Premenstrual syndrome (PMS) treatment by obstetrician-gynecologist Irina Ivanovna Kulbach in Dnipro.

When consulting, patients often complain of regular emotional and physical changes before menstruation that interfere with work or sleep, as well as recurring or worsening symptoms.

The doctor conducts a thorough clinical assessment, reviews complaints and medical history, and, if necessary, orders examinations to clarify the condition.

The patient receives a clear and understandable action plan: what to do now to relieve symptoms, which tests and examinations to undergo, and how to monitor changes in the condition over time.

The doctor pays special attention to differential diagnosis of the causes of symptoms, dynamic observation, and explains the treatment plan in simple and accessible language.

When to See a Doctor

If you notice more pronounced changes before your period that affect your well-being and daily life, it’s worth consulting a specialist. A doctor can help identify the causes of your symptoms, assess their progression, and prescribe necessary examinations. You should make an appointment with an obstetrician-gynecologist if you experience the following during PMS:

• Persistent feelings of irritability or anxiety before your period
• Regular headaches that occur cyclically
• Severe body swelling or noticeable weight gain
• Painful or heavy sensations in the lower abdomen or breasts
• Fatigue and decreased productivity that interfere with daily activities
• Sleep disturbances during the premenstrual period
• Worsening symptoms over time or with repeated cycles
• Complications related to chronic illnesses or stressful situations
• No improvement with self-care methods
• Symptoms appearing for the first time and causing concern or discomfort
• Recurring problems that are difficult to manage
• A need to adjust or choose treatment in the presence of other diagnoses

Seeing a doctor in such cases helps you better understand your condition, avoid complications, and select an appropriate course of action. It is important not to ignore regular or worsening symptoms in order to maintain your quality of life and comfort throughout the cycle.

Emergency conditions or when to see a doctor immediately

• Sudden and severe worsening of well-being with increasing pain in the lower abdomen
• Sudden onset of severe headache accompanied by impaired consciousness or vision
• Bleeding that rapidly worsens and does not stop
• Combination of severe weakness, dizziness, and rapid heartbeat
• High fever with pronounced weakness and deterioration of overall condition

If you experience any of these symptoms, do not wait for a scheduled appointment—seek urgent medical help. Our clinic offers a home visit service for quick response in such cases.

Causes and Risk Factors of Premenstrual Syndrome

This section will help you understand the possible causes and mechanisms behind the development of premenstrual syndrome (PMS), as well as the factors that may increase the risk of its occurrence or severity. It is important to know that an accurate determination of causes requires evaluation by a physician and additional examinations.

Main Causes / Mechanisms (briefly)

• Disruption of hormonal balance, especially fluctuations in estrogen and progesterone levels
• Increased sensitivity of the nervous system to hormonal changes
• Brain function characteristics affecting mood and emotions during the premenstrual period
• Influence of stress and psycho-emotional state on symptom manifestation
• Impact of vitamin and micronutrient levels on the overall condition of the body

Risk Factors

• Age, especially during the reproductive period with regular menstrual cycles
• Heredity: presence of PMS in close relatives
• Chronic diseases, particularly endocrine and mental disorders
• Emotional tension and stressful situations
• Unhealthy lifestyle, including lack of sleep and poor nutrition
• Smoking and alcohol consumption
• Lack of regular physical activity
• Excess weight or sudden fluctuations in body weight

Reversible Causes That Should Be Ruled Out

• Thyroid dysfunction
• Vitamin and mineral deficiencies (e.g., vitamin D or magnesium)
• Use of certain medications affecting hormonal balance or the nervous system
• Chronic fatigue syndrome and overexertion

Understanding the possible causes and risk factors of premenstrual syndrome helps guide examinations and identify what can be adjusted to reduce symptoms. Consultation with a specialist is necessary for accurate assessment and selection of appropriate recommendations.

Diagnosis

Diagnosis of premenstrual syndrome is aimed at understanding the causes of symptoms and ruling out other conditions. The process is gradual and includes several stages to obtain a complete picture of your condition and develop a plan for further action.

