![progesterone ,[object Object],[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Pms And Pmdd 2010
- 1. Progesterone vs Prostaglandin PMS, PMDD, and Dysmenorrhea
- 6. Let’s talk about mood....
Editor's Notes
- Premenstrual syndrome, Premenstrual Dysphoric Disorder, & Dysmenorrhea include a constellation of symptoms for which women often seek care from their primary care physician. We are first going to go through the premenstrual issues followed by a discussion of the symptoms which escalate as menses begin. PMS is a constellation of both physical and affective complaints. Physically, women may experience bloating , constipation, peripheral fluid retention, headaches, & breast tenderness. Mood changes are usually characterized by angry outburst, irritability, depression, anxiety and confusion. In order to be classified and PMS or PMDD the symptoms must be cyclic in nature, escalating during the Luteal phase in frequency and severity as menses approaches. There is no particular personality type nor psychological profile which is more likely to have PMS or PMDD> It can happen to any one, being more common with aging, and more prevalent in a given family. Stress is not a related factor.
- Progesterone levels increase during the luteal or secretory phase of the cycle. IN response to the LH surge, the egg is released from the developing follicle; granulosa cells then increase production of progesterone. Several symptoms caused by elevations in progesterone are typical of ovulatory cycles. Though this rise may not be the total cause of all PMS symptoms, it contributes to the magnification of some symptoms.
- Women may complain of sleepiness or a feeling of overwhelming tiredness for a day or 2 before their menses begin. Mood changes such as irritability, anger, and depression may occur. Progesterone causes relaxation of the smooth muscle. Since peristalsis in the GI tract is a result of smooth muscle contraction, slowing of the peristalsis may lead to bloating and constipation. Migraine headaches are largely caused by vasodilation. With smooth muscle relaxed around the blood vessels, vasodilation can occur as a result of the increased progesterone causing premenstrual migraines. The full mechanism is actually not that clearly understood, but the change in hormones at the end of the luteal phase clearly contributes to the development of PM headaches in susceptible individuals.
- Listen during this short video for cyclicity of symptoms, specific symptoms, timing of initiation of these symptoms.
- At what did Laura’s menses begin. With your knowledge of puberty, is this normal? How long from menarche till her symptoms became distressingenough to seek treatment? Knowing the age of menarche, when would you expect regular ovulation to begin? Is the timing of her symptoms consistent with ovulation? What are her symptoms and what might be causing them in an ovulatory cycle? What causes the elevation of progesterone levels and how can you block it?
- Menstrual magnification is a phenomenon which can explain some of the difficulties noticed in mood with PMS. Things such as the frustration experienced by the figure on the R