The good news about PMS
-
0:01 - 0:05How many people here have heard of PMS?
-
0:05 - 0:07Everybody, right?
-
0:07 - 0:09Everyone knows that women
go a little crazy -
0:09 - 0:12right before they get their period,
-
0:12 - 0:16that the menstrual cycle throws them
onto an inevitable hormonal roller coaster -
0:16 - 0:19of irrationality and irritability.
-
0:19 - 0:21There's a general assumption
-
0:21 - 0:26that fluctuations in reproductive hormones
cause extreme emotions -
0:26 - 0:29and that the great majority of women
are affected by this. -
0:29 - 0:32Well, I am here to tell you
that scientific evidence says -
0:32 - 0:35neither of those assumptions is true.
-
0:35 - 0:38I'm here to give you
the good news about PMS. -
0:39 - 0:42But first, let's take a look
at how firmly the idea of PMS -
0:42 - 0:45is entrenched in American culture.
-
0:45 - 0:48If you examine newspaper
or magazine articles, -
0:48 - 0:53you'll see how widely assumed it is
that everyone gets PMS. -
0:53 - 0:58In an article in the magazine Redbook
titled "You: PMS Free," -
0:58 - 1:04readers were informed that between 80
to 90 percent of women suffer from PMS. -
1:04 - 1:06L.A. Muscle magazine warned its readers
-
1:06 - 1:10that 40 to 50 percent of women
suffer from PMS, -
1:10 - 1:14and that it plays a major role
in women's mental and physical health, -
1:14 - 1:17and a couple of years ago,
even the Wall Street Journal -
1:17 - 1:20ran an article on calcium
as a treatment for PMS, -
1:20 - 1:22asking its female readers,
-
1:22 - 1:24"Do you turn into a witch every month?"
-
1:25 - 1:29From all these articles, you would think
there must be a mountain of research -
1:29 - 1:33verifying the widespread nature of PMS.
-
1:33 - 1:36However, after five decades of research,
-
1:36 - 1:40there's no strong consensus
on the definition, the cause, -
1:40 - 1:44the treatment, or even
the existence of PMS. -
1:44 - 1:47As most commonly defined by psychologists,
-
1:47 - 1:52PMS involves negative behavioral,
cognitive and physical symptoms -
1:52 - 1:55from the time of ovulation
to menstruation. -
1:55 - 1:57But here's where it gets tricky.
-
1:57 - 2:03Over 150 different symptoms
have been used to diagnose PMS, -
2:03 - 2:05and here are just a few of those.
-
2:05 - 2:07Now, I want to be clear here.
-
2:07 - 2:10I'm not saying women don't get
some of these symptoms. -
2:10 - 2:13What I'm saying is that
getting some of these symptoms -
2:13 - 2:16doesn't amount to a mental disorder,
-
2:16 - 2:19and when psychologists
come up with a disorder -
2:19 - 2:21that's so vaguely defined,
-
2:21 - 2:25the label eventually becomes meaningless.
-
2:25 - 2:28With a list of symptoms
this long and wide, -
2:28 - 2:30I could have PMS, you could have PMS,
-
2:30 - 2:33the guy in the third row here
could have PMS, -
2:33 - 2:36my dog could have PMS.
(Laughter) -
2:36 - 2:39Some researchers said
you had to have five symptoms. -
2:39 - 2:40Some said three.
-
2:40 - 2:43Other researchers said that symptoms
were only meaningful -
2:43 - 2:45if they were highly disturbing to you,
-
2:45 - 2:49but others said minor symptoms
were just as important. -
2:49 - 2:52For many years, because
there was no standardization -
2:52 - 2:54in the definition of PMS,
-
2:54 - 2:57when psychologists tried
to report prevalence rates, -
2:57 - 3:00their estimates ranged
from five percent of women -
3:00 - 3:02to 97 percent of women,
-
3:02 - 3:08so at the same time almost no one
and almost everyone had PMS. -
3:08 - 3:14Overall, the weaknesses in the methods
of research on PMS have been considerable. -
3:14 - 3:20First, many studies asked women
to report their symptoms retrospectively, -
3:20 - 3:23looking to the past and relying on memory,
-
3:23 - 3:26which is known to inflate reporting of PMS
-
3:26 - 3:29compared to what's called
prospective reporting, -
3:29 - 3:31which involves keeping
a daily log of symptoms -
3:31 - 3:34for at least two months in a row.
