What causes diarrhea during menstruation. How to alleviate menstrual diarrhea symptoms. When to seek medical attention for period-related gastrointestinal issues. What is the connection between prostaglandins and menstrual diarrhea. How endometriosis affects bowel movements during menstruation.

The Role of Prostaglandins in Menstrual Diarrhea

Diarrhea during menstruation is a common experience for many women. The primary culprit behind this phenomenon is the increased production of prostaglandins in the body. These hormone-like chemicals play a crucial role in various bodily functions, including muscle contractions, blood vessel dilation and constriction, and blood clotting.

During menstruation, cells in the uterine lining ramp up prostaglandin production. This surge causes the uterus muscles to contract, leading to the shedding of the uterine lining – the process we know as menstruation. However, when prostaglandin levels become excessive, they can enter the bloodstream and affect other parts of the body, including the bowels.

How Do Prostaglandins Affect the Digestive System?

The bowels have a smooth muscle lining similar to that of the uterus. When high levels of prostaglandins reach the intestines, they can cause the bowels to contract and release their contents prematurely, resulting in diarrhea. This explains why some women experience loose stools or diarrhea during their menstrual cycle.

Common Gastrointestinal Symptoms During Menstruation

While diarrhea is a frequent complaint, it’s not the only gastrointestinal symptom women may experience during their periods. A 2014 study involving 156 premenopausal women revealed that 73% of participants experienced at least one GI symptom before or during menstruation. The most commonly reported symptoms included:

• Abdominal pain
• Diarrhea
• Bloating
• Nausea
• Vomiting
• Constipation
• Pelvic pain

Interestingly, the study also found a correlation between emotional symptoms, such as depression or anxiety, and the likelihood of experiencing multiple GI symptoms during menstruation.

The Impact of Menstruation on Existing Digestive Conditions

For women with pre-existing digestive conditions, menstruation can sometimes exacerbate symptoms. Research has shown varying effects on different gastrointestinal disorders:

Inflammatory Bowel Disease (IBD)

A 2013 study compared premenstrual GI symptoms in individuals with and without IBD. The findings revealed that those with IBD experienced more frequent premenstrual GI symptoms. However, their IBD symptoms did not significantly change over the course of the menstrual cycle.

Irritable Bowel Syndrome (IBS)

According to an article in Gastroenterology Report, women with IBS may experience a worsening of symptoms during their menstrual period. These exacerbated symptoms often include increased bloating, abdominal pain, and other IBS-related discomforts.

Endometriosis and Its Gastrointestinal Effects

Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. This condition can significantly impact the digestive system, especially during menstruation. The Endometriosis Foundation of America reports that gastrointestinal symptoms are very common in women with endometriosis.

Where Can Endometriosis Occur?

Endometriosis can affect various areas of the body, including:

• Ovaries
• Fallopian tubes
• Area around the uterus
• Vagina
• Cervix
• Bladder
• Bowel
• Rectum

Gastrointestinal Symptoms of Endometriosis

Women with endometriosis often experience a worsening of GI symptoms during menstruation. These symptoms may include:

• Diarrhea
• Intestinal cramps
• Constipation
• Painful bowel movements
• Bloating
• Nausea

If you suspect endometriosis might be causing your menstrual diarrhea and other symptoms, it’s crucial to consult with a healthcare professional for proper diagnosis and treatment.

Home Remedies for Menstrual Diarrhea

While menstrual diarrhea can be uncomfortable, there are several steps you can take at home to alleviate symptoms:

Hydration is Key

Maintaining proper hydration is crucial when dealing with diarrhea. Drink plenty of fluids throughout the day, and consume an extra cup of water after each bout of diarrhea to prevent dehydration.

Dietary Adjustments

1. Opt for a liquid diet: This helps rest the bowels. Try weak tea, apple juice, or clear broth.
2. Eat smaller, more frequent meals: This can make food easier for your body to digest.
3. Consume foods high in pectin: Pectin is a water-soluble fiber that can help reduce diarrhea. Good sources include applesauce, bananas, and yogurt.
4. Replace electrolytes: Diarrhea can deplete potassium and other electrolytes. Replenish them by drinking sports drinks, fruit juices, or coconut water. Bananas and potatoes with skin are also excellent sources of potassium.
5. Incorporate salty foods: Salty foods can help retain water in the body, combating dehydration.

When to Seek Medical Attention

While menstrual diarrhea is often manageable at home, there are instances when professional medical advice should be sought. Consider consulting a healthcare provider if you experience:

• Severe abdominal pain that doesn’t improve with over-the-counter pain relievers
• Diarrhea that lasts for more than a few days
• Signs of dehydration, such as excessive thirst, dark urine, or dizziness
• Blood in your stool
• Fever above 102°F (39°C)
• Unexplained weight loss

These symptoms could indicate a more serious underlying condition that requires medical attention.

Hormonal Treatments and Their Impact on Menstrual Symptoms

For some women, hormonal treatments may offer relief from severe menstrual symptoms, including diarrhea. These treatments work by regulating hormone levels throughout the menstrual cycle, potentially reducing the production of prostaglandins that contribute to gastrointestinal distress.

