Síndrome premenstrual y trastorno disfórico premenstrual / [Premenstrual syndrome and dysphoric premenstrual syndrome].

Premenstrual syndrome is characterized by physical, cognitive, affective and behavioral symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolved quickly at the beginning or within few days after menstruation started. The most severe form is represented by premenstrual dysphoric disorder included in the DSM 5. Over 40

of women experience emotional symptoms such as irritability, tension, emotional lability; and physical symptoms such as breast tenderness, fatigue, and abdominal distension. It has not yet been established the underlying pathophysiological mechanism, although hypotheses related to sex hormones and the GABAergic and serotonergic regulation have been postulated. Treatment includes nonpharmacologic and pharmacologic interventions, being serotonin reuptake inhibitors the first-line treatment.

Síndrome premenstrual y trastorno disfórico premenstrual en la adolescencia / Premenstrual syndrome and premenstrual dysphoric disorder during adolescence

Hasta 85 por ciento de las mujeres en edad fértil presentan síntomas premenstruales. Sólo algunas de ellas cumplen criterios para Síndrome Premenstrual (SPM) y menos aún para Trastorno Disfórico Premenstrual (TDPM). Ambas patologías comienzan en la adolescencia y se asocian a consecuencias negativas que interfieren en el funcionamiento diario. A pesar de eso, pocas adolescentes consultan por estos síntomas y, cuando consultan, muchas veces, no reciben el diagnóstico ni el tratamiento adecuado. En este artículo se hace una revisión de la epidemiología, diagnóstico y tratamiento del SPM y del TDPM en adolescentes. Educación sobre cambios en estilo de vida, alimentación saludable y ejercicio, son las intervenciones más recomendadas en adolescentes. En cambio, en adultos habría mayor evidencia en tratamiento hormonal y con psicotrópicos.

Up to 85 percent of women of child bearing age present premenstrual symptoms. Only some of them meet criteria for Premenstrual Syndrome (PMS) and even less for premenstrual dysphoric disorder (PMDD). Both diseases begin in adolescence and are associated with negative consequences that interfere with daily functioning. Despite this, few adolescents consult for these symptoms, and when they consult, they do not get proper diagnosis and treatment. In this article we review the epidemiology, diagnosis and treatment of PMS and PMDD in adolescents. Education on lifestyle changes, healthy nutrition and exercise are the interventions most recommended in adolescents. In contrast, in adults, hormone therapy and psychotropic have greater evidence.

Characterization of headaches in the premenstrual tension syndrome / Caracterização das cefaléias na síndrome da tensão pré-menstrual

OBJECTIVE: Characterization of headaches in premenstrual syndrome (PMS). Although headache is one of the symptoms for PMS, no details on this headache are given by the American College of Obstetrics and Gynecology (ACOG) criteria. METHOD: A group of 45 fertile age women presenting PMS were invited to complete a registration diary for headache and PMS symptoms for three consecutive months. The diary included details of each headache attack, allowing for classification according to the International Headache Society criteria (IHS-2004). RESULTS: Migraine without aura was the most common type of headache in PMS (n=27, 60 percent), followed by tension type headache (n=15, 30 percent). Only in two cases the type of headache varied among the observed months, and only in one case the diagnosis could not be concluded by the IHS-2004 criteria. CONCLUSION: Better clinical and therapeutic approach to headache in PMS can be achieved if the patient's type of headache could be properly characterized.

OBJETIVO: Caracterização das cefaléias na síndrome da tensão pré-menstrual (TPM). Embora cefaléia seja um dos sintomas associados à TPM, não são fornecidos detalhes sobre esta dor pelos critérios do American College of Obstetrics and Gynecology (ACOG). MÉTODO: Um grupo de 45 mulheres em idade fértil apresentando TPM foi convidado a preencher um diário de registro de cefaléia e dos sintomas de TPM por três meses consecutivos. O diário incluía detalhes de cada crise de cefaléia, permitindo classificação de acordo com os critérios da International Headache Society (IHS-2004). RESULTADOS: Enxaqueca sem aura foi a forma mais freqüente de cefaléia na TPM (n=27, 60 por cento), seguida de cefaléia tipo tensional (n=15, 30 por cento). Em apenas dois casos a cefaléia variou entre os meses observados e em apenas um caso o diagnóstico não pôde ser conclusivo pelos critérios da IHS-2004. CONCLUSÃO: Melhor manejo clínico e terapêutico pode ser obtido na cefaléia da TPM se o tipo de cefaléia apresentado pela paciente puder ser adequadamente caracterizado.

