Previous research on premenstrual tension has typically focused on the hormonal or biological theories of premenstrual tension. Recent research, however, has begun to show a relationship between negative expectancies and reports of premenstrual suffering. In this study it was hypothesized that negative expectancies could be changed by exposing participants to information which either increased or decreased their sense of control over premenstrual symptomatology. It was proposed that information which offered participants a way to control premenstrual symptoms would decrease expectations while information which informed participants that they could not control their symptoms would increase negative expectations. In this study it was further hypothesized that participants exposed to information which decreased their negative expectancies would report more positive moods during the premenstrual phase of the menstrual cycle than those subjects exposed to information which increased their expectations for premenstrual tension. Results from this study supported the hypothesis that expectancies for premenstrual tension are related to the participants' sense of control over premenstrual tension. However, results did not show a relationship between daily reports of mood during the premenstrual phase and negative expectations. / Master of Science

Lee, Antionette Marie. / "May 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 153-171). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Esta pesquisa visa problematizar a síndrome pré-menstrual (SPM) enquanto entidade biomédica a-histórica tornada evidente a partir do preenchimento de critérios diagnósticos. O ponto de partida é a hipótese de que o modelo biomédico de explicação da SPM incorpora e reproduz os padrões sociais vigentes que insistem em visões estereotipadas dos gêneros em função da diferenciação biológica dos sexos. A partir de uma reflexão sobre a construção do fato científico e da preponderância do discurso biomédico na compreensão dos corpos, emoções e comportamentos femininos, analisamos as mudanças históricas ocorridas nessa visão considerada reducionista. No final do século XVIII e início do XIX, a essência da feminilidade era localizada no útero; a partir de meados do século XIX, os ovários passaram a ser considerados a fonte das doenças das mulheres, inclusive as nervosas e mentais. No início do século XX começou a ocorrer uma mudança nos discursos biomédicos e a essência da feminilidade passou a ser localizada em substâncias químicas denominadas hormônios. Desde então o organismo feminino tornou-se cada vez mais representado como controlado pelos hormônios, reificando a crença de que as mulheres são cíclicas e em determinados períodos, instáveis, irracionais e, portanto, não confiáveis. Essa ênfase nos hormônios coincide com a primeira descrição, em 1931, do que era chamado tensão pré-menstrual. Na década de 1950, a terminologia mudou para síndrome pré-menstrual. Inicialmente foi compreendida como diretamente produzida pelos hormônios femininos, mas não há evidência empírica que comprove esta hipótese. Após 80 anos de pesquisas, não se encontrou um marcador biológico ou teste bioquímico que possa ser utilizado para o diagnóstico. Os próprios critérios diagnósticos não são consensuais entre os pesquisadores, pois foram descritos mais de 200 sintomas que incidem de forma variada e inconstante. Não se conhece ainda o mecanismo etiopatogênico e alguns autores questionam a própria existência da síndrome enquanto entidade biomédica e apresentam visões feministas e sócio-culturais para a compreensão do fenômeno. Muitas mulheres, entretanto, afirmam ter TPM (nomenclatura mais comum nos meios leigos). Para aprofundar esta questão e ampliar nossa compreensão, a análise de artigos biomédicos recentes (2000 a 2011) sobre a SPM foi confrontada com a experiência direta ou indireta da TPM em mulheres de camadas médias da população. Com este objetivo, foram analisados artigos científicos sobre a SPM selecionados a partir de um levantamento no PubMed, ferramenta de buscas online, e realizadas entrevistas individuais em profundidade, abertas, semi-estruturadas com mulheres em idade reprodutiva selecionadas através do sistema de amostragem conhecido como bola de neve (snow ball). Após a análise tanto dos artigos científicos quanto das entrevistas, concluímos que apesar de pressupostos comuns que a biologia determina diferenças de gênero naturais e universais entre homens e mulheres a SPM dos artigos biomédicos e a TPM das mulheres não coincidem. Sem desconsiderar as sensações desagradáveis, os problemas e o sofrimento das mulheres que afirmam ter TPM, os resultados deste estudo apontam para uma realidade complexa que enseja mais pesquisa em direção a descrições menos reducionistas destas experiências femininas / This research aims at putting in doubt the premenstrual syndrome (PMS) problem as an ahistorical biomedical entity made evident from the fulfilling of diagnostic criteria. The starting point is the hypothesis that the biomedical model for the explanation of PMS incorporates and reproduces the existing social patterns that insist in stereotypical views of genders due to the biological differentiation of sexes. Upon reflecting about the construction of the scientific fact and the prevalence of the biomedical statement in the understanding of the female body, emotion and behavior, we analyzed historical changes of this vision, regarded as reductionist. At the end of the 18th century and the beginning of the 19th century, the essence of womanhood was located in the womb; from the mid 19th century, the ovaries began to be considered the root of womens diseases, including nervous and mental ones. At the beginning of the 20th century a change in the biomedical statements started to happen and the essence of womanhood was then located in chemical substances denominated hormones. Since then the female body became more and more represented as one controlled by hormones, reifying the belief that women are cyclical and in some moments, unstable, irrational