November 3, 2014 • 47 mins
It might seem like a preposterous question, but many researchers wonder how much of premenstrual syndrome, or PMS, is physical fact versus culturally constructed fiction. Cristen and Caroline chart the medical history of PMS and how moodiness most commonly associated with might not be a byproduct of menstruation.
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Episode Transcript
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Speaker 1 (00:03):
Welcome to stuff Mom Never told you. From how Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and I'm Caroline and Caroline. I have a feeling that
some listeners probably saw the title of this episode is
p MS a myth? And thought what I see and
(00:27):
see off their rockers could possibly be a myth. Yeah,
it's interesting. I mean, I know that I definitely experience
various symptoms every month depending I mean, it depends, but
there's a lot more than just are you crampy? Yeah,
crampy and cranky? Yeah, that's actually what CNC stands for.
(00:49):
Crampy and cranky some days, you know, let's be honest,
it happens. We have our scenes, the kinds of days,
just like the next gal or guy or guy. Yeah. Um. Well,
before we get into the potential mythology of p MS,
which I know people are probably on the edge of
(01:09):
their seats right to find out about, let's start with
some basic facts about what p M S is. For starters,
it stands for pre menstrul syndrome, right, and this whole
syndrome deal refers to a wide range of symptoms that
start during the second half of your menstrreul cycle. That's
(01:32):
fourteen days or more after the first day of your
last menstrual period, and they tend to go away a
day or two after your period starts. And it comes
with all sorts of delightful symptoms, And National Institutes of
Health has such a long, long list of potential symptoms
associated with it, including common things such as mood swings,
(01:56):
breast tenderness, food cravings, fatigue, here to ability, depression, just
general C and C kinds of feelings, right, and in
severe cases, the levels of mood disruption are similar to
those of people with major depression. Actually, and women with
pre menstrual dysphoric disorder or pmd D appeared to be
(02:18):
at a greater risk of developing major depression. And we
will dive a little bit deeper into pm d D
later on in the episode. But just talking about PMS
in general, how many women does it affect? Pretty much
all people who have periods, including women and trans men.
(02:39):
But even the stats for that can be all over
the place, because by some estimates, three of every four
men's training person experiences some form of PMS. But then
when it comes to the types of symptoms, the intensity,
the frequency, things really start to vary. For instance, there's
(03:01):
a paper trying to quantify p MS and it found that, uh,
some degree of temporary quote mental or physical incapacitation is
experienced by women while experience were current prementional symptoms. So
who knows where you might fall in that right and
(03:24):
breaking it down further, the American Congress of Obstetricians and
Kynecologists says that probably somewhere around of women experience at
least one symptom, and we listed a bunch of them,
and there are a whole bunch more. I mean, everything
from mood stuff to physical pain to acne. There's like
a ton of stuff as a lot of you might
guess associated with PMF. But again, the symptoms experience will
(03:49):
vary from person to person and from cycle to cycle,
which is partially why the National Institutes of Health and
plenty of other sources explicitly state that the exact cause
of PMS has not been identified, which is kind of
mind blowing. I mean, I you know, I mean like
(04:10):
I'm a woman with a uterus and ovaries, and I
have a period, and so I have experienced pre menstrual symptoms. Um,
but I thought for sure I thought for sure there
would be more, because you know, there's a lot of
talk about hormones and this and that it's not you know,
it's obviously not that hormones don't play a role in
pre menstrual symptoms, but the fact that nobody has nailed
(04:33):
this sucker down as far as like this, this is why,
this is what causes it, and this is what makes
it bad or not as bad or whatever. It's kind
of like, I just felt doubly disappointed because it's kind
of the same thing with my migraines, Like doctors are,
like a lot of people get migraines, we're not really
sure well. And it's also PMS is also such almost
(04:54):
an indoctrinated part of the menstrual cycle that we learn
about as young girls, probably even before we get our
first period. We know that there's also this other set
of things that might come with it, even before the
bleeding begins, and it's called p MS. And yet, yeah,
doctors are still kind of scratching their heads because I
(05:15):
mean they have some decent guesses. Obviously, it has to
do with hormonal fluctuations, particularly varying levels of progesterone and
estrogen over our cycles, which you know you hear the
average twenty eight days, although again not everybody's mentional cycle
is twenty eight days. Um. It might also have to
do with levels of serotonin, changing, depression, stress, dietary habits, exercise,
(05:41):
so many environmental and biological factors that could maybe contribute
to it. Yeah, and not to mention that your hormones
and your serotonine are connected, because researchers show that falling
levels of hormones, mainly estrogen during the luvial phase or
the pre menstrual phase might effect the activity of central
(06:02):
serotonin in people who are susceptible to experiencing these symptoms.
And seratonin is often referred to as the happy hormone,
you know, the hormone that makes us feel great. So
maybe if the serotonin drops, then you get a case
of the se and seas, which I really I realized
that maybe I shouldn't stop just referring to PMS as
(06:22):
the se and c s because it could possibly sour
people toward us. Yeah, we don't want to be maybe
too closely aligned with p MS. Well, although that could
make for a funny T shirt, that's true. This is true.
Lots of lots of ideas happening here. Um. But in
the meantime, back to PMS and the science of it.
It is so widespread though, some wonder whether there is
(06:46):
an evolutionary explanation to this, And we read a paper
about this called were there evolutionary Advantages to p MS?
By Michael R. Gilling's published in twenty fourteen in a
journal Evolutionary Applications, and Gilling suspects that, yes, there has
to have been some kind of advantage to this, right
(07:08):
because after all, as he points out, PMS does have
certain important attributes to it, which include a high heritability.
So he's saying that you know, if people in your family,
specifically women, if women and your family had, you know,
terrible PMS, for instance, then you might be more likely
to suffer those symptoms. He also talks about gene variants
(07:28):
associated with PMS being identified, but his main point that
he gets to is this whole issue of animosity during
PMS being preferentially directed at a woman's current partner that
may lend itself to increasing the chances of finding a
new partner. And it's like, huh, what your period makes
(07:49):
you go search for a new partner? Not exactly. Well,
so he thinks that perhaps PMS is a vehicle that
was used to help women dissolve in fertile relationships because obviously,
if you get your period usually usually means you aren't pregnant,
(08:09):
and so if a relationship is not resulting in pregnancy,
especially we were talking about way back when, when there's
so much more focused simply on procreation, that if that
wasn't happening, then perhaps PMS sort of prompts this hostility
towards your current partner and to then drive a wedge
(08:32):
between this relationship and send you off searching for someone else.
So there's that. Yeah, but I mean, you know, they're
a bajillion women out there on birth control who are
controlling their reproductive path and choices, and you know, still
having periods on their birth control. So well, that's something
(08:53):
that he points out in terms of the possible theoretical
prior function of PMS us in the days long before
birth control, and how today without that possible function at work,
because we have birth control and more control over our
reproductive cycles, that it's not it's not as applicable obviously today. Yeah. Well,
(09:19):
also under this hypothesis, PMS is not a syndrome per se,
but quote a normal consequence of adaptive strategies developed during
our evolutionary history. So, in other words, the next time
someone maybe uh makes a makes a joke at you
about being all pmss e, you can come back with, hey, listen, buster,
(09:43):
this is just a normal consequence of adaptive strategies developed
during our evolutionary history. All right, then back off, drop
your imaginary microphone or your tampon, use the tampon as
a standoff like a tampon his or her face, and
walk away, right and then apologize because that might be rude.
But so we've established, Caroline, that p MS exists. They're
(10:07):
clearly symptoms. You and I have both experienced them. A
lot of our listeners have probably experienced them. So why
is the title of this episode? Is PMS a myth?
Why are we calling it a myth? Perhaps, Well, it's
that whole keyword pre menstrul that has a lot to
do with it. There was a literature review from researchers
(10:28):
at the University of Toronto called Mood and the Minstrel
Cycle Review of Perspective Data Studies, which called the whole
mood aspect of PMS into question, and it actually got
a lot of people riled up because basically they looked
at a ton of studies and did not find a
whole huge amount of evidence supporting that just in the
(10:52):
pre menstrual period you're more likely to definitely have mood disorders.
This was then interpreted by a lot of people, bloggers, journalists,
whatever to mean that it doesn't exist, and you're all crazy, right,
So a lot of as happens a lot these days,
actually when it comes to reporting on study findings, there
(11:14):
was a lot of misinterpretation. So one of the authors
speaking to The Atlantic clarified that the whole point of
this analysis of the forty one studies they looked at.
