Why the PMS myth is bad for women

"I could have PMS, you could have PMS, my dog could have PMS."

"I could have PMS, you could have PMS, my dog could have PMS." Photo: Stocksy

Your dog or the guy next to you could have PMS.

Well, that's assuming you think of PMS as being the tendency to go a bit nuts once a month.

In a new TED talk, American psychologist Robyn Stein DeLuca, addresses the myths of PMS.

One such myth is that 80 to 90 per cent of women suffer from it.

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But, we don't even know what "it" is, DeLuca argues.

"You would think there must be a mountain of research verifying the widespread nature of PMS," she says. "However, after five decades of research, there's no strong consensus on the definition, the cause, the treatment, or even the existence of PMS."

She says the common - and extremely vague - definition is that the menstrual cycle throws women onto a hormonal roller-coaster of irrationality and irritability. The effect might be physical, psychological, or behavioural. 

"But here's where it gets tricky," DeLuca says. "Over 150 different symptoms have been used to diagnose PMS ...

"Now, I want to be clear here. I'm not saying women don't get some of these symptoms. What I'm saying is that getting some of these symptoms doesn't amount to a mental disorder, and when psychologists come up with a disorder that's so vaguely defined, the label eventually becomes meaningless. 

"With a list of symptoms this long and wide, I could have PMS, you could have PMS, the guy in the third row here could have PMS, my dog could have PMS."

She says part of the problem is that researchers have not agreed upon specific characteristics that constitute the condition.

Instead, PMS has been redefined as  Premenstrual Dysphoric Disorder (PMDD) in  the Diagnostic and Statistical Manual of Mental Disorders (DSM).  

"Dysphoria refers to a feeling of agitation or unease," DeLuca says. 

To be diagnosed with PMDD a woman must experience at least five of 11 possible symptoms in the week before menstruation starts; the symptoms must improve once menstruation has begun; and the symptoms must be absent the week after menstruation has ended. 

"One of these symptoms must come from this list of four: marked mood swings, irritability, anxiety, or depression," DeLuca says. "The other symptoms could come from the first slide or from those on the second slide, including symptoms like feeling out of control and changes in sleep or appetite ...

"Using this criteria and looking at most recent studies, we see that on average, 3 to 8 per cent of women suffer from PMDD."

A far cry from 80 to 90 per cent.

What's the big deal with this?

DeLuca argues that blaming emotional fluctuation on PMS has problematic side effects. 

"The label of PMS allows women to express emotions that would otherwise be considered unladylike," DeLuca says. 

"The near universal definition of a good woman is one who is happy, loving, caring for others, and taking great satisfaction from that role. Well, PMS has become a permission slip to be angry, complain, be irritated, without losing the title of good woman.

"'Oh, that's not who she is. It's out of her control.' And while this can be a useful tool, it serves to invalidate women's emotions. When people respond to a woman's anger with the thought, 'Oh, it's just that time of the month,' her ability to be taken seriously or effect change is severely limited."

DeLuca also suggests that women are taken advantage of with the "PMS" label: PMS is a profitable business with thousands of books as well as clinics, workshops and seminars aimed at "treating" it.

"The PMS myth keeps women from dealing with the actual issues causing them emotional upset," DeLuca says. "Individual issues like quality of relationship or work conditions or societal issues like racism or sexism or the daily grind of poverty are all strongly related to daily mood."

She notes that studies have found that men and women tend to experience similar natural fluctuations in mood over the course of a month.

"Sweeping emotions under the rug of PMS keeps women from understanding the source of their negative emotions, but it also takes away the opportunity to take any action to change them.

"So the good news about PMS is that while some women get some symptoms because of the menstrual cycle, the great majority don't get a mental disorder."