[月经前综合征和月经前失调障碍 - 病理生理学,诊断和治疗概述]
Jana Haußmann1, M Goeckenjan2, R Haußmann3
1Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland. jana.hauszmann@uniklinikum-dresden.de.
Der Nervenarzt
|February 23, 2024
概括
月经前综合征 (PMS) 和月经前失调障碍 (PMDD) 由于周期性情绪和身体症状导致显著损害. 了解它们的病理生理学和差异诊断对于有效的管理至关重要.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 神经精神病学是一种神经精神病学.
- 妇女健康 妇女健康
背景情况:
- 月经前综合征 (PMS) 和月经前失调障碍 (PMDD) 分别影响3-8%和2%的生殖年龄女性.
- 这些情况周期性地表现为心理和身体症状,导致功能和社会障碍.
- 情绪障碍是PMS/PMDD的重要差异诊断.
研究的目的:
- 为管理PMS和PMDD的医疗保健提供者提供临床指导.
- 审查PMS和PMDD的病理生理学,风险因素和治疗选择.
- 突出PMS/PMDD作为相关的差异诊断和情绪障碍中的并发症.
主要方法:
- 关于月经前综合征和月经前失调障碍的文献综述.
- 讨论遗传和社会生物学的风险因素.
- 分析涉及卵巢类固醇和神经递质的病理生理机制.
主要成果:
- PMS/PMDD是由周期性卵巢类固醇变化和中央神经递质之间复杂的相互作用引起的,特别是黄体阶段雌激素/孕激素失衡.
- 治疗方法包括月经周期调节,质支持,口服避孕药,SSRI和GnRH激动剂用于严重病例.
- 作为情绪障碍中的差异诊断和并发症,PMS/PMDD提出了临床挑战.
结论:
- 有效管理PMS和PMDD需要了解其复杂的病因学,并考虑基于证据的治疗方法.
- 选择性血清素再吸收抑制剂 (SSRI) 提供基于证据的治疗方法.
- 医生必须具备在情绪障碍的背景下区分和管理PMS/PMDD的能力.
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