and, therefore, not trustworthy. This emphasis on hormones coincides with the first description, in 1931, of what was called premenstrual tension. In the 1950s, the terminology changed to premenstrual syndrome. Initially, it was understood as being directly produced by the female hormones, but there is no empirical evidence that proves this hypothesis. After 80 years of research, no biological marker or biochemical test that could be used for this diagnosis has been found. The very diagnostic criteria are not consensual among researchers, as more than 200 symptoms that take place in a variable and inconstant manner have been described. The etiopathogenic mechanism is still not known and some authors question the very existence of the syndrome as a biomedical entity and present feminist and socio-cultural views for the understanding of the phenomenon. A great number of women, however, claim to have PMT (most common nonprofessional nomenclature). In order to expand this subject and increase our understanding, the analysis of recent biomedical articles (2000 to 2011) about PMS was confronted with the direct or indirect experience of PMT in women of the average general population. With this in mind, scientific articles about PMS, selected from cited research in PubMed - an online search engine tool - were analyzed, and in depth, open and semi-structured individual interviews were performed with women in reproductive age, who were selected by using the sampling system known as snow ball. After analyzing the articles, as well as the interviews, we conclude that in spite of common assumptions that biology determines natural and universal gender differences between men and women the PMS of the biomedical articles and womens PMT do not match. Without undermining the unpleasant sensations, the problems, and the suffering of women that claim to have PMT, the results of this study point to a complex reality which requires more research aiming at reaching less reductionist descriptions of these female experiences

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Esta pesquisa visa problematizar a síndrome pré-menstrual (SPM) enquanto entidade biomédica a-histórica tornada evidente a partir do preenchimento de critérios diagnósticos. O ponto de partida é a hipótese de que o modelo biomédico de explicação da SPM incorpora e reproduz os padrões sociais vigentes que insistem em visões estereotipadas dos gêneros em função da diferenciação biológica dos sexos. A partir de uma reflexão sobre a construção do fato científico e da preponderância do discurso biomédico na compreensão dos corpos, emoções e comportamentos femininos, analisamos as mudanças históricas ocorridas nessa visão considerada reducionista. No final do século XVIII e início do XIX, a essência da feminilidade era localizada no útero; a partir de meados do século XIX, os ovários passaram a ser considerados a fonte das doenças das mulheres, inclusive as nervosas e mentais. No início do século XX começou a ocorrer uma mudança nos discursos biomédicos e a essência da feminilidade passou a ser localizada em substâncias químicas denominadas hormônios. Desde então o organismo feminino tornou-se cada vez mais representado como controlado pelos hormônios, reificando a crença de que as mulheres são cíclicas e em determinados períodos, instáveis, irracionais e, portanto, não confiáveis. Essa ênfase nos hormônios coincide com a primeira descrição, em 1931, do que era chamado tensão pré-menstrual. Na década de 1950, a terminologia mudou para síndrome pré-menstrual. Inicialmente foi compreendida como diretamente produzida pelos hormônios femininos, mas não há evidência empírica que comprove esta hipótese. Após 80 anos de pesquisas, não se encontrou um marcador biológico ou teste bioquímico que possa ser utilizado para o diagnóstico. Os próprios critérios diagnósticos não são consensuais entre os pesquisadores, pois foram descritos mais de 200 sintomas que incidem de forma variada e inconstante. Não se conhece ainda o mecanismo etiopatogênico e alguns autores questionam a própria existência da síndrome enquanto entidade biomédica e apresentam visões feministas e sócio-culturais para a compreensão do fenômeno. Muitas mulheres, entretanto, afirmam ter TPM (nomenclatura mais comum nos meios leigos). Para aprofundar esta questão e ampliar nossa compreensão, a análise de artigos biomédicos recentes (2000 a 2011) sobre a SPM foi confrontada com a experiência direta ou indireta da TPM em mulheres de camadas médias da população. Com este objetivo, foram analisados artigos científicos sobre a SPM selecionados a partir de um levantamento no PubMed, ferramenta de buscas online, e realizadas entrevistas individuais em profundidade, abertas, semi-estruturadas com mulheres em idade reprodutiva selecionadas através do sistema de amostragem conhecido como bola de neve (snow ball). Após a análise tanto dos artigos científicos quanto das entrevistas, concluímos que apesar de pressupostos comuns que a biologia determina diferenças de gênero naturais e universais entre homens e mulheres a SPM dos artigos biomédicos e a TPM das mulheres não coincidem. Sem desconsiderar as sensações desagradáveis, os problemas e o sofrimento das mulheres que afirmam ter TPM, os resultados deste estudo apontam para uma realidade complexa que enseja mais pesquisa em direção a descrições menos reducionistas destas experiências femininas / This research aims at putting in doubt the premenstrual syndrome (PMS) problem as an ahistorical biomedical entity made evident from the fulfilling of diagnostic criteria. The starting point is the hypothesis that the biomedical model for the explanation of PMS incorporates and reproduces the existing social patterns that insist in stereotypical views of genders due to the biological differentiation of sexes. Upon reflecting about the construction of the scientific fact and the prevalence of the biomedical statement in the understanding of the female body, emotion and behavior, we analyzed historical changes of this vision, regarded as reductionist. At the end of the 18th century