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1- Premenstrual syndrome (PMS)
Premenstrual syndrome (PMS) affects millions of women during their reproductive years. Premenstrual syndrome (PMS) is a recurrent luteal phase condition characterized by physical, psychological, and behavioral changes of sufficient severity to result in deterioration of interpersonal relationships and normal activity.(American Family physician journal)
The disorder is characterized by the cyclic recurrence of symptoms during the luteal phase of the menstrual cycle Up to 85 percent of menstruating women report having one or more premenstrual symptoms, and 2 to 10 percent report disabling, incapacitating symptoms.4,5 More than 200 symptoms have been associated with PMS, but irritability, tension, and dysphoria are the most prominent and consistently described( AMERICAN FAMILY PHYICIAN AND E MEDICINE SITES)
Common Symptoms of Premenstrual Syndrome
Behavioral symptoms: fatigue, insomnia, dizziness, changes in sexual interest, food cravings or overeating
Psychologic symptoms: irritability, anger, depressed mood, crying and tearfulness, anxiety, tension, mood swings, lack of concentration, confusion, forgetfulness, restlessness, loneliness, decreased self-esteem, tension
Physical symptoms: headaches, breast tenderness and swelling, back pain, abdominal pain and bloating, weight gain, swelling of extremities, water retention, nausea, muscle and joint pain
The exact cause of PMS is still not known, but researchers believe that PMS symptoms occur because progesterone and estrogen cause changes in brain chemicals called neurotransmitters that affect women's moods during their monthly cycle.
Every month these brain chemicals are regulated by the hormones estrogen and progesterone. During the first 14 days (the follicular phase) of the menstrual cycle, estrogen is high and progesterone is low. When estrogen is elevated, serotonin is elevated and life is smooth. We are composed and relaxed. Near the 14th day of the cycle, ovulation occurs, endorphins peak, and life is absolutely beautiful. The final 14 days make up the luteal phase (for some women it really does feel like the final 14 days!), when estrogen falls and progesterone is elevated. When estrogen is low, serotonin decreases, endorphin and dopamine levels drop. When these brain chemicals are in low supply, mood and appetite control are affected. During the luteal phase of the cycle, insulin sensitivity increases, which can affect eating habits. Eight percent of women with PMS suffer from sever symptoms. (LAURA LEWIS .COM ARTICLES)
2-Menopause
Menopause is a process, either naturally or medically induced (ex hysterectomy), that occurs in nearly all women at some point in life. Some of the most commonly reported symptoms associated with menopause are hot flushes/flashes, fatigue, headaches, irritability, insomnia, and depression (Neuropsychol Rev. 2003 Sep;13(3):145-52.) The sudden and predictable cessation of ovarian endocrinological function at menopause results in a marked decrease of endogenous estrogen and progestogen secretion. In addition to cessation of menstruation, a wide range of biological functions, including sleep, are affected (CNS Drugs. 2001;15(6):445-52) The accumulated burden of life stress coupled with limited protective psychosocial resources is associated with adverse psychological, biological, and quality of life outcomes. (Best Pract Res Clin Endocrinol ####b. 2003 Mar;17(1):17-31)
Depression During Pregnancy And Postpartum
The Postpartum Period
During the postpartum period, about 85% of women experience some type of mood disturbance. For most the symptoms are mild and short-lived; however, 10 to 15% of women develop more significant symptoms of depression or anxiety. Postpartum psychiatric illness is typically divided into three categories: (1) postpartum blues (2) postpartum depression and (3) postpartum psychosis. (Shaila Misri, MD, FRCPC & Margaret Duke, MD, FRCPC
Journal of the Society of Obstetrics & Gynecology of Canada 1995; 17: 657-63.)
Postpartum Blues
It appears that about 50 to 85% of women experience postpartum blues during the first few weeks after delivery. Given how common this type of mood disturbance is, it may be more accurate to consider the blues as a normal experience following childbirth rather than a psychiatric illness. Rather than feelings of sadness, women with the blues more commonly report mood lability, tearfulness, anxiety or irritability. While these symptoms are unpredictable and often unsettling, they do not interfere with a woman's ability to function. (Shaila Misri, MD, FRCPC & Margaret Duke, MD, FRCPC Journal of the Society of Obstetrics & Gynecology of Canada 1995; 17: 657-63.)
Postpartum Depression
PPD typically emerges over the first two to three postpartum months but may occur at any point after delivery. Some women actually note the onset of milder depressive symptoms during pregnancy. Postpartum depression is clinically indistinguishable from depression occurring at other times during a woman's life.
The symptoms of postpartum depression include:
Depressed or sad mood
Tearfulness
Loss of interest in usual activities
Feelings of guilt
Feelings of worthless or incompetence
Fatigue
Sleep disturbance
Change in appetite
Poor concentration
Suicidal thoughts( Shaila Misri, MD, FRCPC & Margaret Duke, MD, FRCPC Journal of the Society of Obstetrics & Gynecology of Canada 1995; 17: 657-63.)
Postpartum Psychosis
Postpartum psychosis is the most severe form of postpartum psychiatric illness. It is a rare event that occurs in approximately 1 to 2 per 1000 women after childbirth. Its presentation is often dramatic, with onset of symptoms as early as the first 48 to 72 hours after delivery..
the symptoms of puerperal psychosis most closely resemble those of a rapidly evolving manic (or mixed) episode. The earliest signs are restlessness, irritability, and insomnia. Women with this disorder exhibit a rapidly shifting depressed or elated mood, disorientation or confusion, and erratic or disorganized behavior. (Shaila Misri, MD, FRCPC & Margaret Duke, MD, FRCPC
Journal of the Society of Obstetrics & Gynecology of Canada 1995; 17: 657-63.)
The physical and psychological changes that women experience:
Women experience many recurrent physical changes, which are conspicuous either to woman or others. Moreover, the extensive scientific researches have revealed the psychological effects that woman is subjected to, due to undergoing such physical states. Women undergo menstruation, and if she becomes pregnant she passes through phases of pre- and post-conception and post-delivery, while in case of miscarriage or abortion, her body undergoes many changes. In addition to such conditions, she can suffer from infecundity or sterility, and the period of menopause, which results in many changes either before or after it. Thus woman undergoes periods of physical and physiological changes, under which she might suffer. All this might have its dire effect on her physiological state, and her interrelations with others. Also it might affect her way of thinking. Many medical researches have confirmed these statements, where they stated that such conditions have their deep effect on the physiological state of woman, as she can suffer from frustration, lack of concentration, laziness, and they can affect her short-term memory. Moreover, they might cause her irritability, anxiety, nervousness, feeling of loneliness, and slackness. In addition to change in factors, like temperature, pressure, and increase of different hormonal secretions, which consequently, affect her motion, work, and mental activity.
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