-
3:34 - 3:39Many studies also exclusively focused
on white, middle-class women, -
3:39 - 3:43which makes it problematic
to apply study findings to all women. -
3:43 - 3:48We know there's a strong
cultural component to the belief in PMS -
3:48 - 3:51because it's nearly unheard of
outside of Western nations. -
3:51 - 3:55Third, many studies failed
to use control groups. -
3:55 - 3:58If we want to understand
the specific characteristics -
3:58 - 4:00of women who have PMS,
-
4:00 - 4:04we need to be able to compare them
to women who don't have PMS. -
4:04 - 4:07And finally, many different types
of questionnaires were used -
4:07 - 4:11to diagnose PMS, focusing
on different symptoms, -
4:11 - 4:14symptom duration and severity.
-
4:14 - 4:17To do reliable research on any condition,
-
4:17 - 4:20scientists must agree
on the specific characteristics -
4:20 - 4:22that make up that condition
-
4:22 - 4:24so they're all talking
about the same thing, -
4:24 - 4:27and with PMS, this has not been the case.
-
4:27 - 4:29However, in 1994,
-
4:29 - 4:33the Diagnostic and Statistical Manual
of Mental Disorders, -
4:33 - 4:35known as the DSM, thankfully --
-
4:35 - 4:39it's also the manual
for mental health professionals -- -
4:39 - 4:43they redefined PMS as PMDD,
-
4:43 - 4:46Premenstrual Dysphoric Disorder.
-
4:46 - 4:52And dysphoria refers to
a feeling of agitation or unease. -
4:52 - 4:56And according to these new DSM guidelines,
-
4:56 - 4:59in most menstrual cycles in the last year,
-
4:59 - 5:02at least five of 11 possible symptoms
-
5:02 - 5:06must appear in the week
before menstruation starts; -
5:06 - 5:09the symptoms must improve
once menstruation has begun; -
5:09 - 5:14and the symptoms must be absent
the week after menstruation has ended. -
5:15 - 5:18One of these symptoms must come
from this list of four: -
5:18 - 5:24marked mood swings, irritability,
anxiety, or depression. -
5:24 - 5:27The other symptoms could come
from the first slide -
5:27 - 5:29or from those on the second slide,
-
5:29 - 5:31including symptoms like
feeling out of control -
5:31 - 5:35and changes in sleep or appetite.
-
5:35 - 5:39The DSM also required now
that the symptoms -
5:39 - 5:43should be associated with
clinically significant distress -- -
5:43 - 5:46there should be some kind
of disturbance in work -
5:46 - 5:49or school or social relationships --
-
5:49 - 5:52and that symptoms and symptom severity
should now be documented -
5:52 - 5:56by keeping a daily log
for at least two cycles in a row. -
5:56 - 6:00And finally, the DSM required that
the emotional disturbance -
6:00 - 6:06should be more than simply an exacerbation
of an already existing disorder. -
6:06 - 6:09So scientifically speaking,
this is an improvement. -
6:09 - 6:11We now have a limited number of symptoms,
-
6:11 - 6:15and a high impact on functioning
that's required, -
6:15 - 6:20and the reporting and timing of symptoms
have both become very specific. -
6:20 - 6:23Well, using this criteria
-
6:23 - 6:25and looking at most recent studies,
-
6:25 - 6:27we see that on average,
-
6:27 - 6:33three to eight percent of women
suffer from PMDD. -
6:33 - 6:35Not all women, not most women,
-
6:35 - 6:38not the majority of women,
not even a lot of women: -
6:38 - 6:41three to eight percent.
-
6:41 - 6:46For everyone else, variables
like stressful events or happy occasions -
6:46 - 6:48or even day of the week
-
6:48 - 6:52are more powerful predictors of mood
than time of the month, -
6:52 - 6:55and this is the information
the scientific community has had -
6:55 - 6:57since the 1990s.
-
6:57 - 7:00In 2002, my colleagues and I
published an article -
7:00 - 7:03describing the PMS and PMDD research,
-
7:03 - 7:07and several similar articles have appeared
in psychology journals. -
7:07 - 7:12The questions is, why hasn't this
information trickled down to the public? -
7:12 - 7:15Why do these myths persist?
-
7:15 - 7:18Well, certainly the onslaught
of messages that women receive -
7:18 - 7:24from books, TV, movies, the Internet,
that everyone gets PMS -
7:24 - 7:27go a long way in convincing them
it must be true. -
7:27 - 7:32Research tells us that the more
a woman believes that everyone gets PMS, -
7:32 - 7:36the more likely she is
to erroneously report that she has it. -
7:36 - 7:39Let me tell you what I mean
by "erroneously." -
7:39 - 7:41You might ask her, "Do you have PMS?"
