Symptoms of Premenstrual Syndrome
Premenstrual syndrome is defined as physical and emotional signs and symptoms which occur in one or two weeks before a woman experiences her periods(Schellenberg, Zimmermann, Drewe, Hoexter&Zahner, 2012), while pathophysiology is the combination of two words pathology and physiology. Pathology refers to a medical discipline describing undesirable condition observable during the state of disease. For instance, Tracey had severe urinary tract infection 13 years ago. On the other hand, physiology is referred to as a biological discipline describing a process that operates in an organism. They are different depending on a woman and revolve around the start of bleeding(Samadi, Taghian&Valiani, 2013). Pathophysiology describes functional changes that occur within an individual as a result of pathogenic state or disease. From the case study, Tracey symptoms are predictable and occur three days or one week before her menses. This has been happening in her last three monthly menses.
Women with premenstrual syndrome may experience, behavioral and Emotional signs and symptoms which includes, food craving, changes in appetite, anger and irritability, mood swings, mood and depression, anxiety and Tension, lack of sleep (insomnia), inability to socialize, Change in libido(Samadi, Taghian&Valiani, 2013). Tracey reports most of these emotional symptoms to Belmont private hospital.
It is the right time to see a doctor if premenstrual signs and symptoms become unmanageable and affect your daily life’s activities(Chung et al., 2014).
It is always never clear what premenstrual syndrome causes are. Instead, some factors contributing towards it have been identified (Schellenberg, Zimmermann, Drewe, Hoexter&Zahner, 2012). These factors may include, cyclic hormones changes indicating premenstrual syndrome signs and symptoms of with changes fluctuationsin hormones which disappears during menopause or pregnancy(Chung et al., 2014). Tracey is approaching her menopause and fluctuation of her hormones istaking place.
Also, chemical changes in the brain may cause the premenstrual syndrome. For instance, serotoninchanges, a chemical of brain (neurotransmitter) which plays a vitalrole in mood changes, could speed the syndrome(Rapkin&Akopians, 2012). Serotonin may contribute to premenstrual sleep problems, fatigue, food cravings, and depression if in insufficient amounts(Samadi, Taghian&Valiani, 2013). Depression is also a major cause of the premenstrual menstrual syndrome(Chung et al., 2014). However, depression alone may not cause all the symptoms experienced in premenstrual syndrome. Symptoms of premenstrual syndrome may repeat themselves over a period and may be easy to predict them(Rapkin&Akopians, 2012).
Differences between the clinical manifestation of polycystic ovary syndrome and premenstrual syndrome management
- The symptoms the patient is currently having. This relates to the history of the condition at reporting time (Danno, Colas, Terzan& Bordet, 2013). A symptom should either be discovered by the patient or the physician or both. It is about behavior change, outward appearance, lacrimation(tearing), diaphoresis(sweating),etc.
- Symptoms the patient reports to have had in the past by relating the current to the past. The doctor records as the patients describe them to him when making diagnoses. The family medical history is also considered(Fauser et al., 2012).
- Medical signswhere the doctor may discover or not an additional symptom. Signs cannot appear without actions.
- Test results. A good doctor must carry out some text to get the facts as s/he is not God.
- There is the presence of both physical and behavioral symptoms that occur interfering with woman’s cycle repetitively in the second half of MP (Schellenberg et al.,2012).
- Before the onset of menses, most women in reproductive age will experience one or more mild physical and emotional for one or two days.
Most common therapies for premenstrual syndrome and lifestyle changes to help with PMS syndrome
Causes of Premenstrual Syndrome
The treatment of premenstrual syndrome is not always easy but very challenging at times. There have been different medication and approaches that have been used in treating the condition(Danno, Colas, Terzan& Bordet, 2013). Some approaches, however, lack scientific basis though they help some women(Chung et al., 2014). Some approaches that have proved to work includes; smoking cessation, physical exercise, salt restriction before the menstrual periods, limiting alcohol consumption, decreased caffeine intake before menstruation, a decrease in consumption of refined sugar(Danno, Colas, Terzan& Bordet, 2013). Since Tracey smoke and take alcohol, she needs to change these habits.
A clear diagnosis to distinguish between premenstrual syndrome and other conditions that may mimic PMS may be administered(Legro et al., 2013). Some condition that may mimic the PMS may include chronic fatigue syndrome, depression, and anxiety, mood disorder or thyroid disorders(Jang, Kim & Choi, 2014). It is advisable to take some test like mood screening or thyroid function test to establish a clear diagnosis(Danno, Colas, Terzan& Bordet, 2013). For Tracey’s case, there is a need to determine whether her condition is caused by stress from her business or related to her menses.
