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PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD). Aetiology and classification. Refer to page 346-350 and: draw up your summary of the aetiology and classification of PMS;

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PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

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  1. PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

  2. Aetiology and classification • Refer to page 346-350 and: • draw up your summary of the aetiology and classification of PMS; • List the major hormonal and biochemical influences that you understand to be implicated in this condition; • Discuss the main risk factors that you will be dealing with. • Then, using the slide on the next page and the box on page 350, draw an extra line across the bottom and add only the most important herbs that could be considered for each classification.

  3. Subtyping of PMS symptoms and possible herbs (Mills, S. & Bone, K. 2000, Principles and Practice of Phytotherapy,Churchill Livingstone, Sydney p.241)

  4. PMDD is a new term that describes a more severe form of PMS. It is characterised by: • Markedly depressed mood • Marked anxiety • Affective lability • Decreased interest in daily activities during the last week of the luteul phase in most menstrual cycles in the past year

  5. A German study found that the incidence of PMDD was about 5% in a population of women aged 14 to 24. An additional 18.6% were “near-threshold” cases who mainly failed the impairment criteria. (Wittchen,HU., Becker,E., Lieb,R & Krause,P., 2002, ‘Prevalence, incidence and stability of premenstrual dysphagic disorder in the community’, Psychological Medicine, vol.32, no.1, pp.119-132)Consider Hypericum

  6. PMDD is associated with higher prolactin, SAD (Seasonal Affective Disorder), low nocturnal melatonin and responds to light therapy. Consider Vitex and Hypericum. • About 30% of fertile women experience moderate to severe symptoms. The symptoms start shortly after ovulation and decrease rapidly at the onset of the menstrual period.

  7. It is also postulated that changes in oestrogen and progesterone throughout the cycle can lead to a reduction in serotonin levels which affects the mood. Reduced levels of serotonin have been shown to intensify mood changes experienced by women with PMDD. • Symptom severity is sensitive to the level of oestrogen

  8. Some women may be more susceptible than others to PMDD depending on their personal or family history of mood disorders. Those at higher risk are those who have already experienced a major mood disorder, those with a family history of mood disorders or those with a personal or family history of postnatal depression.

  9. Unlike depression, depressive changes in PMS are associated with reduced HPA activity. This suggests more of an adrenal consideration. • Ginkgo has been found to be effective against congestive symptoms associated with PMS. Also, significant improvements have been with Ginkgo treatment over placebo for mastalgia (also Butcher’s Broom)

  10. Now add an extra column to your chart from slide 3 for PMDD and fill in the corresponding sections, including only the major herbs you will need to consider. • You can now use this chart for all your future references when dealing with your clients. This might make a useful addition to your herb book in the reference section at the end of Female Reproductive herbs.

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