What are the signs and symptoms of Primary Dysmenorrhea?
Pain begins with onset of menses and peaks on first day, lower abdominal or suprapubic cramping, Pain with N and V, fever, HA and lightheadedness, pain radiates to back or thighs, stops with menses
What dietary changes can be used to treat Dysmennorhea?
Decrease Sodium, Caffeine and Fat
Why is exercise a treatment for Dysmenorrhea?
Suppresses prostaglandin release, increases endorphins, shunts blood from the uterus and decreases stress
Define Premenstrual syndrome:
Broad term for a number of behavioral and somatic symptoms occurring during the late luteal phase of the menstrual cycle and disappearing after the onset of menses
What is the etiology of PMS?
Unknown
Estrogen peaks before or after ovulation?
Before
Progesterone peaks before or after ovulation?
After
The first phase of the menstrual cycle, which includes menstruation and the development of the follicle, prior to ovulation is called what?
Follicular phase
The second half of the menstrual cycle that occurs after ovulation is called what?
Luteal phase
What is the incidence of PMS?
90% of all women, 40% of childbearing age have significant disruptive systems and 3-5% have severe impairment
What psychological complaints are common with PMS?
Anxiety, Irritability, Depression/sadness/hopelessness, tension, mood swings, crying and difficulty concentrating
What physical complains are common with PMS?
Acne, abdominal bloating/cramping, backache, breast tenderness, HA, Constipation/diarrhea, N/V, weight gain
What is Premenstrual Dysphoric Disorder?
Severe subtype of PMS (5% of most severe PMS)
What percent of women have Premenstrual Dysphoric Disorder?
3-8%
The symptoms of Premenstrual Dysphoric Disorder are similar to what?
Major depressive disorder
Premenstrual Dysphoric Disorder suffers are 14 times more likely to have what?
Major depressive disorder
Why is it difficult to diagnose PMS?
100 symptoms associated, not lab test
How is PMS usually diagnosed?
Charting of symptoms that appear/change during luteal phase and disappear in follicular phase
What are the first line treatments for PMS?
Regular sleep, caffeine restriction, Exercise, Smoking and alcohol cessation, low intake of fats and sodium, stress management, outdoor activities, light therapy, acupuncture
(True/False) Midol contains caffeine.
True 2 Midol caplets = 1 cup of coffee
What are the pharmacologic treatments for PMS?
Antidepressants, NSAIDs and Diuretics
What antidepressants may be prescribed for PMS (per FDA)?
SSRIs: Fluoxetine (Prozac), Sertraline (Zoloft) and Paroxetine (Paxil) (TCAs and SNRIs can also be sued)
Do SSRIs need to be continuously administered for PMS?
