Its onset is before the menstrual period in vivo effects of estrogen and progesterone imbalance that cause endocrine and nervous system dysfunction, and appeared above a series of performance.
Once the menses, rapid automatic adjustment of the proportion of hormones, the symptoms have quickly been mitigated. Therefore, to suffer from premenstrual dysphoric women, if your health, ...Women of childbearing age before menstruation in fresh 7-14 days (i.e. The luteal phase of menstrual cycle), a series of recurring mental, behavioural and physical aspects of symptoms, symptoms after menses immediately disappear.
Due to the disease of the mind, mood disorder, formerly named "premenstrual tension syndrome" and "premenstrual tension syndrome".Many women in menses previous weeks showed mood swings, irritability, anxiety, low heat xuhan breast pain, this phenomenon in medicine known as the "premenstrual tension syndrome".
Its onset is before the menstrual period in vivo effects of estrogen and progesterone imbalance that cause endocrine and nervous system dysfunction, and appeared above a series of performance.
Once the menses, rapid automatic adjustment of the proportion of hormones, the symptoms have quickly been mitigated. Therefore, to suffer from premenstrual dysphoric women, if your health significantly alleviate the symptoms.Because the disease etiology and pathogenesis is unknown, there is also a lack of specific and standardized method of treatment is mainly symptomatic treatment.
Thus, the first clear symptoms of the main aspects that varies from person to person, wisely, including two aspects:1, is specific to the patient's mental pathology, health education, so that patients understand the physiological symptoms to assist patients and knowledge to improve the symptoms of response, and then adjust the rhythm of daily life, strengthening the physical activity, improved nutrition, reduce stress, and other methods to alleviate symptoms;
2, is a drug treatment, apply adjustments the activity of nerve media central nervous system to resolve psychological, emotional disorder, or hormone suppression of ovulation to eliminate breast pain, severe PMS symptoms.
For ease of reference, press control key symptoms of treatment programmes are as follows:
I. strengthening health education:
Make patients aware of PMS is common among women of childbearing age, through a series of lifestyle adjustments and simple drug therapy, can be mitigated, eliminating the worry of patients for disease and unnecessary mental burden before symptom onset mental preparedness and take the following some life, nutrition, and other aspects of preventive measures.
2. added minerals and vitamins:
Has been widely used to treat PMS.
According to reports, taken daily, Mg360mg improves Ca1000mg luteal phase of negative emotions, water retention and pain, but its action mechanism is not understood, the treatment will be very different. There are patients in the treatment of symptoms after significant improvements, some are completely invalid.3. correct the water retention:
Due to the lack of experiments confirmed that PMS patients do have liquid retention, it is not necessary to immediately give diuretics.
Reduce salt intake, the supply of calcium and magnesium minerals, symptoms has not improved or postcoital weight > 2500g, you can give the diuretics — aldactone (spironolactone) 25mg, daily four times to the cycle 18 ~ 26 days. Low potassium excretion without potassium dependence, and difficult to happen. In addition to relieve swelling and reduce body weight, you can alleviate symptoms, including lethargy, sleep, depression, sadness.4. breast pain:
Use naizhao hold up breasts, reducing intake of caffeine-containing beverages and oral contraceptives help to alleviate the symptoms.
The most economical and lesser adverse reaction, Jia for oral norethisterone, it is a kind of androgen and antioxidant E, P synthesis of 19-demethyl steroid. By blocking the breast of E receptor, eliminate the periodic change of the breast, can effectively reduce breast pain and tenderness, and dissipation of breast nodules or smaller size Noe. Adverse reactions mainly by the androgen characteristics due to acne, etc. Severe patients can apply danazol.Bromocriptine lowers and inhibition of prolactin and effectively mitigate cyclical breast pain and dissipation of breast nodules.
But after taking medication has dizziness, nausea, headache, and other reactions to 40%. To reduce the side effects of frequency and severity of treatment should be started by a small dose. 1 for the first time. 25mg/d, increment, maximum daily dose, to menstrual 5mg 14 days before taking the drug withdrawal, menses.5. Control spirit neural symptoms:
Diagnosis and treatment of mental illness often associated with PMS disciplines.
