• Premenstrual syndrome: Pathogenesis, Prevention and Treatment 

Premenstrual syndrome: Pathogenesis, Prevention and Treatment 

HEALTH OF WOMAN. 2016.4(110):48–51 

Premenstrual syndrome: Pathogenesis, Prevention and Treatment 

Pakharenko L. V.

Ivano-Frankivsk national medical University 

The objective: to improve the efficiency of diagnosis and treatment of premenstrual syndrome (PMS) based on the establishment of new aspects of pathogenesis (forming the concept of genetic predisposition) and development of differentiated approach to treatment and prevention of various forms of pathology by studying hormonal, psychological markers.

Patients and methods. Research included 200 women of reproductive age with PMS. We studied the importance of social factors, levels of female sex hormones, as well as the role of polymorphisms of estrogen receptor gene ESR1, progesterone receptor gene PROGINS, angiotensin converting enzyme gene ACE and glutathione-S-transferasegenes (GSTT1 and GSTM1), cytogenetic markers, and psychological aspects, quality of life in these patients. The scheme of correction of clinical manifestations and above data, taking into account the clinical form and severity of the syndrome was developed.

Results. It was determined that social factors, as well as level of progesterone, prolactin, folliclestimulatingand luteinizing hormones, A-351G polymorphism of ESR1estrogen receptor gene, T1T1 genotype of gene PROGINS, DD genotype of geneACE and deletion of GSTT1 gene, specific cytogenetic indiceshave meaning in development of syndrome. In addition, individuals with PMS have certain psychological characteristics and reduced quality of life. Use of differentiated treatment which takes into account the various forms and severity of syndrome has led to decrease of clinical symptoms of the disease, normalization of hormonal, psychological markers and increase quality of life of patients.

Conclusion. Differentiated treatment of PMS, which takes into account the form of pathology has allowed to achieve greater frequency of disappearance of clinical symptoms and improve the quality of life of patients.

Key words: premenstrual syndrome, hormones, gene polymorphism, psychological dysadaptation, quality of life, differentiated treatment.


1. Balan VE, Ilina LM. 2013. Modern view on pathogenesis and principles of treatment of premenstrual syndrome. Gynecology 15(6):7-10.

2. Ventskivska IB. 2005. Functional state of puitary-ovarian system in patients with premenstrual disorders. Reproductive health of woman 4(24):125-7.

3. Zerova-Lubimova TE, Gorovenko NG. 2003. Cytogenetic methods of investigation of man’s chromosomes (methodological recommendations). Kyiv:24.

4. Lekareva TM, Tarasova MA. 2010. Premenstrual dysphoric disorder: role of serotonin in diagnosis and treatment Obsterics and Gynecology. 3:55-8.

5. Lekareva TM. 2007. Role of sex steroid hormones and prolactin in pathogenesis of premenstrual syndrome. Journal of obstetrics and woman’s diseases. LVI(3):100–6.

6. Order # 676 of Ministry of Health of Ukraine, 31.12.2004 “Approval of clinical protocols for obstetric and gynecological care”.

7. Reznikov AG. 2015. Neuroendocrine system – therapeutic target for herbal extract of Vitex agnus castus by premenstrual syndrome. Reproductive endocrinology. 1(21):19–23.

8. Smetnik VP, Tymilovich LG. 1995. Neoperative Gynecology: Guidance for doctors. Book 1. SPb, SOTIS:129-38.

9. Tatarchuk TF, Solsky YaP. 2003. Endocrine gynecology:300.

10. Pluchino N, Santoro A, Casarosa E et al. 2013. Advances in neurosteroids: role in clinical practice. Climacteric. Suppl. 1:8–17. http://dx.doi.org/10.3109/13697137.2013.809647; PMid:23848487

11. Gonda X, Fountoulakis KN, Juhasz G et. al. 2009. Association of the s allele of the 5-HTTLPR with neuroticism-related traits and temperaments in a psychiatrically healthy population. Eur Arch Psychiatry Clin Neurosci. 259(2):106–13. http://dx.doi.org/10.1007/s00406-008-0842-7; PMid:18806915

12. Dennerstein LLehert P, Heinemann K. 2012. Epidemiology of premenstrual symptoms and disorders. Menopause Int. 18(2):48– 51. http://dx.doi.org/10.1258/mi.2012.012013; PMid:22611221

13. Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Sattar K. 2014. Epidemiology of Premenstrual Syndrome (PMS) – A Systematic Review and Meta-Analysis Study. J Clin Diagn Res. 8(2):106–9. PMCid:PMC3972521

14. Jahanfar SLye MS, Krishnarajah IS. 2011. The heritability of premenstrual syndrome. Twin Res Hum Genet. 14(5):433–6. http://dx.doi.org/10.1375/twin.14.5.433; PMid:21962135

15. Nillni YIToufexis DJ, Rohan KJ. 2011. Anxiety sensitivity, the menstrual cycle, and panic disorder: a putative neuroendocrine and psychological interaction. Clin Psychol Rev. 31(7):1183–91. http://dx.doi.org/10.1016/j.cpr.2011.07.006; PMid:21855828 PMCid:PMC3176921