Findings from Scientific Papers

Perceived Stress and Severity of Perimenstrual Symptoms: The BioCycle Study

Conclusions: These analyses show that higher perceived stress precedes an increased severity of perimenstrual

symptoms. Stress reduction programs may be an effective, nonpharmaceutical treatment for physical and

psychological symptom relief.


40%–60% of reproductive-aged women experience


PMS is a collection of physical, behavioral, and psychological

symptoms that occur in the late luteal phase of the menstrual

cycle, abate during menses, and are generally absent

during the week after menses.9

Asuspected etiological pathway is linked to slight irregularities

in the normal variation of ovarian hormones throughout the

menstrual cycle, as ovulation suppression is known to avert

premenstrual symptoms;15 however, differences in reproductive

hormone levels have not been consistently identified.


High perceived stress in the previous month was associated

with a significantly increased risk of moderate=severe

symptoms for all 5 psychological and the majority of physical

symptoms, with odds ranging from 2.0 to 3.0 for most of the

symptoms (Table 2). Adjustment for age, education, and

passive and active smoking did not have an appreciable impact

on results.

It is not clear how stress may contribute to increased perimenstrual

symptom severity, although stress-induced changes

in ovarian hormone levels and neurotransmitters may be


54 Stress reduction programs

we agree with Wang et al.54 that stress reduction

programs for reducing psychosocial stress may be a

potentially noninvasive and cost-effective method for PMS

relief compared with pharmaceutical treatments.

Premenstrual Syndrome as Scientific and Cultural Artifact

Between 1931 and 1980 there were steady references to premenstrual issues in the medical

literature. In her review of the PMS literature, Rittenhouse states: “[a]uthors generally

constructed PMS as a medical phenomenon requiring management and treatment by a

physician or a psychiatrist/psychologist. However, PMS was not seen as a major problem

for the majority of women” (Rittenhouse, 1991:416). Nor was PMS seen as a major research

problem for most scientists.

Dalton’s own popularity, notoriety, and authority as a PMS “expert” heightened when she

served as the chief defense medical expert in a 1981 murder trial in London, in which she

successfully argued that the defendant was not responsible for murdering her lover because

she suffered from a severe form of PMS (see Laws et al., 1985 for an account of this trial). The

publicity generated from this trial and Dalton’s claims of successful progesterone treatments

found many different audiences in the United States and brought publicity to PMS.

Heneson points out that PMS acquired medical

legitimacy: “After years of telling women their problems were ‘all in the head,’ the proportion

of doctors who accepted PMS as a real disease reached critical mass” (1984:67).

Studies of the history of menstruation in human society point out that menstrually related

disorders are often associated with the practice of labeling women and their behaviors crazy

(dating back to ancient Greek writings) (see Delaney et al., 1988; Martin, 1987; Olesen and

Woods, 1986).

Her answer is that it is no accident that the initial interest in

what is now called PMS emerged during the 1930s: “It strikes me as exceedingly significant

that Frank was writing immediately after the Depression, at a time when the gains women

had made in the paid labor market because of World War I were slipping away. Pressure was

placed on women from many sides to give up waged work and allow men to take the jobs”


In an article in Ms. magazine, members of the Boston Women’s Health

Book Collective continue their advocacy by claiming that “the cure for PMS may lie in

resocialization and societal change, not medicine” (1992b:76).

PMS is a serious problem that can be debilitating for those suffering from its effects. The loss

of control, mood swings and depression often impairs one’s function within the family and at

work. The cartoons displayed here are not meant to offend, or belittle the seriousness of the

problems PMS sufferers have to face. Humor can often serve as an introduction to discuss a

sensitive subject. That is the sole purpose wherein this material is provided (1995:http://www.

The images and humor are contradictory and ambivalent. Granted

some of the jokes (e.g., the pit bull joke) are in bad taste and do promote an extremely

negative image of women. On the other hand, “PMS Barbi” seems like a perfect and ironic

inversion of the stereotype of the perfect American woman.

The discussion of PMS humor and artifacts brings us to the important consideration that

one very significant way in PMS is “real”—that PMS is an industry. The PMS industry

consists of what I call the 3 P’s (products, pills, and prescriptions). Most of the PMS humor

and artifacts are found as products that are bought and sold in the economic marketplace.

The postcards, greeting cards, calendars, cartoon and humor books, and songs all come with

a price tag attached. Greeting cards currently cost anywhere from $1.25 to $3.00; books,

calendars, and t-shirts run in the $10 to $15 range. PMS products will be available as long as

people are buying these and other PMS-related products.

The market for over-the-counter PMS products was so great that the Food and Drug

Administration (FDA) came up with its own definition of PMS in 1982. Its Advisory Review

Panel on Miscellaneous Over the Counter Internal Drug Products defined PMS as

A recurrent symptom complex that begins during the week prior to menstruation and usually

disappears soon after the onset of the menstrual flow. This symptom complex consists

predominantly of edema, lower abdominal pain (including cramps), breast tenderness, headache,

abdominal bloating, fatigue, and the feelings of depression, irritability, tension and anxiety (as

quoted in Golub, 1992:182).

Another important piece of the PMS industry is the PMS self-help books. Most of these

books are soft cover, relatively inexpensive ($3-7), have been written since 1980, and

are found in mainstream bookstores. Most of these books are written (solely or in joint

authorship) by physicians or therapists associated with PMS or Women’s Health clinics

(e.g., Lark, 1984; Norris and Sullivan, 1983; Nazzaro and Lombard, 1985). They usually

include short histories about PMS, and medical, nutritional, and exercise advice to overcome

its symptoms.

This image has allowed women to use PMS as an excuse to express their emotions or to account for their otherwise “strange” behaviors.

Other people (husbands, children, doctors, lawyers, judges, juries, co-workers) have also

used PMS to explain women’s behavior often within a scientific or medical framework that

then gives physicians and scientists “expert’ legitimacy over women’s bodies and minds.

Analgesics – UK – June 2014      The Consumer – Pains Experienced and Treatments Sought

The Menstrual Mark: Menstruation as Social Stigma

Clearly, the stigmatized status

of menstruation has detrimental consequences for girls’ and

women’s self-esteem, body image, self-presentation, and

sexual health. Feminist therapists, educators, and healthcare

providers can consider ways to alleviate these negative

consequences and to assist girls and women in their efforts

to resist the stigma of menstruation.

Equally important is

the evidence that suggests that menstrual status, both actual

and symbolic, primes and elicits negative attitudes toward

women. Challenging the stigma of menstruation and

learning to appreciate, or at least not loathe, menstruation

may have a positive impact on girls’ and women’s wellbeing

as well as their social status.

Efficacy of progesterone and progestogens in

management of premenstrual syndrome: systematic review

There is no evidence to support the claimed

efficacy of progesterone in the management of

premenstrual syndrome

There is insufficient evidence to make a definitive

statement about progestogens, but current

evidence suggests that they are not likely to be



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