PMS and why it’s bad for us

In the last couple of weeks I have read two books which have covered PMS and the way it is used to control women.  I hadn’t really thought about it before and I think it’s something we need to be more aware of.

First, I am not talking about PMDD – premenstrual dysphoric disorder – which is a debilitating depression.  Instead I am talking about PMS – premenstrual syndrome – which is a label often used by society to limit or belittle women and our emotions.  PMS tends to refer more to the milder symptoms of bloating, fatigue and anger that most women experience.

Secondly, this isn’t really about the changing ideas around what a period is and how symptoms might be managed although I would like to do a post around that at some stage.

Another aside, when I am talking about women, I am referring to anyone who menstruates.  I am aware that not all people who menstruate are women and not all women menstruate however my hands cannot cope with typing that all out each time cos chronic pain fun… As much of this is about how other people view PMS, much of the research and reading is centred on women as it is generally perceived that women make up the majority of people who menstruate.  This is mostly around perception of menstruation than the actual person who may or may not be bleeding.

I’m going to start with a clearer definition of PMS as it’s something that gets thrown around A LOT.

“Though there is no blood test to confirm the presence of PMS, the diagnosis is calculated clinically just like depression or bipolar disorder.”
– Altman

The upshot is that you cannot just say you have PMS.  You need to have specific symptoms at specific points in your cycle and it has to be a regular thing.  The pre in premenstrual syndrome is important.  The times in the cycle that you’d be experiencing symptoms are a couple of weeks before you start to bleed through till a couple of days after your period begins.  It is important to note here that that gives a wide berth.  Half a woman’s year could be covered by PMS.

Society also affects our understanding or even existence of symptoms around periods.  For example, the ancient greeks didn’t note any mood changes with periods but did not physical changes such as breast tenderness.  Statistics around PMS also vary from culture to culture.  A World Health Organisation study from 1981 highlights this, reporting that only 23% of women in Indonesia described themselves as having premenstrual mood changes whereas for the former Yugoslavia it was 73%.  The study concluded that “socially mediated expectations and beliefs determine the incidence of premenstrual syndrome.”

In fact, according to Michael Stolberg (from Altman’s book) the idea of menstruation and what is happening affects our experiences of PMS:

“Like any disease, people give meaning to the symptoms, and those meanings can be personal, they can be cultural, and they change with time.”
– Stolberg

This means that the symptoms themselves can vary from culture to culture as well:

“World Health Organization surveys indicate that menstrual cycle-related complaints (except cramps) are most likely to be reported by women who live in Western Europe, Australia, and North America. Data collected from women in Hong Kong and mainland China indicate that the most commonly reported premenstrual symptoms are fatigue, water retention, pain, and increased sensitivity to cold. American women do not report cold sensitivity and Chinese women rarely report negative affect.”
– Joan Chrisler and Paula Caplan

Altman goes on to discuss periods in the 16th century which were understood to be the body getting rid of toxins and the associated symptoms such as cramps were due to the fact that the toxins were particularly nasty.  Headaches might arise because of excess blood being collected from the body.

Jumping forward a few centuries, we arise at premenstrual tension – PMT – was described in 1931 by Robert Frank and linked symptoms such as irritability, bloating, pain, depression, nervousness, restlessness and the “impulse for foolish and ill considered actions” with the ovaries.  It was this same decade that Karen Horney said that the mood swings that came with periods were primarily a problem for childless working women and came about because they were suppressing their natural desire for a child.

The idea of periods and how they impaired women has also changed over time, often to reflect the changing ways in which women were oppressed.  Menstruation was used to argue against women learning, becoming doctors and whether we should be able to vote or not.  Essentially, periods are the go to anytime you want to subjugate women.

Then, in the second world war, things changed.  Suddenly women were needed in the work place and so the entire rhetoric around periods flipped.

