Symptoms of premenstrual syndrome begin to develop 2-14 days before menses, while with the beginning of menses most of the symptoms usually resolve or significantly decrease. Symptoms of PMS are extremely manifold – over 120 symptoms are known to develop at various time periods before menses.
There are 6 clinical forms of premenstrual syndrome with characteristic symptoms:
With all this the most common mixed form is the combination of edematous and psychovegetative forms of premenstrual syndrome. One way or another, the most common complaints in overwhelming majority of the cases include the consequences of multiple swelling of tissues and organs.
Unfortunately, it is not common for women to seek medical advice due to premenstrual syndrome. It is partially explained by the widespread opinion that premenstrual syndrome is a norm. .
In fact it is not so. If PMS symptoms are left with no medical attention, they surely progress year after year. The severity and duration of the symptoms will increase.
Besides, multiple advertisement of analgesics and spasmolytics promote its widespread use as self-treatment. Using such medications provides only temporary relief of the premenstrual syndrome symptoms, but without proper treatment the disease may become decompensated, which is why the patient needs to visit the gynecologist as soon as possible.
So far the exact factors and causes of developing PMS are not absolutely clear.
However, most authors lean to the opinion that its occurrence and severity may be promoted by previous neuroinfections, stresses, multiple abortions, surgeries and traumas along with many other gynecological and general disorders which may serve as a background for the premenstrual syndrome.
An opinion is widespread that the reasons defining the course of PMS are changes in the hormonal background during the menstrual cycle.
On this assumption, the basic theories of the development of premenstrual syndrome are constructed
Thus, one of the most popular theories says that the essential cause of the premenstrual syndrome is the changes of the estrogen/progesterone ratio in the second half of the cycle. Estrogen excess promotes water retention in tissues and organs, swelling, breast engorgement, which, in turn, promotes pain.
The effect of estrogens with regard to the brain include neuro-emotional changes – aggression or depression, tearfulness, irritability, proneness to conflict etc.
Other theory says that PMS is associated with increased levels of prolactin hormone that induces water and sodium retention in the organism with further swelling of the breast tissues.
Besides, in the progression of PMS a significant contribution has been proven for so-called prostaglandins – substances produced by the tissues of the organism and taking part in the regulation of such pathologic processes, as inflammation, pain and swelling. Increased tissue concentrations of prostaglandins promote the development of headaches, alimentary disorders, vascular reactions followed by the development of tissue swelling.
Some investigators suggest that PMS is caused by a combination of factors individual for each clinical case.
Whatever the reasons of premenstrual syndrome developing are – most investigators share the opinion that all of the reasons promote the development of interstitial swelling and pain, which in most cases pre-determine the main complaint of PMS.
Using complex statistical studies, the following main risk factors of developing PMS were determined: