Women academics who say PMT is all in your mind
What’s more, they argue it’s a myth peddled by men to keep us down. Hokum? Read their intriguing evidence
WITH nine out of ten women claiming to be sufferers, no wonder it’ s long been accepted that premenstrual syndrome will afflict us at some point in our lives. Indeed, from adolescence onwards we are told to expect a few days every month when we will feel irrationally weepy, snappy and unable to cope with what life has to throw at us. But is that really the case? Increasingly, there’s an argument that PMT — or premenstrual syndrome (PMS) as it is now known — is little more than a figment of our imagination. One respected health psychologist, Robyn Stein DeLuca, goes so far as to say that PMS is really just evidence of modern women struggling under the burden of trying to have — and do — it all. Put bluntly, it’s an excuse for women to get a break.
‘Growing up, when we become women, we are told in books, on the internet and in magazines that PMS is out there. We internalise this idea that our bodies must be faulty,’ she says.
‘The medical community is also to blame. We see this again and again that normal life stages, such as pregnancy and childbirth, are treated as sicknesses that have to have some kind of intervention.
‘That perspective encourages women to think of their bodies as instruments that
cause illness. But it’s more likely that women feel overwhelmed.
‘Women are expected to do a lot of things these days — we work, take care of families, we make sure everyone’s health is OK, we make the Christmas dinner and a lot of women use PMS as a release valve or if they just can’t give any more.
‘You lose your good woman crown if you say: “I just don’t feel like doing this right now,” and relinquish your responsibilities. But if you say it’s PMS, it’s like a get- out- of-jail-free card. It’s women’s excuse for when they need a break.’
It’s a view that will surely have many women howling in outrage.
BUT, as DeLuca explains i n her new book, The Hormone Myth: How Junk Science, Gender Politics And Lies About PMS Keep Women Down, there is scientific evidence that our hormones don’t affect us as much as we might imagine.
‘ Reproductive events l i ke our monthly menstrual cycle, pregnancy or the menopause don’t mentally destabilise us,’ she says. ‘ Most women function at a very high level throughout their lives.
‘While hormones do cause some physical and emotional symptoms — women can get cramps, bloating and feel depressed — they certainly don’t affect us emotionally to the point that it’s a big deal. That’s where the myth is. That’s where it’s not true.’
So where did the PMS ‘myth’ come from? It seems that doctors in as far back as the mid 1800s were writing articles connecting ‘ hysteria’ and women’s emotional state with their periods. The phrase ‘premenstrual tension’ was first coined in 1931, and the term premenstrual syndrome some 20 years later.
Subsequently, there were many psychological studies claiming to uncover how badly women were affected by hormonal changes.
However, DeLuca claims all the psychological studies done on PMS from the fifties to eighties had very poor methodology — for example, they failed to use control groups so they could compare one group with another — and defined PMS far too loosely, citing nearly 150 symptoms linked to hormonal changes.
‘ They were symptoms anyone could have — headaches, feeling tired or cranky — but everyone feels those things some of the time,’ says DeLuca.
She believes the real number of women affected by PMS and other hormonal changes is substantially lower — between 3 and 8 per cent, according to the latest studies, she says, rather than the commonly held figure of 90 per cent.
‘A minority of women do have hormone fluctuations that cause them to suffer serious trouble so they can’t function or work effectively. This is known as premenstrual dysphoric disorder (PMDD). The criteria for PMDD is much more strictly defined — there are only 11 symptoms to choose from, such as insomnia, difficulty in concentrating or a marked change in appetite.
‘Women have to have at least five to be defined as suffering from PMDD. And they should be treated. But for the rest of us, it’s an alteration in mood that has little to do with hormones.’
Why, then, are women so wedded to the idea that we’re slaves to our hormones? DeLuca believes the idea of PMS being a debilitating disorder is drummed into us when we are teenagers — and we quickly latch on to it, using it as an excuse for a wide range of symptoms.
DeLuca doesn’t just blame women for the PMS myth, however. She also says the syndrome is perpetuated by men to invalidate women’s anger — to stop them from succeeding.
‘If a woman is angry or complaining, men can just attribute it to her time of the month,’ she says.
