facilitate it for others.

    PMS: symptoms and methods of their relief. How to prevent premenstrual syndrome ruin your life?

    PMS has long ceased to be an exclusively medical term. Uninformed people tend to explain to PMS any relationship problems, dissatisfaction, irritability, and the complex nature of some women in general. However, PMS - premenstrual syndrome - is manifested not only by changes in mood. This is a complex set of symptoms, and all of them give women suffering from PMS a lot of anguish.

    PMS is a phenomenon not studied enough and to some extent mysterious, even for doctors. Most likely, in order for PMS to be pronounced, several factors must come together. There is no doubt that the main cause of PMS is the monthly fluctuations in the level of hormones, which cause a decrease in the production of certain neurotransmitters - in particular endorphins, which are responsible for a good mood.

    However, things are not so simple. Far from all women experience the ICP effect on a regular basis, and some are not at all familiar with this phenomenon in their own practice. Others experience the full range of all symptoms monthly. Scientists believe that genetics play an identical role (identical twins, genetically identical, are equally affected by PMS) and lifestyle (an unbalanced diet and a lack of vitamins and minerals cause an aggravation of symptoms).

    Premenstrual syndrome appears 2-10 days before the onset of menstruation and, as a rule, stops with the first discharge. It is noticed that the older a woman is, the longer her ICP lasts and the more pronounced it becomes.

    Forms of premenstrual syndrome and their manifestations

    Mood swings are by no means the only sign of PMS. This condition can seriously affect both the psychological and physical condition of the woman.

  • Anxiety, irritability, tearfulness, feeling of depression.
  • Frequent and mood swings.
  • Sleep problems - insomnia, constant night awakening, daytime sleepiness.
  • Fatigue, lethargy and passivity.
  • Distraction, difficulty concentrating.

    Physical symptoms of PMS:

    • Soreness of the mammary glands, an increase in their volume.
    • Edema, sometimes quite noticeable.
    • Migraine or dizziness.
    • Nausea and vomiting.
    • Pain in the back and joints.
    • Thirst, which is accompanied by frequent urination.
    • Gastrointestinal disorders.
    • Attacks of palpitations, fever.
    • The appearance of irritation on the skin.
    • Traction to food - mainly to sweet and salty.

    Stress and overwork are risk factors for PMS. It has been observed that residents of large cities suffer from premenstrual syndrome more often than residents of villages, and workers more often than housewives.

    If the case is limited to only 2-3 symptoms from this list, then we can talk about a mild form of PMS. If you are familiar with 5 signs of PMS or more or fewer symptoms, but they are pronounced and make themselves known 2 weeks before the onset of menstruation, then this is already a severe degree.

    ПМС может стать очень серьезной проблемой — некоторых женщин этот синдром лишает работоспособности на несколько дней, он не лучшим образом сказывается на отношениях с домашними, да и самой женщине бывает тяжело ежемесячно переносить «маленькую депрессию», которая к тому же сопровождается разладом во всем организме.


    На сегодняшний день точно неизвестно, когда возникли учения о предменструальном синдроме. Another Roman doctor Soran Efessky suggested that the sickness of a woman before menstruation depends on the area where the woman lives, and the ancient physician Galen talked about the links between the painful condition of women a few days before cyclic bleeding with the phases of the moon. However, the first scientific studies on the cyclical nature of fluctuations of some physiological parameters were made by Russian scientists Alexander Reprev and Dmitry Ott. In 1931, Robert Frank in his article "Hormonal causes of premenstrual tension" (eng. The hormonal causes of premenstrual tension) gave an official definition of this condition - "premenstrual tension" (also called premenstrual tension), and also formulated and explained some of the causes of physiopsy violations. In his opinion, part of the symptoms he studied were due to a decrease in the serum level of progesterone. After 10 years, Lewis Gray described the woman's psychosexual disorders during PMS [2]. Since that time, the disease is considered a nosological unit, which is included in the classification of diseases of the 10th revision by the World Health Organization [6].