Types of Hormonal Treatments

• Birth control pills
• Hormonal IUDs
• Contraceptive implants
• Contraceptive injections

It’s important to note that hormonal treatments may not be suitable for everyone and can have side effects. Always consult with a healthcare provider to determine the best course of action for your individual needs.

Lifestyle Changes to Manage Menstrual Diarrhea

In addition to dietary adjustments and medical treatments, certain lifestyle changes can help manage menstrual diarrhea and other gastrointestinal symptoms:

Stress Management

Stress can exacerbate digestive issues, particularly during menstruation. Implementing stress-reduction techniques such as meditation, yoga, or deep breathing exercises may help alleviate symptoms.

Regular Exercise

Moderate exercise can help regulate bowel movements and reduce menstrual cramps. However, avoid intense workouts during heavy flow days, as they may worsen symptoms.

Adequate Sleep

Getting enough quality sleep can help regulate hormones and reduce stress, potentially alleviating menstrual symptoms, including diarrhea.

Herbal Remedies

Some women find relief from menstrual symptoms through herbal remedies. Popular options include:

• Ginger tea for nausea
• Chamomile tea for relaxation and digestive comfort
• Peppermint tea for bloating and gas

Always consult with a healthcare provider before starting any new herbal regimen, especially if you’re taking other medications.

The Role of Diet in Managing Menstrual Diarrhea

While we’ve touched on some dietary adjustments earlier, it’s worth exploring the role of diet in managing menstrual diarrhea more comprehensively. Certain foods can exacerbate symptoms, while others may provide relief.

Foods to Avoid During Menstruation

Consider limiting or avoiding the following foods during your period, especially if you’re prone to diarrhea:

• Caffeine: It can increase anxiety and contribute to digestive upset
• Alcohol: It may worsen dehydration and hormonal imbalances
• Fatty foods: These can be harder to digest and may increase inflammation
• Spicy foods: They can irritate the digestive system
• Dairy products: Some women become more lactose intolerant during menstruation

Beneficial Foods for Menstrual Health

On the other hand, incorporating the following foods into your diet may help alleviate menstrual symptoms:

• Leafy greens: Rich in iron to replenish what’s lost during menstruation
• Whole grains: Provide sustained energy and help regulate blood sugar
• Lean proteins: Support muscle health and provide satiety
• Fruits high in vitamin C: Help with iron absorption
• Foods rich in omega-3 fatty acids: May help reduce inflammation and menstrual pain

Understanding the Menstrual Cycle and Its Impact on Digestion

To better manage menstrual diarrhea, it’s helpful to understand how the different phases of the menstrual cycle can affect digestion. The menstrual cycle is typically divided into four phases:

1. Menstrual phase
2. Follicular phase
3. Ovulation phase
4. Luteal phase

Each phase is characterized by different hormonal balances, which can influence digestive function.

Hormonal Fluctuations and Digestive Changes

During the luteal phase (typically days 14-28 of a 28-day cycle), progesterone levels rise. This hormone can slow down digestion, potentially leading to constipation. As progesterone levels drop just before menstruation, some women may experience a sudden shift from constipation to diarrhea.

Understanding these cyclical changes can help you anticipate and prepare for potential digestive issues throughout your menstrual cycle.

The Importance of Tracking Menstrual Symptoms

Keeping a record of your menstrual symptoms, including digestive issues, can be incredibly helpful in managing your health. By tracking your symptoms over several cycles, you can:

• Identify patterns in your digestive symptoms
• Anticipate when you’re likely to experience diarrhea or other GI issues
• Recognize any triggers that may exacerbate your symptoms
• Provide valuable information to your healthcare provider if you need to seek medical advice

Many smartphone apps are available for menstrual tracking, or you can use a simple journal to record your symptoms.

Alternative Therapies for Menstrual Symptom Relief

While conventional medical treatments are often effective, some women find relief through alternative therapies. These approaches may help manage menstrual diarrhea and other symptoms:

Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest that acupuncture may help alleviate menstrual cramps and associated digestive issues.

Aromatherapy

Certain essential oils, such as lavender or peppermint, may help reduce stress and alleviate digestive discomfort when used in massage or diffusers.

Heat Therapy

Applying a heating pad to the lower abdomen can help relax the muscles of the uterus and intestines, potentially reducing cramping and diarrhea.

Mindfulness and Relaxation Techniques

Practices like mindfulness meditation or progressive muscle relaxation may help manage stress and reduce the severity of menstrual symptoms.

As with any treatment approach, it’s important to consult with a healthcare provider before trying alternative therapies, especially if you have underlying health conditions or are taking medications.

The Connection Between Menstrual Diarrhea and Other Health Conditions

While menstrual diarrhea is often a normal part of the menstrual cycle for many women, persistent or severe symptoms may sometimes indicate an underlying health condition. Understanding these potential connections can help you determine when to seek medical advice.