Diagnostic Approach

• Taking a detailed medical history: symptoms, their nature, and relation to the menstrual cycle
• Examination and discussion to assess overall health and possible related issues
• Ordering basic laboratory tests as indicated to check hormonal balance and other important parameters
• Additional investigations if necessary to clarify the condition
• Analyzing results and creating an individualized plan for monitoring, correction, or treatment

Typical Tests as Indicated

• Blood tests for reproductive hormones
• Thyroid function examination
• Assessment of vitamin and mineral levels
• Ultrasound of the pelvic organs
• Additional specialist consultations if needed

What to Bring to Your Appointment

• Medical records and results of previous examinations
• List of medications and dietary supplements you are taking
• Symptom diary, if you keep one
• Questions and notes you want to discuss with your doctor

Diagnosis of premenstrual syndrome requires a comprehensive approach and attention to detail, which allows for optimal recommendations tailored to each patient.

Treatment

Treatment of premenstrual syndrome aims to reduce unpleasant symptoms and improve quality of life. The therapy plan is selected individually, taking into account the specifics of each case and the patient's condition.

Therapy Goals

• Reduce the severity of physical and emotional PMS symptoms
• Improve overall well-being and daily activity
• Address possible underlying causes affecting the condition
• Prevent exacerbations and deterioration of quality of life

Main Treatment Approaches

• May include non-pharmacological methods aimed at reducing stress and enhancing well-being
• Use of medications as indicated to stabilize the condition
• Recommendations for lifestyle and dietary adjustments, including physical activity
• If necessary, interventions in aesthetic gynecology or consultations with other specialists
• Therapy is individualized and requires physician assessment with periodic adjustments

What the Doctor Does

• Selects and adjusts the treatment plan based on changes in symptoms
• Evaluates the impact of concomitant diseases on the patient's condition
• Monitors possible side effects of therapy and the need for their correction
• Explains the criteria for effectiveness and timelines for follow-up
• Coordinates treatment with other specialists as needed

What to Expect: Plan and Monitoring

• Symptom progression is regularly assessed, considering individual characteristics
• The plan may be adjusted if there is no improvement or if side effects occur
• Follow-up visits are scheduled for monitoring and therapy adjustments as necessary
• The time frame for noticeable improvements depends on the individual patient and chosen approach

To develop an individualized plan, schedule a consultation with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention of premenstrual syndrome is important for reducing the severity of symptoms and improving quality of life. The prevention plan is tailored individually, taking into account the body's characteristics and overall health status.

Key Primary Prevention Measures

• Managing stress and psycho-emotional state using available methods
• Maintaining a healthy lifestyle, including a balanced diet
• Avoiding smoking and practicing moderation with alcohol
• Regular physical activity as recommended by a doctor
• Monitoring chronic diseases and timely treatment when indicated

Screening and Secondary Prevention / Regular Monitoring

• Regular check-ups with an obstetrician-gynecologist as needed
• Monitoring hormonal balance and thyroid function when necessary
• Discussing therapy adjustments if symptoms change
• Monitoring overall health and identifying accompanying factors

Practical Tips

• Keep a symptom diary to better understand their nature and variation
• Discuss options for supporting the nervous system and stress response with your doctor
• Avoid sudden lifestyle changes without consulting a specialist
• Maintain regularity and quality of sleep
• Schedule visits to the doctor for timely health assessments

Preventive measures for premenstrual syndrome help reduce the strain on the body but require an individualized approach and specialist supervision.

Important to Know

Premenstrual syndrome (PMS) can manifest in various ways and affect well-being on different days before menstruation. Treatment is aimed not only at relieving symptoms but also at identifying possible causes and triggering factors. Early consultation helps to choose an appropriate approach and reduce the risk of complications. Sometimes ongoing monitoring is required to adjust the plan according to changes in condition and accompanying factors. It is important to consider the impact of physical load, stress, sleep, and other illnesses that may complicate the course. Self-treatment can mask important symptoms, cause side effects, and delay accurate diagnosis.

• It is important to identify causes and triggering factors, not just relieve symptoms
• Early assessment helps to select an effective treatment plan
• Ongoing monitoring is necessary for timely therapy adjustments
• Stress, fatigue, and accompanying diseases influence the course of PMS
• Self-treatment can complicate diagnosis and cause adverse reactions
• Clinic doctors explain the treatment plan in clear language and monitor the results

PMS is a complex condition that requires attentive care and timely diagnosis. For detailed information and to choose the right approach, we recommend visiting our general page on obstetrics and gynecology or scheduling a consultation with a doctor.

