In the US culture, premenstrual syndrome (PMS) is made to be a Big Fucking Deal. From advertisements for premenstrual dysphoric disorder (PMDD) drugs, to casual conversation among females, it is inundated into our lives as normal. “It’s almost as if, given cultural expectations that they will behave badly, they decide to go along with it in order to behave in the ways normally inaccessible to them, [like] being bossy, irritable [or] bold,” said Kathryn Clancy in Is PMS a Myth?
I believe in the placebo effect. In my pharmacy career, I was always fascinated when reading drug inserts and seeing that a percentage of those on the placebo drug (an inactive tablet that looks like the real drug, but is just fillers and/or sugar) reported improvement in the drug studies. There is also the flip side – people taking an inactive “medication” reported side effects (called the nocebo effect). It was most definitely not the “drug” giving them headaches, fatigue, or depression – yet the patients are believing it is. Could the behavioral symptoms of PMS be attributed to other causes in our lives, and PMS be the convenient scapegoat?
The Mayo Clinic lists the following symptoms for PMS.
Emotional and behavioral symptoms
- Tension or anxiety
- Depressed mood
- Crying spells
- Mood swings and irritability or anger
- Appetite changes and food cravings
- Trouble falling asleep (insomnia)
- Social withdrawal
- Poor concentration
Physical signs and symptoms
- Joint or muscle pain
- Weight gain related to fluid retention
- Abdominal bloating
- Breast tenderness
- Acne flare-ups
- Constipation or diarrhea
Some of these seem legit, like breast tenderness, weight gain from fluid retention, and acne flare-ups. But what about the rest – specifically, the behavioral symptoms? Does PMS really cause depression, tension or anxiety? Perhaps women are expecting to have these symptoms because it’s a product of the culture they’ve grown up in. This study found that in terms of mood, PMS may just be “more science-fiction than fact”.
Over 100 randomly selected healthy Canadian women who were unaware that the study was about mood and the menstrual cycle were given smartphones and asked to record their negative and positive moods over a period of six months—providing the researchers with real-time mood data. At the end of the study, the MiDL team found that in a healthy population blinded to the purpose of the study, physical health, perceived stress, and social support were much stronger predictors of mood than any menstrual cycle phase.
One of the experts who participated in a meta-analysis study explains
“There is so much cultural baggage around women’s menstrual cycles, and entire industries built around the idea that women are moody, irrational — even unstable — in the phase leading up to menstruation”
“Our review — which shows no clear evidence that PMS exists — will be surprising to many people, including health professionals.”
Do you have a “real self” and a “pms self” as psychologist Joan Chrisler is quoted saying in Is PMDD real? “[PMDD] undermines women’s self-concepts and feeds into stereotypes about women. It’s convenient for women to use this… The discourse is me, not me, my real self, my PMS self. It allows you to hold onto a view of yourself as a good mother who doesn’t lose her temper.” This was when I realized that I’d been using PMS as an excuse. If I lost control of my emotions, I rationalized it away as PMS. It wasn’t me, it was that other me. Thinking of those in my life who have at one point or another seen me in that state filled me with shame. I might explain my behavior away, but will they?
Armed with this new knowledge, I decided to experiment. For three months, I convinced myself that PMS and periods are no big deal. Just a normal part of daily life, like pooping or having a runny nose. When I felt anger or frustration, I reminded myself that it’s not some disorder causing it, and that I can control myself. Oddly just having that thought seemed to make the negative emotions dissolve. I kept doing the techniques listed in my Managing Conflict post when needed. As a result, there were months of unremarkable menstrual cycles.
It does take constant mindfulness, especially in the beginning. Last month I didn’t revisit my research on this topic, and found myself falling into old habits. After a couple of days of snappish behavior, I caught on to what I was doing and acknowledged to Jesse that I need to do better. He could tell I’d been feeling overly irritated, and had been keeping his distance (I tell you – everything I feel shows on my face). I sure don’t want to be an irrational victim of my hormones. Come to find out, my calorie intake was too low in January, and that may have had more to do with the irritation than PMS.
I leave you with one final study, which suggests that women are “not passive PMS sufferers [Italics added]”. Self monitoring, awareness, avoidance of stress, and care of the self will help not only with PMS, but in your day-to-day life.
So cheer up bitch, it ain’t that serious.