Which non-hormonal pills are best for PMS. How to relieve PMS symptoms? Are there drugs that relieve PMS? Natural Remedies for Menstrual Cramps

The main factor influencing the choice of therapy should be the intensity and manifestations premenstrual symptoms. The manifestations of PMS that cause the greatest disruption to quality of life are rarely mitigated by changes in lifestyle, and attempts to adhere to only this method of treatment often bring nothing but a delay in effective therapy. On the other hand, minimal symptoms or manifestations that occur monthly for a short period of time rarely require the use of extensive drug intervention.

PMS is often accompanied by other gynecological symptoms, such as dysmenorrhea or menorrhagia. In such circumstances, it is necessary to select a therapy that helps achieve several goals at once. First-line drugs will be NSAIDs or oral contraceptives.

Nonsteroidal anti-inflammatory drugs for premenstrual syndrome (PMS). Mefenamic acid (500 mg 3 times daily) given during the premenstrual and menstrual weeks has been shown to have a better treatment effect than placebo in many, but not all, clinical trials. The use of mefenamic acid is contraindicated in women with intolerance to acetylsalicylic acid and in patients at risk for gastric and duodenal ulcers.

Oral contraceptives for premenstrual syndrome (PMS). Although hormonal oral contraceptives are among the most commonly used medications in women of reproductive age and have been prescribed for PMS for 40 years, there is still no clear understanding of their effect on the duration or severity of symptoms. Hormonal contraceptives reduce menstrual pain and bleeding. Perhaps due to this, they can improve women's tolerance of the premenstrual and menstrual periods. However, the reason some women stop taking oral contraceptives appears to be worsening premenstrual symptoms. Some reports have even suggested that conventional oral contraceptives cause some susceptible women to experience premenstrual symptoms earlier in the cycle.

In the first systematic study of the effects oral contraceptives in women with no differences in symptoms between those who used and those who did not use these drugs. There were also no differences found in the effects of drugs with different degrees of progestogenic activity. When using monophasic and triphasic oral contraceptives, the symptoms remained the same.

A new oral drug containing a progestogen with a diuretic effect(drospirenone), has been extensively tested in healthy women and women with well-established premenstrual dysphoric disorder. The dose of progestogen in each tablet is equivalent to 25 mg of spironolactone. Although the assumption about the role of fluid retention as one of the components of the etiology of PMS has not yet been confirmed, many women are concerned about edema. In controlled clinical trials, this new contraceptive drug has been shown to have a positive effect on several physical and psychological manifestations of PMS with an improvement in quality of life.

Pyridoxine for premenstrual syndrome (PMS). Published data on the effectiveness of pyridoxine (vitamin B6) are rather contradictory. However, this drug at a dose of 100 mg per day can be considered at least a safe placebo and part of a comprehensive treatment for women with severe menstrual syndrome, along with lifestyle and dietary changes. Patients should be warned that pyridoxine does not have an effect on all women, and increasing the dose in an attempt to achieve complete resolution of symptoms may result in peripheral neuropathy. If tingling or numbness of the extremities occurs, pyridoxine should be discontinued.

Diuretics for premenstrual syndrome (PMS). The constant use of diuretics in the treatment of PMS should be abandoned. Very few women actually experience weight fluctuations during their menstrual cycle, although PMS sufferers often experience a feeling of puffiness. In this case, spironolactone may be effective and relieve symptoms.

Anxiolytics for premenstrual syndrome (PMS). For some women, the predominant symptoms during the premenstrual week are anxiety, mental stress and insomnia. In this case, the use of hypnotics or short-acting anxiolytics, such as triazolam (0.25 mg at night) or alprazolam (0.25 mg twice a day), can be individually recommended. There is also evidence of a positive effect on anxiety on buspirone, which can sometimes replace SSRIs if they cause sexual dysfunction.

Antidepressants for premenstrual syndrome. A number of newer antidepressants that increase serotonin activity in the central nervous system alleviate severe PMS symptoms. Since these drugs can also reduce endogenous depression, it is very important to make an accurate diagnosis before treatment using prospective recording of symptoms. In women with predominant psychiatric symptoms, treatment with antidepressants can provide excellent results. SSRIs such as fluoxetine, sertraline, paroxetine, fluvoxamine, and venlafaxine (serotonin-norepinephrine reuptake inhibitor) have also been used successfully.

