Premenstrual syndrome - a complex of symptoms that appear in the second half of the menstrual cycle a few days before the onset of menstruation. Every fifth woman under the age of 30 years and every second - after this one faces this condition. Symptoms appear on both the physical and mental levels and can vary greatly among women.
Currently, the exact causes of the development of premenstrual syndrome have not been established. There are many theories explaining the occurrence of various symptoms, but none of them covers the whole complex. The most complete is currently considered to be hormone theory, according to which the cause of PMS is a change in hormonal balance caused by an increase in estrogen levels and a decrease in progesterone levels.
One of the likely factors for the development of premenstrual syndrome is avitaminosis, in particular the deficiency of vitamins B6, A and trace elements calcium, magnesium and zinc. Of great importance is also the genetic factor, i.e. the nature of the flow of PMS can be inherited.
Symptoms of premenstrual syndrome
There are about 150 different symptoms of PMS, which can also occur in different combinations, which significantly complicates the diagnosis. Based on the main symptoms, there are several forms of the syndrome:
Neuropsychic form characterized by disorders in the emotional and nervous spheres. It is characterized by emotional instability, tearfulness, irritability, aggression, weakness, fatigue, dizziness, insomnia, apathy, causeless melancholy, depressive states, suicidal thoughts, olfactory and auditory hallucinations, feelings of fear, sexual dysfunction, and weakening of memory. Also marked appetite, bloating, soreness and an increase in the mammary glands.
With cephalgic form Vegeto-vascular and neurotic symptoms predominate: migraine-like, pulsating headaches, often accompanied by nausea or vomiting, eyelid edema, diarrhea. About a third of women have increased heart rate, pain in the heart area, nervousness, and increased sensitivity to smells and sounds. This form is more common in women with past traumatic brain injuries, frequent stress, and infectious diseases of the nervous system.
The main manifestation of premenstrual syndrome with edema it becomes fluid retention in the body and, as a result, swelling of the face, limbs, mammary glands, weight gain, sweating, thirst, reduced urination, skin itch, dyspepsia, constipation, diarrhea, bloating.
With crisis forms Sympatho-adrenal crises (a condition caused by an increase in the level of adrenaline) are observed, which occur with increased blood pressure, tachycardia, panic attacks, numbness and cold extremities. There may be heart pain without changes on the ECG. As a rule, the end of the attack is accompanied by abundant urination. Overwork and stress can be factors that trigger seizures. This form of premenstrual syndrome is the most severe and requires mandatory medical intervention.
Due to the variety of symptoms, the diagnosis of premenstrual syndrome can be very difficult. The main diagnostic criterion is the cyclical nature of complaints and their disappearance after menstruation. The study of hormone levels (estrogen, progesterone, prolactin) in the blood helps to establish the form of premenstrual syndrome. It is recommended to undergo the procedure of electroencephalography (EEG).
For accurate diagnosis, examination by doctors of various specialties - an endocrinologist, a neurologist, a cardiologist, a therapist, a psychiatrist is recommended.
Treatment of premenstrual syndrome
For the treatment of PMS apply medical and non-drug methods.
Non-drug methods include, first of all, psychotherapy. A woman must comply with the regime, avoid excessive loads and have proper rest and sleep.
A diet high in plant and animal protein, fiber and vitamins is recommended. In the second half of the menstrual cycle, it is necessary to limit the consumption of coffee, chocolate, alcohol, sugar, salt, animal fats and carbohydrates. Relieve condition will help regular exercise, therapeutic aerobics, massages.
Among the medical methods, the main role is given to hormone therapy with drugs - analogues of progesterone. For edematous and cephalgic forms, antiprostaglandin preparations are recommended - indomethacin, naprosyn.
Since neuropsychiatric manifestations are present in any form of premenstrual syndrome, sedative and psychotropic drugs — tazepam, oretel, etc. — are prescribed in the second phase of the cycle a few days before the onset of symptoms. These drugs belong to the tranquilizer group, so they should be used only under medical supervision.
When edematous form antihistamine drugs (tavegil, diazolin) are used in premenstrual syndrome. Veroshpiron is prescribed 25 mg 2-3 times a day for several days before the onset of symptoms. This drug has a potassium-sparing and diuretic action, lowers blood pressure.
With cephalgic and crisis forms use drugs that normalize the synthesis of hormones, for example, parlodel (1.25–2.5 mg per day) in the second phase of the cycle. With pain and engorgement of the mammary glands, the use of progestogel is recommended - a gel containing progesterone.
