Abstract

Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) represent two premenstrual disorders characterized by physical and psychological symptoms that occur in the luteal phase of the menstrual cycle, prior to the onset of menses, and have a negative impact on the psychosocial functioning of affected individuals. PMS, more common than PMDD, affects 20-40% of menstruating women, with common symptoms including fatigue, irritability, mood swings, depression, abdominal bloating, breast tenderness, acne, changes in appetite and food cravings. PMDD, affecting a smaller percentage of women, is characterized by more severe symptoms and is listed as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While the pathophysiology of these premenstrual disorders remains unclear, it has been hypothesized that sensitivity to hormonal fluctuations during the luteal phase of the menstrual cycle, abnormal serotonergic activity, and aberrations in progesterone and the neurotransmitter gamma aminobutyric acid (GABA) may all play a role in these disorders. Treatment of PMS and PMDD is focused on alleviation of symptoms and improvement of functioning and quality of life for affected individuals. The treatment of severe PMS and PMDD typically requires pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs), oral contraceptive pills (OCPs), gonadotropin-releasing hormone (GnRH) agonists, and non-contraceptive estrogen formulations. Non-pharmacologic treatment with diet, exercise, cognitive behavioral therapy (CBT), certain vitamin and herbal supplements, and acupuncture may additionally be effective for some individuals.

中文翻译：

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青少年经前期综合征和经前期烦躁障碍

摘要

经前综合征 (PMS) 和经前烦躁障碍 (PMDD) 是两种经前期疾病，其特征是生理和心理症状，发生在月经周期的黄体期，在月经开始之前，对女性的心理社会功能产生负面影响。受影响的个人。PMS 比 PMDD 更常见，影响 20-40% 的经期女性，常见症状包括疲劳、易怒、情绪波动、抑郁、腹胀、乳房胀痛、痤疮、食欲变化和对食物的渴望。PMDD 影响较小比例的女性，其特点是症状更严重，并在《精神疾病诊断和统计手册》第五版 (DSM-5) 中被列为抑郁症。虽然这些经前疾病的病理生理学仍不清楚，据推测，对月经周期黄体期荷尔蒙波动的敏感性、5-羟色胺能活性异常以及黄体酮和神经递质γ-氨基丁酸 (GABA) 的异常都可能在这些疾病中起作用。PMS 和 PMDD 的治疗重点是缓解症状，改善受影响个体的功能和生活质量。严重 PMS 和 PMDD 的治疗通常需要使用选择性血清素再摄取抑制剂 (SSRI)、口服避孕药 (OCP)、促性腺激素释放激素 (GnRH) 激动剂和非避孕雌激素制剂进行药物治疗。饮食、运动、认知行为疗法 (CBT)、某些维生素和草药补充剂的非药物治疗，