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  1. 1. What is pre menstrualsyndrome???Premenstrual syndrome (PMS orPMT- premenstrual tension)refers to a wide range of physicalor emotional symptoms thattypically occur about 5 to 11 daysbefore a woman starts hermonthly menstrual cycle. It is acollection of physical andemotional symptoms related to awomans menstrual cycle. About85% of women experience somedegree of PMS. A few have moresevere symptoms that disruptwork or personal relationships,known as premenstrualdysphonic disorder (PMDD) the
  2. 2. CravingsMany womendevelop specificcravings when PMSstrikes, usually forsweet, starchy foodslike chocolate cake.The reasons for thisare not wellunderstood. Otherwomen may losetheir appetite ordevelop an upset
  3. 3. AcneAcne is one of the mostcommon signs of PMS, andit doesnt just affectteenagers. Hormonalchanges can cause glandsin the skin to produce moresebum. This oily substance may clog the pores, triggering a breakout -- a visible reminder that your
  4. 4. PainPMS can trigger awide range of achesand pains, including:Back painHeadachesTender breastsJoint pain
  5. 5. Mood SwingsFor many women, themost troubling aspect ofPMS is its unpredictableimpact on mood.Irritability, anger, cryingspells, depression, andanxiety may come and goin the days leading up toyour period. Some womeneven have trouble withmemory and concentrationduring this time
  6. 6. other symptoms:-sleepproblems(sleeping toomuch or too little)Slow,sluggish,lethargicmovementDifficulty inconcentrating
  7. 7. Who Gets PMS?Any woman who has a periodcan get PMS, but the followingpatterns based on age andethnicity have been observed:PMS is more likely in the late 20sto mid-40s. How PMS AffectsOlder teens tend to have more Other Conditions?severe PMS than younger teens. PMS can worsen thePMS may be more severe in the symptoms of certain chronic40s. conditions, including: Asthma and allergies Depression and anxiety Seizure disorders Migraines Be sure to let your specialist know if your condition gets
  8. 8. ? What Causes PMS? ??? The exact cause of PMS is? not clear, but we do know that levels of estrogen and progesterone drop during???? the week before your period. Many doctors believe this decline in hormone levels triggers the symptoms of PMS. Deficiencies in certain??? ??? vitamins and minerals may also play a role.
  9. 9. PMS or Somethin g Else?The symptoms of PMS can besimilar to or overlap with otherconditions, including:PerimenopauseDepression or anxietyChronic fatigue syndromeThyroid diseaseThe key difference is that PMSsymptoms come and go in adistinct pattern, month after
  10. 10. Diagnosing PMS: Symptom TrackerTo figure out whether you havePMS, record your symptoms ona tracking form. You may havePMS if:Symptoms occur during the five It is important to keep adays before your period. daily diary or log toOnce your period record the type ofstarts, symptoms end within four symptoms youdays. have, how severe theySymptoms return for at least are, and how long theythree menstrual cycles. last. You should keep this "symptom diary" for at least 3 months. It will help your doctor make an accurate PMS
  11. 11. MONTH________________ (provided by your PMS symptoms according to the following criteria.Colour the boxes according to your symptoms: NONE = leave blank. MILD = GREEN. MODERATE = YELLOW. SEVERE = RED PMS SYMPTOMS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Abdominal Pain Acne Anger, Aggression Anxiety Back Pain Breast Swelling Breast Tenderness Cervical Fluid Constipation Cramps Diarrhea Difficulty Concentrating Fatigue Food Cravings & Binges Headache Irritability Joint Pain Libido (Decreased) Libido (Increased) Moody Muscle Pain Nausea Ovarian Pain Sadness Sleep (Decreased) Sleep (Increased) Tension Urinary difficulties Water Retention Weight Gain
  12. 12. When to See a Doctor???? If you have any thoughts of harming yourself, seek emergency medical care. You should also see your doctor promptly if your symptoms are causing problems with your job, personal relationships, or other daily activities. This may indicate a more severe form of
  13. 13. Premenstrual Dysphoric DisorderPremenstrual dysphoricdisorder (PMDD) follows thesame pattern as PMS, but thesymptoms are more disruptive.Women with PMDD mayexperience panic attacks,crying spells, suicidal thoughts,insomnia, or other problemsthan interfere with daily life.Fortunately, many of the samestrategies that relieve PMS canbe effective against PMDD.Risk factors for PMDD includea personal or family history ofdepression, mood disorders, ortrauma.