Vitamin E and B6, calcium, potassium, zinc, magnesium, manganese and tryptophan have a beneficial effect. Alternative methods provide a good effect in the treatment - acupressure (acupressure), aromatherapy.
Treatment of premenstrual syndrome is a long process, lasting about 6–9 months, repeated in case of relapse. In rare cases, treatment can last the entire reproductive period. For greater efficiency, it is necessary to strictly observe the regime and instructions of the doctor.
The basis for the prevention of premenstrual syndrome is adherence to work and rest, reduction of psycho-emotional stress. It is important to exclude factors - provocateurs of poor health. It is recommended to limit the consumption of coffee, tea, alcoholic beverages and chocolate, especially at the end of the cycle. Instead, it is recommended food rich in fiber, herbal teas, juices (especially carrot, lemon and pineapple). It is necessary to increase the content of vitamin B6 in the daily diet. It is found in liver, fish, walnuts, and soybeans.
Appointed symptomatic treatment, as a rule, leads to an improvement in the state already in the second half of the menstrual cycle.
The edematous form of premenstrual syndrome (PMS) is one of the most common. In some women, it occurs in conjunction with other types (cephalgic, neuropsychic, and others). There are many theories about the causes of such states on the eve of menstruation, but all of them are only approximate and presumptive. On this basis, the treatment of such disorders is also effective only at the moment of taking the medication, and when canceled, the condition recurs.
The most common theory concerns the excess of female hormones in the body of a girl. It is precisely the imbalance of such active substances that plays the main role in the development and progression of edema and other manifestations of PMS. Its essence is as follows. Estrogens are believed to be capable of retaining sodium in a woman’s body. This entails an accumulation of fluid in the tissues, hence the swelling of the chest before menstruation or even the whole body.
It also plays a significant role in progesterone deficiency. It is believed that it has a sodium diuretic (diuretic) effect. As a rule, an excess of estrogen is accompanied by a deficiency of progesterone, and both processes are synergistic with each other. The result of this interaction brings considerable discomfort to the woman.
Also, studies have shown that prolactin is capable of retaining sodium in the body, which entails a delay of additional fluid. But even with the normal value of this hormone in the tissues may be increased sensitivity to it. As a result, the effect of prolactin will be more pronounced in normal analyzes in a woman.
Against the background of stress, psycho-emotional overload, there is a violation of interconnections at the level of the brain, which leads to excessive production of ACTH, the pituitary hormone. And it through a certain system contributes to enhanced reabsorption of fluid in the kidneys. Also a big role is given to the imbalance and deficiency of vitamins, especially groups B, A, E, and the trace element zinc. In most cases, they act indirectly, affecting the production of prostaglandins, biologically active substances.
So, why edema before menstruation appear in a large number of women is not fully understood. But clearly identified groups of girls exposed to the pronounced clinical picture of premenstrual syndrome. These include women with the following conditions:
- overweight, due to the fact that adipose tissue is a source of estrogen,
- those who have chronic kidney, liver, and cardiovascular diseases,
- after 40 years and in the period of the formation of menstrual function.
As a rule, in women before menstruation, the whole body or its separate parts swells. In the first case, even on the scales a noticeable increase in 2 - 3 kilograms is noticeable. At the same time the body seems heavy and pasty.
When edema of individual parts of the woman feels discomfort in this particular area. The most common complaints are pain and breast augmentation. Also in parallel with this often grows waist. And this is due not only to edema, but, possibly, and swelling of the intestine.
If you suffer from swelling of the eyes before menstruation, hands, feet, etc., there is a high probability of the presence of comorbidities, such as kidney problems. Then the clinical picture can become even brighter.
How to get rid
Knowing the body's inclination to such changes, it is better to try to prevent premenstrual syndrome. Only a doctor can prescribe the most adequate and effective treatment. But often it is necessary to struggle with that which is. To do this, there are some tips to reduce puffiness on the eve of critical days.
It is recommended to use various lotions, baths on certain parts of the body. Popular methods:
- In case of swelling of the eyelids and the area under the eyes, you can apply chilled, moistened with water bags of green tea.
- It is recommended to take cotton pads and moisten in milk, where you should first place the ice cubes. Cold minicompression must be applied for ever.
- Also in these cases, egg white helps well. It must be whipped and applied to the place of puffiness on the face.
- Sometimes fresh or frozen parsley is effective. To do this, chop it and mix with a few spoons of sour cream. The resulting mixture should be used as a face mask.
