A woman's best three-letter excuse for monthly bouts of irritability is being dismissed by a group of Canadian researchers.
Premenstrual syndrome (PMS) is widely used to explain mood swings, food cravings and crying spells that women sometimes experience shortly before their menstrual cycle. But a brave group of female researchers have debunked that idea – and it is sure to set off a firestorm among women who believe their emotional state is more fragile in the days before their period than what the medical evidence suggests.
The hope, the researchers say, is that banishing a phenomenon so engrained in popular culture that it is dragged out as an excuse to explain foul temper will, in fact, empower women to express their emotions freely at any time of the month.
"Women might actually admit to being in a bad mood for good reasons at other times of the month," said Professor Gillian Einstein, one of the study's authors and the director of the collaborative graduate program in Women's Health at the University of Toronto.
The researchers don't debate the physical symptoms – bloating, breast tenderness and stomach pains – linked with menstruation. Nor do they look into premenstrual dysphoric disorder (PMDD), a controversial and uncommon extreme form of PMS. But a review of the literature, which came down to 47 in-depth studies, revealed that only 14 per cent of them found an association between negative mood and the premenstrual phase. The research was published last week in the journal Gender Medicine.
Some women are already showing their displeasure with the findings. "Who are a small group of scientists to tell us how we feel?" asked Elissa Stein, New York-based co-author of the book Flow: The Cultural Story of Menstruation. "I bring my own personal experience to the equation. How can you say there is no such thing?"
Stein said PMS is treated as a joke; it is a way of dismissing a woman's emotions and behaviour. "That's really detrimental to women," Stein said.
Gynecologist Dr. Dustin Costescu-Green fears the study could be a slippery slope where the medical community does not fully appreciate the symptoms women are experiencing. He said that researching a large group of women, as opposed to reviewing the literature, would make for a more robust study.
"My concern is that … women who are finding that their mood is impacting on them, they're not going to come forward because now we have a paper that says this isn't a real problem," said Costescu-Green, a contraceptive advice, research and education fellow at Queen's University.
The issue with the mood swings associated with PMS is that it remains unclear how much of it is a result of biology and what part is socially constructed, critics of the study say. Are changes in estrogen and progesterone levels associated with mood changes? And is it not possible that bloating and other physical symptoms lead to irritability?
The menstruation cycle has a lot of negative connotations in many cultures, and a woman's negative mood has long been linked to her period. One cheeky user at Urban Dictionary defined PMS in the following way: "a powerful spell that women are put under about once every month, which gives them the strength of an ox, the stability of a Window's OS, and the scream of a banshee. Basically, man's worst nightmare."
Anne Rochon Ford, executive director of the Canadian Women's Health Network, said, if anything, the U of T study challenges present-day assumptions, even the most outrageous ones.
"What is worrisome is that it's become so normalized that it is a truism in our culture. We don't question the origins of it [of linking our mood to biology]," Rochon Ford said. "What this study is trying to do – and it's very brave in that regard – is it's starting that discussion."
She added: "We all know women, if not ourselves, who are absolutely certain that their menstrual cycles are a contributing factor to mood. I think [the researchers] challenged how deep-rooted it truly is. Kudos to them for doing this; it's minefield territory."
Einstein said her study should empower women. PMS tends to reinforce the idea that women are moodier than men – and the literature, she said, does not support it. She said that by women holding back their feelings to a certain time of the month could backfire because their feelings could easily be dismissed.
"My advice," she said, "is to take your feelings seriously and if something is bothering you, don't wait till before your period."