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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? How many times have you attributed your bad mood to PMS, only to realize that you're more than a week out from your period? I know I've done it.

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
  • Headache
  • Fatigue
  • 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.” Is blaming your cycle just another way of not taking responsibility of your self, and your actions? "It wasn't the real me" your mind can say, "it was the PMS-me, therefore I can't help it".

What if PMS really is a myth, a no-big-deal, or a day like any other?

Cheer up bitch, it ain’t that serious.


[–][deleted] 15 points16 points  (4 children) | Copy Link

Not to undermine the point of this post (don't use your PMS as an excuse to be a bitch), but I find it difficult to believe that there aren't any mental/emotional symptoms of PMS. I mean, just things triggered from the physical side would be enough to throw me off my game. I know I would be socially withdrawn if I was having wretched cramps and I might be grumpy if I'm fatigued. Not to mention all the changes in hormones...

[–]Kittenkajira[S] 3 points4 points  (3 children) | Copy Link

I mean, just things triggered from the physical side would be enough to throw me off my game. I know I would be socially withdrawn if I was having wretched cramps and I might be grumpy if I'm fatigued.

Would this not fall under normal self-care? I'll just bet you're grumpy when your fatigued on any old day, not just during PMS. Do you allow yourself to be grumpy on those days? Do you socially withdraw yourself when you have a headache, a stomach ache, running nose that just won't stop, or say even a sprained foot (and don't have PMS)?

The point I'm trying to make here is that we've turned it into a "syndrome" that can't be helped, where it really is just normal, everyday occurrences.

[–]Camille113258 points [recovered] (1 child) | Copy Link

This is an excellent point. While hormonal changes can have a physical and emotional affect on a woman, the response that we have does not need to be any different from how we treat ailments and moods at any other time of the month. Almost everyone manages to power through when they have a headache, cold, bad allergies, digestive issues, etc. Yes it can be uncomfortable, but medicine, rest, and self care in general are wonderful solutions that you can work into your normal day.

I think a lot of people are going to fixate on your attempt to downplay the experiences that they have personally gone through. Yes placebo and nocebo effects are real, as is social conditioning, and all of the other factors that you mentioned. But most women are going to trust their personal PMS symptoms more than some studies that attempt to invalidate their perception of reality.

If any woman reading is going through the thought process I just described, can you shift your focus to the idea of holding yourself to the same standard throughout the month? That doesn't mean ignoring any pain or discomfort, but rather addressing it efficiently and continuing as best as possible to handle all of your responsibilities.

[–]stevierose3459 points [recovered] (2 children) | Copy Link

Of course I believe in PMS, but I don’t buy into the idea that excuses bad behavior. It may explain the mood swings and all of the symptoms that go with it that result in irritability, but they are a far cry from temporary insanity. It may excuse an instance of loosing ones temper, but it does not absolve a woman from apologizing for acting like a banshee later. I put this concept into the same category of “I have ADHD so I can’t help it if I don’t get my shit together. (For the record, I also believe that some people are ADHD. I could be a poster child.) The thing is, no one ever heard of ADHD when I was growing up so I had to learn to adapt. I discovered this diagnosis when my own child was tested for it. Because I had learned to adapt, I refused to medicate him and, guess what, he learned to adapt. I am not trying to trivialize PMS. I remember times I felt like I was going to jump out of my skin. Instead I am suggesting finding a way to adapt: Take a brisk walk, soak in the tub, and curl up with a book, etc. for few precious moments of self care that you need to calm yourself down.

[–]BeautifulSpaceCadet9 points [recovered] (10 children) | Copy Link

Anecdotally, I think my PMS is somewhat authentic because

  1. It isn't severe "omg I'm PMSing go kill yourself".

  2. I actually don't even notice when it happens, it's usually the day after.

So I think due to the changing hormones, some attitude changes are a reasonable expectation. I do, however, agree for the most part it is grossly overhyped. I can only speak for myself, but usually I'm just a bit more prone to snapping and definitely to crying. Just something small will get me worked up and then now I'm crying. The next day there is blood in the toilet and I'm calling HB to apologize for the PMS monster the day before. It's usually a good thing to me cuz I'm like "heyooo it's not actually the big deal I made it out to be..sorry babe".

Additionally, I can't say it happens every month. In fact most months I don't experience anything, but the frequency had increased a bit with age. From 14-19 I never understood what girls meant by 'PMS' -- I never experienced anything like what was described at all. In my 20s, it's definitely more an emotional sensitivity than outright aggression or bitchiness.

