7.1. Premenstrual syndrome
Premenstrual syndrome (PMS) is a pathological complex of psychological (anxiety, irritability, loss of self-confidence, mood changes, etc.) and physical (mastalgia, mastodinia, tendency to edema, etc.) symptoms, that are regularly manifested in the luteal phase of the menstrual cycle, usually 2-10 days before the onset of menstruation, and have a negative impact on daily activities (Pri-lepskaya V.N., 2012).
PMS is a medical and social problem due to its negative impact not only on women's health and quality of life, but also on academic performance and working capacity, which, in turn, cause economic losses.
PMS is characterized by a high prevalence in the structure of gynecological morbidity - from 20 to 85%. The prevalence of PMS is not associated with age, educational achievement, or employment status.
Etiopathogenesis. PMS is a hormone-dependent disease, that is confirmed by the absence of PMS symptoms in the prepubescent period, during pregnancy and after menopause. But none of the existing theories of PMS origin fully explains the univocal cause of the disorder. One of the most convincing viewpoints regarding the development of PMS is the concept describing this disorder as the result of an inadequate response of CNS and, above all, the hypothalamus to normal fluctuations in sex hormone levels during the menstrual cycle.
Two interrelated theories prevail in the etiopathogenesis of PMS. The first suggests that some women are "sensitive" to progesterone and progestogens that induce premenstrual disorders. The second theory points to the special role of the neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA) in key aspects of PMS pathogenesis.
Classification. In the International classification of diseases 10 revision (ICD-10), PMS is an independent nosological unit (code N 94.3) "Premenstrual tension syndrome".