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PREMENSTRUAL SYNDROME (Premenstrual Tension; PMS)

PREMENSTRUAL SYNDROME
(Premenstrual Tension; PMS)

DESCRIPTION

Premenstrual syndrome consists of symptoms that begin 7 to 14 days prior to a menstrual period and usually stop when menstruation begins. Body parts involved include the gastrointestinal system, the central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord--and peripheral nerves, as well as the skin, reproductive system, and breasts. Premenstrual syndrome affects about half of all females beyond puberty at some time -- some very frequently.
Appropriate health care includes:
  • Self-care.
  • Physician's monitoring of general condition and medications (sometimes).

    SIGNS & SYMPTOMS

  • Nervousness and irritability.
  • Dizziness or fainting.
  • Emotional instability.
  • Increased or decreased sex drive.
  • Headaches.
  • Tender, swollen breasts.
  • Bloating, constipation, diarrhea, or other digestive disturbances.
  • Fluid retention that causes puffiness in ankles, hands, and face.
  • Higher incidence of minor infections such as colds.
  • Acne outbreaks.
  • Decreased urination.

    CAUSES

  • Fluctuations in the circulating level of hormones (especially estrogen and progesterone). These fluctuations cause retention of sodium in the bloodstream, resulting in edema in body tissues--including the brain.
  • Increased levels of prostaglandin (a chemical) in the bloodstream.

    RISK FACTORS
    The older a woman is and the more children she has, the more likely she is to have PMS. Stress in younger women increases the likelihood of PMS.

    PREVENTING COMPLICATIONS OR RECURRENCE

    No specific preventive measures.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.

    POSSIBLE COMPLICATIONS

    Emotional stress caused by symptoms severe enough to disrupt your daughter's life.

    PROBABLE OUTCOME
    Present treatments may or may not be effective. Medication can relieve some symptoms. However, many new treatments are in the experimental stage, offering hope for the future.

    TREATMENT

    HOME CARE

    Reduce your daughter's stress whenever possible. See Appendix 19.

    MEDICATION
    Your doctor may prescribe:

  • Tranquilizers or sedatives to relieve tension.
  • Non-steroidal anti-inflammatory drugs to decrease prostaglandin levels.
  • Diuretics to reduce fluid retention.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS

  • Your daughter should decrease salt intake during the premenstrual phase.
  • Your doctor may prescribe vitamin B-6 (50mg to 100mg daily) and extra calcium (either in tablets or in milk or milk products). These supplements decrease symptoms in some females.

    OK TO GO TO SCHOOL?

    Yes. Try to keep activities normal.

    CALL YOUR DOCTOR IF

  • Your daughter has symptoms of PMS that interfere with normal activities or relationships, and self-care is not sufficient.
  • Symptoms don't improve, despite treatment.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects. ‡
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