Premenstrual Syndrome (PMS) is a commonly known health issue and has wide variety of symptoms and effects on the health of the women. Premenstrual syndrome is a condition that affects the women emotions, physical health, and the behaviour during the days of menstrual cycle. It is generally referred to as the period or days before the occurrence of menstruation. The problem is observed to affect almost 85% of the women in the phase of menstruation. It has been found that it starts from 5 to 11 days before the cycle, and tends to end once the cycle begins. The cause of the syndrome is unknown, but many researches believed that they are the result of change in the sex hormones (Imai et al., 2015).
The pathophysiology of the PMS is stated as the syndrome and the dysphoric disorder are both stimulated by the hormonal events which ensue after ovulation (Qiao et.al, 2017). The symptoms of the disorder can begin in the early, mid or the later phase and these are not related to the specific contraction of any gonadal or non-gonadal syndrome. It has also been found that lowering of the serotonin can give rise to the PMS-like symptom (Perlman & Kjer, 2016).
With the context to the case study, Tracey Wilson, a 38-year old women faced number of symptoms such as bloating, breast tenderness, mood swings (anger and depression), acne , and others. Therefore, these are the symptoms that relates to the changes in the hormones or hormonal abnormality leading to the premenstrual syndrome as the symptoms and effects on the health of the women leads to the illness for longer term impacting their reproductive system (Jang, Kim & Choi, 2014). Eating food in smaller quantity, reducing the salt intake, more frequent meals will reduce blotting and fullness as it relates to the case of the Tracey. The case study also depicted the removal of the ovarian cyst in the body of Tracey’s which indicates about the situation represented in this syndrome.
Premenstrual syndrome leads to the critical condition sometimes, as the physical pain and the emotional stress are enough to affect the daily lives of women. Therefore, it should be treated well on time. Thus, there are some common causes of the syndrome, such as clinical changes in the hormone, chemical changes in the brain, and depression. In addition, it has been found that the women’s menstrual cycles are controlled by the complex hormone interaction, leading to the premenstrual syndrome symptoms. PMS includes premenstrual fluctuations in a brain chemical called as serotonin as one of the common cause of this syndrome. Some other possible factors leading to the same problem includes lack of certain vitamins and minerals in the body, consumption of alcohol, caffeine, and the intake of diet rich in salty foods (Stewart, 2013).
With context to the case study, it has been observed that Tracey had the habits of smoking and drinking moderately at social events, which is the cause of disturbance in her menstruation cycle, and other symptoms (Pearlstein & O’Brien, 2017). After the research on the symptoms and effects of the PMS syndrome on the women’s health, there has been no certain or particular cause of the problem. It has been connected to the luteal phase, but the changes in the hormones are considered to be one of the major factors, and the changes in the hormone levels also affect the occurrence of this situation. Chemical changes in the brain and the increased stress levels make the situation and symptoms worse. As Tracey’s health condition reported symptoms such as abdominal bloating, tiredness and nausea, which is the result of the high sodium/alcohol, or the low levels of vitamins or minerals in the body.
The clinical manifestation of the difference in the polycystic syndrome and the PMS can be analysed through an understanding of the role and effect of the polycystic syndrome in the body of women. Polycystic syndrome refers to the condition of the women’s health that affects the hormone levels (Safari et al., 2015). It is commonly found to be affecting women during their childbearing years, specifically. In broader sense, it affects the ovaries in the women, the production of estrogen, and progesterone i.e. hormones that regulate the menstrual cycles. In this situation, women secrete the male hormones, known as androgen. This syndrome is group of three symptoms affecting the ovaries and ovulation. The key features of the PCOS syndrome are mentioned below (Yen et al., 2018).
The case depicted the removal of the ovarian cyst in the body of Tracey’s which indicates about the situation represented in this syndrome (Perlman & Kjer, 2016). The clinical manifestation of the PCOS and PMS represents the signs and symptoms of these syndromes and the effect on the women’s health (Rosenblum & Ekhlaspour, 2017). Polycystic syndrome’s clinical manifestation varies with the ethnic, racial and the environmental factors. However, the most commonly observed hormonal abnormalities in PCOS syndrome include hyperandrogenisim, oligomenorrhea, and polycystic ovaries. The clinical presentations also represented the problem of menstrual irregularity. Menstrual dysfunction is one of other clinical features that represent absent or infrequent menstrual bleeding. Premenstrual syndrome represents the presence of both physical and behavioural symptoms (Kandaraki et al., 2017).
