PMS Through a Scientific Lens

PMS Through a Scientific Lens

By Angelin Thipahar

A large part of the misunderstanding surrounding menstruation comes from the fact that it is not understood properly by everyone. In popular media and general conversation, it seems that premenstrual syndrome and the behaviours that accompany it can often be misunderstood.

As an aside, I realize that I have referred solely to women in this article but I do not want to discredit the those members of the trans and queer community who also deal with PMS and should be considered in light of this article as well.

The term PMS is thrown around by many people but what exactly is it?

Premenstrual syndrome (PMS) is a prevalent disorder that develops around reproductive age and tends to have a negative impact on the emotions and performance of menstruators. It is a combination of physical and emotional symptoms that many women experience after ovulation and before the start of their menstrual period. These symptoms include: mood swings, feelings of anxiety or irritability, fatigue or trouble sleeping, bloating, stomach pain, breast tenderness, headaches, spotty skin, greasy hair and changes in appetite and sex drive. Three in four women say that they get PMS symptoms at some point in their lives. Despite general belief, PMS does not affect all women in the same way. Some women do not experience any signs of PMS, while other women have symptoms so severe that they are unable to take part in day-to-day activities like work or school.

So what causes PMS?

Well, according to researchers, PMS occurs post-ovulation due to the drastic decline in estrogen and progesterone levels that happens if you are not pregnant. These same hormones tend to rise within a few days after a women’s period starts. As the hormone levels rise, the PMS symptoms dissipate. Simple enough right? Well not exactly. The rise and fall of estrogen and progesterone can be influenced by other factors and, while the change in hormone level is a plausible cause for PMS, the exact cause for this condition remains unknown. Research has pointed to multiple causes for PMS including but not limited to the following: genetic factors, the role of and changes in sex hormones, neurotransmitters, environmental factors, depression, migraine and lack of social and emotional support. A paper by Zendehdel and Elyasi (2018) takes a biopsychosocial approach to the cause of PMS, citing different pieces of literature that posit various theories on the subject. The heritance of premenstrual symptoms is one such theory that has actually been well accepted. In 1971, a strong correlation between the premenstrual tension of mothers and their daughters was established. A less widespread theory is that changes in body metabolites that occur during menstruation could lead to changes in brain control adjustment processes which cause the impulsive symptoms that are characteristic of PMS. This theory is debated for its contradictions with observations that obesity increases the risk of PMS development. The point remains that PMS is quite complicated even from a biological stance.

Why is this important? Why should we care?

Well, primarily due to the stigma that follows premenstrual syndrome. Premenstrual behaviour has been referred to as temporary insanity or incompetence as a woman. Several jokes and snide comments have been made about women on their “time of the month.” The reality is that the
psychological and physiological distress cause by PMS is involuntary and can drastically affect women. The stigma around PMS that is often enforced by certain cultures and social groups only furthers the narrative that women should not discuss menstruation and should not address the additional barriers they must surmount because of menstruation. As a South Asian woman, I have never really felt comfortable discussing periods or PMS. I am lucky that I have never had to experience intense PMS symptoms however, I have watched friends and family struggle with them. No one should have to justify the severity of their symptoms to others because of the preconceived notions of society or make jokes of a serious condition at the expense of others. Something to consider the next time you make an offhanded remark.