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Premenstrual Syndrome ( PMS)

Premenstrual Syndrome ( PMS). Biological/Psychosocial??? . General Definition. A cyclic recurrence of physical,  , and behavioral Sx 5-10 days before the onset of menses (Marvàn & Cotes-Iniestra, 2001). Biological Sx Affective Sx Bloating Irritability

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Premenstrual Syndrome ( PMS)

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  1. Premenstrual Syndrome (PMS) Biological/Psychosocial???

  2. General Definition • A cyclic recurrence of physical, , and behavioral Sx 5-10 days before the onset of menses(Marvàn & Cotes-Iniestra, 2001). Biological Sx Affective Sx Bloating Irritability Breast tenderness Anxiety Cramps Depression

  3. Hypothalamus GnRH FSH LH Anterior Pituitary Estrogen Progesterone Ovaries

  4. Results in… Sx’s

  5. Premenstrual Syndrome • Over 70 years of research! • Controversial concept • Known etiology? • You tell me!!!

  6. Etiological Hypotheses • Linkage of Sx with a specific phase of menstrual cycle • Biological etiology • Proposed mechanisms • Thyroid dysfunction, serotonin dysregulation, endocrine dysfunction

  7. Biological Basis… • Sx related to hormone levels • Abnormal • High • Low • FSH, LH • Estrogen • Progesterone

  8. Biological Basis cont… • Seippel & Bäckström • Hormone levels and Sx severity in PMS patients (Daily sampling and questionnaires) • High levels of luteal phase estrogen related to severity of negative premenstrual Sx’s

  9. Biological Basis cont… • Hammerback, Damber, & Bäckström • Hormone levels and Sx severity in PMS patients • More (-) Sx associated with higher luteal phase levels of E & P, • More specifically, lowest scores for (+) mood with higher E

  10. Biological Basis cont… • These findings suggests… • A strong a link between PMS and circulating hormone levels

  11. Question • If ovarian hormones are the culprits, then removing them or decreasing their levels should be beneficial

  12. Biological Basis cont… • Mortola, Girton, & Fischer • Treatment of PMS with GnRH agonist • Negative consequences (hypoestrogenism) associated with GnRH agonist treatment alone • Exogenous E & P replacement • 75 % improvement in Sx reporting

  13. Conclusion • Ovarian hormones and perhaps LH as determining factors in premenstrual symptomology • Abnormal levels • E, P, or combination of the two remains unclear…

  14. Psychosocial Etiologies • Learned Expectancies surrounding menstruation acquired through socialization • Ruble •  who thought they were PM report more Sx • Marván & Cortés-Iniestra • Prevalence estimates affect retrospective ratings • PMS as a Culture-specific disorder

  15. Conclusions • Learned expectancies play an important role in determining premenstrual experiences • Reflecting cultural stereotypes rather than actual premenstrual experiences

  16. The Debate...

  17. Biological or Psychosocial?

  18. In the end… • Problems with both approaches to studying PMS • Inclusion criteria • Inconsistencies • Retrospective nature of studies • Ss know that study is about PMS therefore expectations come into play • May account for placebo effects

  19. Is it Bio or  ? Probably both…. • Ovarian hormones are required for Sx to occur (Schmidt et al., 1998) • Expectations play an important role • A premenstrual Experiential State-Change occurs that affects women’s perception of events surrounding normal cyclic changes • Colored by  psychological traits, social contexts, and learned expectancies(Anson, 1999; Woods, Mitchell & Lentz, 1995).

  20. Simply Put…. • Fluctuations in hormones set the stage • The extent to which events are perceived as negative is largely dependent upon learned expectancies

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