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Premenstrual Syndrome 

Premenstrual Syndrome
Chapter:
Premenstrual Syndrome
Author(s):

Daphne Miller

DOI:
10.1093/med/9780195378818.003.0012
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date: 22 February 2020

Almost every woman of reproductive age experiences some amount of physical or psychological discomfort in the week preceding her menstrual period (Freeman 2003; Halbreich et al. 2007; Johnson 2004). Premenstrual symptoms (Table 12.1), when they are present to a degree that they affect the quality of life, social engagements, and/or the work performance are identified as a “syndrome” (PMS or premenstrual syndrome) or, if more stringent criteria are met, a “disorder” (premenstrual dysphoric disorder). The inclusion criteria for these two diagnoses continue to be debated; yet, it is clear that those premenstrual symptoms, PMS, and PMDD represent a continuum of the same entity. In the end, these specific definitions have little relevance for the clinical practitioner (Halbreich et al. 2007). What is important is the degree and nature of symptoms reported by each individual woman and how her experience impacts her quality of life. Therefore, although the term PMS is used throughout this chapter and the research presented primarily includes women with a formal diagnosis PMS or PMDD, the following recommendations will be applicable to anyone wishing to address negative premenstrual symptoms. Theories abound on the potential causes of PMS, but after 40 years of clinical and epidemiological research, the exact etiology remains unclear. For most women, their symptoms are likely to be a complex interplay of physiological, psychological, and environmental factors. Available pharmacologic and surgical treatments are often considered unacceptable treatments for PMS as they frequently offer disproportionately more side effects than perceived benefits. Community-based studies suggest that over 70% of women seeking to alleviate symptoms first turn to alternative (nonpharmaceutical or nonsurgical) strategies (Pullon et al. 1989). Taking into consideration the heterogeneous nature of PMS, the lack of a single highly effective and widely accepted conventional treatment, and a general preference for alternative therapies, PMS lends itself perfectly to an integrative medical approach.

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