Thyroid Disorders

Thyroid conditions, such as hypothyroidism or hyperthyroidism, can affect hormone balance and potentially exacerbate menstrual symptoms, including diarrhea.

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that can cause irregular periods and may influence digestive symptoms during menstruation.

Uterine Fibroids

These non-cancerous growths in the uterus can cause heavy menstrual bleeding and may contribute to digestive issues during menstruation.

Celiac Disease

Some women with celiac disease may experience worsening of symptoms, including diarrhea, during their menstrual period.

If you suspect that your menstrual diarrhea may be related to an underlying health condition, it’s important to discuss your concerns with a healthcare provider. They can perform necessary tests and provide appropriate treatment options.

Menstrual Hygiene and Its Impact on Digestive Health

While the connection may not be immediately apparent, proper menstrual hygiene practices can indirectly affect digestive health during menstruation. Good hygiene habits can reduce stress and discomfort, potentially alleviating some digestive symptoms.

Choosing the Right Menstrual Products

Selecting comfortable and appropriate menstrual products can reduce stress and physical discomfort during your period. Options include:

Diarrhea during period: Causes, treatment, and more

Women may experience a range of symptoms before and during their period. Diarrhea, abdominal pain, and other gastrointestinal issues are common symptoms of menstruation.

Here, we look at why having a period can cause diarrhea and other gastrointestinal issues. We also provide tips on how to ease painful symptoms, and when to see a doctor or other healthcare professional.

Share on PinterestAn increase in the production of prostaglandins in the body during a period may cause diarrhea.

Some people may experience diarrhea during or before their period. This is likely due to an increase in the production of prostaglandins in the body.

Prostaglandins are hormone-like chemicals that assist certain functions in the body, including:

• muscle contractions
• blood vessel dilation and constriction
• blood clotting

Before a period starts, cells in the lining of the uterus increase production of prostaglandins. This increase in prostaglandins causes the uterus muscles to contract, thereby releasing the lining of the uterus. This is what a female experiences as her period.

The more prostaglandins the body makes during menstruation, the more the uterus will contract. As such, excess production of prostaglandins can cause menstrual cramps and pain.

When prostaglandin levels are high, some prostaglandins may enter the bloodstream. They can then travel to various parts of the body, including the bowels.

The bowels have a smooth lining of muscle, similar to the uterus. High levels of prostaglandins can cause the bowels to contract and release their contents, resulting in diarrhea.

Excess prostaglandins can also cause other period-related symptoms, including:

• headaches
• nausea
• vomiting

Apart from causing pain and discomfort, excessive amounts of prostaglandins do not cause any health risks.

Changes in prostaglandin levels can also cause other gastrointestinal (GI) symptoms during a period.

A 2014 study of healthy premenopausal women investigated the GI and emotional symptoms some people experience before and during their period.

Of the 156 participants, 73% experienced at least one GI symptom before or during a period. Abdominal pain and diarrhea were the most common. Participants also experienced:

• bloating
• nausea
• vomiting
• constipation
• pelvic pain

Women who experienced emotional symptoms, such as depression or anxiety, were more likely to report multiple GI symptoms.

A 2013 study compared premenstrual GI symptoms in people with and without inflammatory bowel disease (IBD). The researchers found that people with IBD experienced more frequent premenstrual GI symptoms. However, their IBD symptoms did not change significantly over the course of the menstrual cycle.

In contrast, people with irritable bowel syndrome (IBS) may experience a worsening of bloating, abdominal pain, and other IBS symptoms during their period, according to an article in Gastroenterology Report.

Endometriosis is where tissue similar to the lining of the uterus grows outside the uterus. Endometriosis can occur in the following areas:

• ovaries
• fallopian tubes
• area around the uterus
• vagina
• cervix
• bladder
• bowel
• rectum

According to the Endometriosis Foundation of America, GI symptoms are a very common feature of endometriosis. The symptoms typically worsen during menstruation, and may include:

• diarrhea
• intestinal cramping
• constipation
• painful bowel movements
• bloating
• nausea

Other symptoms of endometriosis include:

• painful menstrual cramping
• persistent pain in the lower back and pelvis
• stomach or intestinal pain
• pain during bowel movements or urination during a period
• blood in stools or urine
• deep-feeling pain during or after sex
• bleeding or spotting in between periods
• infertility

If people suspect endometriosis is causing diarrhea and other menstrual symptoms, they should see their doctor for a diagnosis.

People can take steps to treat diarrhea and other menstrual symptoms at home. We outline some tips below.

Treating diarrhea

Some general tips for easing diarrhea include:

• Drinking plenty of fluids: This is important for preventing dehydration. People should drink throughout the day, and should drink an extra cup of water after each bout of diarrhea.
• Consuming a liquid diet: This helps to rest the bowels. People can try drinking weak tea, apple juice, or clear broth.
• Eating smaller meals more frequently: This can make food easier for the body to digest.
• Eating foods high in pectin: Pectin is a water-soluble fiber that can help to reduce diarrhea. Foods that are high in pectin include applesauce, bananas, and yogurt.
• Replacing electrolytes: Diarrhea can deplete levels of potassium and other electrolytes in the body. People can replace electrolytes by drinking sports drinks, fruit juices, or coconut water. Good food sources of potassium include bananas, and potatoes with the skin.
• Eating salty foods: Salty foods, such as crackers, pretzels, and soups, help to replace lost sodium. This, in turn, helps the body retain more water.

