Zusammenfassung
Das prämenstruelle Syndrom ist mit 20–30% eines der häufigsten zyklusabhängigen Beschwerdebilder der Frau zwischen dem 20. und 40. Lebensjahr. Es tritt fast ausschließlich in der Lutealphase ovulatorischer Zyklen auf. Die Ätiologie ist praktisch unbekannt, das serotoninerge Transmitter-System spielt eine wesentliche Rolle bei Befindlichkeitsstörungen. Die Diagnostik konzentriert sich in erster Linie auf eine exakte Zyklusanamnese, um das PMS z. B. von Formen der Depression zu differenzieren. Zur medikamentösen Therapie sind Serotoninwiederaufnahmehemmer erfolgreich, eingesetzt werden aber auch Aldosteronantagonisten z. B. bei Ödemneigung. Die ovulationshemmende Wirkung von hormonalen Kontrazeptiva unterdrückt ebenfalls das PMS. Invasive Therapiemaßnahmen wie GnRH-Analoga sind Ausnahmesituationen vorbehalten.
Abstract
The premenstrual syndrome (PMS) is a very common condition affecting 20–30% of cyclic women aged 20–40 years. The symptoms appear almost exclusively during the luteal phase of ovulatory cycles. Although the etiology is unknown, the serotoninergic system could play a decisive role in dysphoric disorders. The main diagnostic tool is exact correlation of symptoms to the menstrual cycle in order to exclude other depressive diseases. Medical treatment is based on selective serotonin reuptake inhibitors. Furthermore, aldosterone antagonists and oral contraceptives are helpful. Medical suppression of ovarian function by GnRH analogues should be used in extreme cases only.
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Zahradnik, HP. Prämenstruelles Syndrom. Gynäkologische Endokrinologie 2, 64–69 (2004). https://doi.org/10.1007/s10304-004-0060-y
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DOI: https://doi.org/10.1007/s10304-004-0060-y