    Over time, attention to the problem of this symptom increases. This can be explained by an increase in the incidence of the disease and socio-economic aspects, since in about 5% of cases the symptoms are pronounced and cause a decrease in the working capacity and level of family and social adaptation [6].

    According to the hypothesis of the Australian biologist Michael Gillings, explaining the feasibility of the existence of premenstrual syndrome (PMS) from the point of view of natural selection, with the preceding menstrual nervous and irritable state, the chances of separation of a woman with a fruitless partner increase, which is an evolutionary advantage due to which PMS remained in the population [ 7].

    In modern medicine, the following clinical forms of premenstrual syndrome are distinguished [8].

    • Neuropsychic - in this form, symptoms such as: irritability, depression, weakness, tearfulness, aggressiveness predominate. Depression predominates in young women, and aggression is determined in perimenopausal women [9].
    • Edematous - this form is characterized by the development of pronounced engorgement and soreness of the mammary glands, swelling of the face, legs, fingers. Many women have sweating, increased sensitivity to odors [9].
    • Cephalgic - characterized by the development of a pulsating headache radiating to the eyeballs. Headaches are usually accompanied by nausea, vomiting. Blood pressure does not change. Approximately one third of patients with this form have depression, pain in the heart area, excessive sweating, and numbness of the hands [9].
    • Crisis - characterized by sympathetic-adrenal crises. Crises begin with a rise in blood pressure, then there is a feeling of pressure behind the sternum, the fear of death, a feeling of rapid heartbeat. Usually crises most often occur in the evening or at night and can be caused by stressful situations, fatigue, and infectious diseases. Crises can often result in copious urination [9].
    • Atypical[1] .

    In addition, premenstrual syndrome is divided into stages [1]:

    • compensated (symptoms at the stage do not progress with age and stop with the onset of menstruation),
    • subcompensated (the severity of premenstrual syndrome at this stage is aggravated with age, and the symptoms disappear only after the end of menstruation),
    • decompensated (at this stage, the symptoms of premenstrual syndrome continue for several days after the cessation of menstruation, and the intervals between their cessation and appearance are reduced).

    Depending on the severity of the clinical signs, PMS is divided into mild and severe degrees [10].

    Today, the following major risk factors for the development of premenstrual syndrome can be distinguished [2]:

    • Caucasians,
    • living in large cities
    • intellectual work,
    • the presence of PMS in an identical twin sister,
    • late reproductive age
    • the presence of stress and depression,
    • frequent pregnancies or, on the contrary, their absence,
    • miscarriages or abortions,
    • toxicosis of pregnant women,
    • the presence of side effects when taking combined oral contraceptives,
    • gynecological surgery
    • inflammatory diseases of the reproductive organs,
    • genital candidiasis,
    • head injuries,
    • neuroinfection,
    • other neuroendocrine diseases
    • lack of physical activity
    • unbalanced nutrition.

    The frequency of premenstrual syndrome completely depends on the age of the woman: the older - the more frequency, it ranges from 25 to 90%. At the age of 19 to 29 years, PMS is observed in 20% of women, after 30 years, the syndrome occurs in about every second woman. After 40 years, the frequency reaches 55%. There were also cases when premenstrual syndrome was observed in girls immediately after the onset of menarche. In addition, more often PMS is observed in emotionally labile women with a lack of body weight and intellectual stress. Certain factors, such as childbirth and abortion, neuropsychic stresses, and infectious diseases play a certain role in the manifestation of the symptoms of cyclic syndrome. Most often, PMS occurs in women with disorders of the central nervous system, gastrointestinal tract, and cardiovascular system and can be observed both during the ovulatory cycle (a cycle in which the egg leaves the ovary into the body cavity) and during anovulatory (the in which there is no release of the egg) [3] [6] [9] [11].