The whole point was not to show that menstrual mood
shifts don't exist at all, or that the physical symptoms
don't says, they actually weren't even looking at the physical symptoms,
(11:37):
but rather to examine that connection, like you said, between
menstruation and mood, because she said, the author speaking to
The Atlantic said, quote, the whole p MS notion serves
to keep women non irritable, sweet and compliant the rest
of the time, because out of those forty one studies
(11:57):
that they looked at, only seven found any sort of
link between negative moods and the pre menstrul phase, and
so the study authors concluded that the body of research
so far has failed to provide clear evidence in support
of the existence of a specific pre menstrual negative mood syndrome.
(12:18):
And yet we have this widespread belief that, of course
during in the days leading up to your period, you
will be completely emotionally unstable and cry a lot, right,
which is going to lead us eventually in this episode
to talk a lot more about how those assumptions and
stereotypes have been used against women. And this particular study
(12:40):
is just one that questions the validity of PMS as
we think about it today. So let's take a look
kind of through history at how our perception of menstruation
in general and pre minstrel symptoms in particular have evolved.
So for a little p MS history, let us star
in one the year of PMS sounds amazing. Not only
(13:05):
was the Great Depression on, but this one also the
year the PMS first happened. So the term pre menstrual
tension as opposed to pre menstrual syndrome, was first coined
by Dr Robert T. Frank in a paper he presented
to the New York Academy of Medicine in which he
(13:25):
described this pre menstrual tension as intense personal suffering that
goes along with varying degrees of discomfort and women having
a feeling like jumping out of our skin. Yeah. He definitely,
he and several other researchers in this era, I wanted
to look at what was going on. And it is
(13:47):
interesting to keep in mind the context of all of
these things happening, because one major thing that a lot
of people have focused on when it comes to looking
at PMS and talking about menstruation and reproductive health is
sort of the pairing of the way we talk about
it and the way we think about it and also
what's going on in the world at the time. And
so Frank was writing after the Depression, when a lot
(14:10):
of women's post World War One gains leaving the home,
getting jobs, etcetera. Were slipping and things were kind of
going back to quote unquote normal, and so it was
a time of a lot of social anxiety. And it
seems like a lot of scholarship about women tends to
come out in periods of social anxiety. But Frank's prescription
(14:31):
for severe cases of this pre menstrual tension was either
complete removal or radiation therapy of the ovaries to decrease
estrogen production and therefore restore order in the woman's life
and then therefore in her environment. Well, what's interesting too
is that in the same year in ne psychoanalyst Karen
(14:54):
Horny publishes a paper about quote pre menstrual mood swings
linked to strongly rejected fantasies of motherhood. So talk about,
you know, these kinds of social anxieties and the background
of that and how this is influencing research on women, because,
as Michael Solberg points out in the paper he wrote
(15:16):
about this, called the Monthly Malady, A History of pre
menstrul Suffering. Uh, some of the background to these discussions
that Horny and Frank were initiating about this pre menstrul tension,
these pre menstrual mood swings, or the fact that there
were more women entering the workforce, and along with that
(15:36):
there was growing concern over the potentially negative effects of
menstruation on productivity. And fast forward to today and you
hear similar things in terms of oh, well, if a
female is in the White House, then what happens if
chigezlberiod and all hell breaks loose? That's right, I know, well,
but I mean that's the same thing that's been going
(15:56):
on forever. I mean, you know, sure, now we're worried
about a female president getting her period and will she
get all hormonal and whatever, But you know, hundreds and
hundreds and hundreds of years ago, people were still freaking
out about women's reproductive systems having some crazy effect on
their mental stability. And if we talk about the wandering
(16:18):
womb and hysteria and everything. But we'll get to that.
But in this era, in the thirties, there is an
increasing focus on psychology, and women are starting to complain
to their doctors more than just about physical pain and
physical discomfort and fatigue. They're also starting to complain to
their doctors about psychological symptoms. And that leads us to
Dr Katerina Dalton, who in nineteen fifty three coins pre
(16:42):
menstrual syndrome, which has the same symptoms as what Robert
Frank described earlier, but with the whole incorporation of the
words syndrome, it basically suggests an underlying disease. It tells
women in whoever else is listening, that you don't have
to accept the comfort that you're going through and that
medicine can help out. Kind of seems like a positive,
(17:04):
but it's also pathologizing something natural that happens to women
every month. And what's ironic is that by the nineteen nineties,
this same doctor Karine and Dalton is I'm going to
talk about how she really considers PMS a misnomer because
symptoms aren't restricted to that period right before menstruation. It's
(17:26):
not just limited to the luteal phase. But you mentioned, Caroline,
that pathologizing menstruation in this way, it's clearly it's not
something that that started in nineteen thirty one. And we've
talked many times on the podcast about hysteria and the
wandering womb and all of these more ancient theories about
(17:48):
menstruation because before the twentieth century, doctors really did not
understand the hormonal influences, partially because the medical technology wasn't there,
and so we have all of these different phases that
the concept of menstruation goes through, starting of course with
(18:11):
Hippocrates and hysteria and the wandering womb and Hippocrates Um
he alludes actually two p ms. He refers to these
what we would think of today as menstrual related mood swings,
but attributed to them to hysteria and uteral movement, that
wandering womb, which was supposed to correspond to the phases
(18:36):
of the moon. So this is all tying into why,
for instance, we call menstruation your moon cycle. Well. Yeah.
He also talked about how a woman with a uterus
containing retained menstrual blood, which pressed on the heart and diaphragm,
was inclined to various mental derangements. But it's not like
(18:58):
Hippocrates was alone this. I mean, the ancient Egyptians thought that,
like the control center of your body was not your brain,
but your heart. And so if you had a bunch
of menstrual blood stored up in there and it's pressing
on your heart, then of course you're going to act
like a crazy person. Yeah, And once we get into
the Renaissance, menstruation is thought of as this cathartic process
(19:20):
of women getting rid of that build up of excrement
semen in what they called peckant matter. And this idea
lasts until the mid seventeenth century, and that kind of
idea in a similar way still persists today in the
idea of oh, you need to have your period because
it's cleansing, it's cleaning you out of all of that
(19:42):
and demetrial tissue that is building up just ties into
people thinking that women's reproductive organs are gross and dirty. Yeah,
But also in the Renaissance, PMS syndromes were attributed to
a backup of quote a gross seculent, condensed and clotted,
and at the same time also sharp blood. Those sharp bloods.
(20:05):
What does I mean, what does that mean? I don't know,
but carolina is not good. Does not sound good at all,
not sound good. Well, So, in the seventeenth century, there
was a slightly different perspective. It was the plethora model
of menstruation. Basically, the women bleed to prevent plethora, which
was defined as an overloading and excessive dilation of the
(20:27):
vessels and the body in general with blood. So not
necessarily like cleansing yourself, but just flushing yourself out, getting
rid of all that blood that's been building up and
causing pressure in your body. I'm just imagining it's like
a monthly toilet flushing. That's delightful. Well. Moving into the
eighteenth century, the plethora model is replaced by what's called
(20:50):
the fermentation model. So things are still things are still
sharp and gross in there. But the fermentation model explained
menstrual leading as a result of a quote fermentation or
fivescence hello by a menstrual ferment or a female semen.
Is also when they think that that women have um
(21:11):
a semen that contributes to reproduction as well. But I
just want to stay on a side note that reading
about the effervescence just makes me think about us having
It's really just like a belly full of lacroix building up.
It's gonna say fresco, Yeah, clearly Canadian um. But this
fermentation model, though, also explains more of the sudden onset
(21:36):
of PMS symptoms coming on or right before your menstruation.
You're bleeding, as opposed to plethora, which by that theory
would have been a gradual build up of discomfort over
the entire month. Interesting, and this theory also does its
part to explain breast swelling and tenderness because they figured
(22:00):
that it was involved in the sympathetic influence of the uterus,
causing said breast swelling. But by far my most favorite
menstrual theory of the seventeen hundreds came when they were
trying to figure out this connection between menstruation and mood.
(22:20):
And of course they assumed that with this whole fermentation,
the the lacroix in your belly and whatnot, that it
would lead to women's psychological instability for a period of time.
Um and they referred to it as nervous over excitation,
mood changes, getting the vapors and it worse though, And
(22:42):
this was probably like ye old pmd D. Those women
experienced what was called menstrul folly. Oh, menstrel folly. That
just sounds like you're making like it's causing you to
make terrible life decisions, not that you're necessarily experiencing pain
or anything. I mean, I would vote for calling it
your menstrual folly to be the new period, because I
(23:05):
mean there's also a bit of whimsy in that too. Yeah. Well,
I'm just going through my menstrual folly like you're skipping
with ribbons. And in the nineteenth century, menstruation was described
as an orgasm of the uterus, and Stolberg, citing a
physician of the time, talks about how the uterus, due
to its overwhelming sympathetic influence on the nervous system, subjected
(23:28):
women to its unrelenting tyranny. That sounds awful, the unrelenting
tyranny of your floating, hysterical uterus. Yeah, I mean with
things like peckant matter and menstrual folly and vapor and
lacroix and plethora good, all mixed drink in there. The
uterus is quite a tyrant by this point. But it
(23:50):
was also too in the nineteenth century, as Stolberg talks about,
where you have the development of lifestyle theories associated with
UM the aggressiveness or intensity of PMS symptoms. Particularly wealthy
urban women who ate lots of food, did not have children,
(24:12):
and indulged in quote lascivious novels, music, theater, and painting
were assumed to be the most susceptible to PMS like symptoms.