-
7:41 - 7:43and she says yes,
-
7:43 - 7:45but then, when you have her
keep a daily log -
7:45 - 7:47of psychological symptoms for two months,
-
7:47 - 7:51no correlation is found
between her symptoms -
7:51 - 7:52and time of the month.
-
7:53 - 7:57Another reason for
the persistence of the PMS myth -
7:57 - 8:01has to do with the narrow boundaries
of the feminine role. -
8:01 - 8:03Feminist psychologists like Joan Chrisler
-
8:03 - 8:07have suggested that
taking on the label of PMS -
8:07 - 8:13allows women to express emotions that
would otherwise be considered unladylike. -
8:13 - 8:16The near universal definition
of a good woman -
8:16 - 8:20is one who is happy, loving,
caring for others, -
8:20 - 8:23and taking great satisfaction
from that role. -
8:23 - 8:28Well, PMS has become a permission slip
to be angry, complain, be irritated, -
8:28 - 8:31without losing the title of good woman.
-
8:31 - 8:35We know that the variables
in a woman's environment -
8:35 - 8:39are much more likely to cause her
to be angry than her hormones, -
8:39 - 8:42but when she attributes anger to hormones,
-
8:42 - 8:44she's absolved
of responsibility or criticism. -
8:44 - 8:48"Oh, that's not who she is.
It's out of her control." -
8:48 - 8:54And while this can be a useful tool,
it serves to invalidate women's emotions. -
8:54 - 8:57When people respond to a woman's anger
-
8:57 - 9:00with the thought, "Oh,
it's just that time of the month," -
9:00 - 9:05her ability to be taken seriously
or effect change is severely limited. -
9:05 - 9:09So who else benefits from the myth of PMS?
-
9:09 - 9:12Well, I can tell you that treating PMS
-
9:12 - 9:16has become a profitable,
thriving industry. -
9:16 - 9:23Amazon.com currently offers
over 1,900 books on PMS treatment. -
9:23 - 9:25A quick Google search
will bring up a cornucopia -
9:25 - 9:29of clinics, workshops and seminars.
-
9:29 - 9:32Reputable Internet sources
of medical information -
9:32 - 9:37like WebMD or the Mayo Clinic
list PMS as a known disorder. -
9:37 - 9:39It's not a known disorder,
but they list it. -
9:39 - 9:43And they also list the medications that
physicians have prescribed to treat it, -
9:43 - 9:46like anti-depressants or hormones.
-
9:46 - 9:52Interestingly, though, both websites
say that the success of medication -
9:52 - 9:56in treating PMS symptoms
vary from woman to woman. -
9:56 - 9:58Well, that doesn't make sense.
-
9:58 - 10:00If you've got a distinct disorder
with a distinct cause, -
10:00 - 10:02which PMS is supposed to be,
-
10:02 - 10:06then the treatment should bring
improvement for a great number of women. -
10:06 - 10:09This has not been the case
with these treatments, -
10:09 - 10:13and FDA regulations say that
for a drug to be deemed effective, -
10:13 - 10:15a large portion of the target population
-
10:15 - 10:18should see clinically
significant improvement. -
10:18 - 10:22So we have not had that at all
with these so-called treatments. -
10:22 - 10:26However, the financial gain
of perpetuating the myth -
10:26 - 10:29that PMS is a common mental disorder
-
10:29 - 10:33and is treatable is quite substantial.
-
10:33 - 10:37When women are prescribed
drugs like anti-depressants or hormones, -
10:37 - 10:42medical protocol requires that they have
physician follow-up every three months. -
10:42 - 10:44That's a lot of doctor visits.
-
10:44 - 10:46Pharmaceutical companies
reap untold profits -
10:46 - 10:50when women are convinced
they should take a prescribed medication -
10:50 - 10:53for all of their child-bearing lives.
-
10:53 - 10:56Over-the-counter drugs like Midol
-
10:56 - 11:00even claim to treat PMS symptoms
like tension and irritability, -
11:00 - 11:04even though they only contain
a diuretic, a pain reliever -
11:04 - 11:06and caffeine.
