Cramps and abdominal pains, fatigue and insomnia characterize the “package” of disorders which in many are of such intensity as to interfere with normal activities
If premenstrual symptoms (headache, abdominal bloating and cramps, sleep disturbances, lack of energy, mood swings, anxiety, irritability) affect normal daily activities, women, even minors, can contact the family clinic to try to alleviate the discomfort. The clinic is a territorial social and health service, managed by health companies, in which the patient can find a listening space and receive advice. A midwife and a gynecologist will guide and follow her. There is also a cultural mediator for foreign users.
How to log in
You do not need to have a prescription from a general practitioner, access is free and direct (opening hours are on the company website). While the gynecological examination for the diagnostic assessment and the definition of the treatment path usually must be booked: in person on the spot, by calling the secretariat on the phone, by writing an email, in some cases via Cup (contacts can be found online). The services are completely free and with a guarantee of anonymity, at the time of the appointment it is sufficient to present the health card. In some regions (Lombardy, Emilia Romagna, Liguria, Valle d’Aosta, Marche, Campania), however, the ticket is paid for the specialist gynecological visit. There are no age limits. Normally up to the age of 14 the patient is taken care of by the family pediatrician. However, he could also ask for help at the clinic, where under 18s have the right to access without accompaniment and without parental authorization, with absolute guarantee of privacy.
Where are
In Italy they are present about 1,800 family counseling centers according to a census of the Higher Institute of Health in 2019. One for every 35 thousand inhabitants, although “they are recommended in the number of one in every 20 thousand” underlines the Institute. The result is that they are still too few in relation to the health needs of the population (the clinic provides assistance on several fronts: contraception, reproductive health, birth path, cancer screening, psychological support, menopause, sexually transmitted diseases). Most of the clinics have an area dedicated to young people aged 14 to 19, 21 or 24, with spontaneous access, without reservation and free. Even if, in time of Covid, the entrances could be organized by phone or by email. The map of the network of consultants is available on the portal of the Ministry of Health
e: just click on the region of interest to get the list of offices with address and telephone number. The choice of the clinic can be made regardless of the place of residence. If the waiting list is long, the patient can alternatively ask her GP the prescription on a prescription for a gynecological check-up at a public health facility or an agreement with the National Health Service, for which the payment of the ticket is required if you are not exempt for income or pathology.
What do they offer
Therapeutic options are diverse. “90% of women of reproductive age experience mild premenstrual symptoms. On the other hand, 20-30% suffer from it in a more intense form and recurrently 4-5 days up to 14 days before the arrival of the menstrual flow. In this case we speak more properly of premenstrual syndrome “he declares Gloria Bonaccorsi, associate professor of Gynecology and Obstetrics at the University of Ferrara. If the physical and mental ailments are annoying and debilitating they should not be tolerated with resignation or buffered with do-it-yourself. “Avoid self-prescribing anti-inflammatories and painkillers,” he recommends Giorgia Gaia, gynecologist of the pelvic unit of the Asst Santi Paolo e Carlo of Milan. “Also avoid moving from one health facility to another: since the response to treatments is subjective, sometimes more than one attempt is needed. The therapy must be modulated on the individual case and found together with the doctor “. “Options for more moderate cases include supplements, in particular magnesium, chaste tree and B vitamins,” he explains Rossella Nappifull professor of Gynecology and Obstetrics at the University of Pavia “physical exercise, relaxation techniques and in the luteal phase (in the middle of the cycle, when ovulation begins, ndr) a diet rich in fiber and whole grains, low in fat and sugar, with little coffee and alcohol, which together with smoking promote inflammation of the internal tissues “.
If it does not work?
«We move on to therapy with the estroprogestin pill to block ovulation and eliminate hormonal fluctuation »continues Gaia. “You must be suspended for 7 days a month, if the discomfort persists it is considered a ‘continuous intake”. The drug treatment can be accompanied by psychological support. «When there is a strong emotional decompensation we suggest an interview with the psychologist» he says Cinzia Cacciapuotigynecologist of the ASL clinic in Bari. “We do an ultrasound to rule out other pathologies, for example endometriosis, ovarian infections, cysts, fibroids, and if necessary we send the patient to the hospital for further investigation. 40% of the patients we see have PMS but only two out of ten come to us for this reason. Women should know that when the symptoms become disabling they can talk to the doctor to find a solution ».
April 22, 2022 (change April 22, 2022 | 15:18)
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