People should also avoid foods and drinks that can irritate the digestive tract and worsen diarrhea. Examples include:

• caffeine
• alcohol
• carbonated drinks
• foods that are very hot or very cold
• high-fat, greasy foods
• milk products
• tobacco
• marijuana

Treating other menstrual symptoms

Below are several dietary and lifestyle tips that could help to alleviate GI symptoms and other menstrual symptoms.

• Exercising regularly: Keep up regular exercise throughout the month, especially aerobic activity that raises the heart rate.
• Avoiding certain ingredients: Avoiding foods and drinks that contain caffeine, salt, or sugar for 2 weeks before a period may help to reduce PMS symptoms.
• Getting a good nights sleep: Ensure regular, good-quality sleep, and aim for 8 hours each night. This may help to alleviate mood-related menstrual symptoms.
• Reducing stress and anxiety: Activities such as yoga, meditation, and journaling may help to ease stress-related GI symptoms.
• Avoiding smoking: People should avoid smoking. According to the Office On Women’s Health, smoking may increase the severity and frequency of pre-menstrual symptoms. Learn more about quitting smoking here.

People should see their doctor if they experience any of the following:

• diarrhea lasting more than 2 days
• blood in the stools, which may indicate an infection or other underlying health condition
• severe physical or psychological symptoms before or during periods, which may indicate an underlying health condition

People should also see a doctor or other healthcare professional if they think they may have endometriosis. The doctor will work to diagnose the condition and provide treatments to ease the symptoms and help prevent recurrent symptoms.

People may experience diarrhea and other GI issues before and during their period. This is usually due to an increase of prostaglandins, which can cause cramps, diarrhea, and other GI issues.

People who experience diarrhea during their period can follow standard guidelines for treating diarrhea. This includes drinking plenty of fluids, and replacing lost electrolytes.

Severe symptoms during or before a period can sometimes indicate an underlying health condition. People should take note of their symptoms, and schedule an appointment with their doctor or gynecologist.

These health professionals will work to diagnose the cause of the symptoms, and provide appropriate treatments.

Why It Happens and How to Get Rid of It

Ugh. As if the cramping and unpredictable mood changes weren’t bad enough, periods can also bring on bloating and bowel issues, ranging from constipation to diarrhea (yes, that’s sexy AF, we know).

When they kick in, periods are natural, healthy, and often supremely irritating.

In this article, we deal with one of the side effects of menstruating: stomach wibblies. When your cycle pedals round once more, you might find it harder to poop because of cramps.

However, once you start pooping, it might feel like you’re never going to stop. Sort of like Pringles, but in the wrong direction. This not-so-merry dance of diarrhea and constipation can make periods even more uncomfortable and painful.

Let’s take a look at why this happens and what to do — so you can get back to worrying about whether your paycheck will stretch to cover the amount of pizza you have in mind instead of whether or not you can digest it.

So why does your digestive system go crazy during that time of the month? We tapped Raquel Dardik, MD, clinical associate professor of gynecology at NYU Langone Medical Center, to get some answers.

You’re not imagining things if you tend to feel bloated and constipated right before you get your period. “During the second half of the menstrual cycle, your body is making more progesterone, which happens after you release an egg,” Dardik says.

That’s a good thing, but it comes with a frustrating side effect: “Progesterone slows down contractions of the bowel, so it slows down how quickly food and gas move through. Everything slows down and backs up, so you feel bloated and constipated.”

To add insult to injury, once your period starts, some women find themselves dealing with the opposite problem for the first day or 2: diarrhea. “The diarrhea and cramping is a double whammy,” says Dardik.

Two things are likely at play:

• Progesterone levels drop, which revs bowel contractions back up again so food may pass along quicker than before.
• Prostaglandins, hormone-like substances released by the uterus, trigger uncomfortable cramps.

Some cramps cause pain, and they can also give people diarrhea. Because the one thing you need during period cramps is that to brighten your day.

Menstruation is a sign that your sexual organs are behaving themselves and your hormones are in check.

The good news is that you’re not at the mercy of this monthly hormonal roller coaster. You can take steps to combat bloating, diarrhea, and constipation.

Over-the-counter (OTC) medications are an option for managing digestive issues. Some medications and supplements can gently help nudge stool through your colon.

These include:

• psyllium (Metamucil)
• methylcellulose (Citrucel)
• osmotics such as magnesium hydroxide (Phillips’ Milk of Magnesia) and polyethylene glycol (Miralax)

Or, you can go the natural route. Eat more fiber-rich foods, drink more fluids, and exercise.

