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Premenstrual Pain

Premenstrual Syndrome can severely affect a woman's life. Some of its symptoms include physical discomfort such as breast tenderness, headaches, muscle pain, and excessive appetite, along with emotional symptoms such as irritability, crying spells, or lack of energy.

Premenstrual Syndrome (PMS) is a condition referenced for over 2,500 years. Despite being considered a common and well-known issue socially, women have accepted it as normal, and until relatively recently, the scientific community had not fully acknowledged it.

Definition
PMS is a recurring disorder of the female menstrual cycle, consisting of a range of physical, psychological, and behavioral symptoms with sufficient intensity to disrupt the lives of those who suffer from it.
In simpler terms, women describe it as "an emotional vulnerability where you just want to disappear due to irritation or sadness, and no one understands. It's a bothersome disability that makes you suffer"; it constitutes a problem that makes women suffer and is difficult to integrate into the dynamics of their lives.
Its symptoms appear in the second phase of the cycle (luteal phase) and are significantly alleviated with the onset of menstruation. Many women experience it, to varying degrees of intensity. Based on this and the level of interference with daily activities, there are different degrees.
The mildest form occurs when women only experience some of the symptoms and not too severely, affecting 80% of women. In moderate to severe forms, affecting between 8 and 32%, the symptoms incapacitate women from normal physical, work, family, professional, or social activities. The most severe form, known as Premenstrual Dysphoric Disorder (PMDD), affects between 3 and 8% of women. This severe form is characterized by a predominance of psychological and behavioral symptoms and is included in the international classification of mental illnesses. In fact, as Dr. Campos highlights, this condition has often been more known by psychiatrists than gynecologists, despite its clear connection to the hormones of the menstrual cycle.

Frequent Symptoms
The cause of premenstrual syndrome is not entirely clear, although it is related to female hormones (estrogens and progesterone) in interaction with neurological processes mediated by neurotransmitters. It has also been linked to increased water and ion retention, as well as emotional, psychoaffective, or psychological factors. Genetic and hereditary factors may also play a role. Regarding the clinical presentation, this disorder has both physical and psychological/behavioral symptoms, making it a highly complex and varied condition.

Do not visit the doctor
However, despite the impact on a woman's social and personal life, this symptomatology is generally accepted as normal, and women do not seek medical attention. In fact, according to a survey in our country, 80% of women with premenstrual symptoms claim never to have consulted a doctor about their symptoms.
Regarding the diagnosis, some experts indicate that it is based on the woman's account and the collection of her symptoms, at least over two different cycles. It is noted that "it is characteristic for these symptoms to appear in the second phase of the cycle (luteal phase) and disappear in the first phase (follicular phase)."
To measure the evolution of premenstrual syndrome with different treatments, experts use other tools, such as the "daily severity collection of problems" or DRSP, which tracks the progress of eleven symptoms and three impacts on the woman's life, allowing the doctor to determine if the syndrome is improving, worsening, or remaining the same.

Treating it
Regarding treatment, the survey reveals that the most commonly used medications by women who visit the doctor to relieve these symptoms are hormonal contraceptives in 57% of cases, followed by painkillers in 53.3% and home or natural remedies in 4.1%.
In particular, the most commonly used medications are psychotropic agents and hormonal compounds. Among the former, the only ones indicated for the treatment of this syndrome are selective serotonin reuptake inhibitors (SSRIs), drugs commonly used to treat depression: fluoxetine, paroxetine, or sertraline. These drugs are indicated for women with severe premenstrual syndrome who do not need contraception.

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