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经前期综合征和经前期烦躁障碍

[Premenstrual syndrome and premenstrual dysphoric disorder].

作者信息

Kovács Zoltán, Hegyi Gabriella, Szőke Henrik

机构信息

1 Róbert Magánkórház, Szülészeti Osztály Budapest Magyarország.

2 Pécsi Tudományegyetem, Egészségtudományi Kar, Egészségtudományi Doktori Iskola Pécs Magyarország.

出版信息

Orv Hetil. 2022 Jun 19;163(25):984-989. doi: 10.1556/650.2022.32489.

Abstract

Premenstrual syndrome (PMS) is one of the most common problems for women of reproductive age worldwide, along with painful menstruation and genital inflammation. The physical, mental and behavioural symptoms recur during the luteal phase of the cycle and cause a deterioration in the quality of life, affecting the patient's social, work and family relationships. Symptoms typically disappear spontaneously within a few days after the onset of menstruation. A severe form of PMS is premenstrual dysphoric disorder (PMDD), which requires psychiatric management. The onset and severity of PMS with multifactorial pathogenesis is triggered by psychoneuroendocrine mechanisms that are influenced by the cyclical functioning of the hypothalamic-pituitary-ovarian axis, altering the neurotransmitter or neuropathway functions of the brain, e.g., the serotoninergic system. The psychoneuroendocrine mechanisms contribute to the development of physical, psychological and behavioural symptoms, which are also influenced by the combined presence of other physiological (genetical background, metabolic and chronic inflammatory processes, chronobiological and circadian disorders) and psychological stressors and their interaction.

摘要

经前综合征(PMS)是全球育龄女性最常见的问题之一,与痛经和生殖器炎症一样常见。身体、心理和行为症状在月经周期的黄体期反复出现,导致生活质量下降,影响患者的社交、工作和家庭关系。症状通常在月经开始后的几天内自行消失。经前烦躁障碍(PMDD)是PMS的一种严重形式,需要进行精神科治疗。PMS发病机制具有多因素性,其发作和严重程度由心理神经内分泌机制触发,该机制受下丘脑 - 垂体 - 卵巢轴的周期性功能影响,改变大脑的神经递质或神经通路功能,例如血清素能系统。心理神经内分泌机制促使身体、心理和行为症状的出现,这些症状还受到其他生理因素(遗传背景、代谢和慢性炎症过程、时间生物学和昼夜节律紊乱)和心理压力源及其相互作用的综合影响。

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