and the beginning of the 19th century, the essence of womanhood was located in the womb; from the mid 19th century, the ovaries began to be considered the root of womens diseases, including nervous and mental ones. At the beginning of the 20th century a change in the biomedical statements started to happen and the essence of womanhood was then located in chemical substances denominated hormones. Since then the female body became more and more represented as one controlled by hormones, reifying the belief that women are cyclical and in some moments, unstable, irrational and, therefore, not trustworthy. This emphasis on hormones coincides with the first description, in 1931, of what was called premenstrual tension. In the 1950s, the terminology changed to premenstrual syndrome. Initially, it was understood as being directly produced by the female hormones, but there is no empirical evidence that proves this hypothesis. After 80 years of research, no biological marker or biochemical test that could be used for this diagnosis has been found. The very diagnostic criteria are not consensual among researchers, as more than 200 symptoms that take place in a variable and inconstant manner have been described. The etiopathogenic mechanism is still not known and some authors question the very existence of the syndrome as a biomedical entity and present feminist and socio-cultural views for the understanding of the phenomenon. A great number of women, however, claim to have PMT (most common nonprofessional nomenclature). In order to expand this subject and increase our understanding, the analysis of recent biomedical articles (2000 to 2011) about PMS was confronted with the direct or indirect experience of PMT in women of the average general population. With this in mind, scientific articles about PMS, selected from cited research in PubMed - an online search engine tool - were analyzed, and in depth, open and semi-structured individual interviews were performed with women in reproductive age, who were selected by using the sampling system known as snow ball. After analyzing the articles, as well as the interviews, we conclude that in spite of common assumptions that biology determines natural and universal gender differences between men and women the PMS of the biomedical articles and womens PMT do not match. Without undermining the unpleasant sensations, the problems, and the suffering of women that claim to have PMT, the results of this study point to a complex reality which requires more research aiming at reaching less reductionist descriptions of these female experiences

Bakgrund: Cirka 75% av alla fertila kvinnor påverkas i varierande grad av premenstruella symtom. 15–20% har uttalad PMS medan 2–5% drabbas av den allvarligare varianten PMDS. De vanligaste symtomen är ilska, irritabilitet, ångest, ökad svullnadskänsla i kroppen, ömhet i brösten, huvudvärk, led-/muskelvärk och viktökning. Syfte: Syftet med litteraturstudien var att undersöka kvinnors erfarenheter av att leva med PMS och PMDS. Metod: Examensarbetet utfördes som en litteraturstudie med kvalitativ studiedesign där tio vetenskapliga artiklar sammanställdes för att kunna svara på det valda syftet. Resultat: För vissa kvinnor innebar premenstruella besvär år av månatligt lidande, för andra var det ett tecken på att vara en frisk kvinna. Kvinnorna hade olika copingstrategier för att få vardagen att fungera, de vanligaste var egen tid och att praktisera självövervakning. Många upplevde en negativ samhällelig bild av PMS och hur den premenstruella kvinnan uppfattades, dessa normer och ideal påvisades ha en skadlig inverkan på den egen självbilden och hur kvinnorna upplevde sina premenstruella besvär. Jean Watson (1985) belyser vikten av att sjuksköterskan ingjuter tro och hopp i patienten inför den situation den befinner sig i. På så vis kan sjuksköterskan bidra till beteende- och attitydförändringar. Slutsats: Kvinnorna upplever en samhällelig okunskap om PMS och PMDS som påverkar i vilken utsträckning de vågar tala om sina besvär. Okunskapen leder till att kvinnorna inte får det stöd och den hjälp de behöver för att klara vardagen, något som har direkt inverkan på livskvaliteten. Ökad medvetenhet och kunskap hos sjuksköterskan är grundläggande för att kunna ge adekvat och personcentrerad vård till dessa kvinnor. / Background: Approximately 75% of all women of childbearing age are affected by premenstrual symptoms. 15–20% have more distinct PMS, while 2–5% suffer from the more severe version PMDD. The most common symptoms are anger, irritability, anxiety, increased bloating, soreness in the breasts, headaches, joint/muscle pain and weight gain. Aim: The aim of the literature study was to investigate women's experiences of living with PMS and PMDD. Method: The thesis was carried out as a literature study with a qualitative study design. Ten scientific articles were compiled in order to answer the aim of the study. Results: For some women, PMS can mean years of monthly suffering, for others it's a sign of being a healthy woman. Women witnessed having to resort to different coping strategies to make everyday life work, the most common were personal time and self-monitoring. Many women experienced a negative societal image of PMS and how the premenstrual woman was perceived, these norms and ideals have been shown to have a harmful impact on their self-image and how they experience their premenstrual distress. Jean Watson (1985) highlights the importance of the nurse instilling faith and hope in the patient before the situation they find themselves in. In this way, the nurse can contribute to behavioral and attitudinal changes. Conclusion: Women feel that there is a societal ignorance that affects the extent to which they are comfortable speaking about their distress. This means that women do not receive the support and help they need to cope with everyday life, something that has a direct impact on their quality of life. Increased awareness and knowledge is fundamental in order for the nurse to provide adequate and person centered care for these women.

