Premenstrual Syndrome

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Premenstrual syndrome (PMS) is accompanied by cutaneous manifestations that emerge in the premenstrual phase of the menstrual cycle. Accordingly, approximately 70% of women report that prior to the onset of menstrual bleeding, they suffer from mild acne eruptions, often in association with an increased greasiness of the skin and hair; a premenstrual exacerbation of perioral dermatitis is reported frequently, especially by young women (4). Additional clinical symptoms of PMS include:

1. Migraine and other forms of headache

2. Tiredness, lethargy

3. Depression

4. Irritability and nervousness

5. Feeling of tenseness in and swelling of the breasts

6. Abdominal pain, feeling of fullness

7. Increased thirst, appetite, and weight gain

8. Constipation and flatulence

9. Hot flush symptoms

10. Acneiform cutaneous efflorescences, perioral dermatitis

11. Oily skin and hair

12. Hyperpigmentation of the skin

To date, the definite endocrinologic mechanism responsible for PMS has not been found. Given the temporal association of the symptoms with the luteal phase of the menstrual cycle, it is possible that progesterone plays an important role. Various hypotheses have been offered to explain the pathogen-esis, such as an individual progesterone deficiency, an imbalance between the estrogen and progesterone levels, and even an allergy to progesterone (4,14). One confirmed fact is that the ^-endorphin level in the premenstrual phase is decreased in patients with PMS (2). Research has confirmed the thesis of an immunological mechanism of PMS by the finding of a positive intracutaneous test reaction to female sex hormones in women with PMS and associated cutaneous manifestations (15). A hypersensitization treatment led to a significant reduction of the PMS symptoms, as well as to an improvement of the cutaneous manifestations. A connection with autoimmune progesterone and autoimmune estrogen dermatitis seems possible.

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