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Query: UMLS:C0030193 (pain)
261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many of the features of the premenstrual syndrome are similar to the effects produced by the injection of prolactin. Some women with the premenstrual syndrome have elevated prolactin levels, but in most the prolactin concentrations are normal. It is possible that women with the syndrome are abnormally sensitive to normal amounts of prolactin. There is evidence that prostaglandin E1, derived from dietary essential fatty acids, is able to attenuate the biologic actions of prolactin and that in the absence of prostaglandin E1 prolactin has exaggerated effects. Attempts were made, therefore, to treat women who had the premenstrual syndrome with gamma-linolenic acid, an essential fatty acid precursor of prostaglandin E1. Gamma-linolenic acid is found in human, but not cows', milk and in evening primrose oil, the preparation used in these studies. Three double-blind, placebo-controlled studies, one large open study on women who had failed other kinds of therapy for the premenstrual syndrome and one large open study on new patients all demonstrated that evening primrose oil is a highly effective treatment for the depression and irritability, the breast pain and tenderness, and the fluid retention associated with the premenstrual syndrome. Nutrients known to increase the conversion of essential fatty acids to prostaglandin E1 include magnesium, pyridoxine, zinc, niacin and ascorbic acid. The clinical success obtained with some of these nutrients may in part relate to their effects on essential fatty acid metabolism.
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PMID:The role of essential fatty acids and prostaglandins in the premenstrual syndrome. 635 May 79

Two hundred and sixty-eight women suffering from premenstrual symptoms, particularly breast symptoms, were treated with bromocriptine (Parlodel) continuously (1.25 mg twice daily) or cyclically (1.25 mg once daily from cycle day 11 to 13, and 1.25 mg twice daily from cycle day 14 until menstruation) for three cycles. The treatment was most effective in relieving breast symptoms, and cyclical treatment was more effective than continuous treatment with regard to swelling and pain of the breasts. Side-effects considered to be caused by bromocriptine occurred in 43% of the patients, and 21% interrupted the treatment. As regards the frequency of side-effects, no differences were observed between continuous and cyclical treatment. Thus, the continuous treatment schedule did not prove superior to the commonly used cyclical schedule. Seventy percent of the patients considered the bromocriptine treatment good or fairly good for the relief of the premenstrual syndrome (PMS).
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PMID:Cyclical or continuous treatment of the premenstrual syndrome (PMS) with bromocriptine. 654 Nov 64

Premenstrual syndrome (PMS) is a commonly encountered complaint among women. This study compared the PMS Diary (PMSD), which measures core menstrual symptoms (negative affect, water retention, and pain symptoms), with two commonly used self-rating forms, the Menstrual Distress Questionnaire (MDQ) and the Daily Rating Form (DRF). Thirty-seven premenopausal women with documented PMS completed the forms. A multitrait-multimethod analysis was performed to determine overall agreement and reliability. The three instruments and their component scale scores had strong internal consistency. Correlations between overall scores and between scales measuring similar constructs were strong. Correlations were 0.77 between PMSD and MDQ; 0.67 between PMSD and DRF; and 0.81 between MDQ and DRF. The PMSD performs as effectively as more extensive questionnaires in measuring symptoms in women with PMS. The PMS Diary is a concise yet reliable and valid instrument that can be easily administered in ambulatory care and longitudinal research.
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PMID:Comparative analysis of three PMS assessment instruments--the identification of premenstrual syndrome with core symptoms. 749 97

Pelvic congestion syndrome is encountered in three pathological situations: premenstrual syndrome, intermenstrual syndrome, chronic pelvic congestion syndrome. The first two syndromes, with a range of physical and/or psychological symptoms, are cyclical. Their pathogenesis is multifactorial. Hormonal and circulatory factors are essentially blamed. Treatment is most often based upon combinations of progestogens and venotonics. The third syndrome, that of chronic pelvic congestion, is characterised by long term pelvic pain and raises etiopathogenic problems which remain only partially solved and in which a vascular role may sometimes be recognised. Endovaginal ultrasonography with colour-coded Doppler and celioscopy sometimes reveal pelvic varicose veins and indicate their responsibility for such pain, after having eliminated specific pelvic pathology (post-infectious or post-operative inflammatory sequelae of pelvic tissue, rupture of the broad ligaments, endometriosis, etc.). Treatment is above all medical, based upon hormone therapy acting upon venous receptors, venotonics which decrease the consequences of stasis, intermittent courses of anti-inflammatory agents and antibiotics when there is inflammation secondary to local infection. These various types of treatment may be combined. Surgical treatment should be restricted to certain carefully assessed cases only.
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PMID:[Congestive pelvic syndromes]. 773 55

A past history of depressive illness, defined in terms of treatment by antidepressants, was found to be more common in women seeking help for premenstrual syndrome (PMS) (31.3%; N = 83) than in women complaining of menorrhagia (8.9%; N = 90) or controls (5.8%; N = 104) with dysmenorrhea sufferers (22%; N = '50) reporting intermediate rates. Such a history in the clinical groups was associated with a tendency for premenstrual depression to be relatively prolonged (i.e., persisting through the menstrual phase and sometimes into the postmenstrual week) and with more severe depressive symptoms during the premenstrual, menstrual, and to a lesser extent, postmenstrual phases of the cycle. This, association was not evident for reported heaviness of menstrual bleeding and only weakly evident for severity of pain during the menstrual phase. Women with a depressive history gave higher neuroticism scores. A history of depression, as defined, seems to increase the vulnerability of women to depressive perimenstrual mood change in terms of both duration and severity. This effect on duration may hitherto have served to obscure the relationship between history of depression and premenstrual syndrome.
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PMID:Vulnerability to perimenstrual mood change: the relevance of a past history of depressive disorder. 808 68