D.Litt. et Phil. / Although PMS has been described almost since the beginning of the written history of medicine, it is still not completely understood. There are many theories about its causation and treatment, and a proliferation of symptoms are ascribed to it. The prevalence of PMS in relation to the total population is still unknown, because premenstrual symptoms or a combination of these range from almost 25% to 100% amongst women. Furthermore, different criteria for the assessment of the prevalence of PMS are used by different researchers. Researchers are in agreement, however, that no single definition for PMS exists. Some women experience mainly psychological symptoms, while others present predominantly physical symptoms. Very little is known of the prognosis of the natural history of PMS. The precise causes of menstrually-related distress is not known, although much has been written about the role that nutrition plays in PMS. A direct relationship has not been identified between individual levels of, and changes in, oestrogen and progesterone alone, and the reported psychological, behavioural and physical changes associated with the cycle. Certain observable behaviours are associated with the premenstrual phase of the cycle, such as aggressive and illness behaviour. An important aspect is the link between premenstrual changes and psychopathology, especially mood disorders. Many researchers report a positive association between premenstrual changes and mood disorders, especially depressive disorders. Women suffering from depressive disorders are reported to frequently experience a premenstrual exacerbation of symptoms and a deterioration in functioning. Most studies have found that women report both psychological and somatic symptoms. The psychological symptoms are, owever, more commonly reported and have also been found to be more distressing for women. In respect of aetiological theories, the literature shows a major subdivision between the biological causes and the psychological basis. Potential causes, according to a biological approach include abnormalities in gonadal steroids, excessive fluid retention, hypoglycemia, abnormalities in prostaglandin metabolism, allergy to endogenous hormones and endogenous opiate withdrawal. Research results in each of these areas are conflicting and conclusions reached are speculative. Most psychological aetiologies originate from the psychoanalytical school and include a rejection or resentment of the feminine role, as well as a repressed wish for a child. At present, the psychoanalytical theories have not been supported by controlled studies and, therefore, still remain speculative. The uncertainty of the causes of PMS is reflected in the numerous treatments proposed in the literature. A review of the literature shows that treatment for PMS is generally given indiscriminately for a divergent group of symptoms, without regard for the fact that growing evidence suggests that the Syndrome is made up of a variety of distinct, but related, symptoms. A girl's first menstruation is a developmental milestone with psychological and physiological concomitants. Adolescents of both sexes tend to view menstruation negatively. Many adolescents associate menstruation with dysmenorrhea. Studies have shown that up to 91% of girls report dysmenorrhea, and it is also the leading cause of recurrent short-term school absenteeism among adolescent girls. Dysmenorrhea cannot be ignored, as it leads to a loss in self-esteem, with all the accompanying problems. If an adolescent does not get help with her PMS symptoms, she may be negatively affected. The purpose of the present study was to cross-culturally investigate the psychological concomitants of the premenstrual symptomatology in adolescent girls. Four hypotheses were tested: In an analysis of symptoms associated with PMS, a single factor reflecting will emerge to account for a significant percentage of the variance observed; Dysmenorrhic adolescents will experience a greater number of negative premenstrual symptoms than non-dysmenorrhic adolescents; Adolescents experiencing a number of negative premenstrual symptoms will report lower self-esteem; Adolescents of different cultural groups will report PMS symptoms that are IV commensurate with their culturally-based health beliefs. In order to test these hypotheses, one hundred and twenty five adolescent girls of all race groups, between 13 and 18 years of age, who were not taking any contraceptive, participated in the study. The Premenstrual Assessment Form (PAF) and the Index of Self-Esteem (ISE) were used. Physical and emotional discomfort emerged as two clear interpretable factors. It would appear that for this sample, PMS is not a unitary phenomenon, but consists of dual factors which are depended on cultural expectations. By observing dysmenorrhic and nondysmenorrhic adolescent girls, it was found that dysmenorrhic girls manifested a significantly higher degree of low mood and loss of pleasure, "endogenous" depressive features, lability, "atypical" depressive features, hysteroid features, hostility and anger, social withdrawal, anxiety, impulsivity, organic mental features, general physical discomfort, water retention, autonomic physical changes, fatigue, impaired social functioning, impaired miscellaneous mood and behaviour changes and miscellaneous physical changes than non-dysmenorrhic girls. Non-dysmenorrhic girls showed a significantly higher degree of well-being when compared with dysmenorrhic girls. Thus, the present study supported the findings of previous research which suggested that dysmenorrhic girls will experience more negative premenstrual symptoms than nondysmenorrhic girls. In respect of self-esteem, girls reporting a number of negative premenstrual symptoms were found to have a lower self-esteem than those reporting fewer negative premenstrual symptoms. In respect of culture, it was found that culture seemed to play a role in the girls' perceived experiences of PMS. The present study indicates that adolescent girls do experience many negative symptoms and, if these are not adequately dealt with, they may adversely affect them in adulthood.