Self-Care Before the Appointment: Dos and Don'ts

Before seeing a doctor for premenstrual syndrome, it is important to take safe measures to avoid worsening your condition and to maintain an accurate picture of your symptoms. If your condition worsens, be sure to contact Dr. Irina Ivanovna Kulbach.

What You Can Do Before the Appointment

• Note when and how your symptoms started, as well as what worsens or alleviates your condition
• Keep a symptom diary, recording the intensity and timeframes of your symptoms
• Bring a list of current medications and supplements you are taking
• Ensure you get adequate rest and reduce physical activity if needed
• Maintain a regular sleep schedule as much as possible
• Drink enough water to stay hydrated
• Measure and record your temperature or blood pressure if you have the appropriate devices
• Avoid stressful situations and refrain from self-regulation methods without consulting your doctor

What You Should Avoid Doing Before the Appointment

• Do not stop or change the dosages of your medications without consulting your doctor
• Do not start taking new medications or supplements without a specialist’s recommendation
• Do not use unverified folk remedies or recipes without your doctor’s approval
• Do not ignore worsening symptoms, especially if they become sharp or unusual
• Do not interpret medical tests or examinations on your own
• Do not delay visiting the doctor if your symptoms are becoming more severe
• Do not try to suppress symptoms on your own without understanding their cause
• Do not increase physical activity if your condition is worsening

If you experience signs of an emergency, seek immediate medical attention from Dr. Irina Ivanovna Kulbach.

How I Can Help as a Doctor with Premenstrual Syndrome (PMS)

During a consultation for premenstrual syndrome, I will help you understand the causes of your symptoms and develop an effective plan of action. Together, we will assess your condition, identify risk factors, and determine the most appropriate treatment and monitoring strategy. In a PMS consultation, I can assist you with the following:

• Reviewing your symptoms and medical history to identify possible causes
• Assessing the severity of symptoms and potential health risks
• Analyzing current treatments and therapy tolerance, and adjusting them if necessary
• Creating a plan for further steps: diagnostic tests as indicated, treatment, and follow-up
• Considering any comorbid conditions and medications for a comprehensive approach
• Providing lifestyle and regimen recommendations when appropriate
• Discussing criteria for monitoring progress and when to return for follow-up
• Conducting an initial diagnosis with differential symptom analysis
• Adjusting therapy if there is no improvement or if side effects occur

This comprehensive approach helps identify the root causes of symptoms and select measures to improve quality of life. It is important not only to alleviate symptoms but also to prevent potential complications. Timely medical attention and regular monitoring are key to successful management of PMS.

What questions can you ask your doctor about PMS (premenstrual syndrome)

During a consultation regarding premenstrual syndrome, you can discuss the following issues with Irina Ivanovna Kulbach:

• Frequent irritability, anxiety, or mood swings before menstruation
• Persistent headaches during the premenstrual period
• Swelling and pain in the lower abdomen or breasts before menstruation
• Fatigue, decreased work capacity, and sleep disturbances before your period
• Worsening or recurring symptoms that negatively affect quality of life
• Ineffectiveness of previously prescribed treatment or the need for a second opinion
• The impact of concomitant conditions, such as endocrine disorders, on your condition
• General questions about management strategies and symptom relief options

In case of sudden severe pain, heavy bleeding, or worsening consciousness — urgent medical attention is required; do not wait for a scheduled appointment.

Questions you may want to ask during your visit:

• What is happening to me, and what could this be?
• Why are the symptoms appearing specifically before my period now?
• How can I tell if this is related to PMS or caused by something else?
• What examinations are necessary in my case to clarify my condition?
• Which tests are truly essential, and which can I skip?
• How should I prepare for tests and the appointment?
• What treatment options are available, and how do they differ?
• Is it possible to completely eliminate the symptoms, or is this a chronic issue?
• Why is the prescribed treatment not working, and what should be done next?
• Can I manage without medications or surgical procedures?
• How long does the treatment last, and how often should follow-up visits be?
• What signs indicate that my condition is improving or worsening?
• What should I do if symptoms suddenly worsen or flare up?