The diagnosis and treatment of the premenstrual syndrome is necessary during the adulthood or the childbearing years of women. Therefore, there are some of the common therapies related to the premenstrual syndrome which include hormonal contraceptives, anti-depressants, use of painkillers, diuretics and others. It has been recommended by many doctors in most cases, changes in the lifestyle can help the women deal with the premenstrual syndrome (Bäckström & Bäckström, 2016).
Depending on the severity of the problem or symptoms, treatment varies and the prescription of medications. Amongst all, the most common diuretics, help in the most cases when the limitation of the salt intake and the exercising does not help to reduce the severity. Diuretics refers to taking water pills which helps in shedding out the excess fluids from the kidneys. Spironolactone is one of the diuretics that help, as a hormonal contraceptives stops ovulation which helps in getting relief from this syndrome. The alternative medicines which act as therapies can also help, such as vitamin supplements, acupuncture, contributes in the treatment of the health condition of women (Shoupe, 2017).
A lifestyle change of women can also help contributing to better treatment of this condition, such as modification in the diet, regular exercise, yoga, intake of nutritious food and necessary supplements (Ryu & Kim, 2015).
References
Imai, A., Ichigo, S., Matsunami, K. & Takagi, H. (2015). Premenstrual syndrome: management and pathophysiology. Clinical and experimental obstetrics & gynecology, 42(2), 123-128.
Jang, S. H., Kim, D. I., & Choi, M. S. (2014). Effects and treatment methods of acupuncture and herbal medicine for premenstrual syndrome/premenstrual dysphoric disorder: systematic review. BMC complementary and alternative medicine, 14(1), 11.
Kandaraki, E., Papadakis, G., Tsirona, S., Asimakopoulou, A., Chiotinis, N., Chronopoulou, G. & Diamanti-Kandarakis, E. (2017). Association of basal and post-Synachten stimulated 17-hydroxyprogesterone levels with insulin resistance in Polycystic Ovary Syndrome. Endocr Rev, 33, 98-1030.
Pearlstein, T. & O’Brien, S. (2017). A Woman with Inexplicable Mood Swings: Patient Management of Premenstrual Syndrome. In Bio-Psycho-Social Obstetrics and Gynaecology (pp. 183-198). Berlin: Springer.
Perlman, S. & Kjer, J. J. (2016). Ovarian damage due to cyst removal: a comparison of endometriomas and dermoid cysts. Acta obstetricia et gynaecological Scandinavica, 95(3), 285-290.
Qiao, M., Sun, P., Wang, H., Wang, Y., Zhan, X., Liu, H. & Wang, F. (2017). Epidemiological Distribution and Subtype Analysis of Premenstrual Dysphoric Disorder Syndromes and Symptoms Based on TCM Theories. Retrieved from: https://www.hindawi.com/journals/bmri/2017/4595016/abs/
Rosenblum, J. & Ekhlaspour, L. (2017). Polycystic Ovary Syndrome. In The MassGeneral Hospital for Children Adolescent Medicine Handbook (pp. 187-193). Berlin: Springer.
Ryu, A. & Kim, T. H. (2015). Premenstrual syndrome: a mini review. Maturitas, 82(4), 436-440.
Safari, T., Manzari Tavakoli, A. R., Kheyr Khah, B., Saeedi, H. & Mahdavinia, J. (2015). The relationship between premenstrual syndrome with anxiety, depression and changes in social relations of women in Kerman University of Medical Sciences. Report of Health Care, 1(4), 139-141.
Shoupe, D. (2017). Diagnosis and Treatment of Premenstrual Syndrome: Differentiating PMS from Premenstrual Dysphoric Disorder PMDD and Premenstrual Exacerbation Disorder PMED. Retrieved from: https://link.springer.com/referenceworkentry/10.1007%2F978-3-319-17798-4_33
Stewart, M. (2013). No More PMS: Beat Pre-Menstrual Syndrome with the medically proven Women’s Nutritional Advisory Service Programme. United States: Random House.
Yen, J. Y., Wang, P. W., Su, C. H., Liu, T. L., Long, C. Y. & Ko, C. H. (2018). Estrogen levels, emotion regulation, and emotional symptoms of women with premenstrual dysphoric disorder: The moderating effect of estrogens receptor polymorphism. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 82, 216-223.
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