These actions will help keep your poops in check by decreasing their bulk and softening them so they’re easier to pass, notes Dardik. “It doesn’t counteract progesterone, but it does decrease the symptoms,” she says.

Most fruits and vegetables will settle your stomach, but mangoes, prunes, and kiwis are particularly good for keeping your pooping peaceful. A 2018 study found that eating mangoes for 4 weeks improved constipation better than an equivalent amount of fiber.Venancio VP, et al. (2018.) Polyphenol-rich mango (Mangifera indica L.) ameliorate functional constipation symptoms in humans beyond equivalent amount of fiber. DOI: 10.1002/mnfr.201701034

Rather than take a harsh laxative that’ll leave you crampy and running for the toilet, give probiotics a try for constipation relief. These helpful bacteria don’t cause disease like their harmful cousins. Instead, they help maintain a healthy balance in your GI tract.

One study found that probiotics like Bifidobacterium lactis keep stool moving smoothly through your digestive tract. And while smooth-moving stool may sound gross, it’s a great way to prevent backups and blockages.Dimidi E, et al. (2014.) The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. DOI: 10.3945/ajcn. 114.089151

Better out than in.

Lactobacillus GG, acidophilus, and bifidobacteria are other strains of bacteria that can give gut health a kick. Probiotics may also be helpful for slowing diarrhea down along with unclogging constipation.

You can buy probiotics in a supplement bottle or find them in fermented foods like these:

• sauerkraut
• kefir
• kombucha
• kimchi
• pickled ginger

Yogurt with added live cultures will also help restore the balance of good bacteria in your gut.

Frozen yogurt, however, will never be ice cream, no matter how many well-intentioned bacteria it contains. Yes, even if it believes in itself.

There’s a few natural remedies can help ease bloating, diarrhea, and other gastrointestinal woes. One is peppermint, which has been a staple of GI treatment for centuries.

Peppermint oil helps to keep waste moving through your intestines and combats inflammation. (Don’t ingest pure peppermint essential oil! Take it as a tea or capsule and always consult your healthcare provider first).

According to a 2016 study, peppermint may help relieve stomach pain, reduce bloating, and make a person feel less regularly like they need to poop everywhere.Cash BD, et al. (2016.) A novel delivery system of peppermint oil is an effective therapy for irritable bowel syndrome symptoms.

Digestive issues don’t always wait for your period to rear their ugly head. For monstrous premenstrual symptoms, a cup of ginger tea could be just the ticket. According to a 2014 study, ginger may ease nausea, relieve joint and muscle aches, and improve mood during that uncomfortable pre-period period. Khayat S, et al. (2014.) Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. DOI: 10.1155/2014/792708

If your symptoms are truly unbearable and last beyond your period, you may want to investigate whether your birth control pill is to blame.

Hormones in the pill might make the immune system wonky, increase inflammation, and change the balance of bacteria in the gut in a way that is simply not cool, setting the stage for inflammatory bowel disease (IBD), according to research from 2016.Khalili H. (2016.). Risk of inflammatory bowel disease with oral contraceptives and menopausal hormone therapy: Current evidence and future directions. DOI: 10.1007/s40264-015-0372-y

The link between the pill and IBD symptoms is especially pronounced in women who smoke. So Google some ways to quit and ask your healthcare provider whether you can switch to a non-hormonal mode of protection, like condoms, a copper IUD (IUD), or listening to Peanut Butter Jelly Time at earsplitting volume in a public place.Khalili H, et al. (2013.) Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. DOI: 10.1136/gutjnl-2012-302362

You might be craving a cigarette, but if you’re also craving a period that doesn’t turn your backend into a faucet of liquid-brown misery, you may want to put the lighter back in your pocket.

The hormones that cause havoc during menstruation are also responsible for not being able to poop or not being able to stop pooping. And cramps can make the whole thing feel rotten on top of any irritable bowel distress.

If GI issues have driven you to your wit’s end, there are plenty ways you can find relief, including fiber supplements and probiotics. Women who take a contraceptive pill might find that this has links to the stomach-based chaos unfolding during and after their period.

Take heart: Within a few days, your symptoms should resolve. And then you’ll have next month’s session to look forward to. But this time… you’ll be ready.

Premenstrual syndrome (PMS) – causes, what diseases it occurs in, diagnosis and treatment

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Premenstrual syndrome: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Tearfulness, irritability, unreasonable anger (according to others), pain in the abdomen and lower back, feeling of melancholy and anxiety, headache, swelling – these and many other symptoms are associated with the development of premenstrual syndrome, or PMS. Is PMS a condition that needs to be treated?

Premenstrual syndrome is a complex of pathological symptoms that includes a variety of psycho-emotional, somatovegetative and metabolic-endocrine manifestations that begin during the luteal phase of the cycle, which lasts approximately 14 days before the onset of menstruation, and disappears in its first days.

Thus, all the symptoms of PMS can appear both immediately after ovulation, and one or two days before the start of the next menstruation.

