Premenstrual syndrome

Premenstrual syndrome is defined as recurrent psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20-30% of premenopausal women.

Premenstrual dysphoric disorder

Premenstrual dysphoric disorder includes affective or somatic symptoms that cause severe dysfunction in social or occupational activity. It affects 3-8% of premenopausal women.

Proposed etiologies (causative factors) include:

- increased sensitivity to normal cycling levels of estrogen and progesterone
- increased aldosterone and plasma renin activity
- neurotransmitter abnormalities, particularly serotonin

The Daily Record of Severity of Problems is one tool with which women may self-report premenstrual symptoms.

Symptom relief is the goal, and there is limited evidence for the use of:

- calcium
- vitamin D
- vitamin B6 supplementation

Serotonergic antidepressants (SSRIs) (citalopram, escitalopram, fluoxetine, sertraline, venlafaxine) are first-line pharmacologic therapy.

References:

Premenstrual syndrome and premenstrual dysphoric disorder. Biggs WS, Demuth RH. Am Fam Physician. 2011 Oct 15;84(8):918-24.

Image source: OpenClipArt.org, public domain.

Source:
http://feeds.feedburner.com/CasesBlog