And I have a feeling that it's really though, that
delay of motherhood and possibly marriage that would cast the
(24:32):
brightest spotlight on you. Well, right, because the Greeks thought,
I mean, this is it's so interesting to see the
direct correlation here. But like, I mean, the Greeks thought
that if you were experiencing terrible PMS or what we
would think of as PMDD symptoms, then you needed to
have sex and get yourself pregnant. But before that you
would obviously have to get married. And so that kind
(24:54):
of fixed, you know, that was two birds with one stone, right,
and their in their view at the time that yes,
the sexual intercourse would help ease your symptoms and you
wouldn't be quite so moody and crazy, but you would
also be happily married with children, and society would all
be as it should well. And then if you fast
forward to one you have psycho analysts Karen Horney linking
(25:18):
prementional mood swings to motherhood constructs and essentially us acting
out against that all of those social anxieties. Kristen, that's right.
But yeah, I mean along with this lifestyle theory that
developed in the nineteenth century, I mean people were really
concerned not just about women, not just in general, but like,
people were really concerned about the effect that cities, modernization
(25:41):
and overpopulation we're having on people. They really thought that
living in cities was interfering with our animal natures, and
it just so happened that they assumed that the effects
of this were worse for women, because of course our
sanity was consistently linked to reproductive system. So if we're
having any sort of pre menstrual symptoms and things like that,
(26:04):
then obviously we're just feeling the effects of the city's
overpopulation worse than men are. And then moving into the
twentieth century, things do start to get a little more scientific, because,
for instance, in the nineteen twenties, scientists isolate sex hormones,
which then allows for deeper understanding of at least how
(26:25):
menstruation works and all of the different phases and how
that's linked to reproduction and pregnancy. But nonetheless, by this
time we have a centuries worth of this build up
of this association between menstruation and women's psychological instability and
(26:49):
moodiness and irritability. And in writing about this, Michael Stolberg
points out how this whole time women have been describing
these symptoms, or at least wealthy women who could afford
to go to doctors, they had been describing these kinds
of PMS symptoms, but like in terms of the physical
(27:11):
stuff and even some of the psychological symptoms. But the
question then is how much of it though, is sort
of it's the chicken in the egg of how much
is it just assumed that we're going to feel awful
and we automatically link irritability and moodiness to menstruation, and
(27:32):
how much of that might just be irritability and moodiness
possibly brought on by other things. Yeah, just like life, life,
my life making us moody. Well, we're going to get
way more into basically modern psychology and different groups take
on the constructs of PMS and we get right back
from a quick break. So when we left off, we
(28:01):
had just walked through a pretty pretty long medical history
of the concepts of menstruation and PMS like symptoms, and
a lot of it explains why for so long women
have considered periods both a blessing and a curse, because
on the one hand, there's always been that idea that
(28:23):
we need to have one because it is cathartic, it's cleansing,
our bodies need to get rid of that excess fluid
excess and quotes fluid and endometrial tissue. But at the
same time, the other side of that coin is a
curse because of the assumed physical um discomforts along with it.
(28:44):
But also this question of the psychological instability that that
purging process might bring along with it. So when we
get into like the social constructs of what PMS means
to people, women in particular have cons rude PMS as
both a positive construct in a negative one, because, Hey,
(29:06):
now that we know more about the indo chronology, about
our hormones, about the science of it, it's a good
thing and it should be taken seriously. This is a
thing that women experience and we need to learn more
about it. On the flip side of that, however, the
more we know about PMS, and the more it's tied
to mood in some people's minds, the more it is
used to discount women and what we say and oh,
(29:27):
she's just p ms NG, she's moody, she's out of
her mind. We shouldn't listen to her. Well, and also
think about how we euphemistically refer to our periods. It is,
you know, it's the curse, it's your monthly malady. It's
all we we tend to describe it in negative terms.
It's your uninvited guests, it's aunt flow. And does anyone
(29:50):
ever like ask her to stay? Now? She probably brings
a fruitcake, she probably does bring a fruitcake. And because
of this background of path apologizing PMS in the sense
of assuming making those assumptions about how it renders women
unstable and unreliable, some cultural anthropologists have called it a
(30:14):
Western construct, which quote get ready for this legitimizes the
temporary and politically ineffective expression of suppressed irritation, rage, or
similarly negative unfeminine feelings, which result in particular from the
status and condition of women in late industrial society. Wow. Yeah, well,
(30:40):
so basically a lot of people have claimed that women
and men have claimed that PMS is kind of an
excuse to let women kind of let loose in terms
of not being that prim and proper, quiet, well behaved
woman anymore. That it's a monthly excuse to actually feel feelings.
And you know, like I said, that's been used in
(31:01):
both a positive and a negative direction, right, because on
the positive end, when it comes to feminist critiques of
PMS research and this potential uh sort of cultural construct,
that part of it might have become. On the one hand,
particularly in the seventies and eighties, feminists were among the
biggest champions of conducting more research to find out that
(31:25):
question of what's actually going on, why does it happen
in particularly for women who have more PMDD like symptoms,
what is going on? And hey, well we're at it,
let's reduce this stigma, and yet calling into question that
possible side of it too. That's kind of the most
public facing side of menstruation. That the side that we
(31:47):
talk about the most, not the actual biological part that
includes bleeding and how it affects our bodies, but more
just making jokes about bms. That's what's okay to talk
about this whole potential, socially constructed part of it, right exactly.
I remember in middle school one of my science teachers
making the joke so like not many kids had gotten
(32:10):
their periods yet, but making the joke in talking about
biology of never trust anything that bleeds for four days
and doesn't die. Oh my gosh. Yeah, that was my
seventh grade science teacher. But yeah, basically, you know, a
lot of feminists in this period called into question the
construct that allowed something biological happening to women to be
(32:35):
linked to a dismissal of their emotions, especially anger, by
attributing them to this thing that happens every month, and
just the idea that, um, well, she must not be
angry most of the time. This is just like a
problem she's having this week, or if you encounter a
woman who is upset, irritable, whatever other synonymy you would
(32:57):
like to fill in that blank, and the first question is, oh,
are you on your period? So it allows people to
totally discount a legitimate issue or claim or problem um
at the same time that it kind of makes the
indirect assumption that men never have either hormonal shifts or
(33:20):
problems with it yeah or if there yeah, But and
by the same token that if they are expressing anger irritability,
that it's valid in a way that ours is irrational.
And this was something that Mari Roden talked about in
paper that she wrote, the Social Construction of pre Menstrual Syndrome,
(33:43):
and she points out how, going back to that history
that we went through in it was thought that the
quote madness of the female lunatic becomes more pronounced at
the time of menstruation. She also notes how Dr pattering A.
Dalton attributed the stereotype of women as poor drivers to
(34:05):
p MS thank you very much way after Dalton's yeah,
way to not help a sister out and she describes
PMS as a Western quote unquote safety valve. Yeah, and
Rodin also cites sociologist Karen Pugliessi who says that this
is like when the pressure to quote have it all
(34:26):
gets symbolically released once a month, so another excuse to
let your you know, irritation flag fly or an excuse.
And also that that permissible window and it might have
jumped out of some listeners that we've been describing this
as a Western construct, because when I was reading this,
(34:49):
the question did come to mind of well, is this universal?
Is this really exclusive to Western cultures, because there are
menstrual taboos all around the world in all different sorts
of cultures, But it does seem like this particular pathologizing
of PMS is fairly Western, especially when when it comes
(35:13):
to that sort of moodiness where a lot of times
menstrual taboos are more focused on cleanliness or the absence
thereof associated with the actual bleeding. Like in some cultures,
for instance, you know, women aren't allowed to bathe in
the same water they might interfere with the luck of fishermen,
you know, every day. But you know, it seems like
(35:36):
in our culture, a woman who is either on her
period or experiencing pre menstrual symptoms is a cathy comic. Well,
and it's also it widens the window of instability in
terms of, you know, kind of makes women even more
unreliable because it's pre menstrual and when could that come?