To some women, adjusting lifestyle may help in relieving symptoms of PMS(Jang, Kim & Choi, 2014). For premenstrual syndrome, at times doctors may prescribe one or more medication depending on how severe your symptoms are(Danno, Colas, Terzan& Bordet, 2013). The success of medication for the premenstrual syndrome is different in different women. The most commonly used prescribed medication are; Antidepressants which involves Selective serotonin reuptake inhibitors (SSRIs) and includes; sertraline (Zoloft), paroxetine (Paxil, Pexeva), and fluoxetine (Prozac, Sarafem) has been proved successful in relieving mood swings. The first line best treatment for PMDD and PMS are SSRIs(Marjoribanks, Brown,O’Brien& Wyatt, 2013). They are taken daily but limited to two weeks before menstruation begins for women with PMS(Jang, Kim & Choi, 2014). Tracey needs to adjust her lifestyle of smoking and embrace healthy living.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the other medication which is taken before or during the start of the period like naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others) which helps reduce breast discomfort and ease cramping(Schellenberg, Zimmermann, Drewe, Hoexter&Zahner, 2012). There is also the application of Diuretics to help shed excess fluid through the kidney when exercise and salt reduction does not work well in weight reduction, swelling and bloating of PMS. An example of Diuretics is Spironolactone (Aldactone)which helps in reducing symptoms of PMS. To stop ovulation, prescribing of Hormonal contraceptives is done to relieve symptoms of PMS(Samadi, Taghian&Valiani, 2013).
Differences between the clinical manifestation of polycystic ovary syndrome and premenstrual syndrome management
Lifestyle changes also helpto reduce PMS syndrome(Matsumoto, Asakura& Hayashi, 2013). For instance, changing the way you exercise, eat, or approach life. Diet modification will be of great help and can be achieved by, limiting salt and salty foods to reduce bloating and fluid retention, eat smaller and more frequent meals sensation of fullness and bloating, eating food high in complex carbohydrates like fruits, vegetables, and whole grains and choosing foods rich in calcium(Matsumoto, Asakura& Hayashi, 2013). Also, avoid the intake of alcohol and caffeine. Incorporating exercise in your daily routines at least for 30 minutes a day by brisk walking, cycling, swimming, or other aerobics would help greatly in improving your overall health and alleviating certain symptoms like depressed mood and fatigue.
References
Chung, S. H., Kim, T. H., Lee, H. H., Lee, A., Jeon, D. S., Park, J., & Kim, Y. (2014). Premenstrual syndrome and premenstrual dysphoric disorder in perimenopausal women. Journal of menopausal medicine, 20(2), 69-74.10.6118/jmm.2014.20.2.69
Danno, K., Colas, A., Terzan, L., & Bordet, M. F. (2013). Homeopathic treatment of premenstrual syndrome: a case series. Homeopathy, 102(1), 59-65. 10.1016/j.homp.2012.10.004
Fauser, B. C., Tarlatzis, B. C., Rebar, R. W., Legro, R. S., Balen, A. H., Lobo, R., … &Boivin, J. (2012). Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertility and Sterility, 97(1), 28-38.10.1016/j.fertnstert.2011.09.024
Jang, S. H., Kim, D. I., & Choi, M. S. (2014). Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: a systematic review. BMC complementary and alternative medicine, 14(1),11. 10.1186/1472-6882-14-11
Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013). Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 98(12), 4565-4592. 10.1210/jc.2013-2350
Marjoribanks, J., Brown, J., O’Brien, P. M. S., & Wyatt, K. (2013).Selective serotonin reuptake inhibitors for premenstrual syndrome. Cochrane Database of Systematic Reviews, (6). 10.1002/14651858.cd001396
Matsumoto, T., Asakura, H., & Hayashi, T. (2013).Biopsychosocial aspects of premenstrual syndrome and premenstrual dysphoric disorder. Gynecological Endocrinology, 29(1), 67-73.10.3109/09513590.2012.705383
Rapkin, A. J., &Akopians, A. L. (2012).Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder. Menopause international, 18(2), 52-59. 10.1258/mi.2012.012014
Samadi, Z., Taghian, F., &Valiani, M. (2013).The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls. Iranian journal of nursing and midwifery research, 18(1), 14. 10.1186/s12905-018-0565-5
Schellenberg, R., Zimmermann, C., Drewe, J., Hoexter, G., &Zahner, C. (2012). Dose-dependent efficacy of the Vitexagnuscastusextracts Ze440 in patients suffering from premenstrual syndrome. Phytomedicine, 19(14), 1325-1331. 10.1016/j.phymed.2012.08.006
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