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Doctor's Question

Dear Dr, This may be a dumb question, but what is PMS exactly? Every time I get mad my boyfriend asks "are you having PMS?" I am 28 years old, and I have never had any problems with cramping in my cycle. I have friends who do have cramping, but is this all there is to PMS? Tina in Orlando, Florida

Dear Tina, This is not a dumb question. PMS is real. Premenstrual symptoms occur in 95% of all women but premenstrual syndrome (PMS) occurs in only 5% of these women. By definition PMS is recurrent physical and/or emotional symptoms specifically during the luteal phase resolving by the end of menstruation. The exact cause has not been found. Theories are it is caused by hormonal imbalance, or possibly endocrine imbalance; or possibly from an enhanced sensitivity to progesterone; or from a deficiency in serotonin. PMS can mild to severe and even debilitating during that time. There are many possible medications but review of the medical literature has shown major improvement with the SSRIs. Selective Serotonin Reuptake Inhibitors (SSRIs) are classified as anti-depressants, as are all serotonin medicines. SSRIs are used in conjunction in treating many illnesses not dealing with depression. Sarafem, by Lilly pharmaceuticals, has an indication for premenstrual dysphoric disorder. I have patients on this medicine with good results. PMS is a complicated illness that no woman wants. It is unfair to use "PMS" as verbal insults, or to use it as a manipulation tool in an argument. I advise you to pay attention to futzuki. Thank you for writing.


Dear Doctor, I take Celebrex once a day, but my friend takes it twice a day. We know many people who take different doses, which is right? Ms Erin in Warner Robins, Georgia.

Dear Ms Erin, I'm glad to hear from home-town folks. Celebrex is an anti-inflammatory medicine which has different doses. According to Pharmacia Pfizer who markets Celebrex, dosing for osteoarthritis (OA) is 100mg twice a day or 200mg once a day; for rheumatoid arthritis (RA) dosing is from 100mg twice a day to 200mg twice a day. A patient's dose will depend on illness, results, and patient/physician choices. Thank you for writing.


Dear Doctor, How much water should a person actually drink in one day? I hear 8 eight ounce glasses per day, but this is hard to drink. Why is it so important to drink this much? Ms. Lillian

Dear Ms. Lillian, Wow, this is a lot to drink, but you are correct that the standard answer is 8 eight oz glasses per day. While this may be the correct amount, the optimal fluid is a sports drink: some type of fluid with salt and sugar. Plain water washes out electrolytes and causes more problems with fluid balance. Fluid with added sugar and salt would be a problem for diabetic patients or patients with heart failure. As with all questions, each person needs to discuss their individual case with their doctor.

 
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