    Currently, the etiopathogenetic mechanisms of the syndrome are not well understood. There are many hypotheses explaining the onset of PMS symptoms, but at the moment there is no clear pathophysiological and biochemical substantiation of its occurrence and development. Today, scientists are considering several theories of the etiology of premenstrual syndrome [12]:

    • hormonal,
    • allergic,
    • the theory of "water intoxication"
    • theory of hyperadrenocortical activity and an increase in aldosterone [3],
    • theory of psychosomatic disorders [8].

    The very first established theory of the genesis of premenstrual syndrome is hormonal, founded by Robert Frank. In 1931, he suggested that premenstrual syndrome is due to a violation of the ratio of estrogen and progesterone in the luteal phase of the menstrual cycle. The excess of the first hormone and the lack of the second contributes to the development of such symptoms as, for example, headache, weakness, increased fatigue, decreased diuresis. This is explained by the fact that a large amount of estrogen causes hypoglycemia, which is characterized by a feeling of fatigue, and the lack of progesterone leads to fluid retention in the body [12] [13]. The main provision of the hormonal theory is the thesis: “PMS does not exist without ovarian activity,” that is, premenstrual syndrome cannot occur before puberty, after menopause, during pregnancy and in women who have no ovaries [2].

    Currently, there are works that prove that the hormonal background of a woman does not change with PMS (for example, Oettel's work in 1999). In this regard, it can be assumed that premenstrual syndrome develops not only from progesterone deficiency, but also from the characteristics of its metabolism in the central nervous system. In normal metabolism, progesterone is able to form allopregnanolone, which stimulates the GABA-A receptors, and also increases the activity of the chloride ion channels of the neural membranes, providing a sedative effect. When metabolic disorders of progesterone in the CNS, the hormone produces pregnanolone, which is an antagonist of the A and B-GABA receptors, the presence of which may explain the clinical manifestations of PMS. Also pregnanalon can cause depression, often occurring in premenstrual syndrome. In addition, changes in the content of androgens (such as testosterone, androstenedione, etc.), corticosteroids, as well as hyperproduction of the posterior and middle lobes of the pituitary [2] are considered in the hormonal theory of PMS.

    According to allergic theory, premenstrual syndrome is the result of hypersensitivity to endogenous progesterone. It is possible to prove its essence with the help of a positive intracutaneous test with sex steroid hormones in the luteal phase of the menstrual cycle [2].

    Theory of "water intoxication" states that fluid retention in patients with PMS is caused by neuroendocrine disorders, for example, changes in the renin-angiotensin-aldosterone system. It is assumed that an increase in the secretion of adrenocorticotropic hormone by the pituitary gland under the influence of stress, as well as high levels of the hormones serotonin and angiotensin II affects the increase in the formation of aldosterone. Angiotensinogen, in turn, is secreted by the liver under the influence of estrogens, and renin is an enzyme that converts angiotensinogen to angiotensin [12].

    Theory of hyperadrenocortical activity and an increase in aldosterone hypothesizes that estrogens can increase plasma renin levels by increasing liver angiotensinogen, which increases the activity of hormones renin and angiotensin II, which leads to an excess of aldosterone. In turn, progesterone increases renin activity, resulting in increased secretion and excretion of aldosterone. Thus, with aldosteronism, sodium reabsorption occurs in the renal tubules, during which potassium and calcium are lost, and fluid accumulates in the tissues, and progesterone is an aldosterone antagonist, which means that if it is deficient, secondary hyper aldosteronism may develop [3].

    The most modern theory of the genesis of PMS is theory of "disorders of neurotransmitter metabolism in the CNS. According to this hypothesis, premenstrual syndrome can be considered as a functional disorder of the central nervous system due to the action of external factors against the background of the congenital or acquired lability of the hypothalamic-pituitary – varial system [2].

