Premenstrual syndrome

from Wikipedia, the free encyclopedia
Classification according to ICD-10
N94.3 Premenstrual discomfort
ICD-10 online (WHO version 2019)

Premenstrual Syndrome ( PMS ) is a complex physical and emotional discomfort associated with the menstrual cycle that can occur four to fourteen days before the onset of the menstrual period in any woman's menstrual cycle and which usually stop when the menstrual cycle starts. In one study, every tenth woman of childbearing age reported having regular PMS symptoms.

Symptoms

The severity of PMS varies. A quarter of the women affected complain of pronounced symptoms and three to eight percent of these women suffer from a particularly strong form of PMS, which is then also called premenstrual dysphoric disorder (PMDS). The former suffer from a regular disorder, the latter are considerably limited in their work environment and other social contacts during this time.

Physical symptoms can include:

  • Water retention in the tissue ( edema )
  • Skin changes
  • Fatigue, exhaustion, symptoms of exhaustion
  • Nausea and circulatory problems
  • diarrhea
  • Cramps in the lower abdomen
  • Headache and backache
  • Cravings or loss of appetite
  • Painful tension, swelling, or extreme tenderness of the breasts ( mastodynia )
  • increased sensitivity to stimuli (light, touch, noise, smell, time and work pressure)
  • migraine
  • Faint
  • Bloating
  • Pain in the reproductive organs and pelvis during intercourse ( dyspareunia )
  • Irritations of the mucous membranes
  • Activation of latent foci of inflammation in the body

Mental symptoms can include:

history

The relationship between mental well-being, but especially certain disorders, and the menstrual cycle has been known for a long time. Around 2500 years ago, Hippocrates explained the mood fluctuations depending on the menstrual period as a result of "prevented the outflow of menstrual blood".

At the beginning of the 18th century, menstruation-dependent mental illnesses were researched in more detail. In the 19th century, psychiatrists even assumed that around ten percent of all mental disorders due to organic changes (such as cardiovascular, gastrointestinal, and brain function disorders) in women were related to their menstrual bleeding.

In the first third of the 20th century, the close connection between certain mental symptoms and changes in the so-called ovarian hormone balance during the menstrual cycle was finally recognized . In particular, it was found that depressive and anxious moods mainly occur in the second phase of the cycle after ovulation (luteal phase or corpus luteum phase ), while mental well-being can be observed more frequently in the first half ( follicular phase ) of the menstrual cycle.

Robert T. Frank identified premenstrual symptoms for the first time in 1931 as a separate clinical entity; He described this as a combination of physical and psychological symptoms and called it “premenstrual tension”. In 1953, Raymond Greene and Katharina Dalton emphasized the complexity of the symptoms and referred to them as "premenstrual syndrome". By 1969, 150 symptoms had been described in the literature. In 1980, Katherina Dalton drew attention to the need for standardized criteria for diagnosis. In 1985, Premenstrual Dysphoric Disorder (PMDS) was first added to the list of mental illnesses by the American Psychiatric Association , then under the name Dysphoric Disorder of the Late Luteal Phase (LLPDD).

causes

The exact causes of premenstrual syndrome have not yet been clarified. They do not occur in the first half of the cycle with the menstrual period and follicle maturation, but only in the second half of the cycle with the corpus luteum maturation (between ovulation and the onset of menstrual bleeding). If the cycle is prevented by medication or surgery, the symptoms of premenstrual syndrome will not occur.

In the second half of the cycle, the corpus luteum hormone progesterone is produced, while at the same time the release of estrogen decreases. Along with this, the tendency towards PMS increases. More water is stored in the tissue, which can trigger painful swellings in the breasts (mastodynia), hands and feet (edema).

The mood swings are not the only consequence of the mild to severe pain, so that in psychiatry one speaks of a luteal phase dysphoria (English: late luteal phase dysphoric disorder ). Purely emotional causes can largely be ruled out through extensive research. Comorbidity with mental illness certainly plays a role, but it has been proven that these are not the cause of PMS or PMDS . However, certain lifestyles can have a positive or negative effect on the symptoms of PMS or PMDS.

Other factors, individually or together, can contribute to the triggering or worsening of a premenstrual syndrome. These include excess prolactin , thyroid disorders , fungus infections, environmental toxins, the consumption of caffeine or nicotine , sleep disorders, psychological stress and a lack of exercise.

therapy

Herbal preparations such as chaste tree (Agnus castus) or SSRIs (serotonin reuptake inhibitors), aldosterone antagonists (e.g. if there is a tendency to develop edema) can be used to alleviate the symptoms of premenstrual syndrome . Invasive therapeutic measures (e.g. GnRH analogues ) are only necessary in exceptional cases. Researchers have now also found that a certain combination of fatty acids can alleviate symptoms, which could be taken into account when changing diet.

criticism

So far there is very little research that is dedicated to the topics of PMS and PMDS. The different definitions of PMS used have the consequence that the information on the prevalence varies greatly. In Germany, diagnosis is primarily not made according to DSM-5 in everyday clinical practice , but rather on the basis of the ICD-10 of the World Health Organization (WHO). The diagnoses PMS and PMDS are not listed there in the category “ Mental and behavioral disorders (F00-F99) ”.

