Low central serotonin levels. Acute treatment with SSRIs increases synaptic serotonin and can improve mood symptoms of PMDD. Altered serotonin sensitivity in response to fluctuations in gonadal hormones – tryptophan, a precursor to serotonin is efficacious in PMDD.
What are the signs and symptoms of PMDD?
The most frequent PMDD symptoms among women seeking treatment consist of anger/irritability, anxiety/tension, feeling tired or lethargic, mood swings, feeling sad or depressed, and increased interpersonal conflicts. Women who develop PMDD appear to have serotonergic dysregulation that may be triggered by cyclic changes in gonadal steroids.
What is a PME in PMDD?
When this occurs, the term premenstrual exacerbation or PME is used to refer to the mood worsening which occurs during the premenstrual phase. An estimated 40% of women who seek treatment for PMDD actually have a PME of an underlying mood disorder. 5
What is the best treatment for PMS/PMDD?
These side effects may be mitigated by “add-back” therapy with estrogen and progesterone; however, some women may experience recurrent PMDD symptoms with the addition of these hormones. 27 Similarly, danazol, a synthetic androgen, is an effective therapy for PMS/PMDD when given in doses high enough to inhibit ovulation.
How effective are SSRIs in the treatment of PMDD and PMS?
A significant body of evidence, including numerous double-blind, randomized studies, supports the effectiveness of SSRIs in reducing both the emotional, as well as physical symptoms, of PMS and PMDD. In general, women respond to low doses of SSRIs, and this treatment response usually occurs rapidly, often within several days.
Which of the following best describes Genderlects?
Which of the following best describes the term genderlects ? The fundamental differences in the ways men and women communicate.
What was an important finding from Masters and Johnson's research?
Masters and Johnson really underlined the power of female sexuality, and in their long-term study what they showed was that women had the capacity for multiple orgasms in a way that men would go into what they called 'a refractory period' after having the initial sexual orgasm.
What is the age range in which menopause will typically occur quizlet?
-In the U.S., the average age of menopause is 52, with a normal range of 45-55.
What does the term Mittelschmerz refer to?
Ovulation Pain (Mittelschmerz) If you have ovulation pain, also called mittelschmerz, you may experience twinging or cramps during ovulation. Other ovulation pain symptoms include light vaginal bleeding and discharge. Most of the time, rest and over-the-counter medications help.
What is Masters and Johnson technique?
In the Masters and Johnson technique, a sex history is first taken and the couple given physical examinations to rule out physical problems. Therapists then employ exercises focusing on the giving and receiving of sensual, but not necessarily sexual, pleasure to help the couple overcome anxieties about sex.
What was the Masters and Johnson study and what are its four main components?
In 1966, William Masters and Virginia Johnson proposed a four-stage “linear” model of human sexual response based on some 10,000 recordings of changes in participants' physiology. From these data, they identified four successive (hence, linear) stages: (1) excitement, (2) plateau, (3) orgasm, and (4) resolution.
What is menopause 8th?
Answer: A natural decline in reproductive hormones when a woman reaches her 40s or 50s. Menopause is signalled by 12 months since last menstruation.
When a person is in love his or her body releases the drug phenylethylamine which is also found in which of the following?
During the heart-pounding excitement of new love, your brain releases lots of phenylethylamine (PEA). PEA functions like a natural amphetamine, so you really are high on love. PEA triggers the release of two neurotransmitters: dopamine and norepinephrine.
Which type of medical specialist concentrates on the study and treatment of disorders of the female reproductive system?
A gynecologist is a physician who has successfully completed specialized education and training in the health of the female reproductive system, including the diagnosis and treatment of disorders and diseases.
What hormone causes mittelschmerz?
Smooth muscle cell contraction: At ovulation, this pain may be related to smooth muscle cell contraction in the ovary as well as in its ligaments. These contractions occur in response to an increased level of prostaglandin F2-alpha, itself mediated by the surge of luteinizing hormone (LH).
What happens during mittelschmerz?
Mittelschmerz pain occurs on the side of the ovary that's releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months. Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain.
How is mittelschmerz diagnosed?
To diagnose mittelschmerz, your doctor will start by asking you questions to get a clear idea of your medical history, especially regarding your menstrual periods. Your doctor may also perform a physical exam, including a pelvic exam, to check for signs of an underlying condition that could be contributing to the pain.
What is PMDD in menstrual cycle?
Premenstrual Dysphoric Disorder (PMDD) is a more severe form of Premenstrual Syndrome characterized by significant premenstrual mood disturbance, often with prominent mood reactivity and irritability. Symptoms of PMDD can emerge 1-2 weeks preceding menses and typically resolve with the onset of menses.
What are the risk factors for PMDD?
The major risk factors for PMDD include personal history of a mood or anxiety disorder, family history of premenstrual mood dysregulation, stress and age in the late 20’s to mid-30’s.
How common is PMDD in teens?
It has been reported that at least 20% of adolescents experience moderate to severe premenstrual symptoms. PMDD appears to be as common in teens as in older women, with various studies estimating that about 2%-6% of girls between the ages of 14 and 16 meet criteria for PMDD.
How long before menses does PMS occur?
Premenstrual Syndrome, commonly referred to as PMS, is a broad term that typically refers to a general pattern of physical, emotional and behavioral symptoms occurring 1-2 weeks before and remitting with the onset of menses. PMS is common, affecting from 30-80% of women of reproductive age, though clinically significant PMS symptoms have been reported in 3-8% of patients. 2
What antidepressants are used for premenstrual symptoms?
