WHAT CAUSES THE PMS?

I well remember one evening in the country town of Grafton, NSW, relating the Hippocrates theory on the causation of PMS to an entirely male audience who had come to listen to my after-dinner talk about "How To Be A Perfect Husband''. My mother had got me into this rather sticky situation as she had delighted in 1 'setting me up'' when the Lions Club had requested my presence.
As I related that Hippocrates had blamed a wandering uterus that travelled up to the brain and disturbed the emotions, a little man at the back of the audience became wide-eyed and intrigued. I further related that Hippocrates' treatment for PMS was to entice the wayward uterus back into its rightful position in the pelvis by burning aromatic incense at the vaginal opening. At this juncture the same man's jaw fell open and he looked relieved. After my light-hearted dissertation, he came to me and whispered in my ear saying that he had problems at home and did I have any incense for sale!
After Hippocrates, it took until 1931 for doctors to realize that hormones had something to do with PMS and a certain Dr. Franks preached the theory that too much oestrogen caused PMS. His treatment was more drastic than that of Hippocrates as he recommended large doses of laxatives to flush the demon hormones out of the body. Dr. Franks claimed great success with this treatment which is little wonder as the violence of the resulting diarrhea was enough to drown out all the other woes of the PMS victim.
Some women even had their ovaries subjected to radiation and consequent destruction in a desperate attempt to end their PMS
There is no doubt that the cyclical fluctuations in the levels of the sex hormones oestrogen and progesterone manufactured by the sex glands (ovaries) play a large role in causing PMS. This is supported by the observation that PMS begins only after puberty, recurs on a monthly basis and disappears during pregnancy and after the menopause. You will see that the pituitary gland situated at the base of the brain controls and speaks to the ovaries by sending chemical messengers called Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) via the blood stream to the ovaries. FSH and LH stimulate the ovaries to manufacture both oestrogen and progesterone. Ovulation occurs when an ovary releases a mature egg and the cells left behind in the ovary then form a small yellow gland called the corpus lustrum which sets to work and pumps out progesterone. It is after ovulation in PMS sufferers that the fireworks begin. In a woman without PMS, the levels of oestrogen and progesterone remain in sufficient and balanced amounts between ovulation and menstrual bleeding. In a woman with PMS, the levels of oestrogen and progesterone are out of balance with insufficient oestrogen and/or progesterone between ovulation and bleeding.
Some researchers believe that it is the ratio of oestrogen to progesterone that is more important than the absolute amounts of these hormones. They have found that women who have too much oestrogen compared to progesterone have anxiety, while women with too little oestrogen compared to progesterone complain of depression during the premenstrual phase.
Indeed, there are many subtle variations in the levels of sex hormones produced from the ovaries and a whole range of imbalances in all three ovarian sex hormones, oestrogen, progesterone and testosterone are probably involved. This accounts for the variation in PMS symptoms between different women and between different cycles in the same woman.
The study of female sex hormones is called gynaecological endocrinology and it is a relatively new medical specialty with still much to explore and learn. We stand at the frontier of an explosion in the understanding and scientific discovery of how imbalances in sex hormones influence our mind and bodies. PMS is truly a Pandora's box and we have now dared to lift the lid so that one by one the hormonal demons will be tamed and controlled.
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News

TAKING ESTROGEN

With the onset of menopause, many women suffer from hot flashes and night sweats. Arlene March, 56, a Los Angeles psychotherapist, says she started getting hot flashes 5 years ago. “I’d be working,” she recalls, “and suddenly feel intense heat all over my body. I’d break out in a sweat. I’d have to stop work. Then Dr. Mishell prescribed estrogen pills, and I’ve not had a day of discomfort.”
Some women experience a drying and thinning of vaginal tissues in the absence of estrogen, making sex painful. They also might suffer urinary tract infections and incontinence. Estrogen therapy often helps.
Among the physicians consulted, the most cautious was Dr. Morris Notelovitz, founder of the nation’s first Menopause Center, at the University of Florida, and head of the Women’s Medical and Diagnostic Center in Gainesville, Florida. He says each symptom needs a different treatment and advises that genital tract problems be given estrogen treatment for a couple of years at most. He also urges special measurements of the bones before prescribing estrogen therapy for osteoporosis.
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WOMEN’S HEALTH

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