Premenstrual syndrome (PMS) is a cyclic complaint that causes emotional and physical symptoms in the second phase of menstrual cycles. Approximately 80% of women have premenstrual complaints. However, in 3-5% of cases, these complaints are severe enough to affect the woman's work life and social life. Women with premenstrual syndrome experience physical, behavioral and mood changes associated with the second phase of the cycle. There is an abnormal response of the central nervous system to hormonal changes during menstrual cycles. There are many complaints associated with this syndrome. Therefore, it is very important that the patient's complaints are cyclic in the diagnosis of premenstrual syndrome. The patient may experience complaints such as breast swelling, mastodynia, headache, constipation, fatigue, anxiety, libido change, depression, and overeating.
The timing of symptoms is important in diagnosis. At least 5 complaints must be seen one week before the start of menstruation. With the onset of menstrual bleeding, the patient's complaints begin to improve. During the week when menstrual bleeding ends, complaints decrease to a minimum level or disappear completely. The criterion for diagnosis is the presence of at least one of the following complaints: mood lability (suddenly sad or tearful), irritability, depressive mood and anxiety. There may be physical complaints such as impaired concentration, increased appetite, insomnia, swollen breasts, pain, and musculoskeletal pain, but they are not necessary to make a diagnosis. Symptoms affect the patient's work, school and social life.
Educating and informing the patient is important in the treatment. Many PMS women complain of bloating and tightness. They generally do not have any change in weight or edema. Old medical texts describe weight gain due to sudden edema, especially in PMS women with psychological disorders. This is actually related to sudden fluid retention in the unusual form of PMS. Suddenly changing from a low sodium and carbohydrate diet to a high carbohydrate and sodium diet can cause a weight gain of 5 kg in 24 hours in people with PMS. The common desire of PMS patients for sweet and salty foods and dietary changes in this direction may be the cause of this unusual edema. Therefore, consume salt and refined carbohydrates. Reducing this amount helps in the treatment of edema and swelling. Consuming fresh fruits and vegetables and avoiding red meat and foods containing additives can sometimes be beneficial. However, caffeine intake should be reduced in women with intense complaints of insomnia and tension.
Increased desire to drink alcohol and increased alcohol consumption in premenstrual women may cause marital disputes, and patients should be warned about this.
More Frequent feeding is recommended. There are publications showing that calcium supplementation is beneficial.
Regular aerobic exercise reduces PMS symptoms and helps patients relax and sleep.
Drugs containing mefenamic acid may help relieve complaints, but those who are sensitive to aspirin and It should not be used in those with stomach ulcers.
Vitamin B6, antidepressant drugs, drugs related to serotonin metabolism, hormone drugs are other medical treatment options.
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