Oh well, I don't know, two weeks before your period,
(35:57):
who knows. Katerina Dalton went back and revised her first
of all in the nineties. She said that, you know,
PMS isn't even a correct term because this kind of
moodiness construct at any point, and so we really believe
that then that means that women are really like never
reliable because at any point this switch could be flipped
(36:21):
and our menstrual effortvencence could start to bubble over into
insanity and tears and chocolate eating. Well yeah, and I
mean I think that leads us into talking about pm
d D because that's I think an even bigger example
of the good and the bad in terms of legit
(36:43):
quote unquote legitimizing pre menstrual symptoms and what menstruation does
to women. Because uh, pm d D pre minstrual dysphoric
disorder was listed in the DSM five, but there was
a lot of controversy around it because it doesn't affect
that many women, but it does give a basis to
(37:04):
diagnose women who are experiencing these symptoms with a mental disorder.
And writing about that, Dr Paula Kaplan, who wrote the
book They Say You're Crazy, talks about how including pm
d D in the diagnostic Statistical Manual means that emotional
display is considered normal or fine or whatever, and men
(37:27):
are seen as mental disorders and women, and she wonders
why people aren't calling men's hormonal changes mental illness. Well.
Menstruation in of itself makes it easier to draw that
link between your biological functioning and your psychological functioning because
you have physical evidence of this change going on inside
(37:50):
of you. I e. Menstrual blood, I eat your period panties, Caroline,
let's be honest, um, And we don't want to discount
the fact that these kinds of PMDD symptoms do happen. Statistically,
two to three percent of women experience pre menstrual dysphoric
disorder and the way it is described UM. In one
(38:13):
of the articles we were reading about it, from one
woman who has been diagnosed with PMDD is that she
literally becomes another person leading up to her period. Now,
once menstruation happens, the symptoms tend to go away. Um.
But there was an issue with this drug that was
(38:34):
on the market, seraph m uh in. The FDA actually
had to pull ads for seraphim because it did not
disambiguate PMDD from PMS. Essentially, it just was a commercial
of a woman, say like pushing a grocery cart and
having a little difficulty and then going cozily and I
being like, maybe you need seraphim. Yes. So basically the
(38:55):
FDA took issue with Eli Lily, the drug manufacturer, saying like,
are you having a bad day? Well, maybe you're crazy
and need medicine. Because the whole thing is that the
FDA Okay, seraph I'm in two thousand, but it's identical
to Prozac, which is an S S R I and adepressant,
and it was about to go generic and Eli Lily
(39:17):
wanted to keep making money so they rebranded it, painted
it pink and called it a p M d D drug. Well,
and clearly in this case too, more research is needed,
and a lot of doctors acknowledge that the more research
is needed on this because there is that question of
how how to untangle the clinical depression from the menstrual
(39:42):
related influencers that seemed to aggravate those symptoms of depression.
So the question is which comes first a PMDD or
the depression, and researchers still aren't entirely sure. And then
taking it a few steps back, like you said, it's
inclusion in the d s M five. I've got a
lot of people nervous that, oh, we're just pathologizing this
(40:06):
even more, we're pathologizing PMS even more, even though what
we do need is clearly more research on it. Yeah,
And one thing that Kristen and I were talking about
when we were researching this stuff is how interesting it
is that it is sort of a chicken or the
egg situation when it comes to PMDD and to a
lesser extent, PMS and depression, because researchers have found that
(40:30):
the symptoms of PMDD are usually alleviated by S S
R I drugs UM, although it does differ from woman
to woman, and other studies have shown that PMDD symptoms
respond well to calcium carbonate a K A TOMS. But
it is interesting because I mean, here are these terrible
symptoms that a number of women experience every month that
(40:52):
are aggravated every month, but it's so closely tied to
depression for these PMDD stuffers. So the fact that we
don't know more about what causes it and that we're
still having to have the conversation of don't call me
crazy just because I have this thing that happens once
a month, I mean, I feel like it's we should
(41:13):
know more well, and that goes for pretty much anyone
who has a period. Don't call me crazy because I
have this thing that happens once a month. And so,
and that's why we wanted to do this episode as well,
because I know that it made me really think twice
about how what I think about periods and how it's framed,
and how we're taught about menstruation and this assumption of PMS,
(41:37):
specifically with the mood aspect of that, and how that
impacts women all together, because it's not the last thing
we need is to say, oh, women, you know this
doesn't exist. Just just buck up. It's just a little
bloating No, clearly, I I know I know some women
(41:58):
who get really regular and very aggressive PMS symptoms yeah.
I mean I went to high school with a girl
who had to be out of school once a month,
like for a day because she felt so ill. Oh yeah,
the cramping, bloating, fatigue, all that kind of stuff. That
stuff is very real and it does not need to
be legitimized. But the question is where do we how
(42:21):
do we disentangle that stuff from the stuff that we
actually are okay talking about. I just think that that's
the strangest thing is that we are the least comfortable
talking about the physical symptoms, and yet we're fine making
so many jokes about the psychological symptoms. But now we
(42:42):
want to hear from listeners what are your experiences with PMS,
and also how do we address this question of disentangling
the symptoms of PMS that we do experience and are
very real and valid from the more social, really constructed
aspects of it that might do women more harm than good.
(43:05):
Let us know Mom Stuff at how Stuff Works dot
Com is our email address. You can also message us
on Facebook or tweet us at Mom's Stuff podcast, and
we've got a couple of messages to share with you
right now. Black I'll let her hear from Scott me
about her episode a little while ago on black Hair,
(43:26):
and she writes, I was so excited to hear the
curly hair conundrums and black hair episodes because I have both,
and not only did you all offer so many great
resources on the topic, it was just so nice to
hear it being talked about. It's easy even for me
to wonder if I'm just being oversensitive about my hair
and all my preoccupations about it. I often have to
(43:49):
remind myself that it really is more of a complex
issue than simple fashion trends, especially when it comes to
my professional image, not to mention the dating world. I'm
what I like to call Blaxican Latina mom, black dad,
and through my childhood, my curly, frizzy, and seemingly unruly
hair was always a huge topic of concerned conversation and altercations.
(44:11):
One of my most vivid memories growing up was the
first time I had my hair straighten at a black
beauty shop and went to school the next day. I
was a sophomore in high school, and I remember everything
what I was wearing, and I remember walking across the
campus holding my books, looking demurely down because I was
sure everyone would be staring at me because finally I
thought my hair was beautiful. It was actually blowing in
(44:32):
the wind, and strands of it would blow across my face,
and I was so excited to sweep it behind my
ear like all the other girls always did. That was
the first day I heard someone tell me your hair
looks so much better straight, and I didn't have a
boyfriend or significant other to tell me otherwise until I
was out of grad school. Recently, my little sister asked
if I thought she should go all natural, and I
(44:54):
was so eager to send her videos like I Love
my Hair and links to the Curly Girl Collective to
help pursuit for herself that going all natural is not
the social suicide it once used to be. Thanks for
all you do. I love the program and recommend it
to all the other Peace Score volunteers I work with.
So thanks Scott. Me okay, and I have a letter
(45:16):
here from Megan in response to our vegetarian conversation. Uh.
She says, I went vegetarian ten years ago and then
vegan five years ago. I did so for ethical reasons,
but also gained health benefits, which probably really helped. I
also was introduced to feminism through veganism. As I met
many feminist vegans who were more than happy to share
(45:37):
feminist books and websites with me. I was so inspired
I actually ended up with a gender studies minor. When
I went back to university and met even more vegetarians
and vegans through feminist activism, the two communities always overlapped
for me. But it is also a challenge, as you
pointed out in your podcast, with issues such as Peter
using sexism to try and gain male membership and vegetarianism
(45:58):
used as a diet and pushing unhelp the body ideals.
I also noticed when a new vegan cookbook comes out,
there's often bad reviews left more and more often about
how unhealthy it is if it isn't completely fat free
or uses any sugar at all. Recently, a review on
Amazon even shame the author of a favorite vegan cookbook
for not being thin and looking quote unhealthy. So I've
(46:18):
noticed increasing amounts of fleck towards ethical vegans and vegetarians
from the more health and diet focused ones for failing
to live up to a pretty high standard from meat eaters.
I've gotten a lot of hostility in the past from boyfriends,
so the statistic about singles being more likely to be
vegetarian makes a lot of sense to me. I've even
been asked if my current boyfriend is okay with it,
(46:39):
and once if he allows it. I found the statistic
that women under report meat eating to be interesting because
I've had female friends bring up my vegetarianism to brag
about how much meat they eat so they can bond
over that with any men in our company, but definitely
have noted in my feminist groups, at least most are
happy to bond over vegetarian food. Okay, So Megan closes
(47:00):
her letter was sayings, sorry for making this such a
long letter. I enjoyed the podcast very much, and your
apology she's writing to me for bringing up bacon so
much is accepted Smiley Faith. So thank you for writing in, Megan,
and I'm glad you know that I'm joking about all
the bacon, although I do love it. But thanks for
writing in, and thanks everybody who's written into us. Mom
(47:23):
Stuff at how stuff works dot com is our email
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(47:44):
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com
Welcome to stuff Mom Never told you. From how Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and I'm Caroline and Caroline. I have a feeling that
some listeners probably saw the title of this episode is
p MS a myth? And thought what I see and
(00:27):
see off their rockers could possibly be a myth. Yeah,
it's interesting. I mean, I know that I definitely experience
various symptoms every month depending I mean, it depends, but
there's a lot more than just are you crampy? Yeah,
crampy and cranky? Yeah, that's actually what CNC stands for.