“Women suddenly looked up to Rosie the Riveter with her biceps flexed.  They were told that they were strong, agile and dexterous – their periods and premenstrual pains couldn’t stop them from doing anything.  Even informational videos were made to teach women that premenstrual suffering was nothing more than folkloric balderdash.”
– Altman

But change didn’t last long and following the end of the war, at the same time as men were returning to their jobs, studies came out about the importance of women in the home, the dangers of workplaces to unborn children and the women carrying them.  Studies also alleged to show that women’s periods made them less competent than male workers.

It was in this era that along came Katharina Dalton, in 1953, with PMS.  Dalton was a gynaecologist who had carried out studies which showed that premenstrual women were at risk of becoming shoplifters, child abusers, violent and even murders.  Obviously, this would not be ok at work, even if you suffered from symptoms at the other end of the spectrum where weakness, poor decision making and xxx lay.  She suggested that during certain times of the months, women in the workplace should be given less skilled jobs so that they didn’t screw up important tasks.  According to Dalton, we couldn’t even be expected to go shopping successfully as we’d end up buying dresses of the wrong colour or fit…

Dalton went further than the workplace and laid out the risks involved in the family and even when it came to hobbies.  One should avoid racket sports because of arm weakness, poorer vision and slower movement.  Dressmaking wasn’t safe as you might cut out pieces from expensive fabric only to find you’ve spoilt it.  Even driving was a risk, and not just for the driver with PMS, it was a risk to be a passenger with PMS – “in the few seconds between a car climbing a kerb and before it hits a wall an alert passenger may brace herself and cover her head for protection, but the passenger in her paramenstruum may be too slow to take even these elementary precautions.”  Presumably then too, any woman with PMS must also avoid walking near cars, cycling and climbing ladders because who knows how delayed reactions might affect them.

As if that wasn’t enough restriction in your life, it seems too that you should avoid being the sole carer for children as you might not notice that they are in danger and if you do, you may not be able to react quick enough.

“As proof of this, Dalton cites a 1970 survey of children who were admitted as emergencies to the North Middlesex Hospital in London; 49% of the mothers were in their paramenstruum on the day the child was admitted.  But if the paramenstruum is defined as the week before your period is due plus the week of your period – in other words, two weeks out of every month – wouldn’t it make sense that 50% of all women would have to be in their paramenstruum at any given time, whether in casualty or in the street?”
– Houppert

Hopefully opinions around PMS have changed somewhat today but why then, do we have so many women justifying their behaviour by saying they’re PMS-ing or men blaming PMS for our emotions?  Well, for one it’s convenient.  As women we are still stereotyped to be gentle and giving and to care for others so when we explode from time to time and our behaviour defies this image, it’s handy to have an excuse.  And as PMS is so culturally engrained, who would question that?

“the term has become a convenient catch-all for women’s complaints, a way of discounting women’s anger – and often their legitimate concerns – by attributing their dissatisfaction to hormones.”
– Houppert

In the many years since Dalton labelled a set of symptoms PMS, it has become a short hand for an irrationally angry woman.  And through that, has legitimised the idea that women’s concerns or frustrations need not be taken seriously.

“We’ve decided to tip the balance towards the physiological because potions and cures are easier to come by than social transformation… Blaming women’s anger on PMS lets society off the hook”
– Houppert

Basically, wherever you are in your cycle, your emotions and feelings are valid and no one should be using PMS as a way to ignore, invalidate or mock you.

By lumping period related cycles under PMS, it also seems to have let the medical profession off the hook.  So many times when you go to a doctor with concerns about your periods and the associated symptoms, it’s dismissed as just PMS.  Additionally, there hasn’t been much research into PMS, especially when compared to male health issues such as erectile dysfunction… By saying, “it’s just your hormones”, partners, parents, doctors and so on get away with saying and doing things that wouldn’t be considered ok in other circumstances.

Before I end, I want to be clear that if you are experiencing symptoms around your period, it may be best to speak to a doctor.  What is normal for one person isn’t necessarily for another.  And just because PMS as a label may have abused, it doesn’t mean that the symptoms that fall under it’s umbrella are not serious.

Further reading

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