Síndrome de tensão pré-menstrual, transtorno disfórico pré-menstrual e agressão / Pre-menstrual tension syndrome, pre-menstrual dysphoric disorder premenstrual and aggression

Nas últimas décadas, médicos, mulheres e seus familiares observaram um aumento na incidência de manifestações sintomáticas durante o período pré-menstrual. este período engloba alterações tanto no aspecto físico quanto no psíquico das pacientes que apresentam a síndrome de tensão pré-menstrual e o transtorno disfórico pré-menstrual. é reconhecido que algumas mulheres tornam-se mais agressivas durante o “paramenstrum” e atitudes mais violentas são relatadas. este artigo propõe uma revisão da relação entre a fase pré-menstrual e as atitudes agressivas em seus aspectos fisiológicos e manifestações clínicas, as repercussões no dia-a-dia das pacientes, o diagnósticos e o tratamento.

Síndrome pré-menstrual: abordagem baseada em evidências / Premenstrual syndrome: an evidence-based approach

A síndrome pré-menstrual afetando milhões de mulheres em idade reprodutiva e caracteriza-se por sintomas clínicos recorrentes durante a fase lútea do ciclo menstrual, que diminuem rapidamente com o início da menstruação. A maioria das mulheres experimenta modificações físicas e emocionais periódicas mínimas relacionadas com o ciclo menstrual, mas a condição da síndrome pré-menstrual impõe considerável ruptura nas atividades ocupacionais, familiares e pessoais. Mulheres com sintomas afetivos graves também podem preencher os critérios para o diagnóstico de distúrbio disfórico pré-menstrual. O impacto negativo desses sintomas sobre as atividades diárias e na qualidade de vida já foi documentado e os custos econômicos, especialmente considerando a diminuição na produtividade, já foram estabelecidos. Neste estudo os autores apresentam uma revisão da literatura disponível e fazem uma abordagem baseada em evidências relacionada com a síndrome pré-menstrual, incluindo sua fisiopatologia, quadro clínico, diagnóstico e tratamento.

Influências dos fatores individuais e sócio-culturais na ocorrência da síndrome pré-menstrual (SPM) em adolescentes / Influence of the individual, social and cultural factors in the occurrence of premenstrual syndrome (PMS) in adolescents

Esse trabalho visou avaliar a prevalência, caracterizar sintomas e identificar aspectos individuais e sócio-culturais relacionados à SPM em Adolescentes entre 14 e 18 anos, e suas mães, através de estudo prospectivo. Os protocolos baseados nos critérios de Moss foram preenchidos em entrevistas individuais. Procedeu-se análise descritiva seguida de estudo não pareado. Para variáveis categóricas utilizou-se tabelas de contingência, e como medida de associação o χ2 e o Teste Exato de Fisher / This work aimed at to evaluate the prevalence, to characterize symptoms and to identify related individuals and partner-cultural aspects to the PMS in Adolescents between 14 and 18 years old, and her mothers, through prospective study. The protocols based on the Moss’s criteria had been filled in individual interviews. Descriptive analysis was preceded from the data. For categorical variable was used contingency tables, and as measured of association χ2 and the Fisher’s Accurate Test...

Avaliação videotelelaringoscópica das pregas vocais e análise acústica da voz em portadoras de síndrome pré-menstrual / The videolaryngoscopical evaluation of the vocal folds and the acoustical analysis of the voice in women experiencing a pre-menstrual syndrome

A presente pesquisa objetiva a investigação por videotelelaringoscopia em portadoras de síndrome pré-menstrual, verificando a sua associação com as alterações hormonais e acústicas da voz. Foram selecionadas voluntárias divididas em duas amostras: uma com 29 portadoras de síndrome pré-menstrual e 25 mulheres que formaram o grupo controle. Em todas foram realizadas videotelelaringoscopia, dosagem hormonal e gravação digital e análise acústica da voz. Concluímos que as pacientes portadoras de síndrome pré-menstrual apresentam congestão vascular em bordas superiores e edema de pregas vocais.. Não ocorreram alterações significativas nas medidas acústicas exceto no Shimmer / The present research aims the investigation of women experiencing the pre-menstrual syndrome performed through videotelelaryngoscopy in order to check the presence of an association with hormonal and acoustical voices changes. Twenty-nine women experiencing pre-menstrual syndrome and twenty-five used as controls and designated to two different groups were selected to participate in this study. All those volunteers were submitted to a videotelalaryncoscopy, a hormone dosage, digital recording and acoustical voice analysis. The conclusion was that all women suffering from Pre-Menstrual Syndrome present a vascular congestion of the superior edges and swelling of the vocal folds...

