A wide range of recurrent symptoms that occur during the luteal phase or last half of the menstrual cycle and resolve with the onset of menstruation is known as:
A. Amenorrhea
B. Dysfunctional uterine bleeding
C. Dysmenorrhoea
D. Premenstrual syndrome
Correct Answer: D. Premenstrual syndrome
Explanation
The condition described in your question is Premenstrual Syndrome (PMS). Let’s break it down carefully:
Key points in the question:
- Wide range of recurrent symptoms → This indicates multiple physical, emotional, or behavioral symptoms.
- Occur during the luteal phase / last half of the menstrual cycle → The luteal phase is after ovulation (days 14–28 in a typical 28-day cycle).
- Resolve with the onset of menstruation → Symptoms improve once menstruation starts.
Explanation:
- Premenstrual Syndrome (PMS) is a set of symptoms that appear cyclically in the luteal phase of the menstrual cycle.
- Symptoms may include:
- Emotional/psychological: irritability, mood swings, anxiety, depression
- Behavioral: changes in appetite, sleep disturbances
- Physical: bloating, breast tenderness, headaches, fatigue
- Timing is key: The hallmark of PMS is that symptoms start after ovulation and resolve once menstruation begins.
- The cause is thought to be hormonal fluctuations (estrogen and progesterone) affecting neurotransmitters like serotonin.
✅ Answer: Premenstrual Syndrome (PMS)
Other Options Details
Here’s a detailed description of each option:
A. Amenorrhea
- Definition: Absence of menstruation in a woman of reproductive age.
- Types:
- Primary: Menstruation never occurs by age 15 (with normal growth and secondary sexual characteristics) or by 13 (without secondary sexual characteristics).
- Secondary: Menstruation ceases for 3–6 months in a woman who previously had regular cycles.
- Causes: Hormonal disorders (e.g., PCOS, hypothyroidism), anatomical anomalies (e.g., Müllerian agenesis), stress, excessive exercise, or medications.
- Clinical significance: May indicate underlying endocrine or structural problems affecting fertility.
B. Dysfunctional Uterine Bleeding (DUB)
- Definition: Abnormal uterine bleeding in the absence of organic, systemic, or iatrogenic causes. Usually due to hormonal imbalance.
- Characteristics: Irregular, unpredictable bleeding in amount, duration, or frequency.
- Common causes:
- Anovulatory cycles: Most common in adolescents and perimenopausal women.
- Hormonal imbalances (estrogen-progesterone).
- Clinical significance: Can lead to anemia, disrupt daily life, and may require hormonal therapy or surgery if persistent.
C. Dysmenorrhoea
- Definition: Painful menstruation.
- Types:
- Primary: Menstrual pain without any pelvic pathology, usually due to prostaglandin-induced uterine contractions.
- Secondary: Pain associated with pelvic pathology (e.g., endometriosis, fibroids, PID).
- Symptoms: Cramping pain in the lower abdomen, back pain, nausea, vomiting, headache.
- Management: NSAIDs, hormonal contraceptives, lifestyle modifications, or treatment of underlying cause for secondary dysmenorrhea.
D. Premenstrual Syndrome (PMS)
- Definition: A group of physical, emotional, and behavioral symptoms that occur in the luteal phase of the menstrual cycle (1–2 weeks before menstruation) and resolve with the onset of menses.
- Symptoms:
- Emotional: Irritability, mood swings, anxiety, depression.
- Physical: Breast tenderness, bloating, headaches, fatigue.
- Behavioral: Food cravings, sleep disturbances.
- Management: Lifestyle changes, dietary modifications, exercise, stress management, medications (NSAIDs, SSRIs, hormonal therapy in severe cases).
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Writer: Vandita Singh, Lucknow (GS India Nursing Group