Premenstrual syndrome: symptoms

For the diagnosis of premenstrual syndrome should identify the prevailing symptoms and establish that their development is closely related to the luteal phase of the menstrual cycle. More than 100 symptoms of the disease are described, but the most frequent are the following: bloating (90%), breast engorgement and soreness (90%), headaches (more than 50% of cases), fatigue (80%), irritability, depression and an unstable mood (more than 80% of cases), increased appetite (more than 70% of cases), forgetfulness and decreased attention (more than 50% of cases), palpitations (15%), dizziness (20%).

Each of the clinical forms of premenstrual syndrome is characterized by certain symptoms.

Psycho-vegetative form of premenstrual syndrome: increased irritability, depression, tearfulness, touchiness, aggressiveness, numbness of hands, drowsiness, forgetfulness, hypersensitivity to sounds and smells. It is noted that if in the reproductive age women with premenstrual syndrome are dominated by depression, then in the transitional age, aggressiveness prevails.

The edematous form of the premenstrual syndrome: puffiness of the face, shins, fingers, bloating, itching of the skin, 4-8 kg increase in body weight, breast engorgement and tenderness, increased shoe size, local edema (eg edema of the anterior abdominal wall or feet, knees). In most patients with premenstrual syndrome in the 2nd phase of the menstrual cycle, fluid retention in the volume of up to 500-700 ml is noted, and diuresis remains positive in 20% of patients, despite swelling of the face, bloating and other signs.

Cephalic form of premenstrual syndrome

• Migraine headaches are paroxysmal pains of a pulsating nature, localized mainly in one half of the head, in the frontal and temporal regions, periodically recurring and accompanied by nausea, vomiting, photophobia and noise-abnormalities.
• Tension headaches are diffuse headaches of a squeezing, pressing character, which sometimes create a feeling of "wearing a helmet" or "hoop" on your head. Pain more often are bilateral, lasting several days.
• Vascular headaches are paroxysmal, pulsating, spreading diffuse headaches or in the nape of the neck, accompanied by reddening or puffiness of the face, often combined with an increase in blood pressure.
• Combined forms of headaches (migraine, vascular and tension pains).

Crooked form (panic attack syndrome): panic attacks (crises) begin with an increase in blood pressure, a feeling of compression behind the sternum, a chill, the appearance of a sense of fear, and are accompanied by cold and numbness of the limbs, palpitations with unchanged ECG. Often such crises result in profuse urination. In some women, even a slight increase in systolic pressure (by 10-20 mm Hg from the initial figures) can trigger a crisis. Panic attacks occur usually in the evening or at night and can begin against a background of an infectious disease, fatigue and / or stress.

Atypical forms of premenstrual syndrome.

• Hyperthermic form is characterized by a cyclic increase in body temperature to 37.2-38 ° C in the luteal phase of the cycle and its decrease with the onset of menstruation; changes in blood parameters, characteristic of inflammatory diseases, are absent.
• The ophthalmoplegic form of migraine is characterized by cyclic hemiparesis in the luteal phase of the cycle, unilateral closure of the eye.
• The hypersomnal form is characterized by cyclic drowsiness in the luteal phase of the cycle.
• Cyclic allergic reactions up to Quincke's edema:
  • ulcerative gingivitis and stomatitis;
  • cyclic bronchial asthma;
  • cyclic indomitable vomiting;
  • cyclic iridocyclitis;
  • Menstrual migraine is characterized by migraine attacks only during menstruation. Improvement is usually noted with the onset of pregnancy, or when preventing menstruation with gonadotropin-releasing hormone agonists. Depending on the severity of clinical manifestations, mild and severe disease are isolated.

With a mild course for 2-10 days before the onset of menstruation, 3-4 of the symptoms listed above appear, with only 1 or 2 of them being significantly pronounced.

In severe course for 3-14 days before menstruation begin to disturb at the same time 5-12 of the above symptoms, with 2-5 of them are pronounced.

[1], [2], [3], [4], [5], [6], [7]