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PMS

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"premenstrual syndrome"

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premenstrual syndrome symptoms treatment ACOG patient FAQ

PMS usually means premenstrual syndrome: recurring physical and emotional symptoms in the days or 1-2 weeks before a menstrual period that improve shortly after bleeding begins.
Common symptoms include:
  • Bloating, breast tenderness, headache, fatigue, acne
  • Food cravings or appetite changes
  • Irritability, low mood, anxiety, crying spells
  • Trouble sleeping or concentrating
Helpful first steps include tracking symptoms over 2-3 cycles, regular exercise and sleep, stress management, and using appropriate pain relief if needed. If symptoms significantly disrupt work, school, relationships, or include severe depression, it could be PMDD, the more severe form, and should be assessed by a clinician. ACOG's PMS guidance notes that SSRIs can help some people with PMDD. A 2024 Cochrane systematic review also evaluated SSRIs for PMS/PMDD (PMID: 39140320).
Seek urgent help if there are thoughts of self-harm or suicide.

Post menopausal syndrome

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"menopause" AND "menopausal symptoms"

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NICE menopause symptoms management patient guidance

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https://www.nice.org.uk/guidance/ng23/chapter/recommendation…

Postmenopausal syndrome refers to symptoms and longer-term health effects caused mainly by reduced ovarian estrogen after menopause.
Menopause is diagnosed retrospectively after 12 consecutive months without menstruation when there is no other cause. It commonly occurs between ages 45 and 60.

Features

  • Vasomotor: hot flushes, night sweats, palpitations
  • Psychological/sleep: irritability, low mood, anxiety, poor concentration, insomnia, fatigue
  • Genitourinary syndrome of menopause: vaginal dryness, itching or burning, painful intercourse, urinary urgency, recurrent UTIs
  • Body changes: joint and muscle aches, skin thinning, reduced sexual desire
  • Long-term consequences: bone loss/osteoporosis and fracture risk; cardiovascular risk rises with age and menopause-related changes

Management

  1. Lifestyle and supportive care
    • Regular weight-bearing exercise, adequate calcium and vitamin D intake, healthy weight, no smoking
    • Layers of clothing, avoiding individual hot-flush triggers such as alcohol, hot drinks, spicy foods
    • Sleep support, counselling or CBT where mood, anxiety, or insomnia are prominent
  2. Menopausal hormone therapy (MHT/HRT)
    • The most effective treatment for troublesome hot flushes and night sweats.
    • If the uterus is present, estrogen must be combined with a progestogen to protect the endometrium.
    • After total hysterectomy, estrogen-only therapy is generally used.
    • Choice of treatment depends on age, time since menopause, symptoms, personal/family history, clot risk, breast cancer history, and cardiovascular risk. NICE recommends an individualised discussion and the lowest effective dose. NICE menopause guidance
  3. For vaginal or urinary symptoms
    • Vaginal moisturisers and lubricants
    • Local vaginal estrogen is often effective and can be used alone or with moisturisers/lubricants, subject to individual clinical assessment. NICE recommendations
  4. Non-hormonal options
    • May be considered when HRT is unsuitable or unwanted, particularly for vasomotor symptoms. A clinician can discuss appropriate medicines and CBT.

Seek medical evaluation promptly for

  • Any vaginal bleeding after menopause
  • Bleeding that persists or starts after the initial adjustment period on HRT
  • New pelvic pain, abdominal bloating, unexplained weight loss
  • Severe depression or thoughts of self-harm
Postmenopausal symptoms are treatable, but HRT should not be started without a personalised medical review.
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