This whole post is great and reminds me a bit of what we've had past discussions about regarding pregnancy. Women have given birth for thousands of years in caves and fields. Quit hyping yo spoiled ass up about it.

[–]Kittenkajira[S] 3 points4 points  (9 children) | Copy Link

The next day there is blood in the toilet and I'm calling HB to apologize for the PMS monster the day before. It's usually a good thing to me cuz I'm like "heyooo it's not actually the big deal I made it out to be..sorry babe".

This is the kind of thing that popular culture is making out to be normal, and acceptable, but I don't think it should be. You can control yourself so that you don't need to apologize for being a "PMS monster". I did it through mindfulness and recognizing that PMS isn't a big deal, and accepting that I don’t want to be an irrational victim of my hormones. If I feel what may be sad/mad/irritable, it's no big deal, no need to act on it - just another day in life. Being aware of feelings - without trying to label, defend or rationalize them can be enough to calm yourself back down to your usual happy self.

From 14-19 I never understood what girls meant by 'PMS' -- I never experienced anything like what was described at all. In my 20s, it's definitely more an emotional sensitivity than outright aggression or bitchiness.

If anything, isn't this proving the theory? The older you get, the more you hear about PMS, see the commercials for the PMDD drugs, hear your friends complaining about how bad it is... Then your PMS started to escalate. If the hormones really were to blame, then wouldn't your PMS as a teen be worse?

[–]BeautifulSpaceCadet3 points [recovered] (5 children) | Copy Link

I don't necessarily think it proves the theory. A lot about my periods and hormones have changed with age -- cramps have improved, hormonal acne got worse, flow has changed, etc., etc. I don't think my emotional changes are the result of marketing inundation; it's hard to say "hormones + teens = worse", it's just "hormones + teens = different".

I think there is a lot of value in what your saying about the power of using our rational minds to overcome our moods and to not make excuses for them, but at the same time I don't think it's fair to ignore the profound changes our lady chemicals have on our bodies, which does include our brain and moods.

[–]Kittenkajira[S] 4 points5 points  (4 children) | Copy Link

I don't think it's fair to ignore the profound changes our lady chemicals have on our bodies, which does include our brain and moods.

Did you read this source I provided in the OP?

"Surprisingly, a recent review of published articles measuring links between mood and women's menstrual cycles found that only 15% of studies provided evidence of an exclusive link between the premenstrual phase and negative mood."

"The CIHR-funded Mood in Daily Life (MiDL) study examined the extent to which women's daily moods are influenced by their menstrual cycles and by reproductive hormones. 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."

"A subset of the MiDL study measured participants' estrogen and progesterone levels daily for six weeks, leading to two important findings. First, these hormones contributed only slightly to women's moods. And second, it turned out that the amount of time women spent in each menstrual cycle phase varied so much that it wasn't possible to accurately predict women's hormone levels by simply counting back from the start of the menstrual cycle. This suggests past studies that have identified a link between menstrual cycle and mood without measuring reproductive hormones may have incorrectly attributed cultural factors to biology."

[–]BeautifulSpaceCadet2 points [recovered] (3 children) | Copy Link

Right, but they just debunk other studies that may have not been conducted thoroughly and suggest an alternative correlation (or lack thereof), it's good information to be sure. But it doesn't categorically disprove it either.

Actually, you and I just chatted in the IRC about it yesterday or the day before, and I mentioned feeling emotional and checked my cycle to see if I was about to start my period (and I wasn't). Whether or not we have bad moods for no reason, or bad moods caused by menstration, we can still be aware and control ourselves. But saying it simply doesn't exist is a little aggressive IMO.

[–]Kittenkajira[S] 0 points1 point  (2 children) | Copy Link

But saying it simply doesn't exist is a little aggressive IMO.

Why is it such a difficult thing to consider? I noticed in the first reply you did, you said "my PMS" as if it's a possession of yours. Perhaps some are attached to the label "PMS". Think of what I quoted in the OP - "The discourse is me, not me, my real self, my PMS self." To admit that it may not be real would be admitting that your behavior was for some other reason and within your control, and that can be difficult to confront.

I remember us chatting about it, and it's got me surprised with the stance you're taking, since you experienced firsthand how you can immediately attribute behavior to PMS when it's not even PMS.

[–]HieronymusBoschClone2 points [recovered] (2 children) | Copy Link

The older you get, the more you hear about PMS, see the commercials for the PMDD drugs, hear your friends complaining about how bad it is... Then your PMS started to escalate.

