Prostaglandins and premenstrual syndrome.

We examined plasma PGF2 alpha, PGE, PGE2, TXB2 and 6-keto-PGF1 alpha at intervals throughout 3 menstrual cycles in 20 patients with PMS. Similar measurements throughout 1 menstrual cycle were made in 12 age-matched control women. The plasma concentration of PGF2 alpha in the late luteal phase was significantly lower in patients with PMS compared with that in the control subjects. The plasma concentrations of PGE in the middle follicular phase and middle luteal phase, PGE2 alpha in the middle follicular phase and TXB2 in the middle and late luteal phase were significantly higher in 20 patients compared with the values in the controls. A disturbance of PG metabolism may contribute to the etiology of PMS.     

Legal implications of premenstrual syndrome: a Canadian perspective.

A summary of the symptoms, prevalence and history of premenstrual syndrome (PMS) is presented. The legal implications of PMS, particularly its use as a defence in criminal prosecutions and as an implicit factor in specific offences, are discussed by means of an analysis of Canadian legal cases, with reference to those in England and the United States. The authors offer suggestions on how physicians can make use of PMS in a courtroom more reliable. They conclude that PMS is unlikely to become a substantive criminal defence until the medical community more fully recognizes its significance. Although the role of PMS as a mitigating factor in sentencing may be illogical, the courts now recognize the syndrome in a legally and practically important manner.     

Progesterone and the premenstrual syndrome: a double blind crossover trial.

A double blind, randomised, crossover trial of oral micronised progesterone (two months) and placebo (two months) was conducted to determine whether progesterone alleviated premenstrual complaints. Twenty three women were interviewed premenstrually before treatment and in each month of treatment. They completed Moos''s menstrual distress questionnaire, Beck et al''s depression inventory, Spielberger et al''s state anxiety inventory, the mood adjective checklist, and a daily symptom record. Analyses of data found an overall beneficial effect of being treated for all variables except restlessness, positive moods, and interest in sex. Maximum improvement occurred in the first month of treatment with progesterone. Nevertheless, an appreciably beneficial effect of progesterone over placebo for mood and some physical symptoms was identifiable after both one and two months of treatment. Further studies are needed to determine the optimum duration of treatment.     

Progesterone,fluid, and electrolytes in premenstrual syndrome.

Changes in mood, plasma progesterone concentration, urinary volume, sodium excretion, sodium:potassium ratio, and body weight during the menstrual cycle were determined in 18 women with premenstrual syndrome and 10 symptomless (control group) women. Plasma progesterone concentration was higher in the women with symptoms during the postovulatory phase of the cycle, and the peak progesterone concentration appeared earlier. The changes in progesterone concentration were accompanied by a natriuresis and diuresis that fell towards preovulatory values in the premenstrual phase. Sodium retention was not confined to any definite period. Mood symptoms occurred after the changes in progesterone and electrolyte concentrations. Progesterone deficiency is probably not the cause of premenstrual syndrome. Thus treatment with progesterone is probably illogical unless a deficiency is detected. Treatment should be aimed at preventing the natriuretic effect of progesterone in the postovulatory phase and the sodium-retaining and water-retaining effects of aldosterone in the premenstrual phase.     

The biomedical standardization of premenstrual syndrome

This essay traces the history of premenstrual syndrome (PMS) in French, British, and American medical literature from 1950 to 2004. Aetiological theories, treatments and diagnostic criteria have varied over time and place, reflecting local conditions and changing notions of objectivity and evidence. During the 1970s researchers in each nation utilised different research strategies to overcome variation and contradictory results characteristic of PMS research. Since the 1980s, attempts have been made to standardise research internationally through prospective daily rating questionnaires that diagnose and measure PMS. Amidst controversy, a psychiatric reformulation of the syndrome was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). While the diagnostic criteria for this psychiatric category, now called premenstrual dysphoric disorder (PMDD), are widely accepted for research purposes, efforts to transfer them to medical practice have been less successful. PMDD remains a contested disease construct.     

The premenstrual syndrome and its treatment

The premenstrual syndrome has been described briefly and the literature relating to its pathophysiology and treatment have been reviewed. The great number of theories as to etiology and many different kinds of treatments attest to our ignorance of the exact nature of this problem. Although it is obvious that the hypothalamo-pituitary-ovarian axis must be involved, the exact mechanism whereby the symptoms come about remains elusive. Progestin in the presence of estrogen appears to be essential. Excess estrogen may aggravate the condition. The popular theory of progesterone deficiency has not been supported by double blind trials of progesterone in various forms versus placebo. Because of the important placebo effect in this condition, double blind trials are essential in the assessment of any form of treatment.     

Subjective sleep quality in premenstrual syndrome

Premenstrual syndrome (PMS) is a cyclical disorder observed in late luteal phase and presenting with behavioral changes that can affect interpersonal relationships and normal daily activity. Sleep disturbances are also common. The aim of this study is to investigate the relationship between PMS and subjective sleep quality with Pitsburg Sleep Quality Index (PSQI) in the Medical Academy students, whom have considerable information about menstruation. PMS was detected with "Premenstrual Syndrome Scale", and PSQI was used to evaluate subjective sleep quality. Chi-square test and Kendall's rank correlation analysis were used in statistical analysis. p values (p < 0.05) were considered as statistical significant. Poor sleep quality was found in the 75.6% of the participants with PMS, and 58.8% of the participants without PMS (p < 0.05). Only component 5 (sleep disorder component) of the PSQI components revealed statistically significant difference (1.7 ± 0.6 in participants with PMS, and 1.5 ± 0.6 without PMS, p < 0.05). There was a positive correlation between total PSQI score and all of its' components, except component 6 (sleeping pill usage component) (p < 0.05). The strongest association was found to be in the component 5 (r = 0.528; p = 0.0001). Results of our study suggested the poor sleep quality due to sleep disorders in women with PMS.