Premenstrual sendromda beslenme yaklaşımı

Öz

Premenstrual sendrom PMS , menstrual siklusun luteal fazında görülen ve menstruasyonun başlamasıyla düzelen fiziksel, davranışsal ve duygusal bozukluklardır. Türkiye’de PMS prevalansının %5,9 –76 gibi geniş bir aralıkta değiştiği rapor edilmektedir. PMS, tüm dünyada bireylerin günlük yaşamını, kişiler arası ilişkileri olumsuz etkilemekte ve iş veriminde düşüş ile ilişkilendirilmektedir. Kesin etiyolojisi tam olarak bilinmemekle birlikte gonadal steroidler ve nörotransmitterler arasındaki dengeyi sağlayan bazı değişikliklerin PMS’ye neden olabileceği görüşü ön plandadır. Tiroid disfonksiyonu, sıvı retansiyonu, psikolojik etmenler, hipoglisemi gibi nedenlerin de etkili olabildiği bilinmektedir. PMS’nin ortaya çıkışında sadece hormonal değişikliklerin değil, ait olunan kültür, annenin çalışma ve eğitim durumu gibi sosyokültürel etmenler ile şekillenen menstruasyona ilişkin tutum ile dismenore gibi menstrual problemler yaşama durumunun da PMS etiyolojisinde rol oynadığı belirtilmektedir. PMS’de en yaygın görülen belirtiler, kızgınlık, depresif ruh hali, anksiyete, şiddete eğilim, yalnız kalma hissi, göğüslerde büyüme ve hassasiyet, vücutta ödem, vücut ağırlığında artış, baş ağrısı, bulantı, kusma, ishal, iştah artışı, ciltte akne oluşumu veya artışı, aşırı susama, kas ve eklem ağrısı ve yorgunluktur. Bu semptomların aşırı çay, kahve, kolalı veya alkollü içecekler, çikolata, şeker içeriği zengin atıştırmalıklar ve yetersiz süt tüketimi ilişkili olabileceği gösterilmiştir. Ayrıca PMS’ye bağlı enerji ve karbonhidrat alımlarında bir artış olduğu, kalsiyum, magnezyum, sodyum, potasyum, çinko mineralleri ile tiamin, riboflavin, B6, D vitaminlerinin ve fitoöstrojenlerin diyetle alım miktarlarının PMS semptomları ile ilişkili olabileceği gösterilmiştir. PMS ile beslenme arasındaki ilişkiyi bütüncül bir yaklaşımla incelemek ve bu sayede gerek PMS insidansını azaltmak gerekse semptom şiddetini hafifletmek için beslenme protokolleri geliştirmeye yardımcı olacak araştırmalara ihtiyaç vardır. Bu derlemede, güncel literatür taranarak elde edilen yayınlar doğrultusunda, beslenme durumunun PMS gelişim ve semptom şiddetlerine etkisi ele alınmıştır

Anahtar Kelimeler

• premenstrual sendrom, beslenme, diyet örüntüsü

Nutritional approach in premenstrual syndrome

Abstract

Premenstrual syndrome PMS is defined as physical, behavioral and e motional disorders seen in the luteal phase of the menstrual cycle. It is reported that the prevalence of PMS changes in a wide range such as 5.9-76% in Turkey. PMS affects interpersonal relations negatively and it is associated with decreased productivity. The approach which of some changes in the balance of gonadal steroids and neurotransmitters may cause PMS is in the foreground although the etiology of PMS is not clearly known. Thyroid dysfunctions, fluid retention, psychological factors, hypoglicemia also may affect it. Not only hormonal changes, but also sociocultural factors such as the culture in which the person belongs, mother occupational and educational status, attitude towards to menstruation or dysmenorrhea have a role in the etiology of PMS. The most common symptoms in PMS are irritability, depressive mood, anxiety, tendency to violence, fatigue, feeling alone, enlargement and sensitivity in breast, edema in body, headache, nausea, vomiting, diarrhea, increased appetite, acne formation or increasing, excessive thirst, pain in muscles and joints. It has been shown that the symptoms are associated with excessive consumption of tea, coffee, coke and alcohol beverages, chocolate, snacks rich in simple sugar, and inadequate milk consumption. Furthermore, an increase in energy and carbohydrate intake related to PMS and dietary calcium, magnesium, sodium, potassium, zinc and also thiamine, riboflavin, vitamin B6 and vitamin D and phytoestrogens intake is shown to be associated with PMS symptoms. Further studies on the nutritional status of individuals in premenstrual period are needed to determine the relationship between PMS and nutrition with a holistic approach, and to develop nutrition protocols both decreasing the incidence and alleviating the symptoms. In this review, the effect of nutritional status on the development and symptom severity of PMS has been discussed using the recent literature.

Keywords

• premenstrual syndrome, nutrition, dietary pattern

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