Clear description symptoms will help you choose the most suitable drug (for example, fluoxetine is recommended for fatigue and depression, sertraline for insomnia, irritability and anxiety). The use of SSRIs is associated with loss of sexual desire and anorgasmia, which causes particularly severe stress in this group of patients, so it is necessary to have a conversation with the patient before starting therapy.

Tricyclic antidepressants (TCAs), as a rule, do not provide sufficient effect, with the exception of clomipramine, a TCA with strong serotonergic activity. In addition, intolerance to the side effects of TCAs is common.

Most women suffering PMS, prefer to take medications only during that phase of the menstrual cycle when they experience the corresponding symptoms. Recent studies have shown that therapy given during the luteal phase has a good effect in many women with PMS. In practice, this means that SSRI therapy, once started, should be continued for a long time. Once a woman has experienced the optimal results achieved with long-term therapy, it makes sense for her to try switching to taking medications only during the luteal phase and see if the same effect is maintained.

Unfortunately, recent research, which included follow-up of patients, showed a rapid return of severe PMS with significant social problems after cessation of SSRI treatment. This means that if this line of therapy is preferred, long-term use is necessary.

LH agonists for premenstrual syndrome. Many women express dissatisfaction with the need for long-term use of selective serotonin reuptake inhibitors (SSRIs). Others believe that psychotropic drugs deprive them of some of their natural emotions, and still others report intolerance to the side effects.

A different approach to treating severe PMS serves to suppress the ovarian cycle, which presumably provokes changes in the activity of central neurotransmitters that underlie the manifestations of PMS. LH agonists provide rapid drug suppression of ovarian function, thus causing pseudomenopause and eliminating PMS. This type of treatment is not suitable for long-term use, as it not only brings discomfort caused by menopausal symptoms, but also poses a risk of developing osteoporosis and possibly coronary artery disease. When combined with HRT, luliberin agonists provide excellent results, relieving premenstrual symptoms without the associated risk and signs of premature menopause. The biggest disadvantage of this therapeutic approach is the high cost of drugs and the need to take a large number of different drugs over a long period of time.

If, with enviable regularity, once a month you do not experience irritability, nervousness and inexplicable physical discomfort, you belong to a rare category of lucky women who have not had to deal with premenstrual syndrome (PMS). This term is familiar to all women, but not everyone can recognize it.

A few days or one or two weeks before the start of menstruation, nagging pain appears in the lower abdomen, swelling, thirst begins, painful sensations in the mammary glands and pain in the heart appear, appetite is disturbed (either you don’t want to eat at all, or the so-called gluttons attack), For no apparent reason, the temperature rises, chills, attacks of headache and dizziness or nausea occur. Along with physical discomfort, irritability, aggressiveness, depression, attacks of tearfulness, memory impairment, problems with sleep and sexuality appear. And all these symptoms disappear in the very first days of the onset of menstruation. It is this above condition that doctors call premenstrual syndrome. And if you recognized your portrait in the description above, alas, you also could not avoid this painful condition. According to statistics, PMS most often affects women between the ages of 25 and 45, and the older you are, the more likely you are to encounter severe manifestations of this phenomenon. PMS is also more common among mental workers, those whose work is associated with hazardous industries, and people with chronic diseases.

The cause of PMS is considered to be a hormonal imbalance associated with an excess of female sex hormones in the blood. At the same time, the autonomic nervous system undergoes changes. There is an opinion among doctors that nagging pain in the lower abdomen occurs due to the fact that the menstrual cycle has already begun, and the cervix is ​​not yet dilated and does not allow blood and mucus to come out. This stretching of the uterus leads to pain.

Premenstrual syndrome is associated with the structural features of the female body, so only women experience it. Unfortunately, we are not able to get rid of the monthly release of hormones, but it is quite possible to relieve unpleasant symptoms.

or at least

1. Consult your doctor

Since PMS is primarily associated with changes in the level of female sex hormones, first of all, you need to pay a visit to the gynecologist. If you are concerned about serious emotional disturbances, consult a neuropsychiatrist. It is also advisable to visit an endocrinologist, since disorders in the thyroid gland can intensify the manifestations of PMS.

1. Try it drugs that relieve PMS

Depending on the symptoms that accompany PMS, you can choose medications that reduce discomfort. It is best to start taking these medications well before the syndrome usually occurs.

