Cases reported "Premenstrual Syndrome"

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1/5. Menstrual changes in sleep, rectal temperature and melatonin rhythms in a subject with premenstrual syndrome.

    We studied a sighted woman with premenstrual syndrome who showed menstrual changes in circadian rhythms. She showed alternative phase shifts in the sleep rhythm in the menstrual cycle: progressive phase advances in the follicular phase and phase delays in the luteal phase. Rectal temperature rhythm also showed similar menstrual changes, but the phase advance and delay started a few days earlier than changes in sleep-wake rhythm so that the two rhythms were dissociated around ovulation and menstruation. These results suggest that her circadian rhythms in sleep and temperature are under the control of ovarian steroid hormones and that these two rhythms have different sensitivity to the hormones.
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2/5. Perimenstrual psychosis among female adolescents: two case reports and an update of the literature.

    OBJECTIVES AND methods: Perimenstrual psychosis is an uncommon disorder, not included under the accepted classifications of functional psychoses. Our aim was to describe two Israeli female adolescents who fit this diagnosis. RESULTS: Both youngsters developed an acute psychosis a few days before menstruation, which subsided several days after bleeding, only to reappear in the same form in subsequent cycles. An extensive medical work-up did not show any significant disturbances, with the exception of anovulatory cycles in one youngster. Psychotropic treatment had no effect on the course of the psychosis. Treatment with a combined progesterone/estrogen contraceptive agent in one patient resulted in full recovery within several cycles. The second patient showed a spontaneous remission within four cycles. Follow-up for two to three years indicated a complete remission, with no need to reintroduce any psychotropic agent. CONCLUSIONS: Perimenstrual psychosis may represent a cycloid disorder or an atypical affective disorder, associated with anovulation. The use of psychotropic treatment is considered inconclusive, whereas hormonal agents may prove effective.
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3/5. Psychosis and the menstrual cycle.

    A case of a puerperal psychosis in a 26-year-old woman who had a strong family history of schizophrenia is reported. Her symptoms resolved with chlorpromazine and electroconvulsive therapy, but recurred each month just before the onset of menses. The cyclical recurrence of symptoms was prevented by therapy with danazol, a synthetic steroid which inhibits ovulation and may influence several levels of the reproductive control mechanism from the hypothalamus to the uterus. This therapy may be helpful for other women who suffer from recurrence of severe psychiatric disorders in close association with the menstrual cycle.
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4/5. Catamenial epilepsy: gynecological and hormonal implications. Five case reports.

    The aim of this study was to analyze the gynecological and hormonal condition of five patients with catamenial epilepsy and to establish a relationship with the presence of convulsive crises. The clinical profiles of five patients were obtained and their serum levels of anticonvulsants and sex steroids were determined. Four patients showed obvious signs of premenstrual tension syndrome (PMTS), with retention of fluid and reduction of the serum levels of anticonvulsants, which were restored to therapeutic levels after treatment of the PMTS. The fifth patient presented with chronic anovulation, which was treated by administration of progesterone during the second phase of the menstrual cycle, resulting in an improvement in the frequency of convulsions. In the cases studied, the low levels of progesterone and their rapid fall in PMTS, as well as the raised levels of circulatory estrogens in the anovulatory menstrual cycle, appear to be implicated in the convulsive disorder of catamenial epilepsy.
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5/5. Interactive case challenge. Dysphoric disorders in women: a case of premenstrual syndrome.

    When this woman's long-standing PMS grows progressively more severe over the 3 years following the birth of her third child, what pharmacologic and nonpharmacologic treatments would you recommend? Symptoms of mood swings, irritability, and anxiety occur in many women during the premenstrual phase of the menstrual cycle. Several promising treatment options now exist for women whose symptoms are severe and interfere with daily functioning. These include nonpharmacologic as well as pharmacologic interventions, such as serotonergic antidepressants, anxiolytics, and hormones that suppress ovulation. When PMS becomes intolerably severe for this 36-year-old mother of 3 children--all under 10 years of age--she seeks treatment.
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