PRE-MENSTRUAL SYNDROME AS THE PARADIGM
OF AN INTERNAL BIOCHEMICAL STRESS.
Renato COCCHI MD, a neurologist and a medical
psychologist.
(Traduzione italiana)
Key
words: premenstrual syndrome,internal
stress,metabolic stress,homeostasis,stress
responses,drug modulation
Stress: Definition 1 (Culliman et al. 1995)
Although the concept of "stress" remains ill-defined, it
generally refers to physical or psychological alterations capable of disrupting
homeostasis..."
This definition of stress seems too restrictive because it does not
overtly mention the stress of internal metabolic origin.
Stress: Definition 2 (Cocchi 1996)
We term stress a set of relations linking external or internal stressors
of physical, chemical biological / metabolic and psychological / social origin,
to nonspecific reactions of a living organism. These
reactions come out from the modification of homeostasis made by the stressor or
stressors. In facts, we can find one or more external or internal stressors, or
external and internal stressors acting in the same time.
The premenstrual syndrome (PMS) is the most evident example of stress of
internal metabolic origin. It has the striking feature
of coming out from a physiological process of the fertile woman. The cut down
of the level of progesterone (the late luteal phase of the menstrual cycle)
does influence the homeostasis, inducing stress reactions. Those use final
common pathways and produce nonspecific symptoms (excluding perhaps breast
tenderness, bloating and svelling).
Symptoms of PMS (Mortola,
1997)
Fig.1: Percent of cycles in which PMS symptoms were reported during the
follicular phase (open bar) and luteal phase (total bar)
The supposedd influence of women's steroid hormones on the release of
some brain neurotransmitters involved in mood control is far to be exhaustive.
The nonspecific PMS symptoms can be found also as men's stress reactions. Although
PMS affects nearly 90% of women, the fact that aboutl 10% of them is free of it
needs further explanations. Since the amount of stress reactions depends on
genetic and acquired thresholds, some women could overcome PMS because of a
high threshold to its stress.
It is easy to understand what I mean by the genetic threshold. As for an
acquired threshold of response to stress I mean a threshold without any stable
modification of the hippocampus-corticosoprarenal feedback due severe pre- peri
or neo-natal risk factors (Sapolsky et al. 1990).
But when these women are suffering from another stress, without any link
with the menstral cycle, PMS can also be elicited, because the sum of stresses
exceeds even their high threshold.
Consequences:
1. Any internal biological-metabolic modification capable to disrupting
homeostasis can cause stress reactions.
2. Every illness can have symptoms of stress as accompanying symptoms
besides its direct symptoms.
3. The modulation of stress responses can give some relief to every
illness, even in genetic-chromosomal diseases.
4. Premenstral
syndrome can be treated by drug modulation of stress reactions
References:
Cocchi
R.: Drug therapy of pseudodementia as modulation of stress reactions: Three cases.
It. J. Intellect. Impair. 1996, 9: 173-180
Culliman
W.E. et al.: A neuroanatomy of stress. In: Friedman M.J., Charney D.S., Deutch
A.Y. (eds): Neurobiological and clinical conseguences
of stress. Lippincott-Raven,
Mortola J.F.: The premenstrual syndrome. Curr. Ther. Endocrinol.
Metabolism. 1997, 6: 251-256
Sapolsky
R.M. et al.: Glucocorticoid feedback inhibition of adrenocorticotrope hormone
secretagogue release. Neuroendocrinology 1990, 51: 328-336.
Presented
at the 2nd World Congress on Stress,
Author's address: dr Renato COCCHI, via Rabbeno, 3
42100 Reggio Emilia
renatococchi@libero.it
Traduzione italiana
Speculation
World Congresses on Stress and other congresses
Pre-menstrual syndrome
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