- If on the eve of the monthly swelling of the legs, then you can prepare cubes from a solution of chamomile and coffee. And then daily lubricate the skin of the limbs. It is useful to wash the feet with a solution of salt, soda with the addition of a drop of iodine. You can also make baths out of it.
- It is also recommended to drink infusions of hips, chamomile, lingonberry leaves.
- There is an interesting recipe with a bay leaf. To do this, take it three or four pieces, pour a glass of boiling water and insist a few hours. And then take 100 ml three times a day. It is useful to drink it, even if the hands swell before menstruation.
Prevent swelling before menstruation
But most effectively deal with the manifestations of premenstrual syndrome in advance. Be sure to be examined by specialists, since the usual edema may be hiding a serious pathology, such as renal failure.
Each has its own advantages and disadvantages, but it is more efficient to use complex treatment. How to get rid of edema before menstruation, prompt another tips, time-tested.
Lifestyle and nutrition
No matter how trite it may sound, but proper nutrition, enriched with fresh fruits and vegetables, helps the woman fight the swelling as well. Particular attention should be paid to vitamins B, A, C and zinc. A large number of them are contained in lettuce leaves, pumpkin and sunflower seeds, meat and dairy products. Therefore, the diet of any woman should always contain these ingredients.
Dosed exercise also helps to remove excess fluid from the body. But in no case should you limit your drinking regime, otherwise you can earn dehydration. Any exercise stimulates diuresis and peristalsis of the intestines in any woman, so, as a rule, after workouts, the urge to the toilet always comes at a speed.
Sport also balances the nervous system, and this establishes connections between tissues and organs, balances the hormonal profile of a woman. After all, an excess of estrogen and gestagen deficiency is the main cause of edema.
A woman should adjust her body weight. It is known that fatty tissue is a source of estrogen. The more extra pounds, the more pronounced swelling and other manifestations of premenstrual syndrome.
You should also understand that in the presence of concomitant pathology in women can exacerbate the manifestations of PMS. For example, swelling of the legs before menstruation will be brighter for those who have varicose veins of the lower extremities. Therefore, it is worth thinking about treatment, sometimes even operatively, in order to improve the quality of your life.
We recommend reading the article on pain in the legs as a sign of PMS. From it you will learn about the causes of discomfort before menstruation in adolescents and women, problems with legs during menopause, as well as ways to get rid of pain.
In the fight against premenstrual syndrome, and edema in particular, a large number of drugs are used, usually of a hormonal nature.
This is one of the most effective means. But only a gynecologist will be able to choose the right medicine, taking into account the age and health of the woman. Modern contraceptives often include hormones that have diuretic effects. For example, "Jess." As a result, there is a significant decrease in breast engorgement, pasty tissue leaves and even abdominal edema before menstruation.
But conventional contraceptives, creating an artificial hormones in women, can minimize the manifestations of PMS.
Sometimes it is possible to assign only gestagens to the second phase. Often used "Duphaston" or "Norkolut." It should be taken from 16 to 25 days of the menstrual cycle.
If an increase in the level of prolactin is determined in tests, its correction often leads to a decrease in the severity of swelling, including. The most effective drugs such as "Dostinex" or "Parlodel".
Given that the pathogenesis of edema plays the role of deficiencies of certain vitamins, regular intake of the complexes will also help reduce the severity of PMS. Especially effective special compositions for the correction of hormonal levels. For example, "Time Factor" and the like. Often they help to remove the swelling of the breast before menstruation and its soreness.
The admission of diuretic drugs with the beginning of the second phase helps women also effectively deal with edema. The most suitable for the mechanism of action is "Veroshpiron."
Supplements and homeopathic remedies
It is impossible not to take into account the effect of patented means of alternative medicine. As a rule, at the time of taking dietary supplements and homeopathic medicines, all the symptoms of PMS, including edema, are minimal or do not bother the woman at all.
One of the most popular and effective is "Cyclodinone", "Mastodinon" and others. But often with the abolition of drugs is observed the return of all symptoms.
Many women still prefer the use of plants for treatment and prevention, so they wonder how to remove the swelling before menstruation, using them. The following herbs have proven to be effective in these situations:
If there are swelling before menstruation, the doctor will prompt you how to deal with them. Of course, a woman should be examined and examined by a specialist to identify diseases that may aggravate or provoke such conditions. Since the main reason for the appearance of edema lies in hormonal disturbances, the most effective way is hormonal correction in combination with vitamin and phytotherapy. But the most suitable schemes can be selected only by a qualified specialist after an examination and determination of the level of a woman’s health.