‘Throughout time, men have used PMS, or the idea that women are hormonal lunatics and have mercurial moods, to keep them out of power. It keeps people from thinking women should be leaders. After all, how can we let women make big decisions or be dependable when their crazy hormones can strike at any time?’
In short, says DeLuca, blaming a woman’s hormones is the easy — or even lazy — answer to any ill. In pregnancy, we’re told they give us baby brain and we can’t function cognitively. In menopause, they affect our memory and give us mood swings. When we give birth, they give us postpartum depression.
‘Memory tests done, however, show very small differences between pregnant and non-pregnant women when it comes to memory,’ says DeLuca.
‘We attribute our behaviour to what we have learned. And as for hormones causing postpartum depression, that’s the biggest myth of all. The largest predictor of whether a woman is going to have it is if a woman was depressed before she has the baby. Overwhelming research says it has nothing to do with hormones.’
DeLuca is certainly not alone in her views. Sarah Romans, professor of psychological medicine, is another female academic who wholeheartedly agrees with DeLuca’s theory that PMS is little more than a dangerous fiction.
PROFESSOR Romans conducted a review in 2012 to examine the prevailing research on PMS and concluded that out of 47 studies, nearly 40 per cent of them f ound no association of mood with a woman’s menstrual cycle.
‘We weren’t looking at women who claimed to have PMDD, which is a very severe disorder, but instead the general population. We discovered women who kept a diary day-by-day were experiencing mood changes all over the month, not just connected to their cycle,’ she says.
‘To claim women turn into premenstrual wrecks suggests a woman is nothing more than her biology and the political ramifications of this are enormous.
‘Indeed, would you say that about a man? After all, men have a reproductive aspect to their function, but we don’t say t hat because t hey may be more testosterone- driven at certain times of the month, they may not have good judgment and we should keep them out of decision-making roles in the same way people say that about women.’
Li k e DeLuca, Professor Romans believes women are raised to use PMS as a cause for life’s woes — something she sees more and more with the rise of the ‘ Sandwich Generation’, women who juggle work, raising children and elderly parents.
‘Clinically, women all the time say: “I’m feeling depressed — I don’t know whether i t’s my hormones.” But the reality is they are overloaded with work, have ailing parents and kids to look after and a myriad reasons why they might be depressed, and yet they immediately think it’s hormonal.
‘And their husbands think it, too. It’s extraordinary.’ So what’s the answer? DeLuca is emphatic — no matter how weepy you might f eel as your period approaches, she believes women need to stop perpetuating the myth of PMS and address the real issues that are troubling us.
‘Instead of using PMS as a way to get a break, women need to turn round and tell their partners and families to do the food shopping or to pick up their socks or just to do more and help,’ she says. ‘ Women need t o be more generous with themselves. If they are angry or upset, they shouldn’t just blame it on PMS, but they have reasons to be moody and angry and they should express their anger and own it.
‘It’s an opportunity to give themselves some space to think about what’s going on in their life — whether it’s their job, family, their interactions with people.
That’s much more likely to be the issue than their hormones.’
Yet others remain unequivocal about its existence.
Professor John Studd, a consultant gynaecologist who runs the London PMS and Menopause Clinic and treats about eight to ten women a day with PMS, insists: ‘PMS is a very real and distressing disorder, and it’s so obvious because it happens at the same time every month. Yes, the range of PMS symptoms may be large and extend from depression, anxiety and anger to exhaustion and loss of libido, but the research is not vague or unscientific and has been thoroughly proven.
‘It is clearly connected to a woman’s menstrual cycle with the symptoms usually starting seven to 14 days before a period starts, and ceasing when it comes.’
The cause, Professor Studd says, is usually sensitivity to the hormone progesterone. ‘ Some women, we’re not sure why, are more intolerant to their own progesterone than others,’ he says.
After ovulation, progesterone is passed into the bloodstream from the ovaries, which is where problems can begin. While the Pill is often the first line of treatment as it steadies hormone levels, treatment at Professor Studd’s clinic usually involves suppression of ovulation and progesterone via gels containing oestrogen, applied to the skin.
As for the new theory that PMS doesn’t exist, Professor Studd is insistent: ‘If I have a patient with PMS and she has this treatment, she’ll be better in two months, so to say it doesn’t exist is just not true.’