WHNP Boards: Gynecologic Disorders Exam with Complete Solutions

WHNP Boards: Gynecologic Disorders Exam with Complete Solutions When does Premenstrual Syndrome (PMS) happen? - luteal phase - 5 to 7 days before menses; resolves within 4 days of onset of menses Etiology of PMS - Unknown etiology; multiorgan disorder Suggested causes include: - metabolic and endocrine disorders - alterations in estrogen or progesterone levels - withdrawal of endogenous endorphins - fluid imbalance - vitamin and mineral deficiencies - altered carbohydrate metabolism Differential dx of PMS - depression and/or anxiety - bipolar affective disorder - alcohol or substance abuse - personality disorders - chronic fatigue syndrome - fibromyalgia - diabetes - brain tumor - thyroid disease - hyperprolactinemia - perimenopause Diagnostic testing for PMS - documenting sx in diary for 2-3 months to evaluate consistency of sx with ovulation or menses - individual testing can include glucose tolerance and thyroid profile - HORMONE LEVELS OF LITTLE VALUE Options for nonpharmacologic treatment for PMS - First line: self help strategies (teach sx, reassurance, patience) - little evidence to show helpfulness of dietary revisions (such as less salt/sugar/caffeine)