-
11:06 - 11:10Now, far be it from me to argue
with the magical powers of caffeine, -
11:10 - 11:14but I don't think reducing tension
is one of them. -
11:14 - 11:21Since 2002, Midol has marketed
a Teen Midol to adolescents. -
11:21 - 11:23They are aiming at young girls early,
-
11:23 - 11:28to convince them that everyone gets PMS
and that it will make you a monster, -
11:28 - 11:30but wait, there's something
you can do about it: -
11:30 - 11:33Take Midol and you will be
a human being again. -
11:33 - 11:39In 2013, Midol took in 48 million dollars
in sales revenue. -
11:39 - 11:44So while perpetuating the myth of PMS
has been lucrative for some, -
11:44 - 11:48it comes with some serious
adverse consequences for women. -
11:48 - 11:51First, it contributes
to the medicalization -
11:51 - 11:54of women's reproductive health.
-
11:54 - 11:57The medical field has a long history
of conceptualizing -
11:57 - 12:02women's reproductive processes
as illnesses that require treatment, -
12:02 - 12:06and this has come at many costs,
including excessive Cesarean deliveries, -
12:06 - 12:09hysterectomies and prescribed
hormone treatments -
12:09 - 12:13that have harmed rather than enhanced
women's health. -
12:14 - 12:19Second, the PMS myth also contributes
to the stereotype of women -
12:19 - 12:22as irrational and overemotional.
-
12:22 - 12:26When the menstrual cycle is described
as a hormonal roller coaster -
12:26 - 12:28that turns women into angry beasts,
-
12:28 - 12:33it becomes easy to question
the competence of all women. -
12:33 - 12:36Women have made tremendous strides
in the workforce, -
12:36 - 12:40but still there's a minuscule number
of women at the highest echelons -
12:40 - 12:42of fields like government or business,
-
12:42 - 12:47and when we think about
who makes for a good CEO or senator, -
12:47 - 12:52someone who has qualities like
rationality, steadiness, competence -
12:52 - 12:54come to mind,
-
12:54 - 12:58and in our culture, that sounds more
like a man than a woman, -
12:58 - 13:01and the PMS myth contributes to that.
-
13:01 - 13:04Psychologists know that
the moods of men and women -
13:04 - 13:07are more similar than different.
-
13:07 - 13:11One study followed men and women
for four to six months -
13:11 - 13:14and found that the number
of mood swings they experienced -
13:14 - 13:18and the severity of those mood swings
were no different. -
13:18 - 13:22And finally, the PMS myth
keeps women from dealing -
13:22 - 13:26with the actual issues
causing them emotional upset. -
13:26 - 13:31Individual issues like
quality of relationship or work conditions -
13:31 - 13:35or societal issues like racism or sexism
or the daily grind of poverty -
13:35 - 13:39are all strongly related to daily mood.
-
13:39 - 13:42Sweeping emotions under the rug of PMS
-
13:42 - 13:46keeps women from understanding
the source of their negative emotions, -
13:46 - 13:52but it also takes away the opportunity
to take any action to change them. -
13:52 - 13:54So the good news about PMS
-
13:54 - 13:59is that while some women get some symptoms
because of the menstrual cycle, -
13:59 - 14:03the great majority don't
get a mental disorder. -
14:03 - 14:06They go to work or school,
take care of their families, -
14:06 - 14:08and function at a normal level.
-
14:08 - 14:12We know the emotions and moods
of men and women -
14:12 - 14:13are more similar than different,
-
14:13 - 14:19so let's walk away from
the tired old PMS myth of women as witches -
14:19 - 14:24and embrace the reality of high emotional
and professional functioning -
14:24 - 14:27the great majority of women
live every day. -
14:27 - 14:29Thank you.
-
14:29 - 14:32(Applause)
- Title:
- The good news about PMS
- Speaker:
- Robyn Stein Deluca
- Description:
-
Everybody knows that most women go a little crazy right before they get their period, that their reproductive hormones cause their emotions to fluctuate wildly. Except: There's very little scientific consensus about premenstrual syndrome. Says psychologist Robyn Stein DeLuca, science doesn't agree on the definition, cause, treatment or even existence of PMS. She explores what we know and don't know about it — and why the popular myth has persisted.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 14:44
Krystian Aparta edited English subtitles for The good news about PMS | ||
Morton Bast edited English subtitles for The good news about PMS | ||
Morton Bast approved English subtitles for The good news about PMS | ||
Morton Bast edited English subtitles for The good news about PMS | ||
Morton Bast edited English subtitles for The good news about PMS | ||
Morton Bast edited English subtitles for The good news about PMS | ||
Morton Bast accepted English subtitles for The good news about PMS | ||
Madeleine Aronson edited English subtitles for The good news about PMS |