How are painkillers suitable? drugs that relieve PMS: no-spa, baralgin, analgin, nurofen. Natural sedatives are effective: 300-600 mg per day allows you to achieve stabilization of your mental state, eliminates irritability and softens the manifestations of PMS. A course of 2 capsules of the drug is recommended Valerianovna ® in a day. Duration of treatment is at least 2 weeks. It is better to start the course in the second phase of the cycle.

1. Follow your diet.

Small dietary restrictions will help reduce the symptoms of PMS. Thus, it is recommended to reduce the consumption of coffee, strong tea, and limit total fluid intake to 1.5 liters per day. It will be easier for you to survive the days before your period begins if you reduce the amount of foods rich in potassium in your diet - raisins, dried apricots, baked potatoes. Chocolate lovers should moderate their consumption of this product as it increases heart rate. In general, give preference to foods with low salt content, without spices and hot seasonings. Try to eat less fatty and dairy products, red meat, and eliminate alcohol from your diet.

• At least a week before and during your expected period, increase the amount of calcium in your diet. This element is found in large quantities in leafy greens and leafy vegetables - salads, cabbage, spinach, parsley;
• take additional vitamin complexes with vitamins A, B, E;
• eat foods high in magnesium salts - grains, nuts, seafood. Magnesium helps get rid of fatigue, irritability and depression. The required combination of microelements will be provided by asparagus, fresh strawberries, cucumbers, parsnips;
• take natural sedatives - motherwort, valerian, warm milk with honey, mint tea. Peppermint, among other things, has an analgesic and anticonvulsant effect, and also has a positive effect on metabolism;
• An unpleasant pressing feeling in the lower abdomen will be relieved by cranberry juice. In addition, it is a natural diuretic;
• tea with a decoction of raspberry leaves helps with excessive menstruation.

1. Follow a daily routine.

Adequate sleep and rest also have an impact on PMS. Try to get enough sleep and rest well before and during your period. And for sleeping it is better to choose a cool, well-ventilated room.

1. Walk and relax.

Try to walk more in the fresh air and go out of town.

1. Quit smoking.

Smoking has a negative impact on the female body, and PMS in this case is no exception.

1. Treat yourself to water treatments.

How to relieve PMS symptoms: water treatments

It’s great if you have the opportunity to take a contrast shower in the morning and evening, completing the procedure with a douche of cool water. A warm bath (38-39 degrees) with a herbal decoction of peppermint, mint and horehound in equal parts helps relieve premenstrual tension. The duration of this procedure should not exceed 15 minutes; after completion, rub lavender oil or lemon wormwood oil into your temples or lower back.

1. Do not visit the sauna during or before your period.

1. Play sports

Regular moderate physical activity increases the flow of oxygen in the body, increases vitality and promotes the production of the “good mood” hormone. The only caveat is that you will have to limit yourself to strength exercises for the upper body, jogging and cardio equipment.

1. Try to reduce stress.

If you have a question on the agenda, how to relieve PMS, try to minimize stressful situations, be less nervous and worry. Create a home environment that allows you to relax rather than constantly being on alert.

Very often, the discomfort of premenstrual syndrome can be minimized or avoided altogether. The main thing is not to let things take their course and take timely measures to prevent them, and in case of failure, do not hesitate to consult a doctor who will recommend you how to relieve PMS taking into account the characteristics of your body.

Any little thing during PMS throws a woman out of balance: tears, hysteria and, finally, someone’s irritated question: “Are you getting your period soon?” Some view this phenomenon as a necessary evil. However, you can get rid of PMS. the site consulted with a doctor, obstetrician-gynecologist Kokotyukha Irina.

Premenstrual syndrome (PMS) is a complex of unpleasant symptoms that occurs in women 7-14 days before menstruation.

Symptoms

There are many symptoms of PMS: from depression, irritability and lethargy to severe headaches (migraines), allergic reactions on the skin, diarrhea or constipation, swelling and tenderness of the mammary glands. Moreover, the signs of PMS and its course are individual for each woman. For example, some people have a terrible headache a week before their period, weight gain, and acne appears on their face. While others only 2-3 days before menstruation begin to suffer from depression and insomnia.

Causes

During the premenstrual period, fluctuations in sex hormones occur in a woman’s body and the manifestations of PMS depend directly on the individual reaction to such fluctuations.