Abordaje del síndrome premenstrual: una revisión actualizada / Boarding of the premenstrual syndrome: An update review

El síndrome premenstrual afecta a millones de mujeres en todo el mundo y está descrito como uno de los desórdenes más comunes en las mujeres en edad reproductiva, en general queda reservado para aquellos cambios premenstruales adversos cuya duración e intensidad provoquen cambios en la calidad de vida. Se realiza una revisión del manejo del síndrome premenstrual no solo desde el punto de vista farmacológico, donde los avances más recientes, basados en números estudios clínicos, demuestran la eficacia de los inhibidores selectivos de la recaptura de serotonina como fármacos de primera línea, además se describen otras opciones de tratamiento medicamentoso, así como medidas de ayuda en cuanto a la dieta, hábitos, ayuda psicológica y medicina alternativa entre otras; enfatizando que cada mujer es única y que es necesario monitorizar cada opción de tratamiento e individualizar cada caso.

Menstruation among adolescent school girls

This work was carried out to study the characteristics and problems of the menstrual cycle among adolescent schoolgirls, the knowledge of girls about different aspects of menstruation and to assess the practicing of menstrual hygienic measures in relation to their knowledge. The study was carried out on 210 postmenarcheal schoolgirls aged 13-16 years [104 preparatory school girls and 106 secondary school girls] as a random sample from one preparatory and one secondary school at El-Mahalla El-Kobra City, Gharbia Governorate during the scholastic year 1999-2000. The average menarcheal age was 12.63. +/- 0.99 years. The mean duration of menstrual blood flow was 4.74 +/- 1 .60 days. Most of the studied girls [60%] had menstrual cycle of normal length [28-32 days]. Only 36.67% of the studied girls menstruating blood in average amount. Most of the studied girls menstruating regularly [87.14%]. Nearly two thirds of the studied girls suffered from premenstrual symptoms [66.24%], with significant higher percent among secondary school girls than preparatory ones [72.64% and 57.69% respectively]. Vulvitis was detected among 15.24% of the studied girls during the period of the study with no significant difference between preparatory and secondary schoolgirls. The most frequent premenstrual symptoms among the studied girls were abdominal cramps, impaired concentration, headache, mood changes and low work performance with significant difference between them. Abdominal cramps and low work performance were more frequent among preparatory school girls than secondary school girls. Some premenstrual symptoms, were more frequent among secondary school girls than preparatory ones as headache, mastalgia, backache, fatigue and behavioral changes. The menstrual gynecological problems were detected among 88.10% of the studied girls, with no significant difference between preparatory and secondary schoolgirls. The most frequent menstrual problem was dysmenorrhea [75.71%], with higher percent among preparatory than secondary schoolgirls [81 .73% and 69.8 1% respectively]. Heavy menstrual bleeding represented 47.62%. followed by hypomenorrhea [14.29%] and polymenorrhea [7.62%]. Menstruation was a leading cause to other non-gynecological problems including: decreased daily activities, impaired school performance and school absentism, with no significant difference between preparatory and secondary school girls. 37.03% of the studied girls had correct knowledge, 30.11% had false knowledge and 32.86% had no information about menstruation. The pattern of distribution of' knowledge as being good or unsatisfactory was significantly different between preparatory and secondary schoolgirls regarding good knowledge about; premenstrual symptoms, changes that occur differences regarding their knowledge about menstrual hygiene, Statistically, there were significant differences between correct and bad practice of hygienic measures among the studied girls on the light of their knowledge regarding; perineal hygiene, use of chemicals during perineal wash, frequency of changing pads during menstruation, sanitary disposal of pads, and bathing during menstruation [with higher percents of good knowledge and correct practice among secondary schoolgirls than preparatory ones]. 84.29% of the studied girls depended on a single source of information about menstruation. The highest percent of the studied girls depended on their mothers as a source of information [51.43%]. The level of education among parents of the studied girls denoted that their reproductive knowledge was not sufficient as a source of information and they must be indulged in the programs of reproductive health education for the benefit of their daughters. The occupation of parents and their economic standard may have a role as a barrier for good practice of hygienic measures inspite of the good knowledge among their girls. The findings of the present study point to the need for early school-based reproductive health education programs, incorporating correct information on reproductive biology and the subsequent prevention of reproductive ill health. The reproductive education programs designed for schoolgirls must be based upon their true knowledge at different education grades, putting in consideration the role of their curriculum

O avesso da síndrome pré-menstrual / The contrary of the pre-mestrual syndrome: perception of women

O objetivo deste estudo foi investigar as percepçöes de mulheres sobre a síndrome pré-mestrual-SPN.Foi desenvolvido numa abordagem qualitativa,tendo como foco central a fala de mulheres portadoras da SPN, que partcipam das atividades de saúde de senvolvidas no centro de saúde Vila Ivonete localizada na cidade de Rio Branco-Acre.Os dados mostraram que as mulheres percebem a síndrome pré-mestrual como uma forma de castigo, como coisa de mulher, como resultado de extravagâncias e como decorrente da dupla jornada de trabalho a que estäo sujeitas na vida diária. Os dados mostraram ainda, que por conta do agravamento dos sintomas, as mulheres buscam alívio para os mesmos através da automedicaçäo como por indicaçäo médica.

