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