Varieties of PMS

Depending on what symptoms prevail in the manifestation of premenstrual syndrome, the following forms are distinguished:

• edematous;
• cephalgic;
• crisis;
• neuropsychiatric;
• atypical.

The edematous form of PMS is characterized by swelling of the face, legs, fingers, and associated weight gain. Possible manifestations such as engorgement of the mammary glands, sweating, pruritus and functional bowel disorders (constipation, diarrhea, increased flatulence). All of these symptoms disappear at the onset of menstruation and rarely require medical attention.

The cephalgic form of PMS is characterized by severe headaches, often unilateral, throbbing, aggravated by movement. Such pains are accompanied by irritability, hypersensitivity to smells, aggression, nausea, pain in the heart area. The cephalgic form of PMS occurs in women who have suffered a traumatic brain injury or neuroinfection, as well as those suffering from arterial hypertension and other cardiovascular diseases. The pain disappears at the end of the luteal phase of the menstrual cycle.

The crisis form of PMS is characterized by a predominance of sympathoadrenal crises (something similar to panic attacks), accompanied by an increase in blood pressure, increased heart rate, pain in the heart area without changes in the ECG. Such attacks may result in increased urination.

The neuropsychic form of PMS includes a number of symptoms that a woman usually does not pay attention to. They regularly appear before the onset of menstruation and are a reason for consulting a doctor: irritability, tearfulness, insomnia, aggression, depression, fatigue, sexual disturbances, suicidal thoughts and various hallucinations.

The neuropsychic form often co-occurs with other forms, especially in severe cases of PMS.

The atypical form of PMS is rare, passes under the guise of other diseases – bronchial asthma, ulcerative gingivitis or stomatitis, iridocyclitis, myocardiopathy.

According to the severity of the course, a mild form of PMS is distinguished – 2–10 days before menstruation, up to four symptoms appear, while up to two symptoms are expressed to a significant extent.

In severe PMS, more than five symptoms appear 3 to 14 days before the onset of menstruation, and many of them are severe.

Possible causes of premenstrual syndrome

The incidence of PMS depends on the age of the woman. If at the age of 30 years, symptoms of PMS occur only in 20% of women, then after 30 years, PMS occurs in almost every second woman.

Emotionally labile women, asthenic physique, often with a lack of body weight are predisposed to the development of premenstrual syndrome.

Other risk factors for developing PMS include:

• frequent stressful situations at home and at work;
• complicated childbirth;
• history of abortion;
• surgical interventions;
• neuroinfections;
• frequent change of climatic zones;
• the presence of chronic gynecological diseases.

According to modern data, a change in sensitivity to the hormone progesterone is of decisive importance in the development of negative symptoms. The role of the trigger mechanism in the onset of PMS is played by the normal change in the level of sex hormones during the menstrual cycle. In the second half of the cycle (luteal phase), progesterone has the main effect on the woman’s body.

Progesterone indirectly affects the dynamic change in the level of serotonin secretion. It is this system that provides the regulation of mood at the level of neurons.

It is believed that in the luteal phase of the menstrual cycle, there is an increase in the processing time of negative emotions in the structures of the brain and a decrease in control over the level of expression of emotions.

Another mechanism that affects the change in the level of serotonin in the brain is constant stress, prolonged experiences of unresolved conflict situations, fear, expectation of real or imaginary events. Anxiety in most cases increases appetite, and “jamming in a bad mood” leads to the development of flatulence and other dyspeptic disorders (constipation and diarrhea), which contributes to the course of premenstrual syndrome.

Hereditary predisposition plays a huge role in the development of PMS.

Which doctors to contact for PMS

If the manifestations of PMS prevent you from leading a full social and personal life, to solve this problem, you should turn to
gynecologist.

It is important to exclude the presence of other somatic pathology that may worsen the course of the second phase of the menstrual cycle. For this you need to contact
therapist. If necessary, the doctor will refer you to the necessary laboratory and instrumental examinations and consultations of narrow specialists.

If the organic cause of the disease is not found, it is necessary to consult a psychiatrist to determine tactics to overcome anxiety and other stressful conditions.

Diagnostics and examinations for PMS

During the diagnosis of premenstrual syndrome, an important role is played by the patient’s diary for several cycles.

It notes all the symptoms of PMS, their severity in points from 0 to 10.
In the course of exclusion of somatic and neuroendocrine pathology, a complex of laboratory and instrumental diagnostics is performed depending on the symptomatic picture.

• Hormonal blood test: follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, estradiol, adrenocorticotropic hormone (ACTH), thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone (TSH).

Follicle Stimulating Hormone (FSH)

Synonyms: Blood test for FSH; Follitropin. Follicle-Stimulating Hormone; follitropin; FSH.

Brief description of the analyte Follicle-stimulating hormone

…

Up to 1 business day

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Luteinizing Hormone (LH)

Synonyms: Glycoprotein gonadotropic hormone; luteotropin; Lutropin. luteinizing hormone; LH; Lutropin; Interstitial cell stimulating hormone; ICSH.

