Premenstrual stress syndrome
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Template:DiseaseDisorder infobox | }} Template:Redirect Premenstrual Stress Syndrome (PMS, also called Premenstrual Stress, Premenstrual Tension, PMT, Premenstrual Syndrome, Periodic Mood Swing) is stress which is a physical symptom prior to the onset of menstruation. PMS should not be confused with dysmenorrhea, which refers to pain or cramps during menstruation.
PMS is exceedingly common, occurring in 75% of women of reproductive age during their lifetime. A more severe form of PMS is premenstrual dysphoric disorder (PMDD). This occurs in about 5% of women. Both are characterized by symptoms of mood swings, depression, anxiety and irritability that occur prior to menses, usually in the two week period between ovulation and menses. It is often accompanied by physical symptoms bloating and cramping.
Diagnosis and treatment
Diagnosis of PMDD differentiation from major depression and anxiety disorders.
Treatment usually begins with lifestyle modification. Reducing caffeine, sugar, and sodium intake may help. Supplements of vitamin B6 and calcium carbonate have been shown to help alleviate some symptoms; calcium carbonate should be taken in doses of 1200 milligrams a day. Exercise will help reduce depression and anxiety symptoms. Keeping a symptom diary will help cue sufferers to exacerbating and relieving strategies.
Prescription treatments include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). While commonly described as the selective serotonin reuptake inhibitors, several drugs of this class (such as fluoxetine) have been demonstrated to increase the bioavailability of the neurosteroid allopregnanolone by altering the metabolic favorability of the reaction.
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Herbal treatments include Vitex (Chasteberry) and Evening primrose (Oenothera Biennis). Both herbs have been proven to remedy the symptoms of PMS. Template:Fact They work by stimulating and normalizing the pituitary gland, which regulates the balance of estrogen in the body. Template:Fact
Controversial views
In a 1989 study of menstruating women, Cathy McFarland and colleagues discovered that study participants recalled feeling worse during the two weeks preceding ovulation and menses than the intermenstrual period or during menstruation. However, the daily record of the women's moods suggested that their actual mood varied very little over the course of their cycle.
Other studies have shown that for many PMS sufferers, placebo drugs work just as well as pharmaceuticals in providing relief. A controversial and not widely-accepted theory holds that PMS may be a socially constructed disorder with enough symptoms that almost anyone (including men) could feign its existence.
Four major explanations have been proposed to explain the existence of PMS:
- The feminist perspective proposes that PMS is the result of patriarchal forces.
- The social constructionist perspective proposes that social forces (but not necessarily the patriarchy) result in PMS.
- The psychosomatic perspective proposes that there is a cognitive interpretation of bodily signals that, perhaps due to social or biological forces, results in PMS.
- The biomedical perspective proposes that PMS is the psychological result of biological changes associated with the menstrual cycle.
Most new research on PMS is biomedical in nature, with feminist research following as the second largest source of new research. Little new research comes from other perspectives.
Researchers from each of these fields have accused the other field of poor methods. It may take some time to resolve this conflict, as feminism and biology stem from different domains of knowledge (humanities and sciences, respectively), and the researchers are therefore in a poor position to critically evaluate the others' claims, though both sides try.
External links
he:תסמונת קדם וסתית nl:Premenstrueel syndroom pl:Zespół napięcia przedmiesiączkowego sv:Premenstruellt syndrom zh:經前緊張徵候群