    In recent years, in the pathogenesis of ICP, considerable attention has been paid to peptides intermedial lobe of the pituitary gland: melanostimulating hormone. This hormone, under the influence of sex steroids and when interacting with endorphin, can contribute to mood changes. Endorphins can also cause changes in mood, behavior, appetite and thirst. In some cases, the result of an endorphin-induced increase in the levels of prolactin, vasopressin and their inhibitory effect on the action of prostaglandin E may include engorgement of the mammary glands, constipation, fluid retention and flatulence [8].

    In addition, the development of premenstrual syndrome may be due to the presence of avitaminosis in the luteal phase of the menstrual cycle [3].

    The woman's menstrual cycles are directly connected with the ovaries and, accordingly, with estrogen. The most active hormone of the estrogen group is estradiol, which is synthesized in the follicles, the other two estrogens, which are derivatives of estradiol, are synthesized even in the adrenal glands and placenta. During the menstrual cycle, these hormones induce proliferation of the endometrium and vaginal epithelium, as well as increased secretion of mucus by the cervical glands. In addition, the secretion of estrogen stimulates the manifestation of secondary sexual characteristics in women, an increase in the mammary glands during pregnancy, the synthesis of a number of transport proteins and regulates the luteinizing hormone and GnRH [14] [15].

    Progesterone, in turn, is produced by the yellow body of the ovary, the placenta and the adrenal glands. It is formed in the second half of the menstrual cycle, acting on the endometrium and inducing mucus secretion. As well as estrogen, progesterone is responsible for the increase in the mammary glands of a woman during pregnancy. In addition, this hormone performs the function of restraining the contractile muscles of the uterus, and its use from 5 to 25 days of the menstrual cycle can slow down ovulation [15].

    The clinical picture of premenstrual syndrome is characterized by its symptomatic diversity. It includes [9]:

    • psycho-emotional symptoms (for example, irritability, depression, tearfulness),
    • symptoms of vegetative-vascular disorders (headache, nausea, vomiting, pain in the heart),
    • symptoms that reflect metabolic and endocrine disorders (engorgement of the mammary glands, swelling, itching, fever, etc.).

    Depending on the prevalence of certain symptoms, there are four main clinical forms of the disease: neuropsychiatric, edematous, cephalgic, and crisp. In addition, depending on the number, duration and intensity of symptoms during PMS, mild and severe forms of the disease can be distinguished. The mild form of PMS includes a condition in which there are 3–4 symptoms 2–10 days before menstruation, and a severe form includes a condition characterized by 5–12 symptoms 3–14 days before the onset of menstruation. Three stages of the syndrome are also distinguished: compensated, subcompensated and decompensated [8].

    Clinic neuropsychic form PMS is characterized by symptoms such as irritability, depression, weakness, aggressiveness, tearfulness, and also increased sensitivity to smells and sounds, numbness of the extremities, engorgement of the mammary glands and flatulence. It has been noted that while young women with this form of premenstrual syndrome are dominated by depression, then aggressiveness prevails in transitional age. The neuropsychic form ranks first in prevalence among other forms, it is observed in approximately 43.3% of female patients. The average age of patients with this form of PMS is 33 ± 5 years. In early reproductive age, this form is registered in 18%, in active reproductive - in 69%, in late - in 40% of those suffering from premenstrual syndrome [2] [8].

    In the clinical picture edematous form PMS is dominated by tenderness of the mammary glands, swelling of the face and extremities, bloating, itchy skin, and sweating and weakness. Most women with PMS in the luteal phase have fluid retention up to 500-700 ml. The edematous form of premenstrual syndrome ranks third in terms of prevalence among other forms of cyclic disease, yielding to neuropsychiatric and cephalgic (found in 20% of women). This form of PMS is most common in women of early reproductive age (≈ 46%), and the least edematous form is found in women of active reproductive age (≈ 6%) [2] [8].