See also: Link

[–]BeautifulSpaceCadet3 points [recovered] (1 child) | Copy Link

I don't find that to be an accurate explanation for changes in emotion as it relates to hormonal fluctuations.

[–]sugarcrush 8 points9 points  (0 children) | Copy Link

Honestly, it doesn't matter if PMS is real or not. You have to learn to rein yourself in either way. Are PMSing or pregnant ladies bitchy to their boss? Of course not, because they know their ass will be fired in 2 seconds if they treated them the same way they treated their husband. If you can control yourself for your boss, you can control yourself at home too.

[–]blarggggggggggg 4 points5 points  (3 children) | Copy Link

I wonder what percentage of women with difficult PMS and periods are actually suffering from undiagnosed endometriosis.

[–][deleted] 4 points5 points  (1 child) | Copy Link

I don't think endo contributes to the emotional symptoms of PMS (aside from extra grumpiness due to pain), unless I'm missing something?

[–]gabilromariz 2 points3 points  (0 children) | Copy Link

I think the pain is much much worse than regular period cramps and it would make sense that someone in a lot of pain would have trouble sleeping, prone to crying and so on

[–]gabilromariz 4 points5 points  (0 children) | Copy Link

As far as I'm concerned, yes, claiming PMS is just an excuse for being a bitch. I am far more simpathetic and willing to help if someone being grumpy to me says something like "sorry I was rude, I just have this wicked headache and I just wanna go home"

I'd give them a pill from my purse or something.

I for example realize I have a fair amount of painful cramping on my lower belly before my period. Maybe I'll be more withdrawn and feel more like taking a long bath and going to bed early but it's no excuse for being mean or rude

[–]batalanah 2 points3 points  (1 child) | Copy Link

From experience, there are some cycles where I get extremely fatigued, terrible aches, and and just all around feel like crap. And there's other times were I don't.

The only thing I can really compare it to is being sick. And really, who doesn't get a bit crabby or cranky when they don't feel 100%? Now do I believe that's a good excuse to be a bitch? Hell no. Woman up like the rest of us.

[–]VintageVee29f, engaged, together 2yrs 1 point2 points  (0 children) | Copy Link

PMS is a real thing in my experience. It is absolutely not an excuse to dine out on it and be a cow. I keep myself introverted when I'm due on, because I know I get irritable. I would do the same if I still got regular migraines or something similar.

[–]ElCuloTeAbrocho 1 point2 points  (0 children) | Copy Link

Very, very interesting, I've been saying something similar to my girlfriends all my life, 'don't flash the PMS card when you want to be a bitch'.

[–]littleteafox 1 point2 points  (0 children) | Copy Link

Eh I think it's both depending on the woman. I have physical symptoms than can create emotional ones (I get really tired/lethargic and some acne so end up feeling antisocial and just want to veg, cramps make me feel more grumpy at being in pain) but I've never felt irrational because of it. Also, just because I'm feeling this way doesn't mean other people are subject to it. Usually people can't tell when I am PMSing.

[–]Shroom_Toad 1 point2 points  (0 children) | Copy Link

No. I know this is 5 years old but I’m experiencing PMS right now I think. And the emotional side effects, piled on with the rest of life, and I’m already someone who deals with chronic depression, is making it 10x worse than it would be if life were more balanced. The other day I became so irrational and impulsive I almost took a knife and jabbed myself. 9/10 times I’m a calm, rational person who has plenty of self control, and for the first time ever I just blew up irrationally on one of my closest friends. Someone I love who is very near and dear to me and normally I wouldn’t wish anything bad on them. But today? I did that.

Something small happens and i fly off the handle or start crying. I cried this morning because my grandma forgot to feed the cats before she left, meaning I was gonna be late for class. Something I normally wouldn’t cry over. It’s real.

[–]HooterTooterShooter 0 points1 point  (0 children) | Copy Link

yes.

[–][deleted] 0 points1 point  (0 children) | Copy Link

I've had years of severe PMS symptoms. I was insecure, bitchy and just wasn't fun to stand around. This all started when I replaced the pill with a copper IUD.

PMS was a real problem for me, because I would start to cry because of nothing and made a scene out of nothing. That was a real pain in the ass.

Seriously ladies, if you have a problem with PMS, talk to your gyn about it. I did and got a prescription for vitamine B6 which did the deal for me.

I think PMS can be a real problem, but there are ways to handle it.

You can kill a man, but you can't kill an idea.

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