Premenstrual Tension and Idiopathic Edema

  • Edward L. Marut

Abstract

Premenstrual tension or, more commonly premenstrual syndrome (PMS), is a long-recognized heterogeneous symptom complex that has defied adequate characterization, elucidation of pathophysiology, and treatment for many years. First described by Frank1 in 1931, premenstrual syndrome has taken on a spectrum of presentations ranging from purely physiologic symptoms during the luteal phase (molimina) to a pattern of aberrant violent behavior that has apparently involved assault, child abuse, spouse battering, and murder.2 The myriad of reported symptoms attributed to the premenstrual interval is pointless to list, but those most likely to be associated with endocrine changes in the premenstruum are noted in Table 22–1. In general, they most often involve breast symptoms, fluid retention, and emotional changes. The pattern of waxing and waning symptoms, which typically encompass approximately the last 7 days of a luteal phase, is actually highly variable. It presents with a spectrum of symptoms starting from the periovulatory interval to only 1 or 2 days premenstrually, and with resolution occurring from initiation of menses to the end of the menstrual flow.3 Thus, defining what “PMS” really means is not always clear cut. Documentation of cyclic symptomatology in relationship to the menses may require charting of symptoms on a menstrual calendar to determine whether such an association really exists. However, the problem of self-evaluation has been demonstrated by a study in which women reported “premenstrual” symptoms when they were falsely told their cycles would be shortened by medication, but menses did not actually occur until the expected time.4 Generally, follicular phase symptoms or intermittent acyclic symptoms are unlikely to be due to endocrine changes related to the menstrual cycle. This is further compounded by the presence of apparent premenstrual symptoms in some women without evidence of ovulation as well as some receiving anovulatory steroids. The opposite effect may be obtained, on the other hand, where unexplained cyclic symptomatology is found to relate to the menstrual cycle when previously unexplained.

Keywords

Placebo Migraine Cortisol Angiotensin Prostaglandin 

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Copyright information

© Plenum Publishing Corporation 1987

Authors and Affiliations

  • Edward L. Marut
    • 1
    • 2
  1. 1.Division of Reproductive EndocrinologyMichael Reese Hospital and Medical CenterChicago, IllinoisUSA
  2. 2.Department of Obstetrics and GynecologyPritzker School of Medicine-University of ChicagoChicago, IllinoisUSA

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