    Clinical picture cephalgic form Premenstrual syndrome is characterized by headaches, irritability, nausea, vomiting, dizziness, increased sensitivity to smells and sounds, depression, heart pain, engorgement of the mammary glands, numbness of the hands, sweating. Headache with this form of the disease is pulsating, twitching and begins in the temporal lobe. Cephalgic PMS is characterized by a severe course with constant relapses. In terms of prevalence, this form takes the second place and occurs in about 20% of women suffering from the syndrome. Most often observed in patients of early and late reproductive age (≈ 32% and 20%, respectively) [2] [8].

    With crisis form PMS pronounced sympathoadrenal crises, which begin with increased blood pressure, the emergence of the fear of death, a feeling of pressure on the chest, numbness of the extremities. Crises, as a rule, occur in the evening or at night and end with abundant urination. Such crises can be the result of prolonged stress, fatigue, infections. This form is the most severe manifestation of premenstrual syndrome, but the least common. Only in 4% of patients of women of early reproductive age, there is a crisp form of PMS, in 12.5% ​​of patients of active fertile age and in 20% of late [2] [8].

    However, in addition to these four basic forms of premenstrual syndrome, there is atypical form, including the hyperthermic, hypersomnic forms, the ophthalmoplegic form of migraine, as well as cyclic allergic reactions. Hyperthermic form characterized by an increase in body temperature in the second phase and its decrease with the onset of menstruation, hypersomnic form - drowsiness in this phase of the menstrual cycle. Ophthalmoplegic form of migraine characterized by unilateral closing of the eye, as well as hemiparesis in the luteal phase. Cyclic allergic reactions include ulcerative gingivitis and stomatitis, vomiting, bronchial asthma, iridocyclitis, menstrual migraine [1].

    To date, more than 200 symptoms of premenstrual syndrome are known, but irritability, tension and dysphoria are considered the most common [16].

    It is shown that the symptoms of premenstrual syndrome are more pronounced if a woman’s blood contains more C-reactive protein (HS-CRP), the level of which increases with inflammation [17].

    В связи с тем, что симптомов ПМС насчитывается огромное количество, в диагностике заболевания имеются некоторые трудности. Основой проведения диагностики является цикличность патологических симптомов, возникающих за несколько дней до менструации. Women suffering from this syndrome often turn to specialists of different professions depending on the prevalence of certain symptoms, but sometimes doctors, unaware of a PMS patient, consider the treatment of these symptoms to be positive, although in fact the same effect will be without treatment immediately after the beginning. the first phase of the menstrual cycle, and with the onset of the luteal phase in a month, only a worsening of the patient’s condition is noted [4] [8] [9].

    Often, the establishment of a diagnosis helps a woman to keep a peculiar diary in which all the symptoms are noted daily during the whole menstrual cycle. In addition, it is necessary to conduct an electroencephalogram and cerebral vascular rheoencephalography, the definition of prolactin, PGE2, progesterone in the blood before and during menstruation. Depending on the severity of the disease and the age of the patient, the state of the central nervous system is also assessed, the levels of brain damage are determined using x-ray and neurophysiological studies [8] [9].

    In the neuropsychic form of PMS, it is necessary to consult a neurologist and a psychiatrist, who, as a rule, prescribe EEG, REG, and craniography. In edematous form, it is necessary to monitor diuresis and the amount of fluid consumed within 3-4 days before and during menstruation (in the normal state of fluid emitted 300-400 ml more than drunk). With this form of cyclic syndrome, mammography may be prescribed, residual nitrogen and creatinine levels are also determined, and renal excretory function is investigated [12]. When the cephalgic form of premenstrual syndrome is observed, changes in the bones of the cranial vault and the Turkish saddle are observed, in connection with which X-rays are taken, EEG, REG are performed, and the fundus is examined. It is recommended to consult a neurologist, an oculist and an allergist [8] [9]. When the ICP is in the form of a frost, diuresis, the amount of fluid consumed and blood pressure are measured. Conducted EEG, REG of cerebral vessels, craniography [13].