טכניון מכון טכנולוגי לישראל
הטכניון מכון טכנולוגי לישראל - בית הספר ללימודי מוסמכים  
M.Sc Thesis
M.Sc StudentRosenfeld Rimma
SubjectNeurohumoral Homeostatic Functions Controlling the
Cardiovascular System in Women with Premenstrual
Syndrome (PMS)
DepartmentDepartment of Medicine
Supervisor Mr. Giris Jacob


Abstract

Premenstrual syndrome (PMS) is a cluster of emotional, behavioral and physical symptoms that appear during the luteal phase and subside after the beginning of the menstrual period. Although the most knowledge is concentrated on the psychological and psychiatric aspects of PMS, the pathophysiology of the physical symptoms remains unknown. The purpose of this study was to investigate the autonomic nervous system controlling the cardiovascular system in PMS and to examine whether fluid regulatory mechanisms are disturbed in PMS.

Nine regularly menstruating healthy women were compared to nine age-matched women with PMS, during the early follicular, mid-luteal and late luteal (LL) phases along the menstrual cycle.

We found no evidence of dysautonomia in PMS. The central control of autonomic nervous system tended to be more vagotonic rather than sympathotonic in women with PMS. The relative reduction in sympathetic tone was confirmed by the lower concentration of plasma NE in PMS group. Hemodynamic changes were similar in both groups. Adrenoreceptor responsiveness in women with PMS was similar to that described in pregnant women.

The ovarian hormones profile during the LL phase was different in PMS subjects, as compared to controls. The ankle edema and decreased plasma shift to the extra-vascular compartment during orthostatic stress in the LL phase suggest the presence of a disturbed fluid redistribution in the PMS. The existence of increased fluid regulatory hormones (plasma renin activity and aldosterone) during LL phase confirms the hypothesis of fluid dysregulation.

Thus, we can conclude that there is coexistence of fluid retention and non-physiological fluid redistribution in women with PMS.