Reproductive Imbalances

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Premenstrual Syndrome

Late luteal dysphoric disorder; Premenstrual dysphoric disorder

Cyclic group of physical, psychological, or behavioral symptoms

7-10 days before menstruation

Distressing enough to impair relationships or interfere with ADL’s

usually 14th day of cycle; last week of luteal cycle

Symptoms begin to decrease a few days before onset of menses

Etiology (idiopathic) theories

Estrogen excess

Progesterone deficit

Multi-factors

Hypothalamic-pituitary dysregulation

Hormone effects on brain chemicals

Family history

Usually considered stress related

Diagnosis: PMS

One of each category of the following symptoms required during the 5 days before menses in each or 3 prior menstrual cycles

Affective

Depression

Angry outbursts

Irritability

Social withdrawal

Fatigue

Somatic

Breast tenderness

Abdominal bloating

Headache

Swollen extremities

Symptoms are present without

Hormonal medication therapy

Drugs or alcohol

Identifiable problem with one of the following

Marital discord

Parenting problems

Poor work, school performance

Increased social isolation

Legal difficulty

Suicidal ideation

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