Introdução. A Síndrome Pré-menstrual (SPM) é caracterizada por sintomas de estresse somáticos e comportamentais que se desenrolam logo após a ovulação, atingindo um pico máximo próximo à data da menstruação e desaparecendo em média em até quatro dias após o início do sangramento. A presença da formação do corpo lúteo seria necessária para a presença dos sintomas, contudo essa dinâmica dos hormônios da fase lútea associados à SPM é pouco conhecida. O hormônio antimülleriano (HAM) é um dos melhores marcadores de declínio da capacidade reprodutiva das mulheres. Até o momento o mesmo não foi correlacionado a sintomas da SPM. A percepção de piora dos sintomas da SPM na perimenopausa é sugerida, existindo a possibilidade de que com a menor função ovariana (redução do HAM) exista uma exacerbação da SPM durante essa fase da vida reprodutiva da mulher. Objetivo: avaliar o padrão de SPM em mulheres com idade superior a 35 anos e correlacionar seus sintomas com a redução de HAM. Métodos: Estudo observacional, transversal, com uma amostra de conveniência composta por mulheres recrutadas através da mídia local. O questionário Registro Diário da Intensidade de Problemas (DRSP) de 2 meses foi utilizado para o diagnóstico de SPM. As participantes (N = 101) foram avaliadas em seus perfis antropométricos (peso, altura, índice de massa corporal) e social (paridade, nível educacional, uso de contracepção oral). Depois de completar o questionário DRSP por 2 meses, as mulheres retornaram no período prémenstrual para a coleta do sangue. Entre as participantes que utilizaram contracepção hormonal, foi solicitado um período de wash out de um mês para a coleta de sangue e dosagem de HAM no soro. O HAM foi analisado usando um kit comercial ELISA, de acordo com as instruções do fabricante. A análise estatística foi realizada na versão SPSS 18.0. O nível de significância adotado para todas as análises foi estabelecido em 5%. Resultados: A análise de HAM mostrou uma redução significativa após a idade de 35 anos, e não foi relacionada à severidade dos sintomas de SPM. Os sintomas físicos na fase lútea, mas não os emocionais, foram maiores em mulheres com mais de 35 anos de idade. A análise de Spearman mostrou uma correlação positiva entre um grupo de ≥35 anos e uma correlação negativa entre o uso de contracepção oral com piora dos sintomas físicos da SPM. Conclusão: este estudo mostrou que não houve piora dos sintomas emocionais entre as mulheres com SPM após os 35 anos de idade, apenas piora dos sintomas físicos, que necessitam uma investigação mais aprofundada. Não há relação entre os sintomas físicos e emocionais com níveis de HAM nas mulheres com SPM. / Background. Premenstrual Syndrome (PMS) is characterized by somatic and behavioral stress symptoms that take place soon after ovulation, reaching a peak near the time of menstruation and disappears on average within 4 days after the start of the bleeding. The presence of the corpus luteum formation would be needed for the presence of symptoms, however, these dynamics luteal phase of hormones associated with PMS is not well known. The anti-müllerian hormone (AMH) is one of the best markers of decline in women's reproductive capacity, and AMH has not been correlated with PMS symptoms. The perception of worsening of PMS symptoms in perimenopause is suggested, with the possibility that with less ovarian reserve (reduction of AMH) there is an exacerbation of PMS during this phase of the woman's reproductive life. Objective: To evaluate the pattern of PMS in women aged over 35 years, and correlate its symptoms to the reduction of AMH. Methods: It was an observational, cross-sectional study with a convenience sample composed of women recruited through local media. The 2-months DRSP questionnaire was used for PMS diagnosis. The participants (N=101) were evaluated in their anthropometric (weight, height, body mass index) and social (parity, educational level, use of oral contraception) profiles. After completing the DRSP questionnaire for 2 months, women returned in the pre-menstrual period for serum collection. Among participants using hormonal contraception, a one-month washout period was requested for serum collection and AMH dosage. AMH was analyzed using an ELISA commercial kit, according the manufacturer’s instructions. Statistical analysis was carried out in SPSS version 18.0. Significance level adopted for all analyzes was set at 5%. Results: AMH analysis showed a significant reduction after the age of 35 years, and it was not related to PMS symptoms severity. Physical symptoms in luteal stage were greater in women aged over 35 years, emotional symptoms were equal in both ages. Spearman’s analysis showed a positive correlation between ≥ 35years group and a negative correlation between the use of oral contraception with PMS physical symptoms worsening. Conclusion: this study showed that there is no worsening of emotional symptoms among women with PMS after 35 years of age, with a greater physical complaint, that needs further investigation. There is no relation between the physical and emotional symptoms with AMH levels in PMS women.