(00:49):
Crampy and cranky some days, you know, let's be honest,
it happens. We have our scenes, the kinds of days,
just like the next gal or guy or guy. Yeah. Um. Well,
before we get into the potential mythology of p MS,
which I know people are probably on the edge of
(01:09):
their seats right to find out about, let's start with
some basic facts about what p M S is. For starters,
it stands for pre menstrul syndrome, right, and this whole
syndrome deal refers to a wide range of symptoms that
start during the second half of your menstrreul cycle. That's
(01:32):
fourteen days or more after the first day of your
last menstrual period, and they tend to go away a
day or two after your period starts. And it comes
with all sorts of delightful symptoms, And National Institutes of
Health has such a long, long list of potential symptoms
associated with it, including common things such as mood swings,
(01:56):
breast tenderness, food cravings, fatigue, here to ability, depression, just
general C and C kinds of feelings, right, and in
severe cases, the levels of mood disruption are similar to
those of people with major depression. Actually, and women with
pre menstrual dysphoric disorder or pmd D appeared to be
(02:18):
at a greater risk of developing major depression. And we
will dive a little bit deeper into pm d D
later on in the episode. But just talking about PMS
in general, how many women does it affect? Pretty much
all people who have periods, including women and trans men.
(02:39):
But even the stats for that can be all over
the place, because by some estimates, three of every four
men's training person experiences some form of PMS. But then
when it comes to the types of symptoms, the intensity,
the frequency, things really start to vary. For instance, there's
(03:01):
a paper trying to quantify p MS and it found that, uh,
some degree of temporary quote mental or physical incapacitation is
experienced by women while experience were current prementional symptoms. So
who knows where you might fall in that right and
(03:24):
breaking it down further, the American Congress of Obstetricians and
Kynecologists says that probably somewhere around of women experience at
least one symptom, and we listed a bunch of them,
and there are a whole bunch more. I mean, everything
from mood stuff to physical pain to acne. There's like
a ton of stuff as a lot of you might
guess associated with PMF. But again, the symptoms experience will
(03:49):
vary from person to person and from cycle to cycle,
which is partially why the National Institutes of Health and
plenty of other sources explicitly state that the exact cause
of PMS has not been identified, which is kind of
mind blowing. I mean, I you know, I mean like
(04:10):
I'm a woman with a uterus and ovaries, and I
have a period, and so I have experienced pre menstrual symptoms. Um,
but I thought for sure I thought for sure there
would be more, because you know, there's a lot of
talk about hormones and this and that it's not you know,
it's obviously not that hormones don't play a role in
pre menstrual symptoms, but the fact that nobody has nailed
(04:33):
this sucker down as far as like this, this is why,
this is what causes it, and this is what makes
it bad or not as bad or whatever. It's kind
of like, I just felt doubly disappointed because it's kind
of the same thing with my migraines, Like doctors are,
like a lot of people get migraines, we're not really
sure well. And it's also PMS is also such almost
(04:54):
an indoctrinated part of the menstrual cycle that we learn
about as young girls, probably even before we get our
first period. We know that there's also this other set
of things that might come with it, even before the
bleeding begins, and it's called p MS. And yet, yeah,
doctors are still kind of scratching their heads because I
(05:15):
mean they have some decent guesses. Obviously, it has to
do with hormonal fluctuations, particularly varying levels of progesterone and
estrogen over our cycles, which you know you hear the
average twenty eight days, although again not everybody's mentional cycle
is twenty eight days. Um. It might also have to
do with levels of serotonin, changing, depression, stress, dietary habits, exercise,
(05:41):
so many environmental and biological factors that could maybe contribute
to it. Yeah, and not to mention that your hormones
and your serotonine are connected, because researchers show that falling
levels of hormones, mainly estrogen during the luvial phase or
the pre menstrual phase might effect the activity of central
(06:02):
serotonin in people who are susceptible to experiencing these symptoms.
And seratonin is often referred to as the happy hormone,
you know, the hormone that makes us feel great. So
maybe if the serotonin drops, then you get a case
of the se and seas, which I really I realized
that maybe I shouldn't stop just referring to PMS as
(06:22):
the se and c s because it could possibly sour
people toward us. Yeah, we don't want to be maybe
too closely aligned with p MS. Well, although that could
make for a funny T shirt, that's true. This is true.
Lots of lots of ideas happening here. Um. But in
the meantime, back to PMS and the science of it.
It is so widespread though, some wonder whether there is
(06:46):
an evolutionary explanation to this, And we read a paper
about this called were there evolutionary Advantages to p MS?
By Michael R. Gilling's published in twenty fourteen in a
journal Evolutionary Applications, and Gilling suspects that, yes, there has
to have been some kind of advantage to this, right
(07:08):
because after all, as he points out, PMS does have
certain important attributes to it, which include a high heritability.
So he's saying that you know, if people in your family,
specifically women, if women and your family had, you know,
terrible PMS, for instance, then you might be more likely
to suffer those symptoms. He also talks about gene variants
(07:28):
associated with PMS being identified, but his main point that
he gets to is this whole issue of animosity during
PMS being preferentially directed at a woman's current partner that
may lend itself to increasing the chances of finding a
new partner. And it's like, huh, what your period makes
(07:49):
you go search for a new partner? Not exactly. Well,
so he thinks that perhaps PMS is a vehicle that
was used to help women dissolve in fertile relationships because obviously,
if you get your period usually usually means you aren't pregnant,
(08:09):
and so if a relationship is not resulting in pregnancy,
especially we were talking about way back when, when there's
so much more focused simply on procreation, that if that
wasn't happening, then perhaps PMS sort of prompts this hostility
towards your current partner and to then drive a wedge
(08:32):
between this relationship and send you off searching for someone else.
So there's that. Yeah, but I mean, you know, they're
a bajillion women out there on birth control who are
controlling their reproductive path and choices, and you know, still
having periods on their birth control. So well, that's something
(08:53):
that he points out in terms of the possible theoretical
prior function of PMS us in the days long before
birth control, and how today without that possible function at work,
because we have birth control and more control over our
reproductive cycles, that it's not it's not as applicable obviously today. Yeah. Well,
(09:19):
also under this hypothesis, PMS is not a syndrome per se,
but quote a normal consequence of adaptive strategies developed during
our evolutionary history. So, in other words, the next time
someone maybe uh makes a makes a joke at you
about being all pmss e, you can come back with, hey, listen, buster,
(09:43):
this is just a normal consequence of adaptive strategies developed
during our evolutionary history. All right, then back off, drop
your imaginary microphone or your tampon, use the tampon as
a standoff like a tampon his or her face, and
walk away, right and then apologize because that might be rude.
But so we've established, Caroline, that p MS exists. They're
(10:07):
clearly symptoms. You and I have both experienced them. A
lot of our listeners have probably experienced them. So why
is the title of this episode? Is PMS a myth?
Why are we calling it a myth? Perhaps, Well, it's
that whole keyword pre menstrul that has a lot to
do with it. There was a literature review from researchers
(10:28):
at the University of Toronto called Mood and the Minstrel
Cycle Review of Perspective Data Studies, which called the whole
mood aspect of PMS into question, and it actually got
a lot of people riled up because basically they looked
at a ton of studies and did not find a
whole huge amount of evidence supporting that just in the
(10:52):
pre menstrual period you're more likely to definitely have mood disorders.
This was then interpreted by a lot of people, bloggers, journalists,
whatever to mean that it doesn't exist, and you're all crazy, right,
So a lot of as happens a lot these days,
actually when it comes to reporting on study findings, there
(11:14):
was a lot of misinterpretation. So one of the authors
speaking to The Atlantic clarified that the whole point of
this analysis of the forty one studies they looked at.
The whole point was not to show that menstrual mood
shifts don't exist at all, or that the physical symptoms
don't says, they actually weren't even looking at the physical symptoms,
(11:37):
but rather to examine that connection, like you said, between
menstruation and mood, because she said, the author speaking to
The Atlantic said, quote, the whole p MS notion serves
to keep women non irritable, sweet and compliant the rest
of the time, because out of those forty one studies
(11:57):
that they looked at, only seven found any sort of
link between negative moods and the pre menstrul phase, and
so the study authors concluded that the body of research
so far has failed to provide clear evidence in support
of the existence of a specific pre menstrual negative mood syndrome.
