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16 Cards in this Set

  • Front
  • Back
What is the primary feature of PMS that helps in its diagnosis?
Cyclical occurence of symptoms
What are the most common SOMATIC symptoms of PMS?
-Bloating
-Constipation/diarrhea
-Headache
-Fatigue
-Breast swelling and pain
What are the most common EMOTIONAL symptoms of PMS?
-Irritability
-Changes in libido
-Hostility
-Anxiety
-Depression
What are the most common BEHAVIORAL symptoms of PMS?
-Food cravings
-Loss of concentration
-Loss of motor skills
-Sensitivity to noise
What phase of the female reproductive cycle does PMS seem to be related to? Why?
Luteal phase - because estradiol levels are much higher than progesterone
Why would lower progesterone levels be related to anxiety and irritability?
Progesterone seems to have a sedating effect on the CNS
What drug withdrawal do symptoms of PMS in some patients mimic? Why?
Opiate withdrawal - because of lower endorphin levels
What can alleviate PMS in this subset of patients?
Exercise - releases endorphins
How is PMS diagnosed?
Patient keeps a diary of key symptoms and at which part of the cycle they occur in.
What is necessary to confirm the diagnosis of PMS?
Absence of symptoms in the FOLLICULAR phase, but presence in the LUTEAL phase
What is the 1st step in treating PMS?
Educate the patient and reassure her that there likely is a physiologic explanation for her symptoms
What dietary recommondations are given for PMS?
-More fresh foods
-Less processed
What should be advised in addition to dietary recommendations?
Exercise
What medications can help PMS?
Meds to induce anovulation
-OCPs
-Danazol
-GnRH agonists
(last 2 are medical oophorectomy)
What 2 additional meds help with pain in PMS?
-NSAIDs
-Progesterone - vag suppository or oral micronized
What diuretics can be given to reduce bloating and swelling in PMS?
-Spironolactone
-HCTZ with K+ suplementation
-HCTZ w/ Triamterene (Dyazide)