Chapter 41 Premenstrual Syndrome
INTRODUCTION
Description: Premenstrual syndrome (PMS) involves physical and emotional symptoms characterized by their relationship to menses. Symptoms are confined to a period of not more than 14 days before the onset of menstrual flow with complete resolution at, or soon after, the end of menstrual flow.
ETIOLOGY AND PATHOGENESIS
Causes: The physiologic foundations of PMS, premenstrual dysphoric disorder (PMDD), and premenstrual magnification (PMM) have yet to be established. The most promising research into a cause of PMS has been in the areas of β-endorphins and serotonin.
DIAGNOSTIC APPROACH
Workup and Evaluation
Laboratory: Complete blood count, liver enzyme studies, endocrine studies (androgens, follicle-stimulating hormone [FSH]/luteinizing hormone [LH], glucose tolerance test, prolactin, thyroid function studies [highly sensitive thyroid-stimulating hormone, thyronine, thyrotropin-releasing hormone stimulation]), all to rule out other conditions.
Special Tests: Prospective menstrual calendar or other diary for a 3-month period to establish the diagnosis.