(12:18):
And yet we have this widespread belief that, of course
during in the days leading up to your period, you
will be completely emotionally unstable and cry a lot, right,
which is going to lead us eventually in this episode
to talk a lot more about how those assumptions and
stereotypes have been used against women. And this particular study
(12:40):
is just one that questions the validity of PMS as
we think about it today. So let's take a look
kind of through history at how our perception of menstruation
in general and pre minstrel symptoms in particular have evolved.
So for a little p MS history, let us star
in one the year of PMS sounds amazing. Not only
(13:05):
was the Great Depression on, but this one also the
year the PMS first happened. So the term pre menstrual
tension as opposed to pre menstrual syndrome, was first coined
by Dr Robert T. Frank in a paper he presented
to the New York Academy of Medicine in which he
(13:25):
described this pre menstrual tension as intense personal suffering that
goes along with varying degrees of discomfort and women having
a feeling like jumping out of our skin. Yeah. He definitely,
he and several other researchers in this era, I wanted
to look at what was going on. And it is
(13:47):
interesting to keep in mind the context of all of
these things happening, because one major thing that a lot
of people have focused on when it comes to looking
at PMS and talking about menstruation and reproductive health is
sort of the pairing of the way we talk about
it and the way we think about it and also
what's going on in the world at the time. And
so Frank was writing after the Depression, when a lot
(14:10):
of women's post World War One gains leaving the home,
getting jobs, etcetera. Were slipping and things were kind of
going back to quote unquote normal, and so it was
a time of a lot of social anxiety. And it
seems like a lot of scholarship about women tends to
come out in periods of social anxiety. But Frank's prescription
(14:31):
for severe cases of this pre menstrual tension was either
complete removal or radiation therapy of the ovaries to decrease
estrogen production and therefore restore order in the woman's life
and then therefore in her environment. Well, what's interesting too
is that in the same year in ne psychoanalyst Karen
(14:54):
Horny publishes a paper about quote pre menstrual mood swings
linked to strongly rejected fantasies of motherhood. So talk about,
you know, these kinds of social anxieties and the background
of that and how this is influencing research on women, because,
as Michael Solberg points out in the paper he wrote
(15:16):
about this, called the Monthly Malady, A History of pre
menstrul Suffering. Uh, some of the background to these discussions
that Horny and Frank were initiating about this pre menstrul tension,
these pre menstrual mood swings, or the fact that there
were more women entering the workforce, and along with that
(15:36):
there was growing concern over the potentially negative effects of
menstruation on productivity. And fast forward to today and you
hear similar things in terms of oh, well, if a
female is in the White House, then what happens if
chigezlberiod and all hell breaks loose? That's right, I know, well,
but I mean that's the same thing that's been going
(15:56):
on forever. I mean, you know, sure, now we're worried
about a female president getting her period and will she
get all hormonal and whatever, But you know, hundreds and
hundreds and hundreds of years ago, people were still freaking
out about women's reproductive systems having some crazy effect on
their mental stability. And if we talk about the wandering
(16:18):
womb and hysteria and everything. But we'll get to that.
But in this era, in the thirties, there is an
increasing focus on psychology, and women are starting to complain
to their doctors more than just about physical pain and
physical discomfort and fatigue. They're also starting to complain to
their doctors about psychological symptoms. And that leads us to
Dr Katerina Dalton, who in nineteen fifty three coins pre
(16:42):
menstrual syndrome, which has the same symptoms as what Robert
Frank described earlier, but with the whole incorporation of the
words syndrome, it basically suggests an underlying disease. It tells
women in whoever else is listening, that you don't have
to accept the comfort that you're going through and that
medicine can help out. Kind of seems like a positive,
(17:04):
but it's also pathologizing something natural that happens to women
every month. And what's ironic is that by the nineteen nineties,
this same doctor Karine and Dalton is I'm going to
talk about how she really considers PMS a misnomer because
symptoms aren't restricted to that period right before menstruation. It's
(17:26):
not just limited to the luteal phase. But you mentioned, Caroline,
that pathologizing menstruation in this way, it's clearly it's not
something that that started in nineteen thirty one. And we've
talked many times on the podcast about hysteria and the
wandering womb and all of these more ancient theories about
(17:48):
menstruation because before the twentieth century, doctors really did not
understand the hormonal influences, partially because the medical technology wasn't there,
and so we have all of these different phases that
the concept of menstruation goes through, starting of course with
(18:11):
Hippocrates and hysteria and the wandering womb and Hippocrates Um
he alludes actually two p ms. He refers to these
what we would think of today as menstrual related mood swings,
but attributed to them to hysteria and uteral movement, that
wandering womb, which was supposed to correspond to the phases
(18:36):
of the moon. So this is all tying into why,
for instance, we call menstruation your moon cycle. Well. Yeah.
He also talked about how a woman with a uterus
containing retained menstrual blood, which pressed on the heart and diaphragm,
was inclined to various mental derangements. But it's not like
(18:58):
Hippocrates was alone this. I mean, the ancient Egyptians thought that,
like the control center of your body was not your brain,
but your heart. And so if you had a bunch
of menstrual blood stored up in there and it's pressing
on your heart, then of course you're going to act
like a crazy person. Yeah, And once we get into
the Renaissance, menstruation is thought of as this cathartic process
(19:20):
of women getting rid of that build up of excrement
semen in what they called peckant matter. And this idea
lasts until the mid seventeenth century, and that kind of
idea in a similar way still persists today in the
idea of oh, you need to have your period because
it's cleansing, it's cleaning you out of all of that
(19:42):
and demetrial tissue that is building up just ties into
people thinking that women's reproductive organs are gross and dirty. Yeah,
But also in the Renaissance, PMS syndromes were attributed to
a backup of quote a gross seculent, condensed and clotted,
and at the same time also sharp blood. Those sharp bloods.
(20:05):
What does I mean, what does that mean? I don't know,
but carolina is not good. Does not sound good at all,
not sound good. Well, So, in the seventeenth century, there
was a slightly different perspective. It was the plethora model
of menstruation. Basically, the women bleed to prevent plethora, which
was defined as an overloading and excessive dilation of the
(20:27):
vessels and the body in general with blood. So not
necessarily like cleansing yourself, but just flushing yourself out, getting
rid of all that blood that's been building up and
causing pressure in your body. I'm just imagining it's like
a monthly toilet flushing. That's delightful. Well. Moving into the
eighteenth century, the plethora model is replaced by what's called
(20:50):
the fermentation model. So things are still things are still
sharp and gross in there. But the fermentation model explained
menstrual leading as a result of a quote fermentation or
fivescence hello by a menstrual ferment or a female semen.
Is also when they think that that women have um
(21:11):
a semen that contributes to reproduction as well. But I
just want to stay on a side note that reading
about the effervescence just makes me think about us having
It's really just like a belly full of lacroix building up.
It's gonna say fresco, Yeah, clearly Canadian um. But this
fermentation model, though, also explains more of the sudden onset
(21:36):
of PMS symptoms coming on or right before your menstruation.
You're bleeding, as opposed to plethora, which by that theory
would have been a gradual build up of discomfort over
the entire month. Interesting, and this theory also does its
part to explain breast swelling and tenderness because they figured
(22:00):
that it was involved in the sympathetic influence of the uterus,
causing said breast swelling. But by far my most favorite
menstrual theory of the seventeen hundreds came when they were
trying to figure out this connection between menstruation and mood.
(22:20):
And of course they assumed that with this whole fermentation,
the the lacroix in your belly and whatnot, that it
would lead to women's psychological instability for a period of time.
Um and they referred to it as nervous over excitation,
mood changes, getting the vapors and it worse though, And
(22:42):
this was probably like ye old pmd D. Those women
experienced what was called menstrul folly. Oh, menstrel folly. That
just sounds like you're making like it's causing you to
make terrible life decisions, not that you're necessarily experiencing pain
or anything. I mean, I would vote for calling it
your menstrual folly to be the new period, because I
(23:05):
mean there's also a bit of whimsy in that too. Yeah. Well,
I'm just going through my menstrual folly like you're skipping
with ribbons. And in the nineteenth century, menstruation was described
as an orgasm of the uterus, and Stolberg, citing a
physician of the time, talks about how the uterus, due
to its overwhelming sympathetic influence on the nervous system, subjected
(23:28):
women to its unrelenting tyranny. That sounds awful, the unrelenting
tyranny of your floating, hysterical uterus. Yeah, I mean with
things like peckant matter and menstrual folly and vapor and
lacroix and plethora good, all mixed drink in there. The
uterus is quite a tyrant by this point. But it
(23:50):
was also too in the nineteenth century, as Stolberg talks about,
where you have the development of lifestyle theories associated with
UM the aggressiveness or intensity of PMS symptoms. Particularly wealthy
urban women who ate lots of food, did not have children,
(24:12):
and indulged in quote lascivious novels, music, theater, and painting
were assumed to be the most susceptible to PMS like symptoms.
