Premenstrual tension is as the name suggests certain symptoms (symptoms include headache, gastro-intestinal upset, irritability, lethargy, constipation, frequency of urination, fullness of breasts and some women experience eruption of acne or pimples) few days preceding menstruation. Treatment of premenstrual tension depends on elimination of extra-cellular fluid by a salt free diet and also by limiting water intake for about 10 days preceding menstruation. The treatment regimens used are:
- Use of diuretics like chlorthiazide 250 mg single dose or saline purgatives for 10-12 days starting at the onset of the premenstrual symptoms until menstruation starts is very successful.
- Use of methyl testosterone 10 mg daily in the last half of the menstrual cycle in certain cases of premenstrual tension and use of large dose of progesterone is useful. But use of progesterone and testosterone can not be explained scientifically because if the theory of water retention as causative factor for premenstrual tension is accepted, than progesterone and testosterone are contra-indicated.
- For treatment symptoms like breast fullness or congestion adequate breast support and fluid restriction and elimination is required. For treating the premenstrual headache (migraine like) ergotamine tartrate in large dose of maximum 10 mg daily and care should be taken so that the dose does not exceed 10 mg per day otherwise there is danger of serious side effects like peripheral vascular spasm (which is seen with all alkaloid drugs).
- Many women with premenstrual tension suffer from acne on the body and face and also some skin eruption. Unfortunately the treatment of these conditions is unsatisfactory.
The most important factor in premenstrual tension is psychosomatic and it commonly affects women who are highly strung, introspective and neurotic. The headache or breast tenderness is exaggerated into an obsession of serious nervous disease or the woman becomes that she is having cancer. Due to all these the woman becomes short tempered and her family life and social life get disturbed. There may be tendency to suicide due to extreme depression. Study reveals that the female crime is higher during premenstrual phase of the period. These patients should be treated with patience and reassurance. Psychiatric consultation should be advised for these patients.