Introdução. A Síndrome Pré-menstrual (SPM) é caracterizada por sintomas de estresse somáticos e comportamentais que se desenrolam logo após a ovulação, atingindo um pico máximo próximo à data da menstruação e desaparecendo em média em até quatro dias após o início do sangramento. A presença da formação do corpo lúteo seria necessária para a presença dos sintomas, contudo essa dinâmica dos hormônios da fase lútea associados à SPM é pouco conhecida. O hormônio antimülleriano (HAM) é um dos melhores marcadores de declínio da capacidade reprodutiva das mulheres. Até o momento o mesmo não foi correlacionado a sintomas da SPM. A percepção de piora dos sintomas da SPM na perimenopausa é sugerida, existindo a possibilidade de que com a menor função ovariana (redução do HAM) exista uma exacerbação da SPM durante essa fase da vida reprodutiva da mulher. Objetivo: avaliar o padrão de SPM em mulheres com idade superior a 35 anos e correlacionar seus sintomas com a redução de HAM. Métodos: Estudo observacional, transversal, com uma amostra de conveniência composta por mulheres recrutadas através da mídia local. O questionário Registro Diário da Intensidade de Problemas (DRSP) de 2 meses foi utilizado para o diagnóstico de SPM. As participantes (N = 101) foram avaliadas em seus perfis antropométricos (peso, altura, índice de massa corporal) e social (paridade, nível educacional, uso de contracepção oral). Depois de completar o questionário DRSP por 2 meses, as mulheres retornaram no período prémenstrual para a coleta do sangue. Entre as participantes que utilizaram contracepção hormonal, foi solicitado um período de wash out de um mês para a coleta de sangue e dosagem de HAM no soro. O HAM foi analisado usando um kit comercial ELISA, de acordo com as instruções do fabricante. A análise estatística foi realizada na versão SPSS 18.0. O nível de significância adotado para todas as análises foi estabelecido em 5%. Resultados: A análise de HAM mostrou uma redução significativa após a idade de 35 anos, e não foi relacionada à severidade dos sintomas de SPM. Os sintomas físicos na fase lútea, mas não os emocionais, foram maiores em mulheres com mais de 35 anos de idade. A análise de Spearman mostrou uma correlação positiva entre um grupo de ≥35 anos e uma correlação negativa entre o uso de contracepção oral com piora dos sintomas físicos da SPM. Conclusão: este estudo mostrou que não houve piora dos sintomas emocionais entre as mulheres com SPM após os 35 anos de idade, apenas piora dos sintomas físicos, que necessitam uma investigação mais aprofundada. Não há relação entre os sintomas físicos e emocionais com níveis de HAM nas mulheres com SPM. / Background. Premenstrual Syndrome (PMS) is characterized by somatic and behavioral stress symptoms that take place soon after ovulation, reaching a peak near the time of menstruation and disappears on average within 4 days after the start of the bleeding. The presence of the corpus luteum formation would be needed for the presence of symptoms, however, these dynamics luteal phase of hormones associated with PMS is not well known. The anti-müllerian hormone (AMH) is one of the best markers of decline in women's reproductive capacity, and AMH has not been correlated with PMS symptoms. The perception of worsening of PMS symptoms in perimenopause is suggested, with the possibility that with less ovarian reserve (reduction of AMH) there is an exacerbation of PMS during this phase of the woman's reproductive life. Objective: To evaluate the pattern of PMS in women aged over 35 years, and correlate its symptoms to the reduction of AMH. Methods: It was an observational, cross-sectional study with a convenience sample composed of women recruited through local media. The 2-months DRSP questionnaire was used for PMS diagnosis. The participants (N=101) were evaluated in their anthropometric (weight, height, body mass index) and social (parity, educational level, use of oral contraception) profiles. After completing the DRSP questionnaire for 2 months, women returned in the pre-menstrual period for serum collection. Among participants using hormonal contraception, a one-month washout period was requested for serum collection and AMH dosage. AMH was analyzed using an ELISA commercial kit, according the manufacturer’s instructions. Statistical analysis was carried out in SPSS version 18.0. Significance level adopted for all analyzes was set at 5%. Results: AMH analysis showed a significant reduction after the age of 35 years, and it was not related to PMS symptoms severity. Physical symptoms in luteal stage were greater in women aged over 35 years, emotional symptoms were equal in both ages. Spearman’s analysis showed a positive correlation between ≥ 35years group and a negative correlation between the use of oral contraception with PMS physical symptoms worsening. Conclusion: this study showed that there is no worsening of emotional symptoms among women with PMS after 35 years of age, with a greater physical complaint, that needs further investigation. There is no relation between the physical and emotional symptoms with AMH levels in PMS women.