The essence of the concept of "premenstrual syndrome"
Premenstrual syndrome is a symptomatic complex characterized by these types of disorders:
They are observed in phase 2 of the ovulatory cycle, approximately 3–10 days before the onset of menstruation, and are completed either immediately before their onset or at their end.
In accordance with the predominant emergence of specific negative sensations, doctors subdivide cyclic disease into 6 forms:
According to the number of symptoms, the duration and severity of these, doctors determine 2 more variants of the pathological condition - light and heavy.
Light is observed for 3-10 days before menstruation, there are 2-3 manifestations, and no more than 2 of them are pronounced.
Severe is characterized by 5-12 symptoms, which are observed for 3-14 days before menstruation. Manifestations can be all pronounced, but not less than 3-5.
The syndrome is divided into 3 stages:
- Compensated - symptoms arise immediately before menstruation and passes through their start, while with age, the manifestations do not become more intense.
- Decompensated - there is a severe PMS, and with age decreases the duration of the gap between manifestations of the syndrome.
- Subcompensated - there is increased progression of manifestations, may increase their number, duration and severity.
The most common disorder such as PMS is detected in women whose age has exceeded the threshold of 30 years - every 2 patients have it.
Among younger women, it develops less frequently - no more than 20% of the total.
Causes of PMS
There are many assumptions regarding the source of the syndrome, however, none of the theories can reflect the true cause and mechanisms of the progression of the pathological condition.
However, there are a number of etiological factors that contribute to the development of premenstrual syndrome:
- The disorder of the proportional relationship between progesterone and estrogen in the luteal phase, that is, the concentration of estrogen increases, and progesterone decreases.
- Overproduction of prolactin, which causes the transformation of the mammary glands.
- Negative processes of the thyroid gland, often - progressive tumor formation.
- Lack of micro and macronutrients, vitamins, specifically zinc and vit.B6.
- Overly frequent stressful situations.
- Pathological changes in water-salt metabolism due to enhanced aldosterone synthesis, leading to the retention of salts and fluids.
In addition to the above, there are also a number of factors predisposing to cyclic disease:
Also, one of the key predisposing factors is the imbalance of the usual diet, which leads to inhibition of all body systems.
The woman becomes hot-tempered, touchy and easily upset. There is increased fatigue, apathy, or depression.
There may be flashes of aggression. Also, these symptoms are present:
- lack of sexual attraction
- daytime sleepiness,
The intolerance of certain smells or tastes can be shown, mammary glands are roughened. In some embodiments, patients complain of numbness in the limbs.
Due to fluid retention and sodium edema occurs. Basically, there is swelling of such areas of the body:
In addition to this, a slight increase in body weight is possible - up to 700g. In addition to puffiness, a woman with PMS has the following negative manifestations:
- breast tenderness,
- general weakness
- strengthening the work of sweat glands.
Also, due to fluid retention, a decrease in diuresis is observed.
With this form of PMS, a woman has an acute intolerance to certain sounds and smells, as well as patients complain of dizziness, increased irritability and migraine-like headaches.
These symptoms often include the following symptoms:
- heart muscle pain,
- a feeling of beating your own heart
- fainting or pre-unconscious states.
Gastrointestinal symptoms are likely to occur - diarrhea, retching and nausea.
In the case of the cyclic form of cyclic disease, a woman has sympathoadrenal crises, manifested by sharp increases in pressure, pain in the area of the heart muscle, tachycardia and a sudden fear of dying.
At the same time, during the passage of the ECG, the patient does not reveal any deviations from the physiological norm. Crisis variant is often present in postmenopausal patients, that is, from 45 years.
Also, this form of PMS can occur among women who have pathologies of the kidneys, gastrointestinal tract and heart.
Atypical PMS options
There are 3 types of atypical forms of cyclic disease:
Hyperthermia is characterized by a jump in body temperature of up to 38 ° C before menstruation, which decreases at the onset of them.
Hypersonmic is manifested by excessive drowsiness in the luteal phase, and ophthalmoplegic is expressed by unilateral ptosis and hemiparesis before menstruation.
The mixed form of premenstrual disease is expressed by a combination of symptoms that are characteristic of other forms of PMS, but at the same time there is no way to isolate any particular symptomatic complex.
In some embodiments, each successive occurrence of cyclic disease can be expressed by different symptoms.
The basic principle of determining the ICP is to conduct a differential diagnosis.
As part of this diagnostic method, it is required to separate this condition from the doctor from those that have symptoms similar to the premenstrual tension syndrome:
- mental disorders
- chronic renal disease,
- brain neoplasms,
- classical and menstrual migraines,
- inflammatory processes of the membranes of the spinal cord,
- thyroid gland disorders,
- arterial hypertension.
