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Premenstrual Syndrome (PMS or PMT)
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| The list of biological theories offered to explain the cause of PMS is impressive. It includes such conditions as progesterone deficiency in the luteal phase of the menstrual cycle and vitamin deficiencies. Although there's no evidence that PMS is hormonally mediated, failure to identify a specific disorder with a specific mechanism suggests that PMS represents a variety of manifestations triggered by normal physiologic hormonal changes. |
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Clinical effects vary widely among patients and may include behavioral symptoms, somatic symptoms, or both. These symptoms include:
The patient history shows typical symptoms related to the menstrual cycle. To help ensure an accurate history, the patient may be asked to record menstrual symptoms and body temperature on a calendar for 2 to 3 months prior to diagnosis. Estrogen and progesterone blood levels may be evaluated to help rule out hormonal imbalance. A psychological evaluation is also recommended to rule out or detect any underlying psychiatric disorders.
Educating and reassuring patients that PMS is a real physiologic syndrome are important parts of treatment. Because treatment is predominantly symptomatic, each patient must learn to cope with her own individual set of symptoms. Treatment may include antidepressants, vitamins such as B6 (pyridoxine), hormonal contraceptives, selective serotonin reuptake inhibitors, prostaglandin inhibitors, diuretics, and nonsteroidal anti-inflammatory drugs.
Herbal remedies for PMS
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