Saturday, June 24, 2006

Forget PM, it's just S!

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A research study into pre-menstrual syndrome (PMS), post-natal depression (PND) and the menopause has been creating a fair amount of controversy in Australia.

The reason?

The study's claim that PMS, PND and menopause do not reflect changes in hormones levels but instead are a product of women's minds.

While confirming that physiological changes occur in the body, the study suggests that many of these symptoms for PMS, PND and menopause are caused primarily by stress.

The study is based on 20 years of research, including in-depth interviews with British and Australian women. The study author, Professor of Women's Health and Psychology at the University of Western Sydney, Jane Ussher, says PMS and PND are products of repressed rage stemming from social pressure.

"I would argue that PMS and PND are essentially a form of repressed rage women feel, rather than a medical illness. Our research has shown that their distress often stems from women trying to do too much for everyone - except themselves."

Professor Ussher said PMS, PMD and menopause had become "catch-all" diagnostic categories that wrongly legitimised medical management of their condition.

She says further:

"We have this representation of the reproductive body as monstrous and needing drugs to help us through it and when women come off the drugs they find they don't need them at all."

"Looking after children, working full-time, looking after partner's emotional needs, no time for themselves, no time to eat properly, no time to rest, they're the reasons they are feeling angry."

"Women who have more demands report more PMS. You say to women 'do you have PMS on holiday?' but most women say 'no'."

Interesting viewpoint. Of course, the possible psychological and physical effects of stress are well-documented but could the answer to PMS, PND and menopausal symptoms be as simple as removing or reducing all stressors?

I'd like to read more about the study but, unfortunately, I have not been able to locate a specific article detailing the findings. Professor Ussher has, however, published a book titled 'Managing the Monstrous Feminine: Regulating the body, regulating woman' on this subject.

And the response from leading Gynaecologist and menopause expert Dr Elizabeth Farrell?

"I have a great sense of disbelief about her research. It could harm those women who are vulnerable and need to have a combination of treatments including counselling, therapy and prescriptive medications."

A very valid point indeed. What do you think?



Alison said...

What a fabulous post! I think both the Prof and the Doc have valid points.The idea that 'repressed rage stemming from social pressure' is the cause will be greeted with a lot of head nodding from women who know exactly what she's talking about. And while the doctor here is understandably cautionary, my experience is that most people would far prefer to avoid medication if at all possible. So the idea that PMS etc., is not hormonally based deserves all the attention it can get.

healthpsych said...

Hi Alison,
It definitely has the potential to open an interesting debate!

Some of the initial comments has been quite reactive, with direct comparisons to Tom Cruise's attack on Brooke Shields for taking anti-depressants for PND.

My personal view is that it's not as simplistic as hormonal or psychological, rather an interplay of the two. Perhaps this might lead to a greater consideration of non-drug approaches to treatment?

Alison said...

I agree. This is not a black or white issue, most likely the difficult grey in between (again!)

Tiesha said...

God I love this blog! I agree that there are components of both and treatment should be approached on an individual basis. If medications are working for someone and they are able to function and regain quality of life, fine! On the other hand, if someone is resistent to medication, then go with that at least for awhile. This is a great post.

jumpinginpuddles said...

oh brother what next, pregnant women arent in pain in childbirth its just a figment of their imagination due to the stress of wondering what having a baby is like.
Some people have more time than brains i think, yes you can see where our opinion lies ;)

healthpsych said...

Hi Tiesha,

Yes, my concern about this is that is has the potential to make women feel like failures if they need to resort to medicine. Doesn't that add stress in itself? Each individual case is unique and while I certainly agree that stress can have a powerful impact on the way we feel both physically and emotionally, hormones are also potent moderators of mood.

Without actually reading the research, it's hard to say anything concrete but the way the study has been presented in the press makes for some sweeping generalisations.

I think many would express the same opinion as you. :) It would be interesting to hear some male opinion on this.

healthpsych said...

Hi Alison,

Got to love that grey!

tkj said...

I always thought that the whole PMS thing was partially true - I mean with all that physiological craziness going on it seems logical that it would lead to increased levels of stress.

Yet, the one reservation I've maintained is that it seems to get exaggerated at times. Of course, I'm the same person that thinks sick (just a common cold or whatnot) people are also exaggerating and should just suck it up and get on with life. Well, until I get sick that is - then I completely understand how easy and necessary it is to get your rest. So maybe it's just because I lack perspective here...

healthpsych said...

Hey TKJ,

Thanks for stepping up! A brave man indeed to suggest some women might exaggerate the impact of PMS, PND and menopause ;)

A valid point, as you say, is that unless you've experienced it yourself, it's hard to conceptualise the ramifications, as with illness.

The 'get over and get on with it' attitude is easy to express until illness blindsides you. Nothing like that to revise a longheld opinion!

Alison said...

I'm so glad to see this intelligent and interesting post has generated some spirited debate. The pressure's on healthpsych - we're waiting for the next one! Just kidding, great stuff.

Garethf said...

Great stuff everyone. I have been searching for a health psych blog for a while now. I am stoked to have found one and a good one at that!

healthpsych said...

Thanks, GarethF. The cheque is in the post.... ;)

You've set up some excellent psych resources..setting up a blogroll entry right now.

Dr. Deborah Serani said...

Issues are not black or white, all or nothing, this or that. We need to embrace the duality of disorders and symptoms. More often than not, there is a correlation, an interplay, and pressing of one layer upon another.

This topic would have me ranting too!!!

Great post!

Anonymous said...

Does that mean that bloated feeling is all in my head too? Dang, then why can't I button my pants?