ПРЕДМЕНСТРУАЛЬНЫЙ СИНДРОМ: КЛИНИКА, ДИАГНОСТИКА И ТЕРАПЕВТИЧЕСКИЕ ПОДХОДЫ
https://doi.org/10.21518/2079-701X-2017-2-106-111
Аннотация
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.
Об авторах
Л. П. Гулиева
Первый Московский государственный университет им. И.М. Сеченова
Россия
Москва
Россия
Москва
С. В. Юренева
Научный центр акушерства, гинекологии и перинатологии им. В.И. Кулакова
Россия
Россия
д.м.н.,
Москва
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Рецензия
Для цитирования:
Гулиева ЛП, Юренева СВ. ПРЕДМЕНСТРУАЛЬНЫЙ СИНДРОМ: КЛИНИКА, ДИАГНОСТИКА И ТЕРАПЕВТИЧЕСКИЕ ПОДХОДЫ. Медицинский Совет. 2017;(2):106-111. https://doi.org/10.21518/2079-701X-2017-2-106-111
For citation:
Guliyeva LP, Yureneva SV. PREMENSTRUAL SYNDROME: CLINICAL PATTERN, DIAGNOSTICS AND THERAPEUTIC APPROACHES. Meditsinskiy sovet = Medical Council. 2017;(2):106-111. (In Russ.) https://doi.org/10.21518/2079-701X-2017-2-106-111
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