premenstrual tension

Premenstrual Tension (PMT) Symptoms

Premenstrual tension, also known as premenstrual syndrome (PMS), is a common condition that affects many women before their menstrual period. The symptoms can vary from woman to woman but often include:

• Emotional Symptoms: Irritability, anxiety, mood swings, and feelings of overwhelm [1][2]
• Physical Symptoms: Breast tenderness, bloating, weight gain, headaches, and joint pain [3][4]
• Behavioral Symptoms: Difficulty concentrating, feeling tired, and changes in appetite [5]

What is PMDD?

PMDD (Premenstrual Dysphoric Disorder) is a more severe form of PMS that can occur at any time but is often experienced when periods start or during the luteal phase. It's characterized by intense emotional symptoms such as depression, anxiety, and mood swings [6].

Causes of PMT

The exact cause of premenstrual tension is not known, but it may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle [7]. The hormone fluctuations can affect the brain's neurotransmitters, leading to the symptoms experienced by women.

Symptoms of PMS

PMS symptoms usually ease once menstruation begins. However, some women may experience more severe symptoms, which can impact their daily lives and relationships [8].

References: [1] - Context 1 [2] - Context 4 [3] - Context 2 [4] - Context 7 [5] - Context 9 [6] - Context 5 [7] - Context 8

Common Signs and Symptoms of Premenstrual Tension (PMT)

Premenstrual tension, also known as premenstrual syndrome (PMS), is a collection of physical, emotional, and behavioral symptoms that many women experience in the days leading up to their menstrual period. The symptoms can vary from woman to woman, but here are some common signs and symptoms:

• Mood Swings: Irritability, anxiety, depression, and mood swings are common emotional symptoms of PMT.
• Physical Symptoms:
  • Bloating and weight gain
  • Breast tenderness or swelling
  • Headaches
  • Joint pain or backache
  • Constipation or diarrhea
  • Food cravings
• Emotional Symptoms:
  • Feeling sad, irritable, or emotional
  • Tiredness or trouble sleeping
  • Increased anxiety or tension

According to [1], nearly 48 percent of women who are of reproductive age experience PMT, and for about 20 percent of them, symptoms are severe enough to affect their daily lives.

The symptoms of PMT usually arise one to two weeks before the menstrual period and return at the same time each month. While most women experience mild symptoms, some may have more severe symptoms that can impact their work or school life [4].

It's essential for women to be aware of these symptoms and seek medical attention if they experience severe or debilitating symptoms.

References: [1] Context result 3 [2] Context result 14 [4] Context result 3

Diagnostic Testing for Premenstrual Tension

Premenstrual tension, also known as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), is a complex condition that affects many women. While there is no single test to diagnose PMS/PMDD, various diagnostic tests and evaluations can help rule out other medical conditions and confirm the diagnosis.

Laboratory Studies

• Thyroid function tests: These tests are often ordered to rule out thyroid disorders, which can cause symptoms similar to those of PMS/PMDD [3].
• Complete blood count (CBC): A CBC may be performed to check for anemia or other blood-related conditions that could contribute to PMS/PMDD symptoms [3].
• Follicle-stimulating hormone (FSH) level: This test can help determine if hormonal imbalances are contributing to PMS/PMDD symptoms [3].

Diagnostic Screening Tools

• The Premenstrual Symptoms Screening Tool (PSST): This is a diagnostic screening tool that helps identify women with PMS/PMDD. A positive result on the PSST should be further evaluated using the Daily Record of Highs and Lows (DRSP) to confirm the diagnosis [4].

Clinical Evaluation

• A healthcare provider will conduct a thorough clinical evaluation, including:
  • Medical history: To rule out other medical conditions that may be contributing to PMS/PMDD symptoms.
  • Physical examination: To check for any physical symptoms or signs related to PMS/PMDD.
  • Pelvic exam: To evaluate the reproductive system and rule out any gynecological issues [7, 9].
• The healthcare provider will also ask about the timing and severity of symptoms, as well as their impact on daily life.

No Unique Physical Findings or Lab Tests

There are no unique physical findings or lab tests that can positively diagnose PMS/PMDD. A healthcare provider may attribute a particular symptom to PMS if it's part of a predictable premenstrual pattern [10].

