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PMS
Diagnosis PMS
is difficult to diagnose because there is not a clear cause and the
symptoms are varied and are found in other disorders. The cyclical
pattern is crucial for a diagnosis: symptoms appear prior to
menstruation and resolve when bleeding begins.
The medical history and physical examination
involve an evaluation of the symptoms and when they occur in relation
to menstruation. Many health care providers advise women to keep a
diary of menstrual cycles and the physical and psychological changes
they experience over the course of several months. The menstrual diary
provides clues to the physician and helps women understand and cope
with the changes.
Thyroid function tests and other tests that
evaluate the production of hormones are used to rule out other medical
disorders. Tests may be done to rule out dysmenorrhea
(menstrual-related pain that occurs just before and during
menstruation) and endometriosis.
Because depression is a common feature of PMS, some women undergo
psychological counseling as part of the diagnostic procedure.
Psychologists, who are professionally trained to recognize depression
and other mood disorders, may be able to differentiate the cyclical
pattern of depression associated with PMS from the psychiatric
disorder.
Menopause Diagnosis
The obvious symptoms include cessation of the periods, which can occur
suddenly or gradually – often there will be one or more missed
periods, before they finally stop. In many cases the periods can
become very irregular over a number of years before the menopause
occurs and this is often referred as being “peri-menopausal”.
25% of women have no problems with going through the menopause, 50%
will have some problems and 25% have significant problems.
The other symptoms include hot flushes, sweats, palpitations, fatigue,
weight gain, fluid retention, bloating, urinary frequency, joint
pains, insomnia, panic attacks, sexual difficulties and mood change.
This can be anything from irritability or mood swings to full blown
depression. Headaches can also occur and it is not uncommon to develop
digestive problems such as food intolerance as well. The other
significant problem associated with the menopause is osteoporosis
which results in weakening of the bones which can fracture easily
following a fall.
The Menopause is diagnosed when there have
been no periods for eighteen months. This is because some women stop
for six months then have one or more periods before another long gap.
This is still the “peri-menopause. Investigations may include a blood
test to look at hormone levels such as oestrogen and progesterone.
These will be low and there will be an associated rise in the
pituitary hormones Follicle Stimulating Hormone (FSH) and Luteinising
Hormone (LH). These are the results of the body’s efforts to drive the
failing ovaries in an attempt to make them produce the female hormones
again. These tests are rarely needed, as the clinical picture is
usually so clear.
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Moody
and irritated with feelings of pain bloating.
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nopausis :
meno- + Greek pausis, pause; see pause.]