And I have a feeling that it's really though, that
delay of motherhood and possibly marriage that would cast the
(24:32):
brightest spotlight on you. Well, right, because the Greeks thought,
I mean, this is it's so interesting to see the
direct correlation here. But like, I mean, the Greeks thought
that if you were experiencing terrible PMS or what we
would think of as PMDD symptoms, then you needed to
have sex and get yourself pregnant. But before that you
would obviously have to get married. And so that kind
(24:54):
of fixed, you know, that was two birds with one stone, right,
and their in their view at the time that yes,
the sexual intercourse would help ease your symptoms and you
wouldn't be quite so moody and crazy, but you would
also be happily married with children, and society would all
be as it should well. And then if you fast
forward to one you have psycho analysts Karen Horney linking
(25:18):
prementional mood swings to motherhood constructs and essentially us acting
out against that all of those social anxieties. Kristen, that's right.
But yeah, I mean along with this lifestyle theory that
developed in the nineteenth century, I mean people were really
concerned not just about women, not just in general, but like,
people were really concerned about the effect that cities, modernization
(25:41):
and overpopulation we're having on people. They really thought that
living in cities was interfering with our animal natures, and
it just so happened that they assumed that the effects
of this were worse for women, because of course our
sanity was consistently linked to reproductive system. So if we're
having any sort of pre menstrual symptoms and things like that,
(26:04):
then obviously we're just feeling the effects of the city's
overpopulation worse than men are. And then moving into the
twentieth century, things do start to get a little more scientific, because,
for instance, in the nineteen twenties, scientists isolate sex hormones,
which then allows for deeper understanding of at least how
(26:25):
menstruation works and all of the different phases and how
that's linked to reproduction and pregnancy. But nonetheless, by this
time we have a centuries worth of this build up
of this association between menstruation and women's psychological instability and
(26:49):
moodiness and irritability. And in writing about this, Michael Stolberg
points out how this whole time women have been describing
these symptoms, or at least wealthy women who could afford
to go to doctors, they had been describing these kinds
of PMS symptoms, but like in terms of the physical
(27:11):
stuff and even some of the psychological symptoms. But the
question then is how much of it though, is sort
of it's the chicken in the egg of how much
is it just assumed that we're going to feel awful
and we automatically link irritability and moodiness to menstruation, and
(27:32):
how much of that might just be irritability and moodiness
possibly brought on by other things. Yeah, just like life, life,
my life making us moody. Well, we're going to get
way more into basically modern psychology and different groups take
on the constructs of PMS and we get right back
from a quick break. So when we left off, we
(28:01):
had just walked through a pretty pretty long medical history
of the concepts of menstruation and PMS like symptoms, and
a lot of it explains why for so long women
have considered periods both a blessing and a curse, because
on the one hand, there's always been that idea that
(28:23):
we need to have one because it is cathartic, it's cleansing,
our bodies need to get rid of that excess fluid
excess and quotes fluid and endometrial tissue. But at the
same time, the other side of that coin is a
curse because of the assumed physical um discomforts along with it.
(28:44):
But also this question of the psychological instability that that
purging process might bring along with it. So when we
get into like the social constructs of what PMS means
to people, women in particular have cons rude PMS as
both a positive construct in a negative one, because, Hey,
(29:06):
now that we know more about the indo chronology, about
our hormones, about the science of it, it's a good
thing and it should be taken seriously. This is a
thing that women experience and we need to learn more
about it. On the flip side of that, however, the
more we know about PMS, and the more it's tied
to mood in some people's minds, the more it is
used to discount women and what we say and oh,
(29:27):
she's just p ms NG, she's moody, she's out of
her mind. We shouldn't listen to her. Well, and also
think about how we euphemistically refer to our periods. It is,
you know, it's the curse, it's your monthly malady. It's
all we we tend to describe it in negative terms.
It's your uninvited guests, it's aunt flow. And does anyone
(29:50):
ever like ask her to stay? Now? She probably brings
a fruitcake, she probably does bring a fruitcake. And because
of this background of path apologizing PMS in the sense
of assuming making those assumptions about how it renders women
unstable and unreliable, some cultural anthropologists have called it a
(30:14):
Western construct, which quote get ready for this legitimizes the
temporary and politically ineffective expression of suppressed irritation, rage, or
similarly negative unfeminine feelings, which result in particular from the
status and condition of women in late industrial society. Wow. Yeah, well,
(30:40):
so basically a lot of people have claimed that women
and men have claimed that PMS is kind of an
excuse to let women kind of let loose in terms
of not being that prim and proper, quiet, well behaved
woman anymore. That it's a monthly excuse to actually feel feelings.
And you know, like I said, that's been used in
(31:01):
both a positive and a negative direction, right, because on
the positive end, when it comes to feminist critiques of
PMS research and this potential uh sort of cultural construct,
that part of it might have become. On the one hand,
particularly in the seventies and eighties, feminists were among the
biggest champions of conducting more research to find out that
(31:25):
question of what's actually going on, why does it happen
in particularly for women who have more PMDD like symptoms,
what is going on? And hey, well we're at it,
let's reduce this stigma, and yet calling into question that
possible side of it too. That's kind of the most
public facing side of menstruation. That the side that we
(31:47):
talk about the most, not the actual biological part that
includes bleeding and how it affects our bodies, but more
just making jokes about bms. That's what's okay to talk
about this whole potential, socially constructed part of it, right exactly.
I remember in middle school one of my science teachers
making the joke so like not many kids had gotten
(32:10):
their periods yet, but making the joke in talking about
biology of never trust anything that bleeds for four days
and doesn't die. Oh my gosh. Yeah, that was my
seventh grade science teacher. But yeah, basically, you know, a
lot of feminists in this period called into question the
construct that allowed something biological happening to women to be
(32:35):
linked to a dismissal of their emotions, especially anger, by
attributing them to this thing that happens every month, and
just the idea that, um, well, she must not be
angry most of the time. This is just like a
problem she's having this week, or if you encounter a
woman who is upset, irritable, whatever other synonymy you would
(32:57):
like to fill in that blank, and the first question is, oh,
are you on your period? So it allows people to
totally discount a legitimate issue or claim or problem um
at the same time that it kind of makes the
indirect assumption that men never have either hormonal shifts or
(33:20):
problems with it yeah or if there yeah, But and
by the same token that if they are expressing anger irritability,
that it's valid in a way that ours is irrational.
And this was something that Mari Roden talked about in
paper that she wrote, the Social Construction of pre Menstrual Syndrome,
(33:43):
and she points out how, going back to that history
that we went through in it was thought that the
quote madness of the female lunatic becomes more pronounced at
the time of menstruation. She also notes how Dr pattering A.
Dalton attributed the stereotype of women as poor drivers to
(34:05):
p MS thank you very much way after Dalton's yeah,
way to not help a sister out and she describes
PMS as a Western quote unquote safety valve. Yeah, and
Rodin also cites sociologist Karen Pugliessi who says that this
is like when the pressure to quote have it all
(34:26):
gets symbolically released once a month, so another excuse to
let your you know, irritation flag fly or an excuse.
And also that that permissible window and it might have
jumped out of some listeners that we've been describing this
as a Western construct, because when I was reading this,
(34:49):
the question did come to mind of well, is this universal?
Is this really exclusive to Western cultures, because there are
menstrual taboos all around the world in all different sorts
of cultures, But it does seem like this particular pathologizing
of PMS is fairly Western, especially when when it comes
(35:13):
to that sort of moodiness where a lot of times
menstrual taboos are more focused on cleanliness or the absence
thereof associated with the actual bleeding. Like in some cultures,
for instance, you know, women aren't allowed to bathe in
the same water they might interfere with the luck of fishermen,
you know, every day. But you know, it seems like
(35:36):
in our culture, a woman who is either on her
period or experiencing pre menstrual symptoms is a cathy comic. Well,
and it's also it widens the window of instability in
terms of, you know, kind of makes women even more
unreliable because it's pre menstrual and when could that come?
Oh well, I don't know, two weeks before your period,
(35:57):
who knows. Katerina Dalton went back and revised her first
of all in the nineties. She said that, you know,
PMS isn't even a correct term because this kind of
moodiness construct at any point, and so we really believe
that then that means that women are really like never
reliable because at any point this switch could be flipped
(36:21):
and our menstrual effortvencence could start to bubble over into
insanity and tears and chocolate eating. Well yeah, and I
mean I think that leads us into talking about pm
d D because that's I think an even bigger example
of the good and the bad in terms of legit
(36:43):
quote unquote legitimizing pre menstrual symptoms and what menstruation does
to women. Because uh, pm d D pre minstrual dysphoric
disorder was listed in the DSM five, but there was
a lot of controversy around it because it doesn't affect
that many women, but it does give a basis to
(37:04):
diagnose women who are experiencing these symptoms with a mental disorder.
