Premenstrual tension

Abstract

Investigation of twenty-nine women with premenstrual tension indicates that the symptomatology is the result of an estrogen-progesterone imbalance with a relative excess of estrogen, due to deficient progesterone secretion. This conclusion was reached on the basis of endometrial biopsies, vaginal smears, basal temperatures, and urinary hormone assays.The unopposed estrogen displays its activity by stimulating increased epithelial proliferation in the breasts and pelvic organs, by altering electrolyte and water metabolism to allow increased retention of extracellular tissue fluid and by altering carbohydrate metabolism to permit increased sugar tolerance.A new and striking finding in premenstrual tension is the hypoglycemia. This is clinically manifested by increased appetite or a craving for sweets, and a trembling of the hands described by patients as the “shakes.” The psychic manifestations as well as the weakness and fatigue are also largely ascribed to the hypoglycemia. The anxiety neurosis, when present during the hypoglycemic state, is probably a subjective reaction to the profound weakness and fatigue.The treatment of premenstrual tension is directed toward the correction of hormonal imbalance. Symptomatic treatment of the edema by salt restriction and administered diuretics, and of the hypoglycemia by dietary measures, are helpful adjunct measures.