Introduktion: Många kvinnor påverkas negativt av fysiska och psykiska besvär under sin menstruationscykel. Det råder idag stor kunskapsbrist om hur subkliniska menstruella besvär som kraftig menstruationssmärta, riklig menstruationsblödning, premenstruellt syndrom, premenstruellt dysforiskt syndrom, oregelbunden menstruation och menstruationsbortfall kan lindras utan att använda läkemedel. Fysisk aktivitet och kost har visats ge stora hälsoeffekter vid många sjukdomar och besvär och därför var syftet att undersöka om det även ger positiva hälsoeffekter vid menstruella besvär. Syfte: Syftet med litteraturstudien var att studera om fysisk aktivitet och kost kan minska fysiska och psykiska subkliniska menstruella besvär och därigenom ge ökat välmående. Metod: Sökt i Pubmed med sökorden subkliniska besvär i relation till fysisk aktivitet respektive kost hos fertila tränade och otränade kvinnor utan inverkan av hormonella preventivmedel. Resultat: Studien har visat vissa belägg för att fysisk aktivitet och kost kan lindra några subkliniska menstruella besvär. Premenstruellt syndrom (PMS) kan främst lindras genom lugna, meditativa aktiviteter. Vidare sågs god effekt på PMS av mindre men fler måltider med komplexa kolhydrater, samt intag av vitaminer och mineraler. Yoga har även visats minska menstruationssmärta, och allmän fysisk aktivitet har visat antydan till att förbättra menstruationens regelbundenhet. För att undvika oregelbunden menstruation eller menstruationsuppehåll behövs adekvat energiintag. Övriga subkliniska menstruella besvär saknade tydliga rekommendationer. Konklusion: Studien har visat att fysisk aktivitet och kost kan ha positiva effekter på vissa menstruella subkliniska besvär. För kvinnor med PMS verkar lugna, meditativa former av fysisk aktivitet kunna lindra syndromet. Yoga och fysisk aktivitet har även visats minska dysmenorré. Tillräckligt energiintag är essentiellt för att undvika oregelbunden och utebliven menstruation. Ytterligare studier behövs inom området för att säkerställa resultat och ge generella rekommendationer. / Background: Many women experience physical and psychological symptoms during their menstrual cycle. Research is scarce about how to ease subclinical menstrual disorders like dysmenorrhea, menorrhagia, premenstrual syndrome, premenstrual dysphoric syndrome, oligomenorrhea and amenorrhea without using medicines. Physical activity and diet is proved to have positive effects on several diseases and we therefore wanted to see if positive effects also could be seen on subclinical menstrual disorders. Aim: The aim of this study was to investigate if physical activity and diet could reduce physical and psychological subclinical menstrual disorders and lead to a better wellbeing. Method: Searching for subclinical menstrual disorders in relation to physical activity and diet in fertile, active and inactive women without the use of hormonal contraceptives was done using Pubmed. Results: The study has shown that physical activity and diet could reduce some of the problems associated with subclinical menstrual disorders. Premenstrual syndrome (PMS) could be eased through calm, meditative activities. Positive effects could be seen when eating more often but smaller meals containing complex carbohydrates and by taking additional vitamins and minerals. Yoga has been proved to reduce menstrual pain and there’s also an indication that physical activity could improve the regularity of the menstrual cycle. Adequate energy intake is needed to avoid oligomenorrhea and amenorrhea. No clear recommendations were found for the remaining subclinical menstrual disorders. Conclusion: The study has shown that physical activity and diet have positive effects on some subclinical menstrual disorders. Symptoms of PMS could be eased by calm, meditative activities. Yoga and physical activity have been shown to reduce dysmenorrhea. Adequate energy intake is essential to avoid oligomenorrhea and amenorrhea. Further research is needed to give general recommendations.

