The young patients of secondary amenorrhea, dysmenorrhea, premenstrual syndrome (PMS) and premenstrual dysphoric disorders (PMDD) have increased in recent five years. We also examined 66 cases of secondary amenorrhea, 118 cases of dysmenorrhea, and 281 cases of PMS & PMDD in recent five years. 57 (48.3%) cases of dysmenorrhea were in the teens, 19 (28.8%) cases of secondary amenorrhea were in the twenties and 20 (30.3%) cases of secondary amenorrhea and 126 (44.8%) cases of PMS & PMDD were in the thirties. When they were diagnosed by DSM-5, 115 (97.5%) cases of dysmenorrhea and 57 (48.3%) cases of secondary amenorrhea belonged to the somatic symptom group, and 81 (28.8%) cases of PMS & PMDD to the depressive disorders.

When they were sorted into four groups from a psychosomatic view, 110 (93.2%) cases of dysmenorrhea were in the somatic type, 26 (39.4%) cases of secondary amenorrhea were in the psychosomatic type and 99 (35.2%) cases of PMS & PMDD were in the depressive type. 31 (26.3%) cases of dysmenorrhea and 27 (40.9%) cases of secondary amenorrhea were treated by hormone therapies. 25 (37.9%) cases of secondary amenorrhea were treated by counseling therapy. 257 (90.9%) cases of PMS & PMDD were treated by Kampo medicine. 53 (18.9%) cases of PMS & PMDD were treated by antidepressants. Prognoses : 60 (90.9%) cases of secondary amenorrhea, 103 (87.3%) cases of dysmenorrhea and 214 (76.2%) of PMS & PMDD were improved.

Primary amenorrhea is defined as having no menstruation at the age of 18. There are various causes of primary amenorrhea. Chromosomal abnormalities occupy about 40% of the causes. Turner syndrome and androgen insensitivity syndrome are representative cases. In the former, the sex chromosome is XO and short stature is a characteristic example. In the latter, the sex chromosome is XY. About 15-20% of primary amenorrhea is caused by uterine and vaginal disorders, which lack uterus and vagina, namely Rokitansky syndrome.

It is essential to pay extreme caution at the time of explaining the disease to patients and their relatives. Explanation depends on the causative disease of amenorrhea but the following are common points to be stressed : 1) inability to expect fertility, 2) need of continuous hormone replacement therapy, 3) no hindrance in sexual life with a partner. It is crucial to have a number of occasions to explain. It is important to consider age of the patient and select appropriate words. A medical practitioner should transmit the correct concept of the disease and take appropriate measures based on the basics of psychosomatic medical care while supporting the patients to have the gender identity as a female.

Secondary amenorrhea in the context of psychosomatic medicine has two important aspects : one is “amenorrhea induced by psychosomatic diseases or treatments thereof”, and the other is “the effects of amenorrhea on the psychology of adolescent women.” The former is represented by functional hypothalamic amenorrhea (FHA) and drug-induced amenorrhea, and the latter by primary ovarian insufficiency (POI). In FHA, the pulsatile release of gonadotropin releasing hormone in hypothalamus is disturbed by either excessive psychosocial stress, weight loss, or exercise, or any combination of those, leading to secondary amenorrhea. The most complex cases of FHA are those of anorexia nervosa. The drugs that could induce amenorrhea most frequently by elevating serum prolactin levels are typical antipsychotics. On the other hand, the psychological burdens and their management in POI women are not usually paid much attention. However, the effects of abrupt decline in serum estrogen on the mood of women with POI should be taken into consideration in the clinical practice of psychosomatic medicine, as well as their anxiety towards the disorder in their menstrual cycles.

Secondary amenorrhea is defined as the cessation of regular menses for a period of three months or the cessation of irregular menses for six months. Except for menstrual suppression, which purposely ceases menstruations for relief of menstrual-related symptoms or management of medical conditions, drug-induced amenorrhea includes hypothalamic amenorrhea due to hyperprolactinemia and ovarian amenorrhea after cancer treatment.

It is well-recognized that antipsychotics, also known as neuroleptics, and antidepressants can cause hyperprolactinemia. In cases of medication-induced hyperprolactinemia secondary to medication use, the preferred approach is to discontinue or change the offending causative drug. Therefore, discussion among psychiatrists and gynecologists about treatment strategy for each patient is essential.

As chemotherapy-induced amenorrhea, alkylating agents are the most common medications associated with ovarian dysfunction. Such cases are sometimes irreversible and lead to primary ovarian insufficiency, which causes infertility along with prolonged effects of estrogen deficiency. In order to keep the patient's quality of life, embryo cryopreservation and hormonal replacement therapy are performed, depending on the patient's underlying condition.

Menstruation-associated symptoms which are not caused by any organic lesions are classified into primary dysmenorrhea and premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD). The former occurs during the menstrual flow and the latter during the luteal phase of the menstrual cycle. Both of them are repeatedly induced by hormonal fluctuations of the normal ovulatory cycle, affecting the quality of life of reproductive-aged women. Low dose estrogen-progestins are effective options for primary dysmenorrhea as well as PMS/PMDD, while the etiology is different between them. Menstruation-associated diseases, including endometriosis, are regarded as “modern diseases” that have been brought about by the changes in women's lifestyle toward the decline in birthrates. To promote the mental and physical health of reproductive-aged women, they should be aware that they can control menstruation instead of enduring it and be provided with healthcare measures in modern style.

Objectives : The purpose of this study was to elucidate the food preferences of patients with anorexia nervosa (AN) and develop an accurate nutritional care plan.

Method : A total of 29 patients with AN (patient group), who were admitted to the departments of psychosomatic medicine or psychiatry, were surveyed with regard to their food preferences. We performed a questionnaire-based survey that recorded their responses regarding 420 food products and processed food items. The response options were “like” or “dislike”, “can eat” or “cannot eat”, and “I do not know” for food items the respondents were not familiar with. Their responses were compared with those of 49 healthy students (controls).

Results : In terms of preferences for food products, significantly fewer respondents in the patient group responded “like” and “can eat,” mainly regarding staple food, meat, and oil and fat ; thus, these patients tended to avoid high-calorie food items. Food items to which more than 80% of patients responded “can eat” included salmon, chicken, yogurt, and many vegetables and fruits. In the patient group, the proportion of responses indicating that the respondent “can eat” a food item was lower than that of responses indicating preference (“like”). A significantly lower proportion of patients responded with “can eat” when asked about 19 processed food items, such as egg sandwich and fried chicken.

Conclusion : A therapeutic diet tailored to patient preferences was developed based on the results of the survey. An improvement in symptoms is expected once the patients are able to ingest even small amounts of food.

Home oxygen therapy (HOT) does not necessarily improve their quality of life of the patients with chronic respiratory disease because most of them suffer from depression, anxiety and other comorbid symptoms derived from their dyspnea.

This paper reports the effectiveness of self-monitoring and autogenic training for relieving the patient of his dyspnea, anxiety and irritability with chronic respiratory failure derived from interstitial pneumonia after providing home oxygen therapy and attending pulmonary rehabilitation. Four months treatment substantially mitigated the symptoms of dyspnea, anxiety and irritability and enabled him to live without HOT.

Our approach appeared to comprise of the subset of cognitive behavioral therapy (CBT) for chronic obstructive pulmonary disease (COPD), and the clinical course of this case appeared to elucidate the essentials of efficacy of CBT.

Our approach is superior to that of CBT with respect to demand for less time and expense. We expect that more and more patients who are in similar conditions have our treatment and should evaluate its efficacy for the patients.