Premenstrual syndrome (PMS) is a myth, according to an expert who said that social conditioning in Western society makes women falsely attribute their emotions to their hormones.
Speaking on the Clue Hormonal podcast, Jane Usher, a professor of women’s health psychology at Western Sydney University, said that women from other cultures do not report many emotional signs of PMS.
She said that a long-standing ‘pathologising discourse’ – dating back to the 20th century – is the reason many women believe they’re having symptoms.
According to Jane, all women experience emotional distress throughout their cycle, however they will attribute it to their periods if they are pre-menstrual, rather than blaming things like their relationship or work life.
And she added that those in caring relationships are less likely to report symptoms than those in more one-sided partnerships.
Premenstrual syndrome (PMS) could be the result of Western culture and women in ‘supportive’ relationships report fewer emotional symptoms, says a psychologist (stock image)
‘What we know is that symptoms and illnesses are always culturally located,’ she explained.
‘So if you go to different cultures different points in history we have symptom complexes, which is what we see as legitimate illnesses and ways that we report distress.’
She explained that PMS first entered discourse in North America in 1931, when women were diagnosed with ‘hysteria’, which was associated to the reproductive system.
What PMS and does it really exist?
PMS (premenstrual syndrome) is the name for the symptoms women can experience in the weeks before their period.
The phrase ‘premenstrual tension’ was first coined in 1931, and the term premenstrual syndrome some 20 years later.
Symptoms are said to include:
feeling upset, anxious or irritable
tiredness or trouble sleeping
bloating or tummy pain
spotty skin or greasy hair
changes in appetite and sex drive
While experts advise trying to manage symptoms by eating healthily, getting enough sleep and gentle exervcise such as yoga, treatments for more severe cases include taking the contraceptive pill, cognitive behavioural therapy and antidepressants.
There have been psychological studies claiming to uncover how badly women were affected by hormonal changes.
However, in 2012 Sarah Romans, professor of psychological medicine, conducted a review to examine the prevailing research on PMS and concluded that out of 47 studies, nearly 40 per cent of them found no association of mood with a woman’s menstrual cycle.
The NHS recognises PMS as a condition, but says it is ‘not fully understood’ why women experience it, saying only that it ‘may be because of changes in your hormone levels during the menstrual cycle’.
Prior to that, there was ‘no mention’ of the condition in medical history.
‘These notions that women would have psychological disturbance were happening in the UK and US and really had little impact anywhere else in the world. You really see this legacy today’, said Jane.
‘In the UK, US and Australia we have taken up this pathologising discourse around the menstrual cycle.
‘We expect women to be mad or bad or dangerous and women take that up and feel irritable and feel angry and then they blame it on their bodies’.
She said that women in other cultural contexts don’t report emotional signs of PMS at that stage in their cycle, but begin to if they move to Western countries.
‘What we also know is that when women come from cultures where there isn’t a discourse around it move to the UK or the US, they begin to report symptoms.
‘It’s a culture bound syndrome, because it’s a way of attributing anger and distress to their body.
‘Women actually experience anger, depression and distress across the whole cycle.
‘What we know is that when they are pre-menstrual they will attribute it to their bodies, but at other points in their cycle they attribute it to other parts of their lives.’
She revealed women often tell her about an argument with their partner or children when asked about PMS, rather than their hormones or physical symptoms.
Giving a ‘classic example’ of an interview, Jane recalled: ‘She said, “I was standing at the kitchen sink, I was doing the dishes, I had the dinner on the stove, the kids were arguing. I was trying to get them to do homework and I looked out into the garden and my husband was sat drinking a beer”.
‘She told me that was her PMS and she was feeling really, really angry and she yelled and felt really bad about herself.’ And she said “That’s just typical PMS”.
‘I would say that’s more about what’s going on between her and her partner and less about her cycle.’
Jane explained that although women are less likely to ‘self-silence’ when they feel they have PMS, those in supportive relationships report fewer signs of emotional stress.
She told: ‘It might be that in that phase of her cycle that she is less likely to self-silence and be cranky with him.
‘But actually, what’s useful to do is think – maybe it’s about asking for support and getting the partner on board.
‘In fact what we saw that in those relationships, where women have that support, they’re less likely to report signs of pre-menstrual stress.’