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Prolactin (+ additional macroprolactin test if prolactin result is above 700 mU/l)

Synonyms: Prolactin blood test; Lactotropic hormone; lactogenic hormone; Mammotropin; mammotropic hormone. lactotropin; PRL; luteotropic hormone; LTH.
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Testosterone

Testosterone is the main androgenic hormone. The test is used in the diagnosis of disorders of sexual development and hypogonadism in men; cycle disorders, infertility, virili…

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Estradiol (E2, Estradiol)

Synonyms: Blood test for estradiol. 17-beta-estradiol.
Brief description of the analyte Estradiol
Estradiol is a steroid hormone with maximum estrogen…

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ACTH (Adrenocorticotropic hormone, corticotropin, Adrenocorticotropic Hormone, ACTH)

Adrenocorticotropic hormone is a pituitary hormone that regulates the production of glucocorticoids in the adrenal cortex.

Synonyms: Blood test for ACTH; Address…

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Free thyroxine (Free T4, Free Thyroxine, FT4)

Free thyroxine not bound to blood plasma transport proteins.
Synonyms: Blood test for free thyroxine. Free T4; Free Form of Thyroxin.
Short description …

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Free triiodothyronine (Free T3, Free Triiodthyronine, FT3)

Synonyms: Free triiodothyronine.
Free T3.
Brief description of the test substance Triiodothyronine free
Free triiodothyronine (T3free) belongs to the thyroid . ..

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Thyroid Stimulating Hormone (TSH)

A pituitary hormone that regulates thyroid function. One of the most important tests in the laboratory diagnosis of thyroid diseases.

Synonym…

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Glucose (in the blood) (Glucose)

Research material

Serum or blood plasma. If it is not possible to centrifuge the sample 30 minutes after collection for serum/plasma separation…

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Cholesterol total (cholesterol, Cholesterol total)

Synonyms: Cholesterol, cholesterol. Blood cholesterol, Cholesterol, Chol, Cholesterol total.
Brief characteristics of the analyte Total cholesterol
Approximately 80% of total cholesterol is synthetic…

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Cholesterol – VLDL (VLDL Cholesterol, VLDL Cholesterol)

Synonyms: Very low density lipoprotein cholesterol;
Very Low Density Lipoprotein; VLDL; Very low density lipoproteins.
Brief characteristics of analyte Cholesterol – LPO…

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LDL Cholesterol (Low Density Lipoprotein Cholesterol, LDL, Cholesterol LDL)

Synonyms: LDL; Low density lipoproteins; LDL; LDL cholesterol; Low density lipoprotein cholesterol; Cholesterol beta-lipoproteins; Beta lipoproteins; Beta LP.
…

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HDL Cholesterol (HDL Cholesterol)

Synonyms: High density lipoproteins; HDL; HDL; HDL cholesterol; alpha cholesterol; α-cholesterol. High density lipoprotein cholesterol; high density lipoprotein; Alpha-Lipoprotein Cholesterol; α-lipoprotein cholesterol; α-Lp c…

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Glycated hemoglobin (HbA1С, Glycated Hemoglobin)

Synonyms: Blood test for glycated hemoglobin. Glycohemoglobin; HbA1c; Hemoglobin A1c; A1c; HgbA1c; Hb1c.

Brief characteristics of the analyte Glycated hemo…

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Urinalysis according to Zimnitsky.

Ultrasound of the mammary glands and regional lymph nodes

Informative study for the diagnosis of neoplasms and determining the involvement of lymph nodes in the pathological process.

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Brain MRI

Safe and informative scanning of brain structures for diagnosing its pathologies.

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MRI of the lumbosacral spine

Diagnostic examination to determine the pathology of the lumbosacral spine and surrounding tissues.

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What to do with PMS

Prevention and reduction of the severity of premenstrual syndrome is based on a change in habitual lifestyle and vitamin therapy.

If possible, it is necessary to exclude stressful situations, sudden changes in climate, the use of combined oral contraceptives.

In addition, caffeine and alcohol should not be abused, it is also advisable to eat small meals throughout the day. To prevent irritability and fatigue, it is recommended to take vitamins B6 and E, magnesium, calcium.

PMS treatment

To reduce the level of anxiety that causes an increase in appetite (“stress eating”), leading, in turn, to dyspepsia, it is recommended to follow a diet aimed at increasing the content of serotonin.

Products with a large amount of tryptophan help in solving this issue: yogurt, cheese, cottage cheese, bananas, mushrooms, dates.

It is also important to observe the rest regime, because a tired person is more sensitive to external stimuli and is capable of inadequate reactions in response to exposure.

Other non-pharmacological methods of treatment include various types of massage, physiotherapy, reflexology and spa treatment.

To relieve stress, aerobic exercise for 20-30 minutes 3 times a week is recommended in the absence of contraindications.

In some difficult cases, and after conducting the necessary studies, the doctor may prescribe hormone therapy with progesterone or estrogen-gestagen preparations. Also, with some forms of PMS, the use of antidepressants and psychotherapy methods is recommended.