If your complaints exceed routine care or dangerous symptoms appear, emergency medical care is necessary. The clinic doctor will assess your condition, order the necessary examinations, and develop an appropriate management plan tailored to your needs.

How the Consultation Proceeds

A consultation for premenstrual syndrome involves a careful review of your complaints, assessment of your current condition, and development of a plan for further action. The extent of examinations is determined individually and depends on your symptoms and indications. A definitive diagnosis is not always possible during a single visit, but the doctor will provide an initial assessment and outline the necessary steps.

1. Clarifying complaints and the purpose of the visit: what exactly is bothering you, when symptoms appeared, what worsens or alleviates your condition, and what you expect from the consultation.
2. Taking medical history, including information about menstrual cycles, stress factors, and accompanying illnesses that may affect your state.
3. Reviewing previous treatments and examinations, if any; it is important to bring test results, medical records, and a list of medications you are taking.
4. Physical examination and additional simple tests as indicated, aimed at excluding other diseases and specifying your condition.
5. Preliminary evaluation: possibly identifying the most likely causes and determining what requires more detailed investigation.
6. Discussing the examination plan, which may include blood tests for hormones, ultrasound of the pelvic organs, assessment of thyroid function, and other tests as needed.
7. Formulating a treatment or management plan that includes lifestyle change recommendations, medical therapy, and subsequent monitoring.
8. Scheduling follow-up visits to assess treatment effectiveness and adjust the plan if necessary.

If this is your first consultation, the focus will be on thoroughly clarifying symptoms and identifying possible causes. If you have received treatment before, special attention will be given to evaluating its effectiveness and, if necessary, adjusting the approach.

This structured approach helps to understand your condition and build an effective collaboration to improve your quality of life.

Preparation for the Appointment

Preparing for an appointment with an obstetrician-gynecologist for premenstrual syndrome will help speed up diagnosis and the development of a treatment plan. Gather all necessary documents and information in advance to make the consultation as productive as possible.

• Bring a list of all current medications, including names and dosages, if known
• Bring results of previous examinations: hormone blood tests, pelvic ultrasound, medical records, and any other available documents
• Write down your main complaints and symptoms: when they start, what worsens or relieves them
• Do not stop taking prescribed medications without consulting the doctor
• Wear comfortable clothing suitable for an examination, especially if additional procedures may be performed
• If unsure, clarify preparation details when making the appointment or by phone
• Come on an empty stomach if separately recommended by the doctor (usually 8–12 hours fasting unless otherwise instructed)
• Avoid using cosmetics and creams in the examination area if a visual inspection is planned (as indicated)

If you have questions about preparation or specifics of the appointment, it’s best to clarify them in advance to avoid misunderstandings and receive quality care. Do not change your medication regimen without consulting a specialist — this is important for an accurate assessment and proper treatment plan.

About the Doctor

Irina Ivanovna Kulbach is a highly qualified obstetrician-gynecologist with over 40 years of experience. She regularly works with patients experiencing recurring symptoms of premenstrual syndrome, as well as those for whom previous treatments have been ineffective.

In her practice, the doctor focuses on differential diagnosis of causes and dynamic monitoring to select the most suitable treatment plan. Irina Ivanovna pays special attention to explaining the plan in simple and clear terms, which helps patients better understand their condition.

During the consultation, you will receive an analysis of your situation and recommendations for the next steps.

Why Patients Choose Dr. Irina Ivanovna Kulbach

Choosing the right doctor for premenstrual syndrome is crucial for accurate diagnosis and effective management of the condition. Irina Ivanovna organizes her work so that patients understand every stage of treatment and feel secure with her comprehensive approach. Her practice is distinguished by a thorough analysis of symptoms and attention to detail, which helps avoid unnecessary prescriptions and speeds up recovery. Unlike other specialists at the clinic, she places greater emphasis on therapy adjustment based on the clinical course and consideration of comorbidities, which is especially important in complex or chronic cases.