All of these deviations have no relationship with the menstrual cycle - patients have complaints regardless of the period.
Detection of PMS is characterized by a number of difficulties, since few women perceive this condition as a health disorder.
However, medical assistance and screening for suspected PMS is required.
When referring to a specialist, the latter must take anamnesis and study it, and as a result, identify the relationship between the phase of the ovulatory cycle and the occurrence of negative manifestations, as well as detect the cyclical nature of the occurrence.
In the course of making a diagnosis, a woman is required to note her existing ones, based on the list issued by the doctor:
- emotional instability
- propensity for depression,
- flashes of rage or aggression,
- fear, anxiety, nervous tension,
- anguish, a sense of hopelessness,
- sleep disorders
- feeling of pain or engorgement of the mammary glands,
- sore muscles and joints,
- causeless weakness or fatigue
- reduced ability to concentrate
- bulimia missing or excessive appetite
- abnormal weight gain.
The diagnosis is established when a doctor identifies 5 or more of the listed symptoms, subject to the presence of at least 1 of the first 5 indicated among them.
Next, blood tests for estradiol, prolactin and progesterone are prescribed in phase 2 of the cycle. Based on the results of blood tests, a specific form of PMS is detected.
The main causes of swelling before menstruation
Swelling of girls before critical days is due to hormonal imbalances. The hormone estrogen contributes to the retention of salt in the body and water is eliminated much more slowly, which provokes the formation of edema of the extremities of the chest, neck and other parts of the body. Before menstrual bleeding, the hormone progesterone, which interacts with an antidiuretic hormone that has the ability to retain urine, makes itself known. In this case, urination occurs less frequently than usual, which causes the appearance of edema.
Water in the body before the critical days may linger, leading to swelling, due to a lack of magnesium needed to control the water balance in the body. There are more serious causes, the formation of edema before menstruation, not related to the hormonal background of the woman. In this case, it can be diseases of the veins, lymphatic vessels, joints, kidneys and heart. Therefore, it is very dangerous to self-medicate and it is necessary to visit a gynecologist who can say with certainty that such edema is hormonal in nature and does not pose a threat or the reason lies deeper.
Often the fair sex complain that they get better during critical days. It is believed that such an increase in weight is not associated with fat deposits, namely, an excess of fluid in the body, with the removal of which everything will be full circle.
Tendency to swelling before menstruation.
Edema before menstruation affects not all women. Some women are at risk of edema during the menstrual period. Risk factors include:
- overweight because fatty weave is a source of estrogen,
- a large number of pregnancies
- a lot of interruptions of pregnancies, which violates the hormones in general,
- late first childbirth and the absence of lactation after them,
- hormonal contraceptives,
- inflammatory processes and diseases of the reproductive organs,
- brain injury,
- poor nutrition,
- lack of exercise,
- kidney disease
- heart disease,
- vascular dystonia,
- the period of menopause or the period of the onset of menstrual function in which the imbalance of hormones is more pronounced.
It is believed that women of the Caucasian race are more prone to puffiness before menstruation, as well as young ladies living in big cities.
Diet for swelling before menstruation
In order to avoid the formation of edema before the month of the girl must follow a certain diet. First you need to exclude products with a large amount of salt, so as not to retain excess fluid in the body, leading to puffiness. Include in the diet of vegetables and foods rich in potassium. The fact is that excess fluid leads to sodium retention, and potassium, in turn, contributes to the release of more sodium, leading to the right balance in the body.
Red meat is better to replace white fish. Will be useful and foods rich in magnesium and vitamin B6. It is necessary to drink plenty of pure water. Yes, it is water. It would seem, why even water with its excess in the body.
By itself, water does not trap fluid in the body, but contributes to the leaching of salt, which is the true cause of such stagnation. Good results are given by fruit drinks and drinks from lingonberries and cranberries, which have a diuretic effect. It is also impossible to neglect proper rest and sleep. When these rules are followed, in the absence of comorbidities, most girls will forget about the question of why I swell when menstruation is approaching.
Medicine and premenstrual edema
If traditional methods are not able to cope with edema before menstruation, you should contact a gynecologist, who, if necessary, will prescribe the correct treatment or send for additional examination. Most often, the patient is prescribed vitamins, diuretics, sedatives, or hormonal drugs. Sometimes, it is recommended to take diuretics that promote increased secretion of fluid from the body, and relieve swelling. But this can only be done under the strict supervision of a doctor, otherwise you can do more harm than help.