Hormones not only regulate the menstrual cycle, but also “hit” other systems of the body, for example, the central nervous system, genitourinary system, etc. This results in irritability, and a slowdown in kidney function leads to edema. Fortunately, by the beginning of menstruation, everything returns to normal, and we temporarily forget about PMS.

There are other reasons, for example, lack of vitamins and minerals in the body, consumption of large amounts of salt, alcohol, coffee, smoking, sedentary lifestyle and of course, stress. So, if you feel that PMS periods are becoming more difficult, think about your lifestyle. Experts believe that severe PMS can also be inherited.

No. 1. Go to the doctor

Listen to yourself. Try to keep a diary for 4 to 6 months in which you clearly describe your emotional experiences and physical sensations.
Contact your gynecologist. Having studied your “mood,” the doctor will be able to understand whether it is really PMS and will help you choose medications, diet, and tell you what regimen you need to follow during the premenstrual period.

Typically, treatment for PMS depends on the symptoms you experience. There are many drugs for this: sedatives, analgesics and antispasmodics, non-steroidal anti-inflammatory drugs, hormonal drugs, diuretics.

In addition, the doctor may prescribe oral contraceptives, vitamin preparations and nutritional supplements.

#2: Change your diet

Very often you can get rid of PMS without resorting to medications. To do this, it is enough to refrain from bad eating habits at least 10 - 7 days before the start of your period:

• Limit your consumption of sugar, salt, coffee, strong tea and do not exceed the required daily amount of liquid - 1.5 liters per day (it is better if it is mineral water and unsweetened juices)! Excess fluid in the body leads to painful breast swelling and swelling.
• Alcohol is also harmful. It increases the feeling of hunger, headache, irritability.
• Forget about products containing artificial additives and flavors.
• Beware of large amounts of animal fats, as they are the main source of cholesterol, the excess of which contributes to the disruption of blood circulation. But dishes made from fish, poultry or lean beef will come in handy.
• Replace butter with vegetable oil. Do not limit yourself to fresh vegetables and fruits, as they contain the necessary vitamins, minerals, and fiber. By the way, vitamins A and D improve skin condition and prevent the appearance of acne during PMS. And vitamin E relieves pain in the mammary glands and relieves depression.

No. 3. Lead a healthy lifestyle

Exercising increases the body's endurance, and this is important in the fight against premenstrual syndrome.

Don't overload your nervous system! Insufficient sleep only increases irritability and reduces the body's resistance to stress.

Therefore, take a week's break from night work, try to sleep for at least 8 hours, in a well-ventilated room, and take a contrast shower before bed.

The fewer cigarettes you smoke, the easier your PMS will be. Scientists have long proven that nicotine significantly worsens the course of premenstrual syndrome.

Yoga and breathing exercises are great for PMS headaches. For example, sit cross-legged and, smoothly raising your arms up, take a deep breath. When your arms are above your head, hold the air for a few seconds. Then, slowly lowering your arms, exhale.

Let's try to figure out together how much we can, on our own or with the help of medical means, solve a problem that concerns millions of women living in different countries, different ages and social groups. For many of them, unfortunately, it is very vital.

Read in this article

Causes

Every modern woman knows that her body is complex. Nature has thought out thousands of options for its correct reaction to changes occurring in the surrounding world and in itself - under the influence of various circumstances, during contacts with other people, with the onset of certain age-related changes. Ecology, constant stress, and the rapid acceleration of the pace of life cause a number of painful conditions that are difficult to make a correct diagnosis and treat. And one of them is .

This phenomenon is familiar to every woman - some, fortunately, know about it only by hearsay. Almost everyone is faced with the same global question that requires taking urgent measures: how to survive PMS? Is it possible to minimize extremely unpleasant sensations? How to deal with it?

How to alleviate the condition?

There are several ways to alleviate PMS that will help minimize psychological distress and physical ailments:

1. Daily routine

It is strongly recommended to review your daily routine: less physical activity, no rush jobs in the workplace, no prolonged sitting in front of the monitor. Active sports activities are equally contraindicated. A little exercise will only help, as will calm walks in the park, along your favorite quiet streets.

2. Get a good night's sleep

You should definitely get enough sleep - give your body the opportunity to gather its strength. Avoid obviously stressful situations, put off clarifying relationships and solving unpleasant issues that can cause stress.

