pre menstrual syndrome

Question 1

what is pre menstrual syndrome

Answer 1

behavioural and physiological changes associated with luteal phase (about a week pre menses)

Question 2

epideimeilogy of pre menstrual syndrome

Answer 2

affects 40% of women 20-45y

Question 3

what causes pre menstrual syndrome

Answer 3

occurs due to hormonal changes + decreased serotonin in luteal phase

Question 4

risk factors for pre menstrual syndrome

Answer 4

depression
fhx of depression
smoking
stress
alcohol
mood disorders

Question 5

what is mittelschmen

Answer 5

mid cycle pre ovulatory low abdo pain between day 7-24 in 40% of females

Question 6

hormonal related symptoms of pre menstrual syndrome

Answer 6

bloating (progesterone)
tired
hot flushes (oestrogen)

Question 7

serotonin related symptoms of pre menstrual symptoms

Answer 7

depression symptoms
anxious
irritable
fatigue
constipation

Question 8

how to clinically diagnose pre menstrual syndrome

Answer 8

2 or more cycles like this with symptom diary
must be associated with luteal phase

Question 9

gold standard diagnosis for pre menstrual syndrome

Answer 9

give GnRH analogue for 3 months
(1m to work, 2m for effect)
+ve test shows –> complete resolution of symptoms

Question 10

conservative treatment of pre menstrual syndrome

Answer 10

regular sleep
stop alcohol and smoking
increased excercise

Question 11

medical treatment of pre menstrual syndrome

Answer 11

NSAIDS for pain
COCP for physical symptoms
GnRH for physical symptoms (last line)
CBT + SSRI for behaviour symptoms

Question 12

complications of pre menstrual syndrome

Answer 12

post menstrual dysphoric disorder (PMDD)
- severe version
- severe mood swings, agitation +/- psychosis
- increased risk of self harm and suicide