And writing about that, Dr Paula Kaplan, who wrote the
book They Say You're Crazy, talks about how including pm
d D in the diagnostic Statistical Manual means that emotional
display is considered normal or fine or whatever, and men
(37:27):
are seen as mental disorders and women, and she wonders
why people aren't calling men's hormonal changes mental illness. Well.
Menstruation in of itself makes it easier to draw that
link between your biological functioning and your psychological functioning because
you have physical evidence of this change going on inside
(37:50):
of you. I e. Menstrual blood, I eat your period panties, Caroline,
let's be honest, um, And we don't want to discount
the fact that these kinds of PMDD symptoms do happen. Statistically,
two to three percent of women experience pre menstrual dysphoric
disorder and the way it is described UM. In one
(38:13):
of the articles we were reading about it, from one
woman who has been diagnosed with PMDD is that she
literally becomes another person leading up to her period. Now,
once menstruation happens, the symptoms tend to go away. Um.
But there was an issue with this drug that was
(38:34):
on the market, seraph m uh in. The FDA actually
had to pull ads for seraphim because it did not
disambiguate PMDD from PMS. Essentially, it just was a commercial
of a woman, say like pushing a grocery cart and
having a little difficulty and then going cozily and I
being like, maybe you need seraphim. Yes. So basically the
(38:55):
FDA took issue with Eli Lily, the drug manufacturer, saying like,
are you having a bad day? Well, maybe you're crazy
and need medicine. Because the whole thing is that the
FDA Okay, seraph I'm in two thousand, but it's identical
to Prozac, which is an S S R I and adepressant,
and it was about to go generic and Eli Lily
(39:17):
wanted to keep making money so they rebranded it, painted
it pink and called it a p M d D drug. Well,
and clearly in this case too, more research is needed,
and a lot of doctors acknowledge that the more research
is needed on this because there is that question of
how how to untangle the clinical depression from the menstrual
(39:42):
related influencers that seemed to aggravate those symptoms of depression.
So the question is which comes first a PMDD or
the depression, and researchers still aren't entirely sure. And then
taking it a few steps back, like you said, it's
inclusion in the d s M five. I've got a
lot of people nervous that, oh, we're just pathologizing this
(40:06):
even more, we're pathologizing PMS even more, even though what
we do need is clearly more research on it. Yeah,
And one thing that Kristen and I were talking about
when we were researching this stuff is how interesting it
is that it is sort of a chicken or the
egg situation when it comes to PMDD and to a
lesser extent, PMS and depression, because researchers have found that
(40:30):
the symptoms of PMDD are usually alleviated by S S
R I drugs UM, although it does differ from woman
to woman, and other studies have shown that PMDD symptoms
respond well to calcium carbonate a K A TOMS. But
it is interesting because I mean, here are these terrible
symptoms that a number of women experience every month that
(40:52):
are aggravated every month, but it's so closely tied to
depression for these PMDD stuffers. So the fact that we
don't know more about what causes it and that we're
still having to have the conversation of don't call me
crazy just because I have this thing that happens once
a month, I mean, I feel like it's we should
(41:13):
know more well, and that goes for pretty much anyone
who has a period. Don't call me crazy because I
have this thing that happens once a month. And so,
and that's why we wanted to do this episode as well,
because I know that it made me really think twice
about how what I think about periods and how it's framed,
and how we're taught about menstruation and this assumption of PMS,
(41:37):
specifically with the mood aspect of that, and how that
impacts women all together, because it's not the last thing
we need is to say, oh, women, you know this
doesn't exist. Just just buck up. It's just a little
bloating No, clearly, I I know I know some women
(41:58):
who get really regular and very aggressive PMS symptoms yeah.
I mean I went to high school with a girl
who had to be out of school once a month,
like for a day because she felt so ill. Oh yeah,
the cramping, bloating, fatigue, all that kind of stuff. That
stuff is very real and it does not need to
be legitimized. But the question is where do we how
(42:21):
do we disentangle that stuff from the stuff that we
actually are okay talking about. I just think that that's
the strangest thing is that we are the least comfortable
talking about the physical symptoms, and yet we're fine making
so many jokes about the psychological symptoms. But now we
(42:42):
want to hear from listeners what are your experiences with PMS,
and also how do we address this question of disentangling
the symptoms of PMS that we do experience and are
very real and valid from the more social, really constructed
aspects of it that might do women more harm than good.
(43:05):
Let us know Mom Stuff at how Stuff Works dot
Com is our email address. You can also message us
on Facebook or tweet us at Mom's Stuff podcast, and
we've got a couple of messages to share with you
right now. Black I'll let her hear from Scott me
about her episode a little while ago on black Hair,
(43:26):
and she writes, I was so excited to hear the
curly hair conundrums and black hair episodes because I have both,
and not only did you all offer so many great
resources on the topic, it was just so nice to
hear it being talked about. It's easy even for me
to wonder if I'm just being oversensitive about my hair
and all my preoccupations about it. I often have to
(43:49):
remind myself that it really is more of a complex
issue than simple fashion trends, especially when it comes to
my professional image, not to mention the dating world. I'm
what I like to call Blaxican Latina mom, black dad,
and through my childhood, my curly, frizzy, and seemingly unruly
hair was always a huge topic of concerned conversation and altercations.
(44:11):
One of my most vivid memories growing up was the
first time I had my hair straighten at a black
beauty shop and went to school the next day. I
was a sophomore in high school, and I remember everything
what I was wearing, and I remember walking across the
campus holding my books, looking demurely down because I was
sure everyone would be staring at me because finally I
thought my hair was beautiful. It was actually blowing in
(44:32):
the wind, and strands of it would blow across my face,
and I was so excited to sweep it behind my
ear like all the other girls always did. That was
the first day I heard someone tell me your hair
looks so much better straight, and I didn't have a
boyfriend or significant other to tell me otherwise until I
was out of grad school. Recently, my little sister asked
if I thought she should go all natural, and I
(44:54):
was so eager to send her videos like I Love
my Hair and links to the Curly Girl Collective to
help pursuit for herself that going all natural is not
the social suicide it once used to be. Thanks for
all you do. I love the program and recommend it
to all the other Peace Score volunteers I work with.
So thanks Scott. Me okay, and I have a letter
(45:16):
here from Megan in response to our vegetarian conversation. Uh.
She says, I went vegetarian ten years ago and then
vegan five years ago. I did so for ethical reasons,
but also gained health benefits, which probably really helped. I
also was introduced to feminism through veganism. As I met
many feminist vegans who were more than happy to share
(45:37):
feminist books and websites with me. I was so inspired
I actually ended up with a gender studies minor. When
I went back to university and met even more vegetarians
and vegans through feminist activism, the two communities always overlapped
for me. But it is also a challenge, as you
pointed out in your podcast, with issues such as Peter
using sexism to try and gain male membership and vegetarianism
(45:58):
used as a diet and pushing unhelp the body ideals.
I also noticed when a new vegan cookbook comes out,
there's often bad reviews left more and more often about
how unhealthy it is if it isn't completely fat free
or uses any sugar at all. Recently, a review on
Amazon even shame the author of a favorite vegan cookbook
for not being thin and looking quote unhealthy. So I've
(46:18):
noticed increasing amounts of fleck towards ethical vegans and vegetarians
from the more health and diet focused ones for failing
to live up to a pretty high standard from meat eaters.
I've gotten a lot of hostility in the past from boyfriends,
so the statistic about singles being more likely to be
vegetarian makes a lot of sense to me. I've even
been asked if my current boyfriend is okay with it,
(46:39):
and once if he allows it. I found the statistic
that women under report meat eating to be interesting because
I've had female friends bring up my vegetarianism to brag
about how much meat they eat so they can bond
over that with any men in our company, but definitely
have noted in my feminist groups, at least most are
happy to bond over vegetarian food. Okay, So Megan closes
(47:00):
her letter was sayings, sorry for making this such a
long letter. I enjoyed the podcast very much, and your
apology she's writing to me for bringing up bacon so
much is accepted Smiley Faith. So thank you for writing in, Megan,
and I'm glad you know that I'm joking about all
the bacon, although I do love it. But thanks for
writing in, and thanks everybody who's written into us. Mom
(47:23):
Stuff at how stuff works dot com is our email
address and to find links to all of our social
media as well as all of our blogs, videos, and podcasts,
including this one with links to our sources. So you
can read along. It's all found over It's stuff Mom
Never told you dot com For more on this and
(47:44):
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