This is a syndrome in women, characterised by irregular intermittent bouts of generalised swelling. Sometimes the ﬂuid retention is more pronounced before the menstrual period (see MENSTRUATION). The eyelids are puﬀy and the face and ﬁngers feel stiﬀ and bloated. The breasts may feel swollen and the abdomen distended, and ankles may swell. The diurnal weight gain may exceed 4 kg. The underlying disturbance is due to increased loss of ﬂuid from the vascular compartment, probably from leakage of protein from the capillaries increasing the tissue osmotic pressure. Recent evidence suggests that a decrease in the urinary excretion of DOPAMINE may contribute, as this has a natriuretic action (see NATRIURESIS). This may explain why drugs that are dopamine antagonists, such as chlorpromazine, may precipitate or aggravate cyclical oedema. Conversely, bromocriptine, a dopamine agonist, may improve the oedema.
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