Sources:

1. Yakovleva E.B., Babenko O.M., Pilipenko O.N. Premenstrual syndrome. Emergency Medicine, journal. No. 3 (58), 2014, pp. 159-163.
2. Gulieva L.P., Yureneva S.V. Premenstrual syndrome: clinic, diagnosis and therapeutic approaches. Medical Council, journal. No. 2, 2017. P. 106-111.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories can use different research methods and units of measurement to perform the same analyzes.

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Menstrual leave – salvation or discrimination? – DW – 17.05.2022

HealthEurope

Yanina Moroz | Sonya Dean

05/17/2022 May 17, 2022

Spain may be the first European country to meet women suffering from severe menstrual pain. They are scheduled to be released from work for this time.

https://p.dw.com/p/4BQh2

Photo: Annette Riedl/dpa/picture alliance Advertising

“I was supposed to teach a lesson. But the pain was so strong – to the point of tears,” recalls Judy Burch. “I had to go home.” Today she runs a British therapy service for those with lower abdominal pain. Billions of women suffer from painful menstruation. Heavy bleeding, spasms, weakness, nausea, diarrhea – current research shows that 90 percent of women of childbearing age are familiar with these symptoms, a third also feel unbearably severe pain. And one in five women, according to the American Academy of Family Physicians, in such a situation is unable to cope even with everyday activities.

“I was just trying to get by, I couldn’t concentrate, I couldn’t function,” says Judy Burch. Dysmenorrhea is the medical name for painful menstruation. In Germany, according to the insurance company Techniker Krankenkasse, every tenth woman experiences pain so intense that she drops out of her work schedule for 1-3 days every month.

Additional leave for women: a novelty in Europe

In some non-European countries, women are allowed to take leave during this period. But the practice is controversial because women fear stigma and discrimination. Nevertheless, Spain can become a pioneer in Europe. On May 17, the country’s Council of Ministers voted for the possibility for women to take an additional three days of paid leave once a month, and five days for especially severe symptoms. This requires a certificate from a doctor. All expenses will be reimbursed by the state. Now the bill must be approved by Parliament.

In Spain itself, the attitude towards such a reform is ambiguous. Some politicians, as well as representatives of trade unions and women’s organizations, oppose it and believe that it will negatively affect women, for example, when looking for work, since firms will give preference to men. These views are shared by Economy Minister Nadia Calvino. Tony Morillas, head of the government’s Women’s Institute, by contrast, sees no threat of discrimination. “In our country, there is a difficulty in recognizing menstruation as a physiological process, which should be associated with certain rights,” she said in an interview with Politico. According to statistics, every third Spaniard painfully endures menstruation.

In Germany, feminine hygiene products fell a year ago – thanks to activists Photo: Science Photo Library/imago images

The innovation is part of a bill that also provides for the abolition of VAT on hygiene products, vacation days for women who decide to have an abortion, as well as admission to the abortion procedure of girls from the age of 16 without the consent of their parents.

Countries with menstrual leave

A similar bill was proposed in Italy in 2017, but it sparked heated discussion there too due to fears that the innovation would only increase discrimination in the workplace. As a result, these plans were abandoned. To date, countries where menstrual leave or, at least, work from home on critical days for women are allowed, can be counted on the fingers. In Taiwan, in particular, vacation is additionally allowed up to three days a year with half the salary. In South Korea, women are given one day a month, but payment is not regulated by law. Other examples are Japan, Indonesia and Zambia.

Menstrual pain is still a taboo at work Photo: Robert Kneschke/Zoonar/picture alliance

Veve Hitipev, director of the consulting firm Kiroyan Partners in Indonesia, as an employer is obliged to give women free days, but this rule helped her too: days, it happened, I could not sit on a chair and stand at the computer for 8-9 hours. She thinks the extra paid time off is a good idea, but she’s seen some bias from people who think women are just shirking their jobs. This is especially true of employment in factories. In Japan, this rule has been in effect since 1947 years old. However, recent polls show that only one in ten women in this country takes extra days off. Almost half admit that there were situations when they would take advantage of such an opportunity, but did not dare, because they did not want to contact a male boss or because other women do not do this either.

And in European countries, where there are relatively liberal rules regarding vacation and sick leave, absence from work due to painful menstruation is also unusual. Held in the Netherlands in 2019A survey showed that 14 percent of women took sick leave because of such problems, but only one in five indicated the true reason.

What women themselves think

In her work in therapy, Briton Judy Burch often hears from women that they prefer not to be absent from work because of menstrual cramps. “Many people have problems if they regularly take sick leave every month,” she says. Women face disciplinary action or even dismissal. Each country has its own degree of freedom in this matter. In the United States, for example, in general, opportunities to take paid vacations are severely limited.

Judy Burch considers the Spanish initiative insufficient: “If you’re in pain every month, three days isn’t enough. It’s a pitiful handout.” In her opinion, global changes in the working environment towards greater flexibility are much more important.