To identify women who find outpatient laser cervical surgery painful we designed a prospective observational study correlating surgical pain with multiple variables. The pain scoring systems were validated by comparing the subjective linear analogue score with an objective scoring method. The pain of surgery was compared with age, parity, acute anxiety scores, psychological state, premenstrual syndrome scores, phase of the menstrual cycle, contraceptive use, menstrual history, nature of the lesion, and intraoperative bleeding. Anxious women with no children suffered most. Nulliparity, acute preoperative anxiety, and a history of dysmenorrhea independently predict high pain scores. Young women and those using the combined oral contraceptive pill also find laser surgery more painful but this is because they are less likely to have delivered children and more likely to suffer from dysmenorrhea. Psychological state, premenstrual syndrome score, phase of the menstrual cycle, type of surgery, and perioperative bleeding have no predictive value. We suggest that nulliparous women and dysmenorrhea sufferers who are anxious about outpatient surgery but ambivalent about hospital admission should be offered cervical surgery under general anesthesia. Parous women who do not suffer from dysmenorrhea can be reassured that outpatient laser treatment should be tolerable.
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PMID:Who finds cervical laser therapy painful? 830

The antidepressant efficacy of fluoxetine in major depression has been briefly reviewed. A brief outline of dose selection, therapeutic onset, and pharmacokinetics of fluoxetine were made. The potential use of the drug in management of various psychiatric conditions has been examined. These include obsessive-compulsive disorder and related variances, anorexia nervosa, bulimia nervosa, Tourette's syndrome, and trichotillomania. The suggested use of fluoxetine in pain relief in certain diabetics, premenstrual syndrome, and migraine headache were assessed. The reports on the use of fluoxetine in panic disorders, paraphilias, and related conditions and in the management of substance abuse, alcoholism, and cocaine abuse, were summarized and elaborated upon. A composite of preliminary reports cited in literature pertinent to the potential of fluoxetine in treatment of abusing injurious behavior, dysthymic disorder, fibrositis, postanoxicaction myoclonus, pathologic jealously, personality disorder, pseudobulbar affect, and social phobia were also reviewed. Fluoxetine pharmacological profile may be extended to cover a relative wide range of application, provided future controlled studies confirm the preliminary data found in the literature.
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PMID:Fluoxetine: a spectrum of clinical applications and postulates of underlying mechanisms. 830 48

Two-hundred and seventy-six oral contraceptive (o.c.) users (171 combine o.c. and 105 triphasic o.c.) were compared with 276 non-o.c. users. All women regarded themselves as PMS sufferers, and the groups were matched for age, parity and marital status. Each woman rated severity of 27 symptoms during the premenstrual, menstrual and postmenstrual phases of their last menstrual cycle. The o.c. users reported significantly less menstrual pain and premenstrual breast tenderness. When controlling for the severity of premenstrual depression, there were no differences between the three groups in the timing or severity of perimenstrual food craving or clumsiness. When controlling for the severity of menstrual pain, the o.c. users showed significantly less improvement in negative mood during the menstrual phase, compared with non-users. The apparent tendency for o.c. users to show either a delayed or more prolonged pattern of perimenstrual negative mood deserves further study.
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PMID:The impact of oral contraceptives on the experience of perimenstrual mood, clumsiness, food craving and other symptoms. 846 94

Four groups of women were compared in terms of their perimenstrual symptoms, reported menstrual blood loss and period pain, and neuroticism scores: three patient groups were referred to a Gynaecology Outpatient Clinic because of menorrhagia (N = 101), PMS (N = 104), dysmenorrhea (N = 56), and a control group (N = 105). The three patient groups showed considerable overlap in a number of symptoms. This has led us to postulate three factors contributing to perimenstrual complaints: a) a 'timing factor' linked to the ovarian cycle; b) a 'menstruation factor,' associated with the buildup of the endometrium and its shedding; and c) a 'vulnerability factor,' one aspect of which, 'neuroticism,' was measured in this study. Depressive symptoms, which were the most important in leading women to seek help for their PMS, were related to all three factors. Depressive mood changes seemed to be linked to the 'timing factor' but were noticeably worse and more prolonged in women with high neuroticism, heavy bleeding, or severe pain. One premenstrual symptom, food craving, was of considerable interest. This was weakly related to neuroticism, not apparently affected by the 'menstruation factor' and differed in severity between those in the PMS group and the other three groups. It is potentially relevant that both carbohydrate craving and depression are linked to serotonergic changes in the brain, which may prove to be particularly marked in the late luteal phase.
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PMID:Perimenstrual complaints in women complaining of PMS, menorrhagia, and dysmenorrhea: toward a dismantling of the premenstrual syndrome. 847 27

Daily ratings of depression, pain, and menstrual blood loss, as well as past history of treated depression, were analyzed in 210 women attending a Premenstrual Syndrome Clinic. Severity and duration of perimenstrual depression was strongly associated with the severity of premenstrual and menstrual pain, raising the possibility of a causal relationship. It is not yet clear whether the occurrence of depression alters a woman's perception of pain, pain aggravates a tendency to perimenstrual depression, or some common factor aggravates both. A relationship between depression and subjective ratings of blood loss was also observed but was less marked than the relationship with pain. Both relationships had been reported in an earlier study using retrospective ratings. A relationship between past history of treated depression and severity and timing of current perimenstrual depression, observed previously, was not found in this study. This discrepancy was not due to differences between retrospective and prospective methods of assessment, but may have partly resulted from differences in the reporting of premenstrual pain in the two studies. Further studies of this association should control for the confounding effect of pain.
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PMID:Perimenstrual depression: its relationship to pain, bleeding, and previous history of depression. 855 35


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