• Clear treatment plan with a logical structure: what is done now, how follow-up and reexaminations are scheduled
• Examinations only when indicated, without unnecessary procedures, reducing burden and costs
• Consideration of comorbid diseases and medications for safe therapy combinations
• Monitoring of condition dynamics with regular plan adjustments when needed
• Review of previous prescriptions and side effects for effective treatment correction
• Explanation of the plan and risks in simple language to help better understand the situation
• Focus on prevention of exacerbations and complications in the long term
• Experience managing complex and recurrent cases, providing confidence in an adequate approach

This approach enables patients to receive comprehensive support and timely assistance for premenstrual syndrome. A consultation with Irina Ivanovna is an opportunity to understand the causes of symptoms and develop a convenient plan for managing the condition without unnecessary procedures.

Clinical Cases

Initial Presentation with Pronounced PMS Symptoms

A middle-aged female patient came in complaining of regular irritability, headaches, and bloating before menstruation. It was important to rule out other causes, including hormonal disorders and concomitant diseases. A thorough history was taken, physical examination performed, and additional tests were recommended as indicated. Over several weeks, symptoms became less pronounced, allowing for the development of a supportive management strategy. Observation and therapy adjustments continue depending on changes in her condition.

Adjustment of Management Due to Lack of Effect from Previously Prescribed Treatment

A woman returned with complaints of persistent PMS symptoms despite treatment received elsewhere. The physician carefully reviewed previous prescriptions and assessed treatment tolerance. The treatment plan was revised considering individual characteristics and associated factors. After one month of follow-up, partial improvement in wellbeing was noted, additional supportive therapy was prescribed, and monitoring of her condition continues.

Chronic Course with Comorbidities

A patient with a long history of premenstrual syndrome and endocrine disorders came for a comprehensive evaluation. The physician considered the impact of comorbid diseases and potential drug interactions. Based on examination results, the management plan was adjusted taking all factors into account. On follow-up visits, symptom stabilization and overall condition improvement were observed under systematic monitoring.

Exacerbation and Plan for Preventive Measures

With worsening PMS symptoms, a young woman sought assistance to stabilize her condition. The physician conducted a thorough case review, assessed risks, and ordered the necessary comprehensive examinations. After initial interventions, a reduction in symptom severity was noted, a prophylactic plan was developed, and regular monitoring was recommended to prevent exacerbations.

Recurring Symptoms with Need for a Second Opinion

A patient with persistent premenstrual syndrome complaints sought an additional consultation to confirm or clarify the diagnosis. The physician re-analyzed the medical history and reviewed previous investigations, suggesting further clarifying studies. Following the consultation, the management approach was adjusted and an individualized observation plan was established. The patient received explanations and support for condition control.

How long does the consultation last?

The consultation usually takes 30–60 minutes; please confirm the exact time when booking.

How should I prepare for the appointment?

Write down your symptoms, their nature and duration, as well as any questions for the doctor.

What should I bring to the appointment?

Bring any previous test results, a list of medications, and a symptom diary if you keep one.

Do I need to come on an empty stomach?

Usually not required unless there are special instructions from the doctor.

How many visits are usually needed?

The number of visits depends on your condition and progress; sometimes a few appointments are sufficient.

When can I expect the first results after starting treatment?

This varies individually and depends on the chosen treatment approach and symptom severity.

What should I do if my condition worsens before the appointment?

If serious symptoms occur, seek emergency care without waiting for your scheduled visit.

Can treatment be combined with my current medications?

Discuss this during the appointment; do not change or stop any medications on your own.

Is online consultation available?

Yes, online consultations are possible, including symptom discussion and planning tests.

Can I come with tests I already had done?

Yes, bring all available analyses and results for evaluation.

Do I need to come for follow-up visits and how often?

Follow-up visits are scheduled based on treatment outcomes and changes in your condition.

Can I get a second opinion?

Yes, the doctor is ready to review your concerns and provide an additional opinion.

What should I do if symptoms return after improvement?

Contact the doctor for assessment and possible adjustment of your treatment plan.

What tests might be prescribed?

The list of tests depends on your symptoms and is determined individually during the appointment.

How can I know if the symptoms are related specifically to PMS?

A comprehensive evaluation by the doctor is required, taking into account your history and test results.

Can treatment proceed without medications?

The approach is chosen individually; non-drug methods and observation are possible.

How often do I need to have tests?

Frequency depends on your condition’s progress and the doctor's recommendations.

Can I stop medications without consulting?

Do not stop or change medication without consulting a specialist.

What if the prescribed treatment does not help?

You can discuss therapy adjustments and additional options during your appointment.