American Academy of Family Physicians, Leawood, KS 66211, USA.
Am Fam Physician. 2011 Oct 15;84(8):918-24.
Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. Women with premenstrual dysphoric disorder experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. The disorder affects 3 to 8 percent of premenopausal women. Proposed etiologies include increased sensitivity to normal cycling levels of estrogen and progesterone, increased aldosterone and plasma renin activity, and neurotransmitter abnormalities, particularly serotonin. The Daily Record of Severity of Problems is one tool with which women may self-report the presence and severity of premenstrual symptoms that correlate with the criteria for premenstrual dysphoric disorder in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision. Symptom relief is the goal for treatment of premenstrual syndrome and premenstrual dysphoric disorder. There is limited evidence to support the use of calcium, vitamin D, and vitamin B6 supplementation, and insufficient evidence to support cognitive behavior therapy. Serotonergic antidepressants (citalopram, escitalopram, fluoxetine, sertraline, venlafaxine) are first-line pharmacologic therapy.
经前期综合征定义为反复出现的中度心理和生理症状，发生于月经周期的黄体期，随月经来潮而缓解。它影响 20%至 32%的绝经前妇女。经前期烦躁障碍患者出现情感或躯体症状，导致社会或职业功能严重障碍。该疾病影响 3%至 8%的绝经前妇女。推测病因包括对正常周期性雌、孕激素水平的敏感性增加，醛固酮和血浆肾素活性增加，以及神经递质异常，尤其是 5-羟色胺。《问题严重程度日常记录》是一种工具，女性可以用其自我报告经前期症状的存在及其严重程度，这些症状与《精神障碍诊断与统计手册》第 4 版文本修订版中的经前期烦躁障碍标准相符。经前期综合征和经前期烦躁障碍的治疗目标是缓解症状。有有限的证据支持补充钙、维生素 D 和维生素 B6，也没有足够的证据支持认知行为疗法。5-羟色胺能抗抑郁药（西酞普兰、艾司西酞普兰、氟西汀、舍曲林、文拉法辛）是一线药物治疗。
