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      Prevalência dos Sintomas da Síndrome Pré-Menstrual Translated title: Prevalence of Symtoms in Premenstrual Syndrome

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          Abstract

          Objetivos: analisar os sintomas pré-menstruais relatados pelas mulheres com quadros graves de síndrome pré-menstrual (SPM), sua duração e época de aparecimento e patogênese. Métodos: estudo de corte transversal por meio de questionário aplicado a 254 mulheres com idade entre 20 e 44 anos, sem doenças ginecológicas ou clínicas que comprometessem o estado geral ou bem-estar físico. Foram excluídas as que estavam em amenorréia há mais de seis meses, a histerectomizadas e as grávidas. Resultados: 110 mulheres (43,3%) relataram pelo menos um sintoma intenso na fase pré-menstrual causando danos à sua vida, sendo consideradas portadoras de SPM. A irritabilidade foi relatada por 86,4%, cansaço por 70,9%, depressão por 61,8%, cefaléia por 61,8%, mastalgia por 59,1% e dor abdominal por 54,5%. Quase todas (94,5%) tinham mais de uma queixa, 89,1% apresentaram sintomas psíquicos e mais de três quartos das pacientes (76,4%) associavam queixas físicas e psíquicas. A maioria declarou duração de três a quatro dias (32,4%) ou de cinco a sete dias (31,4%). Conclusões: o quadro clínico da SPM, apesar de multivariado, em geral é composto por irritabilidade e/ou depressão, associados a cansaço e dores de cabeça ou nas mamas, coexistindo sintomas físicos e psíquicos, por três a sete dias, sendo difícil atribuí-lo a uma etiologia única, à luz dos conhecimentos atuais.

          Translated abstract

          Purpose: to analyze the symptoms of premenstrual syndrome (PMS), its duration, time of presentation and pathogenesis. Methods: a questionnaire was applied to 254 women aged 20 to 44 years, without gynecological or clinical conditions affecting their general state or physical well-being, excluding those with amenorreha for more than six months, hysterectomized or pregnant. Results: one hundred and ten women (43.3%) describing at least one intense symptom causing harm to their life, were considered as having PMS. Irritability was presented by 86.4%, tiredness by 70.9%, depression by 61.8%, headache by 61.8%, breast tenderness by 59.1% and abdominal pain by 54.5%. Almost all (94.5%) had more that one symptom, 89.1% presented psychological complaints, and 76.4% associated physical and psychological complaints. Most declared that duration of the symptoms was three to four days (32.4%) or five to seven days (31.4%). Conclusions: the clinical picture of PMS is generally composed of irritability and/or depression, associated with tiredness and headache or breast pain, there being association of physical and psychological symptoms, for 3 to 7 days, and it is difficult to attribute a single etiology to it at this stage of knowledge.

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          Most cited references26

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          Premenstrual syndrome

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            Hormones and depression: what are the facts about premenstrual syndrome, menopause, and hormone replacement therapy?

            The diagnosis, epidemiology, etiology, and treatment of premenstrual syndrome are reviewed. A relationship between depression and premenstrual syndrome is suggested by the increased prevalence of prior depressive episodes in women with premenstrual syndrome, common neurotransmitter and chronobiologic abnormalities, and the successful treatment of premenstrual syndrome with regimens used for depression. The relationship between menopause and depression is not clearly defined, but the perimenopausal years may be a time of increased depression for women who are at risk for depressive recurrences. The role of hormone replacement treatments in either ameliorating or promoting depression in menopausal women is a subject for future studies.
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              The role of essential fatty acids and prostaglandins in the premenstrual syndrome.

              Many of the features of the premenstrual syndrome are similar to the effects produced by the injection of prolactin. Some women with the premenstrual syndrome have elevated prolactin levels, but in most the prolactin concentrations are normal. It is possible that women with the syndrome are abnormally sensitive to normal amounts of prolactin. There is evidence that prostaglandin E1, derived from dietary essential fatty acids, is able to attenuate the biologic actions of prolactin and that in the absence of prostaglandin E1 prolactin has exaggerated effects. Attempts were made, therefore, to treat women who had the premenstrual syndrome with gamma-linolenic acid, an essential fatty acid precursor of prostaglandin E1. Gamma-linolenic acid is found in human, but not cows', milk and in evening primrose oil, the preparation used in these studies. Three double-blind, placebo-controlled studies, one large open study on women who had failed other kinds of therapy for the premenstrual syndrome and one large open study on new patients all demonstrated that evening primrose oil is a highly effective treatment for the depression and irritability, the breast pain and tenderness, and the fluid retention associated with the premenstrual syndrome. Nutrients known to increase the conversion of essential fatty acids to prostaglandin E1 include magnesium, pyridoxine, zinc, niacin and ascorbic acid. The clinical success obtained with some of these nutrients may in part relate to their effects on essential fatty acid metabolism.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rbgo
                Revista Brasileira de Ginecologia e Obstetrícia
                Rev. Bras. Ginecol. Obstet.
                Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (Rio de Janeiro )
                1806-9339
                2000
                : 22
                : 6
                : 347-351
                Affiliations
                [1 ] Universidade Estadual de Campinas Brazil
                Article
                S0100-72032000000600005
                10.1590/S0100-72032000000600005
                22375041-f702-4221-99cc-0182179a30e0

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0100-7203&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Premenstrual syndrome,Premenstrual tension,Menstrual cycle,Depression,Tensão pré-menstrual,Ciclo menstrual,Depressão

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