3. Balanced nutrition

• One of the most important points is proper organization. A varied, balanced menu that includes vegetables and will greatly support you during this period.
• You should exclude smoked, salty foods, everything fatty and spicy from your diet, and increase the amount of plant fiber and fresh juices.
• Strong drinks are not helpful these days - alcohol, coffee, black tea, soda. Their use causes unnecessary arousal, increases irritability, and can cause insomnia.
• Honey, dried fruits, and nuts have a wonderful effect on the female body, and in this difficult period they are real saviors.

4. No smoking!

Stop smoking. It not only intensifies PMS; cigarettes are, in principle, incompatible with women's health and beauty.

How to overcome PMS

How can a woman fight PMS? Gather your strength and start following the rules of a healthy lifestyle - all those tips that we hear and read a lot about, but are in no hurry to take advantage of them. They really help relieve PMS:

• Drink more pure water and herbal teas - lemon balm, chamomile, mint, linden. They remove waste and toxins, relieve nervousness, promote good deep sleep;
• cook fish dishes more often, eat a lot of greens;
• take vitamins. For PMS, specially developed vitamin complexes significantly alleviate the condition and relieve pain.

Treatment

However, there are conditions when you cannot cope with it on your own. Qualified medical care is needed; self-medication can not only aggravate an already serious condition, but also cause significant harm to health. What drugs treat PMS?

Even generally healthy women really suffer from PMS from sudden and severe headaches, unexpected increases in blood pressure, and depression.

If the cup of suffering is overflowing, be sure to undergo a full medical examination. It will help to find out the causes and give the right directions for treatment.

Medicines

Sometimes you cannot do without serious medications that only a doctor can select.

Sedatives and psychotropic drugs:

• drugs that eliminate the feeling of increased anxiety - Rudotel, Seduxen;
• antidepressants Coaxil, Tsipramine.

Effective medications for PMS are:

• Duphaston, Utrozhestan;
• contraceptives: , Yarina, Zhanine;
• Danazol is usually prescribed for discomfort in the mammary glands;
• , Zoladex disables ovarian function, which leads to the disappearance of PMS symptoms;
• in the premenopausal period, Dostinex and Parlodel are used.

If you are worried about severe swelling during PMS, diuretics are prescribed; if blood pressure increases, antihypertensive drugs are prescribed.

For severe allergic reactions, antihistamines are used.

Homeopathy is also used to treat PMS. An experienced homeopathic doctor will tell you how to cope with PMS, who will select suitable herbal non-hormonal preparations. For example, Remens or. They effectively restore the balance of hormones, eliminate symptoms of anxiety, nervousness, and fear.

Folk remedies

PMS can be effectively treated with folk remedies. There are many recipes that traditional medicine has created so that women can endure unpleasant symptoms with the least loss.

The following fees will help alleviate the condition and eliminate menstrual irregularities:

• lemon balm and mint take 1.5 tablespoons each; 1 tablespoon each of valerian, jasmine and chamomile flowers. Pour boiling water over everything and cover for 10 minutes. Drink the broth in small sips throughout the day;
• A decoction of 3 tablespoons of chamomile, to which one and a half tablespoons of yarrow and lemon balm are added, has a therapeutic effect. The decoction is taken three times a day.
• gentian and acacia leaves, 2 tablespoons each, pour boiling water and leave for 15 minutes. This herbal tea is drunk during the week preceding the onset of menstruation;
• prepare a mixture of peppermint leaves, lemon leaves, valerian roots, yarrow and chamomile - 1.5 tablespoons of each herb. Pour boiling water over two tablespoons of the mixture and leave in a thermos.

Premenstrual syndrome (PMS) is a pathological condition that is experienced before menstruation by more than half of the population of women and girls. It is characterized by a complex of mental and physical manifestations ranging from vague to pronounced. The causes of cyclic disease have not been precisely established; therapy is aimed at relieving symptoms and stabilizing the functioning of the nervous system. A number of remedies are used for treatment, each of which helps to cope with a specific cause of the ailment.

Forms and symptoms of PMS

There is no single set of signs that distinguish PMS; each woman experiences this condition in her own way. Some suffer severe pain of different localization, others experience mental discomfort, and still others are susceptible to both groups of symptoms. However, some are unfamiliar with the negative sensations before the onset of menstrual periods.