The more severe form of PMS, premenstrual dysphoric disorder (PMDS), is often seen from a feminist point of view as a purely social construct, which was introduced by the pharmaceutical industry to legitimize the prescription of medication. Critics of the diagnosis of PMDS fear that natural processes are pathologized by making them.

See also

literature

  • Michelle Harrison: The Premenstrual Syndrome. Munich 1985, ISBN 3-88104-150-8 .
  • Lois Jovanovic, Genell J. Subak-Sharpe: Hormones. The medical manual for women. (Original edition: Hormones. The Woman's Answerbook. Atheneum, New York 1987) From the American by Margaret Auer, Kabel, Hamburg 1989, ISBN 3-8225-0100-X , pp. 14, 91 ff., 384 and more often.
  • David Hänggi-Bally: The premenstrual syndrome. In: Swiss Medical Forum. Volume 7. 2007, pp. 734-738.

Web links

Individual evidence

  1. ↑ Premenstrual Syndrome. In: Pschyrembel . Clinical Dictionary. 2014. Founded by Willibald Pschyrembel. Edited by the publisher's Pschyrembel editorial team. 265th, revised edition. De Gruyter, Berlin 2013, ISBN 978-3-11-030509-8 ( Pschyrembel commercial online portal advertising notice ). Keyword in the 255th edition online here. From: books.google.de , 2006, accessed November 12, 2013.
  2. ↑ Premenstrual Syndrome (PMS), monthly symptoms of women. on: sprechzimmer.ch from November 15, 2012, accessed on November 12, 2013.
  3. ↑ HP Zahradnik, B. Wetzka, W. Schuth: Cycle-dependent disorders of the well-being of women. In: The gynecologist. 2000; 33 (3), pp. 225-238; doi: 10.1007 / s001290050539 .
  4. ↑ Signs and complaints of premenstrual syndrome (PMS). From: experto.de , accessed on November 12, 2013.
  5. ↑ a b c d Katja Rolker: On the application of diagnostic guidelines for premenstrual syndrome among doctors. Dissertation . Berlin 2010 (online)
  6. ^ R. Greene, K. Dalton: The premenstrual syndrome. In: Br. Med. J. 1953; 1, pp. 1007-1014.
  7. ↑ History of the PMS (online)
  8. ^ DE Webster, J. Lu, S.-N. Chen, NR Farnsworth, Z. Jim Wang: Activation of the μ-opiate receptor by Vitex agnus-castus methanol extracts: Implication for its use in PMS . In: Journal of Ethnopharmacology . tape 106 , no. 2 , 2006, p. 216-221 , doi : 10.1016 / j.jep.2005.12.025 , PMID 16439081 .
  9. ↑ HP. Zahradnik: Premenstrual Syndrome. In: Gynecological Endocrinology. 2004; May 2004, 2 (2), pp. 64-69.
  10. ↑ Fatty acids helpful against premenstrual syndrome. From: aerzteblatt.de , January 19, 2011, accessed on November 12, 2013.
  11. ^ EA Rocha Filho, JC Lima, JS Pinho Neto, U. Montarroyos: Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study. In: Reproductive health. Volume 8, 2011, p. 2, ISSN  1742-4755 . doi: 10.1186 / 1742-4755-8-2 . PMID 21241460 . PMC 3033240 (free full text).
  12. ↑ Carolyn Janda: Understanding, Diagnosing and Treating Premenstrual Discomfort. Randomized controlled trials investigating cognitive behavioral approaches in premenstrual dysphoric disorder. 2015, accessed on January 31, 2020 (German).
  13. ↑ Alia Offman & Peggy J. Klein Place: Does PMDD belong in the DSM? Challenging the medicalization of women's bodies . Ed .: Canadian Journal of Human Sexuality. University of Toronto Press, 2004.
  14. ↑ JC Wakefield: DSM-5, psychiatric epidemiology and the false positive problem . In: Epidemiology and Psychiatric Sciences . tape 24 , no. 3 , June 2015, ISSN  2045-7960 , p. 188–196 , doi : 10.1017 / S2045796015000116 ( cambridge.org [accessed January 31, 2020]).