References:

[3] - Context 3 [4] - Context 4 [7] - Context 7 [9] - Context 9 [10] - Context 10

Treatment Options for Premenstrual Tension (PMT)

Premenstrual tension, also known as premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), is a condition characterized by physical and emotional symptoms that occur in the days leading up to menstruation. While there are various treatment options available, drug therapy is often considered a first-line approach for managing PMT.

Selective Serotonin Reuptake Inhibitors (SSRIs)

• SSRIs, such as sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac), are commonly prescribed to treat PMDD. These medications work by increasing the levels of serotonin in the brain, which can help alleviate symptoms like anxiety, depression, and mood swings.
• According to a study published in 2002, serotoninergic antidepressants such as fluoxetine, citalopram, sertraline, and clomipramine are effective when used intermittently during the luteal phase of the menstrual cycle [7].
• The FDA has approved three SSRIs for treatment of PMDD: fluoxetine, sertraline, and paroxetine (TABLE 2) [8].

Other Medications

• In addition to SSRIs, other medications like ibuprofen and acetaminophen can be used to alleviate physical symptoms such as cramps and bloating.
• However, it's essential to note that these medications should only be taken under the guidance of a healthcare provider.

Key Points

• Drug therapy is often considered a first-line approach for managing PMT.
• SSRIs are commonly prescribed to treat PMDD due to their effectiveness in increasing serotonin levels.
• Other medications like ibuprofen and acetaminophen can be used to alleviate physical symptoms, but should only be taken under the guidance of a healthcare provider.

References

[7] A study published in 2002 found that serotoninergic antidepressants are effective when used intermittently during the luteal phase of the menstrual cycle. [8] The FDA has approved three SSRIs for treatment of PMDD: fluoxetine, sertraline, and paroxetine (TABLE 2). [11] A study found that ibuprofen is prescribed to approximately 9% of females and 7% of males for pain and other symptoms associated with female genital organs.

Premenstrual Tension (PMT) Differential Diagnosis

Premenstrual tension, also known as premenstrual syndrome (PMS), is a condition that affects many women before their menstrual period. While it can be a distinct entity, there are several other conditions that may present with similar symptoms, making differential diagnosis essential.

Conditions to Consider:

• Anxiety Disorders: Women experiencing anxiety disorders, such as generalized anxiety disorder or panic disorder, may exhibit symptoms like irritability, mood swings, and physical complaints.
• Bipolar Disorder: Bipolar disorder can manifest with mood swings, which may be mistaken for premenstrual tension. However, the presence of manic episodes and a distinct pattern of mood changes over time are key differentiators.
• Chronic Fatigue Syndrome (CFS): CFS, also known as myalgic encephalomyelitis, can present with fatigue, muscle pain, and other symptoms that may overlap with premenstrual tension.
• Depression: Depression, particularly the atypical subtype, can feature mood swings, changes in appetite, and sleep disturbances, which may be confused with premenstrual tension.

Key Differentiators:

While these conditions share some similarities with premenstrual tension, there are distinct differences that help differentiate them:

• Timing: Premenstrual tension symptoms typically occur 1-2 weeks before menstruation, whereas anxiety disorders and depression can have a more variable timing.
• Pattern of Symptoms: The pattern of symptoms in premenstrual tension is often cyclical, with symptoms recurring predictably each month. In contrast, anxiety disorders and depression tend to have a more random or unpredictable pattern.
• Physical Complaints: Premenstrual tension often involves physical complaints like breast tenderness, bloating, and fatigue, which are less common in anxiety disorders and depression.

References:

1. Sep 15, 2021 — Differential Diagnoses · Anemia · Anxiety Disorders · Bipolar Disorder · Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) · Depression · Dysthymic ...
2. by S HOFMEISTER · 2016 · Cited by 348 — Prospective questionnaires are the most accurate way to diagnose premenstrual syndrome and premenstrual dysphoric disorder because patients have ...

These conditions require a comprehensive evaluation, including a thorough medical history, physical examination, and laboratory tests, to determine the underlying cause of symptoms. A healthcare professional can provide an accurate diagnosis and develop an effective treatment plan tailored to individual needs.