Where a severe emotional disturbance, shall invite the psychiatrists common treatment. Through drug treatment will only be able to lessen the symptoms the patient feel better, improve functional status, and cannot completely eliminate symptoms. And because individual drug reactions vary, cannot predict in advance which programmes on the effect of a particular patient, so better to determine the programme before the need for pilot treatment, each treatment programmes for best application of three cycles to clear.1, premenstrual symptoms of abnormal anxiety feelings: shorter than 1 week should emphasize physical exercise, adjust the diet, Supplement, vitamins and minerals, and other self-help therapy.
If necessary, to take diazepam for luteal phase, sleep furtun 200 ~ 400mg, or Librium 5 ~ 5mg 10mg or stability, is to be taken 3 times. Headache, muscle pain, pelvic pain and other symptoms have abdominal laborers can take naproxen, after the first dose 500mg,, may 2nd 250mg; or mefenamic acid (flapping wet pain) 250 ~ 500mg, 2 ~ 3 times/d. Sleep abnormalities (sleep easy, but often in the wake, Kiss, can no longer sleep), because insomnia cause fatigue and emotional changes during the day, you can give Doxepin, starting dose 10mg, necessary to 25mg, before sleeping 1-2 hours.2, intensified by the former
Depressive feelings exception: can be used throughout the cycle taking antidepressants, such as a three-ring-blue pills, or to bed every night before serving to nortriptyline 25mg, necessary to increase the dose until 125mg; or Clomipramine 25mg/d, if necessary, to 75mg/d. Or daily morning dose fluorophenoxy amphetamine 20mg, insomnia laborers of the start shall be avoided.3, bipolar cycle of temperament: manic depression and mild depression alternating, may be given to drug taking anti-Mania — small spiral ketone.
May 12 days before menstruation started taking it and 25mg/d; or alprazolam (triazole stability) 0. 25 ~ 5mg/d, pre-menstrual 6-14 days. Symptoms longer continuous date from 14 days before menstruation has served until via second day only, 0. 25mg, daily 3, based on patient response to increment until 4mg/d, via per day after the start of a 25% decline until the follicular phase or withdrawal anxiety. Atenolol, can cross the blood-brain barrier, blocking the CNS and peripheral receptor β-adrenergic blocking effect, produce, and have lower plasma Renin activity and aldosterone inhibitors, or mitigate the emission of noise eager, dose 50mg/d.Six, hormone therapy and inhibits ovulation:
1, progesterone therapy: although not explicitly PMS morbidity associated with progesterone deficiency, but in the luteal phase application widespread progesterone therapy and clinical epidemiologist.
Common progesterone vaginal suppositories suppository, 200 ~ 400mg/d, or micronized progesterone oral 200mg, 2/d.2, inhibiting ovulation: applies only to the effect of many medications are not obvious, or symptoms particularly severe loss of normal life and work capacity.
① application the highest success rate GnRHa, expensive, and the need for hormone replacement therapy to avoid the consequences of low-E; ② danazol 200mg/d× 3 months towards a ovulation, low-E and androgen environment fake menopause treatment. Many PMS symptoms such as depression, mania anxious, nervous, breast pain, swelling sense and so significantly reduced, but the androgen effects side effects of the high incidence and serious long-term metabolic reactions, such as high-density lipoprotein concentrations declined, low density lipoprotein concentrations increase, accelerate the occurrence of cardiovascular disease; ③ long-term treatment, common 0 E2. 2mgE2 skin sticking/d in menstrual cycle XIX ~ 26 days by norethisterone 5mg; ④ medroxyprogesterone oral 30mg/d, most economic and convenient, side effects are less effective than the above, but the 3 drugs. Some patients may occur after the depression, found that drug withdrawal. If the application after a few months, you can instead use reliable long-term medroxyprogesterone acetate, 150mg, intramuscular injection every 3 months.In short, although there is currently no specific drugs to cure the symptoms of PMS, but control can be satisfied with the General overall.
The total treatment time per person, most women will take approximately 2 years, individual or even need treatment to menopause.(Edit: Zheng Yan internships, MD)
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