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Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation


Premenstrual Syndrome (PMS)

Dr. Nelson Soucasaux, Brazilian gynecologist

The symptoms and clinical manifestations that can occur on the days that precede the coming of menstruation can be included basically into three groups:

1. Psychological signs and symptoms: Increase of nervous tension, anxiety, irritability, changes in the personality, emotional instability, depression, as well as increase or reduction of the sexual desire. The symptoms that will predominate in each woman will obviously depend on the basic psychological predispositions of each one. All of this is very individualized.

2. Signs and symptoms in the genital apparatus and in the breasts: Sensation of pelvic discomfort (possibly due to a localized congestion in the uterus, tubes, ovaries, ligaments and other near structures), uterine cramps (which can precede the dysmenorrhea or disappear with the beginning of menstruation), lumbosacral pain (probably due to the reflex pain related to the areas of metameric projection of the nervous system, but which may also originate from the inner genitals). Mammary swelling and pain are very frequent, with an increase in the volume of the breasts, which can even be greater on one side than on the other - a fact that demonstrates the importance of the specific reaction of the "target" organs in relation to the stimuli that cause the hydric retention and the edemas.

3. Extragenital signs and symptoms: Edemas (that only exceptionally can produce some premenstrual increase of the body weight), sensation of "swelling" in the lower belly (probably due to an intestinal accumulation of air by some functional disturbance caused by a congestion of these organs), sensation of "weight" and fatigue in the legs (perhaps by a greater venous stasis), diverse symptoms of neurovegetative origin, as headache, dizziness, nausea, diarrhea, etc. There also can occur exacerbation of acne and allergic phenomena.

The quantity and the intensity of the presented signs and symptoms vary greatly from woman to woman and, in the same woman, from cycle to cycle, in the same way as in accordance with the phases of life, the emotional conditions and the endocrine variations. As is known, almost all women present minimal degrees of premenstrual symptoms. The most usually referred to are mammary swelling and/or painful breasts, sensation of hydric retention, slight distension of the lower belly, uterine cramps and nervousness. Some women have only the psychological symptoms.

Among all signs and symptoms that characterize the premenstrual manifestations, there are subjective and objective ones. Mammary congestion is the most frequent objective sign and the one that is more easily verified at the clinical examination. The increase of density and volume of the mammary parenchyma thickenings and nodules that characterize the functional mastopathies (or benign functional alterations of the breasts) becomes evident in the premenstrual phase. Visible edemas in other parts of the body are rare.

It has been proved that the main physio-pathological manifestation responsible for many premenstrual symptoms is the retention of sodium and water, which causes edemas and congestive phenomena mainly situated in specific parts of the female body. Because of this, one of the most widely used clinical treatments for this disturbance are diuretics that produce sodium excretion. What remains a mystery and a very controversial subject are the possible reasons for this retention of water and sodium on the days that precede menstruation. Attempts to discover specific alterations in the levels of estrogens and/or progesterone that could characterize women who suffer from severe premenstrual syndrome have been usually inconclusive. The only obvious fact is that the intensity of the signs and symptoms increases as the blood levels of these hormones physiologically fall at the end of each cycle, triggering the coming of menstruation.

I suppose that in a great number of cases, the physical discomforts caused by the mentioned liquid accumulation in specific areas of the female body (mostly in the sexual organs), together with the woman's emotional problems, can act as an "irritative factor" at the psychical level. This, in turn, increases the sensibility to the symptoms, and acting through the psychosomatic pathways can intensify the disturbances. On the other hand, the emotional disorders related to the many aspects of the female constitution can be somatized by means of physiological and endocrine alterations that can cause, through mechanisms not well elucidated yet, this retention of sodium and water during the premenstrual period.

Many hypotheses, based on detectable alterations in the endocrine physiology and in other parts of the organism of women who suffer from these premenstrual manifestations, have been constructed by different researchers in the last decades, but not one of them was capable, all by itself, of explaining all of the disturbances. To enter into details about these hypothesis is not the purpose of this text and, for a detailed analysis of them, I recommend the reading of my article "Tensão Pré-Menstrual" ("Premenstrual Syndrome")*. In any case, a very curious fact is the usually quick disappearance of the edemas and of many other premenstrual symptoms with the beginning of menstruation - that is, with the necrotic endometrium desquamation.

*Soucasaux, Nelson - "Tensão Pré-Menstrual" ("Premenstrual Syndrome") - in: Jornal Brasileiro de Medicina, vol 53, nº 2, August 1987.


The text above is an excerpt from my book "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology"), published by Imago Editora, Rio de Janeiro, 1990. For more information on the book, see page http://www.nelsonginecologia.med.br/novas.htm from my Web site http://www.nelsonginecologia.med.br .

© Nelson Soucasaux, 1990, 2001

________________________________________

Nelson Soucasaux is a gynecologist especially dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993.

Web site (Portuguese-English): www.nelsonginecologia.med.br

E-mail: nelsons@nelsonginecologia.med.br


NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation

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