medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-2-106-111medsovet-1732Research ArticleНАРУШЕНИЯ МЕНСТРУАЛЬНОГО ЦИКЛАПРЕДМЕНСТРУАЛЬНЫЙ СИНДРОМ: КЛИНИКА, ДИАГНОСТИКА И ТЕРАПЕВТИЧЕСКИЕ ПОДХОДЫPREMENSTRUAL SYNDROME: CLINICAL PATTERN, DIAGNOSTICS AND THERAPEUTIC APPROACHESГулиеваЛ. П.GuliyevaL. P.

Москва

ЮреневаС. В.YurenevaS. V.

д.м.н.,

Москва

MD

Первый Московский государственный университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian FederationНаучный центр акушерства, гинекологии и перинатологии им. В.И. КулаковаРоссияScientific Center for Obstetrics, Gynecology and Perinatology named after V.I. KulakovRussian Federation20173012201702106111Copyright © Гулиева Л.П., Юренева С.В., 20172017Гулиева Л.П., Юренева С.В.Guliyeva L.P., Yureneva S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1732

Предменструальный синдром (ПМС) – это сложный, циклический, полиэтиологичный, многофакторный комплекс соматических и психических нарушений, которые возникают у некоторых женщин репродуктивного возраста во второй, лютеиновой фазе менструального цикла и, в свою очередь, негативно сказываются на привычном для женщины образе жизни. Предменструальное дисфорическое расстройство (ПМДР) – это тяжелая форма ПМС, при которой превалирует психоневрологическая симптоматика.

Для постановки диагноза ПМДР Американской психиатрической ассоциацией были разработаны специальные критерии DSM-5, согласно которым наличие пяти и более симптомов у женщины в течение недели, предшествующих менструации, и их исчезновение через несколько дней после начала менструации подтверждают данный диагноз. Эти симптомы должны присутствовать по крайней мере в двух циклах.

Лечение женщины с ПМС/ПМДР прежде всего должно начинаться с нормализации образа жизни, включения регулярных умеренных физических нагрузок в повседневную деятельность. Эффективность назначения витаминов B6, E и кальция в проведенных исследованиях не была доказана.

В качестве медикаментозной терапии препаратами первой линии являются СИОЗС или комбинированные оральные контрацептивы, содержащие дроспиренон, а затем агонисты гонадотропин-рилизинг гормона.

Premenstrual syndrome (PMS) is a complex, cyclical, polyethiological, multifactorial combination of physical and mental disorders that occur in some women of reproductive age in the second - luteal - phase of the menstrual cycle and negatively affect the woman’s usual lifestyle.

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS in which psychoneurological symptoms prevail. For the diagnosis of PMDD, the specific DSM-5 criteria were developed by the American Psychiatric Association according to which the the diagnosis is confirmed by the presence of five or more symptoms in women during the week prior to menstruation and their disappearance a few days after the onset of menstruation. These symptoms are observed for at least two cycles.

Treatment of women with PMS/PMDD, first of all, should start with the lifestyle adjustment, inclusion of regular mode rate physical activity into daily activities. The effectiveness of vitamins B6, E and calcium has not been confirmed in studies. First-line drug therapy includes SSRIs or combined oral contraceptives containing drospirenone are prescribed first, then agonists of gonadotropin-releasing hormone.

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The authors declare that there are no conflicts of interest present.