Premenstrual Syndrome
Definition
Epidemiology
Aetiology
Clinical Features
Diagnosis
Daily mood charting for 3 menstrual cycles
Management
Non pharm:
Pharm:
Source
Llewellyn-Jones. 9th Ed 2010
- Negative mood/ physical changes during luteal phase (ovulation)
- Can happen just before/ during pill-free week too
- No PMS if no ovaries
Epidemiology
- 5-15% women
- 20-40y (usually around 30s)
Aetiology
- Unknown
- Theory: Oestradiol levels fluctuate, directly affecting mood/ reduce serotonin levels
Clinical Features
- Always a sx free interval of at least 1/52 after menstruation
- Mood: Irritable, depressive, anxious, tense, fatigued, avolition
- Physical: breast swelling, abdo swelling, headache, backache
Diagnosis
Daily mood charting for 3 menstrual cycles
Management
Non pharm:
- Reduce stress
- Identify and treat dominant sx from daily charts
- CBT
Pharm:
- OCP
- Transdermal oestrogen patch
- Implant
- SSRI
Source
Llewellyn-Jones. 9th Ed 2010