There are two groups of symptoms of premenstrual illness:

1. 1. Emotional and behavioral disorders: outbursts of anger, irritability, tearfulness, feelings of depression, anxiety, sleep disturbances, frequent mood swings, decreased or increased appetite, intolerance to certain odors.
2. 2. Physical manifestations: migraine, pain in the lower back, lower abdomen, in the heart area, dizziness, nausea, loss of strength, flatulence, stool disorders, breast swelling, swelling, numbness of the limbs, changes in blood pressure.

Premenstrual syndrome can be mild, moderate or severe. The first is characterized by the presence of no more than 4 symptoms; in severe cases, a woman experiences up to 12 different manifestations of the pathology. If the condition before menstruation worsens so much that it affects the usual lifestyle and ability to work, it is classified as premenstrual dysphoria.

Cyclic syndrome has four forms, distinguished by predominant symptoms:

• neuropsychic with a predominance of behavioral and emotional disorders;
• cephalgic - characterized by migraine-like pain, nausea, vomiting, dizziness, up to loss of consciousness;
• edematous - characterized by the appearance of swelling of the legs, fingers, face, weakness, swelling of the mammary glands;
• crisis - increased blood pressure, chest pain, tachycardia, panic attacks.

Atypical forms of PMS are identified, accompanied by fever, an irresistible desire to sleep, and unilateral weakening of the body muscles.

Drugs to treat the syndrome

Treatment is prescribed depending on the form, symptoms and severity of the syndrome. For mild and mild manifestations, vitamin complexes, homeopathic, sedative herbal remedies, and magnesium preparations help. Among them are drops and tablets for PMS:

1. 1. Magne B6. Relieves nervous tension, soothes migraines, pain in the lower abdomen, normalizes sleep, mood, removes swelling and muscle spasms.
2. 2. Mastodinon. Homeopathic medicine, normalizes the menstrual cycle, relieves mental stress, swelling, headaches.
3. 3. Cyclodinone. The active substance is a dry extract of common twig fruit. The medicine regulates the level of female sex hormones and is prescribed to treat irregular menstrual cycles, PMS, and breast tenderness.
4. 4. Remens. Homeopathic remedy in the form of tablets or drops. Regulates the cycle, reduces bleeding during heavy periods, reduces the intensity of psycho-emotional manifestations during PMS and during menopause.

For increased nervousness, anxiety, and irritability, sedatives are used:

1. 1. Glycine. A remedy for improving brain function, relieves nervous tension, helps normalize sleep without causing lethargy.
2. 2. Preparations based on valerian. They relieve irritability, normalize sleep, and have a calming effect. With prolonged use or in large doses, they reduce concentration and are therefore contraindicated for drivers.
3. 3. Peony extract. A sedative that helps cope with anxiety and fear during PMS, it is contraindicated for people whose work requires attention and good reaction.
4. 4. Sedavite. A herbal preparation containing herbs and vitamins. Eliminates feelings of fear, normalizes sleep, and has a mild antispasmodic effect.
5. 5. Relaxil. Herbal sedative. Eliminates anxiety, nervous excitement, helps with sleep disorders.

Pain Remedies

To relieve pain during PMS, painkillers based on paracetamol, ibuprofen, aspirin (non-steroidal anti-inflammatory drugs) or antispasmodics are used. Names of drugs:

These medications are taken 1-2 tablets 3-4 times a day for no more than 4-5 days. If the pain does not stop, further treatment should be agreed with your doctor. NSAIDs and antispasmodics are not recommended for impaired kidney function, liver function, gastric bleeding, high blood pressure, or heart failure.

Analgesics also help with pain: analgin, Baralgin, Novalgin, Minalgin and others.

Hormones and antidepressants

For a woman suffering from moderate to severe cyclic illness, contraceptives with female sex hormones are used, which are effective against physical symptoms of PMS (pain, tension in the mammary glands), but are useless for psycho-emotional disorders. The best oral contraceptives for the treatment of premenstrual syndrome:

Hormonal contraceptives normalize the monthly cycle, regulate the intensity of menstrual bleeding, relieve swelling and abdominal pain. Contraindicated in heart failure, severe hypertension, headaches of unknown etiology, cerebral vascular pathologies, diabetes mellitus, predisposition to thrombosis, chronic liver and kidney diseases, malignant tumors.