  14. 14. PMS Exercise can help boost your mood and Remedy fight fatigue. To get the benefits, you need to exercise regularly -- not just when PMS symptoms appear. Aim for 30 minutes of moderate physical (a) Exercise activity on most days of the week. VigorousTheres evidence that foods rich in Bvitamins may help ward off PMS. In (b)Diet Rich in days exercise on fewer B Vitamin can also be study, researchers followed morethan 2,000 women for 10 years. Theyfound that women who ate foods highin thiamine (pork, Brazil nuts) andriboflavin (eggs, dairy products) werefar less likely to develop PMS. Taking
  15. 15. (c) Complex Carbs Complex carbohydrates, such as whole- grain breads and cereals, are packed with fiber. Eating plenty of fiber can keep your blood sugar even, which may reduce mood swings and food cravings. Enriched whole-grain products also contain the PMS-fighting B vitamins thiamine and riboflavin.
  16. 16. (d) Foods to AvoidYou may be able to reduce PMS symptoms by cutting back on these foods: Salt, which can increase bloating Caffeine, which can cause irritability Sugar, which can make cravings worse Alcohol, which can affect mood
  17. 17. (e)Small (f)Fluid-meals Drink plenty of fluids (water or juice, not soft drinks orEat frequent, small other beverages withmeals. Leave no more caffeine) to help reducethan 3 hours between bloating, fluid retention, andsnacks, and avoid other symptoms.overeating. (g)Stress Relief Because PMS can cause tension, anxiety, and irritability, its important to find healthy ways to cope with stress during this time. Different strategies work for different women. You may want to try yoga, meditation,
  18. 18. (h)OTC DrugsOver-the-counter pain relieverscan ease some of the physicalsymptoms of PMS, such asbreast tenderness, headaches,back pain, or cramps. OTCdrugs that work well for thesesymptoms include:AspirinIbuprofen (Advil, Motrin, MidolCramp)Naproxen (Aleve)
  19. 19. (i) HormoneTreatments Birth control pills prevent ovulation by regulating hormones. This usually leads to lighter periods and may reduce the symptoms of PMS. Other hormonal treatments may include GnRH agonists lupron or nafarelin, or synthetic steroids such as danazol. You may need to try more than one type before you find
  20. 20. (j) Other MedicationsWomen with severe mood swings or PMDD maybenefit from antidepressants. The most commonlyused drugs are known as SSRIs(Selective serotoninre-uptake inhibitors or serotonin-specific reuptakeinhibitor); however, other types of antidepressantsare often prescribed to treat PMDD. Antidepressantsmay be taken for 10 to 14 days before each periodor throughout the menstrual cycle. Those prescribedto treat PMS include:Fluoxetine (Prozac, Sarafem)Paroxetine HCI (Paxil CR)Sertraline (Zoloft)Nefazodone (Serzone)Clomipramine (Anafranil)Other treatments for PMS include anti-anxietymedications (Xanax, Buspar) and diuretics (HCTZ,
  21. 21. (k)SupplementsStudies suggest the followingvitamin and mineralsupplements may reduce PMSsymptoms:Folic acid (400 mcg)Magnesium (400 mg)Vitamin E (400 IU)Calcium (1,000 mg to 1,300 mg) (l) Herbal Extracts Herbal remedies for PMS have not been well studied, but there is some evidence supporting the use of chasteberry, black cohosh, and evening primrose oil. Check with your doctor before trying these herbs. They may interact with medications or
  22. 22. Some of the lifestyles changesPrevention often recommended for treating PMS may help preventGetting regular symptoms or keep them fromexercise and getting worse.eating a balanceddiet (withincreased wholegrains,vegetables, fruit,and decreased orno salt, sugar, Your body may havealcohol, and different sleepcaffeine) may needs at differentprove beneficial. times during your menstrual cycle, so it is important to get enough rest.