Other antidepressants with serotonergic activity have evidence to endorse their use in the treatment of premenstrual symptoms, including clomipramine (a tricyclic antidepressant), 18 venlafaxine (Effexor), 19 and duloxetine (Cymbalta).
What are the symptoms of premenstrual mood disorders?
Recent data suggest that women with premenstrual mood disorders have abnormal serotonin neurotransmission, along with a lower density of serotonin transporter receptors, which is thought to be associated with symptoms such as irritability, depressed mood and carbohydrate craving.
What are the symptoms of a woman's mood during her period?
In fact, at least 90% of women with regular menstrual cycles report unpleasant physical or psychological symptoms premenstrually. 1 For the majority of women, these symptoms are mild and tolerable .
What is PMDD in women?
Premenstrual dysphoric disorder (PMDD) represents the more severe and disabling end of the spectrum of premenstrual syndrome and occurs in an estimated 2% to 9% of menstruating women. The most frequent PMDD symptoms among women seeking treatment consist of anger/irritability, anxiety/tension, feeling tired or lethargic, mood swings, ...
When did PMS start?
In 1989, the modern era of PMS research began with the appearance in the DSM-III-R of operationally defined diagnostic criteria for PMS (renamed “late luteal phase dysphoric disorder” [LLPDD]).
How many women have PMDD?
PMDD occurs in 2% to 9% of women of reproductive age and requires clear impairment of functioning.3–7Even though the symptoms of PMDD vary from woman to woman, the symptoms experienced by each individual have been shown to be relatively consistent from cycle to cycle.8,9.
Is 20 mg of a placebo good for PMDD?
However, the 60-mg dose was not tolerated well enough to be a useful treatment. The dose of 20 mg is much better tolerated and is the appropriate therapeutic dose for PMDD.
Is fluoxetine good for PMDD?
Irrespective of dosing strategy, fluoxetine has shown broad efficacy in the treatment of the full array of PMDD symptoms, including improvement in physical symptoms78and in ability to function during the late luteal phase of the cycle. The 20-mg dose of fluoxetine should be considered a first-line treatment for PMDD.
Diagnosing PMS and PMDD in the adolescent
To make a diagnosis, PMS symptoms must be tracked and recorded prospectively for at least two menstrual cycles. There are no specific findings on the physical exam useful for diagnosing PMS, and generally laboratory and other diagnostic testing is not needed for diagnosis.
Treatment options
Premenstrual disorders can be complex, multifaceted, and chronic in nature. It is essential for nurse practitioners to consider a holistic, multiple strategy approach to aid in symptom management and improvement in overall wellbeing.
Nonpharmacologic options
Nonpharmacologic management should begin with a patient-centered approach, including the adolescent, her primary caregivers, and the nurse practitioner. First-line therapy includes education, supportive therapy, and behavior change.
Pharmacologic options
Used in conjunction with nonpharmacologic therapy, pharmacologic management including nonsteroidal anti-inflammatory drugs, combined oral contraceptives (COCs), selective serotonin reuptake inhibitors (SSRIs), and/or gonadotropin-releasing hormone (GnRH) agonists has proved effective for the treatment of PMS and PMDD.
Implications for practice
PMS and PMDD are common disorders among adolescents that can significantly impact quality of life and in the case of PMDD can be very debilitating.
In Brief
Learn about the latest treatments for premenstrual syndrome and premenstrual dysphoric disorder.
What causes PMS and PMDD?
Although we know a lot about PMS/PMDD, the cause remains elusive. For every study that might identify a cause, another refutes the findings, sending us back to square one.
How are PMS and PMDD diagnosed?
Diagnosing PMS/PMDD is relatively simple, requiring few costly lab tests. Many of the symptoms are common to all women, but others may vary—which means the diagnostic assessment must be individualized. A history, complete physical examination, and pelvic examination are essential.
How are PMS and PMDD different?
Sometimes, the terms PMS and PMDD are used interchangeably. Although they're similar, they're also different. A careful history will help to differentiate between the two.
How are PMS and PMDD treated?
Lifestyle changes—including dietary changes, exercise, vitamin B and calcium supplements, and stress reduction—are the cornerstone of treatment for PMS.
Dietary modifications
Although research hasn't shown overwhelming value in changing the diet, it does help in some cases. What's more, some of the changes recommended here can help women lose weight, which can decrease their risk of developing heart disease and diabetes, improve self-esteem, and reduce stress.
Exercise
Women benefit from exercise regardless of whether they have PMS or PMDD. Exercise reduces fatigue, promotes a sense of well-being, and can reduce stress. In several studies, aerobic exercise helped lower the intensity and number of premenstrual symptoms.
Prognosis
Symptoms
Overview
Epidemiology
Diagnosis
Signs and symptoms
Causes
Pathophysiology
Publication
Prevention
Side effects
Treatment
Uses
- Herbal Remedies Herbal remedies may have some role in the treatment of premenstrual symptoms. A recent systemic review of all randomized controlled trials using vitex agnus castus fruit extract, also known as chasteberry, concluded that it is a safe, efficacious treatment for PMS/PMDD symptoms. Though the RCTs examined had slightly different modes ...
Research