Síndrome premenstrual / Premenstrual syndrome

El Síndrome Premenstrual (SPM) es una entidad caracterizada por un conjunto de disturbios somáticos, afectivos y de conducta, que recurren en forma cíclica durante la fase lútea del ciclo menstrual. Casi todas las mujeres manifiestan tener síntomas premenstruales; no obstante, menos del 50 por ciento de las mujeres que menstrúan concurren al médico por esa causa y sólo el 5 por ciento de ellas tienen síntomas graves que obligan a la consulta médica, estos casos son los denominados SPM. La fisiopatología de estos trastornos es variada y el análisis de la misma resulta por ello de gran complejidad. El tratamiento adecuado del SPM en la adolescencia, reviste por todo lo expuesto gran importancia para el control de los síntomas de modo que les permita desempeñar adecuadamente y con confort todas sus funciones durante todas las fases del ciclo menstrual. De este modo, algunas de estas pacientes pueden ser ayudadas impartiéndoles tranquilidad a través de la información a cerca de la fisiología del ciclo menstrual, mientras que otras dada la severidad y características de los síntomas sólo se benefician con el uso de medicaciones que manejan el síntoma primordial

Inescapable shocks accentuate fluctuations of forced swimming immobility in different phases of the rat estrous cycle

The forced swimming test is an animal model that is sensitive to the different antidepressant treatments. On the other hand, it is also sensitive to the characteristics changes suffered by animals that have been previously exposed to different depression models. In the present study we xplored the effects on inescapable shock on the forced swimming test, during different phases of the rat estrous cycle. There was an increase of the immobility during diestrus as compared to estrus. Furthermore, inescapable shock increased the immobility, byt only during diestrus. Thus the differences found between both phases of the estrous cycle were accentuated. Due to the fact that diring diestrus there is an absence of progesterone, and that depressed women exacerbate their symptoms during the premenstrual phase, the authors suggest that the immobility registered during the forced swimming test may be useful in the study of premenstrual depression

Effect of premenstrual stress on audiovisual reaction time and audiogram.

A study of weight, auditory reaction time (ART), visual reaction time (VRT) and audiogram was carried out on 105 healthy female subjects between the age of 17-20 years during the premenstrual and post-menstrual phase. A significant increase in weight and prolongation in auditory reaction time (ART) and visual reaction time (VRT) were observed during premenstrual phase. A slight increase in decibel loss was also observed during premenstrual phase in audiogram though not significant. These changes could be attributed to fluid and salt retention due to overain steroids leading to decrease in the processing capability of central nervous system.

Síndrome pré-menstrual: um sofrimento ao feminino / Pre-menstrual syndrome: a complaint to feminine

A síndrome pré-menstrual (SPM) afeta até 95 por cento das mulheres em idade fértil com pelo menos um sintoma leve, e até 11 por cento das mesmas com sintomas invalidantes. Apesar da alta freqüência deste transtorno, muito pouco se sabe sobre sua fisiopatologia, o que explica que o arsenal terapêutica seja limitado apenas a tratamentos sintomáticos. Implicaçoes sócio culturais da menstruaçao e as as principais manifestaçoes clínicas sao analisadas, bem como as dificuldades para se estabelecer um diagnóstico preciso. Ne sentido, as principais classificaçoes nosológicas atuais sao descritas. A relaçao da SPM com outros transtornos psiquiátricos, especialmente com os transtornos afetivos, levou certos autores a proporem que esta síndrome seja incluída em futuras classificaço nosológicas. Estudos prospectivos estao sendo realizados na tentativa de examinar a oportunidade de tal possibilidade. Os autores concluem que muito caminho deve ainda ser percorrido no campo da SPM, o que nao impede que algumas propostas terapêuticas sejam já utilizadas.

Clomipramine modifies fluctuations of forced swimming immobility in different phase of the rat estrous cycle

Many symptoms that define the premenstrual syndrome (PMS) are present in depressive states. The fact that there are not adequate animal models to study the OMS may explain the lack of knowledge about its etiology. An alternative might be the use of animal models which are useful to study depression, such as the forced swimming test. Eighteen female rats were subjected to the forced swimming test once a week for six consecutive weeks. An increase of immobility was observed during diestrus as compared to estrus. On the other hand, some premestrual symptoms have been suggested to be caused by the influence of gonadal hormones on the activity of cental serotonergic systems. Thus, the effects of clomipramine were further studied. The drug reduced rat immobility during diestrus, so that the differences between the two estrous cycle phases disappeared. We conclude that the use of the forced swimming test might be a helpful model in the study of OMS