Does Premenstrual Syndrome (PMS) Exist?

“Of course it does” you say.

Now, let me confess that I often experience pre-menstrual turbulence…

…that fails all logical explanations.

I can start crying if somebody just looks at me the wrong way.

Grumpy? Hell yeah, my boyfriend has a little suitcase packed by the door just in case he has to run for his life…

Not to mention the tiredness, food cravings and physical tension in my body.

Sometimes, I’m counting the minutes to my period (even though it starts with painful cramps) just to get that sense of physical and mental relief that comes with it.

So why on earth would I question the existence of PMS then? Well, because, to be honest, I can also be moody, irritable, anxious, tired and feeling overwhelmed at other times of the month. And because I’m a bit of a science geek and like to know what’s what.

But, before we dig into the research behind PMS, let’s just have a quick look at the scientific definition of premenstrual syndrome:

Premenstrual syndrome can be broadly defined as any constellation of psychological and physical symptoms that recur regularly in the luteal phase of the menstrual cycle, remit for at least 1 week in the follicular phase and cause distress and functional impairment.[1] (For details of menstrual phases, see our previous blog, The Menstrual Cycle Explained.)

In other words, PMS refers to physical, psychological and emotional symptoms that occur in relation to the menstrual cycle and can interfere with a woman’s life.

What Does the Research Say?

Here’s a summary of what I’ve found on PMS:

  • According to the Canadian Institutes of Health Research, PMS is widely accepted as a medical reality. However, a study that included a sample of over 100 healthy women showed that “physical health, perceived stress, and social support were much stronger predictors of mood than any menstrual cycle phase.”[2] The authors conclude that the evidence for PMS is limited.
  • A literature review conducted at the University of Toronto also failed to provide clear evidence that mood is associated with any menstrual cycle phase. Based on 47 studies on PMS, the researchers suggest that the negative belief about PMS needs challenging.[3]
  • Robin Stain DeLuca, a female psychologist, wrote a provocative book titled The Hormone Myth: How Junk Science, Gender Politics and Lies About PMS Keep Women Down. She argues that PMS is a normal reaction to pushing yourself too hard and experiencing distress. PMS gives society a licence to disregard women as being “hormonal”.
  • Other sources, however, disagree that PMS is a myth. For instance, studies in the field of neuroscience confirm that hormone estrogen has a powerful influence on mood and behaviour.[4] Health authorities such as the NHS in the UK also don’t question the existence of PMS and describe it as a consequence of changes in hormone levels.

Conclusion

Looking at the science, the story about PMS does not appear clear cut. On the one hand, the belief about PMS might be limiting us. On the other hand, denying it ignores the experience of many women. Some women definitely have debilitating PMS symptoms and require support. However, they might be fewer than first thought.

I think each case should be looked at individually. As for me, I’m still not sure whether my mood swings correlate with the menstrual cycle or are they just a part of my personality. Nothing wrong with that.

[1] Henshaw, C. A. (2007). PMS: diagnosis, aetiology, assessment and management: Revisiting… Premenstrual syndrome. Advances in Psychiatric Treatment, 13(2), 139

[2] Romans, S. E., Kreindler, D., Asllani, E., Einstein, G., Laredo, S., Levitt, A., Morgan, K., Petrovic, M., Toner, B. & Stewart, D. E. (2012). Mood and the menstrual cyclePsychotherapy and Psychosomatics82(1), 53-60.

[3] Romans, S., Clarkson, R., Einstein, G., Petrovic, M., & Stewart, D. (2012). Mood and the menstrual cycle: A review of prospective data studies. Gender Medicine, 9, 361–384.

[4] Fink, G., Sumner, B. E. H., Rosie, R., Grace, O., & Quinn, J. P. (1996). Estrogen control of central neurotransmission: Effect on mood, mental state, and memory. Cellular and Molecular Neurobiology, 16(3), 325–344.