Introdução. A Síndrome Pré-menstrual (SPM) é caracterizada por sintomas de estresse somáticos e comportamentais que se desenrolam logo após a ovulação, atingindo um pico máximo próximo à data da menstruação e desaparecendo em média em até quatro dias após o início do sangramento. A presença da formação do corpo lúteo seria necessária para a presença dos sintomas, contudo essa dinâmica dos hormônios da fase lútea associados à SPM é pouco conhecida. O hormônio antimülleriano (HAM) é um dos melhores marcadores de declínio da capacidade reprodutiva das mulheres. Até o momento o mesmo não foi correlacionado a sintomas da SPM. A percepção de piora dos sintomas da SPM na perimenopausa é sugerida, existindo a possibilidade de que com a menor função ovariana (redução do HAM) exista uma exacerbação da SPM durante essa fase da vida reprodutiva da mulher. Objetivo: avaliar o padrão de SPM em mulheres com idade superior a 35 anos e correlacionar seus sintomas com a redução de HAM. Métodos: Estudo observacional, transversal, com uma amostra de conveniência composta por mulheres recrutadas através da mídia local. O questionário Registro Diário da Intensidade de Problemas (DRSP) de 2 meses foi utilizado para o diagnóstico de SPM. As participantes (N = 101) foram avaliadas em seus perfis antropométricos (peso, altura, índice de massa corporal) e social (paridade, nível educacional, uso de contracepção oral). Depois de completar o questionário DRSP por 2 meses, as mulheres retornaram no período prémenstrual para a coleta do sangue. Entre as participantes que utilizaram contracepção hormonal, foi solicitado um período de wash out de um mês para a coleta de sangue e dosagem de HAM no soro. O HAM foi analisado usando um kit comercial ELISA, de acordo com as instruções do fabricante. A análise estatística foi realizada na versão SPSS 18.0. O nível de significância adotado para todas as análises foi estabelecido em 5%. Resultados: A análise de HAM mostrou uma redução significativa após a idade de 35 anos, e não foi relacionada à severidade dos sintomas de SPM. Os sintomas físicos na fase lútea, mas não os emocionais, foram maiores em mulheres com mais de 35 anos de idade. A análise de Spearman mostrou uma correlação positiva entre um grupo de ≥35 anos e uma correlação negativa entre o uso de contracepção oral com piora dos sintomas físicos da SPM. Conclusão: este estudo mostrou que não houve piora dos sintomas emocionais entre as mulheres com SPM após os 35 anos de idade, apenas piora dos sintomas físicos, que necessitam uma investigação mais aprofundada. Não há relação entre os sintomas físicos e emocionais com níveis de HAM nas mulheres com SPM. / Background. Premenstrual Syndrome (PMS) is characterized by somatic and behavioral stress symptoms that take place soon after ovulation, reaching a peak near the time of menstruation and disappears on average within 4 days after the start of the bleeding. The presence of the corpus luteum formation would be needed for the presence of symptoms, however, these dynamics luteal phase of hormones associated with PMS is not well known. The anti-müllerian hormone (AMH) is one of the best markers of decline in women's reproductive capacity, and AMH has not been correlated with PMS symptoms. The perception of worsening of PMS symptoms in perimenopause is suggested, with the possibility that with less ovarian reserve (reduction of AMH) there is an exacerbation of PMS during this phase of the woman's reproductive life. Objective: To evaluate the pattern of PMS in women aged over 35 years, and correlate its symptoms to the reduction of AMH. Methods: It was an observational, cross-sectional study with a convenience sample composed of women recruited through local media. The 2-months DRSP questionnaire was used for PMS diagnosis. The participants (N=101) were evaluated in their anthropometric (weight, height, body mass index) and social (parity, educational level, use of oral contraception) profiles. After completing the DRSP questionnaire for 2 months, women returned in the pre-menstrual period for serum collection. Among participants using hormonal contraception, a one-month washout period was requested for serum collection and AMH dosage. AMH was analyzed using an ELISA commercial kit, according the manufacturer’s instructions. Statistical analysis was carried out in SPSS version 18.0. Significance level adopted for all analyzes was set at 5%. Results: AMH analysis showed a significant reduction after the age of 35 years, and it was not related to PMS symptoms severity. Physical symptoms in luteal stage were greater in women aged over 35 years, emotional symptoms were equal in both ages. Spearman’s analysis showed a positive correlation between ≥ 35years group and a negative correlation between the use of oral contraception with PMS physical symptoms worsening. Conclusion: this study showed that there is no worsening of emotional symptoms among women with PMS after 35 years of age, with a greater physical complaint, that needs further investigation. There is no relation between the physical and emotional symptoms with AMH levels in PMS women.