PMS

I seem to have caused a bit of a shitstorm over on Ambivalent Academic's blog because of my comments on this post. Reading my comments back to myself, I realized that not only was I not really making any sense, I also was totally not conveying the point I was trying/hoping to make. So after re-reading the material I was referring to, I am taking this opportunity to address the issue. The issue in question? PMS. 

Now I would like to offer a few disclaimers before I get into this - first, the material I am referring to is dated. Myths of Gender by Anne Fausto-Sterling is copyrighted 1985. Second, I don't give enough of a shit to do a lit search and read a bunch of articles on PMS so that I have all the updated science. It's not my field. But human behavior is, and so is feminism. My goal is to give you something to think about, not to convey worldly truths. 

Anne Fausto-Sterling is a biologist at Brown University. Her book, and specifically the chapter on PMS is mostly about critiquing so-called science-based differences between men and women that society just accepts as truth. 

Pages 95-96 of her book include the following quote by three scientists in 1974:

"It is estimated that from 25% to 100% of women experience some form of premenstrual or menstrual emotional disturbance....Eichner makes the discerning point that the few women who do not admit to premenstrual tension are basically unaware of it but one only has to talk to their husbands or co-workers to confirm its existence."

Fausto-Sterling writes in response to this quote:

"Is it possible that up to 100 percent of all menstruating women regularly experience emotional disturbance? Compared to whom? Are males the unstated standard of emotional stability? If there is but a single definition of what is normal and men fit that definition, then women with 'female complaints' must by definition be either crazy or in need of medical attention. A double bind indeed." 

On page 100 she says the following:

"Many of those who reject the alarmist nature of the publicity surrounding PMS believe nevertheless that women undergo mood changes during their menstrual cycle. Indeed most Western women would agree. But do studies of large segments of our population support this generality? And if so, what causes these ups and downs? In trying to answer these questions we confront another piece of the medical model of human behavior, the belief that biology is primary, that hormonal changes cause behavioral ones, but not vice versa. Most researchers use such a linear, unicausal model without thinking about it. Their framework is so much a part of their belief system that they forget to question it...."

She goes through the types of research that have been used in studying PMS, including correlational designs and retrospective questionnaires. I think all of us know the problem with correlational studies used to infer causation, but on the questionnaires she says the following:

"The retrospective questionnaire holds additional problems, including the selective memory of the women completing it combined with their prior knowledge of the purpose of the study. Many women grow up with the expectation that they should feel bad just before their periods, and this belief can certainly predispose them to selectively remembering feeling bad just before menstruation but not at other times of the month. As one researcher writes in a study on moods and menstruation in college students, 'negative behavior exhibited premenstrually is perceived as evidence for the prevailing negative stereotype of female emotional behavior while positive behavior is ignored as something for which biology is irrelevant.'"

On page 109, and highly relevant to the discussion at hand, is the following:

"Dr. Sharon Golub found that premenstrually related increases in anxiety were far smaller than the heightened anxiety experienced by students subjected to the stress of an examination. In general she found premenstrually related mood changes to be of small magnitude, concluding that 'the premenstrual hormonal changes appear to impose little psychological burden,' and are often so slight that women 'are sometimes not even aware of them.'" (The citation for this study is: "Premenstrual Changes in Mood, Personality, and Cognitive Function" in The Menstrual Cycle, vol. 1.)

Now, the overall argument that Fausto-Sterling makes is that the PMS research prior to the date of her publication was extremely flawed. 

We're all scientists in one form or another here. We know the importance of random sampling, double-blind procedures, the inherent faultiness of self-reports, and control conditions. 

Problem #1: Participants are nearly always a restricted sample in PMS studies. Women of a certain age, on a 28-day cycle, all with prior complaints of PMS symptoms. 

Problem #2: The definition of the problem. What, exactly, constitutes a symptom of PMS? Headache? Moodiness? Dizziness? There is no symptom of PMS that cannot also occur at other times of the month. Nor is there a symptom of PMS that men cannot also experience. (I'm not talking about menstruation symptoms, just the PMS). They can say what is most common, but they can't actually define PMS by its symptoms. 

A seemingly pissed-off Arlenna posted an article in response to my comment on AA's blog, entitled "The female brain hypoestrogenic continuum from the premenstrual syndrome to menopause. A hypothesis and review of supporting data." Who wants to tell me what's wrong with that title? If you read through the synopsis of the article posted on AA's comment section, you'll see that this was not an experiment. This is an attempt to "unify" PMS symptoms including: "depression, sleep disturbance, irritability, anxiety and panic, memory and cognitive dysfunction and a decreased sense of well-being." Is there anyone in the world who doesn't experience those things throughout the month, not just around her period?

But here's the part that I find offensive: "It is proposed that whenever brain estrogen levels fall below the minimum brain estrogen requirement, for whatever reason and at whatever age, brain center dysfunction may ensue."

Brain DYSFUNCTION?? I say FUCK YOU to that. As Fausto-Sterling argues, if women are rendered "abnormal" during their menstrual cycle, what the fuck is normal? 

If our brains, as women, are not FUNCTIONING properly because of our hormone levels, then why the fuck aren't we all put on medication to correct this? This is what you ladies aren't getting that I'm trying to explain to you - NOTHING about your behavior during your menstrual cycle should be considered "abnormal" because it's "female-related." So you cried during the exam, AA, is it okay with you, after you walk out of the exam, for the committee to say "Oh, she must be PMSing?" Because it's not okay with me. Not at all. 

Testosterone cycles monthly just like estrogen. Why is no one examining the effects of that on men? Because they are the "normal" standard, whereas we have something WRONG with us because we are female and have female hormones. 

But back to the problems with the research. 

Problem #3: Agreement in the literature. Some studies look at only the first couple of days preceding the period, others look at the week preceding, and still others look at the 2 weeks prior AND the week following. It's a 4 week month, people. Are you telling me that women are only "normal" for 12 weeks per year? Because if so, that's fucked up. 

The other article included by Arlenna was first of all from the field of psychiatry. The medical study of ABNORMAL human behavior and MENTAL DISORDERS. Again, the article is NOT an experiment. It was a literature review resulting in a hypothesis about serotonin levels in women with severe PMS symptoms. One important quote from this article: "Their pathophysiology is still unknown, despite increased interest and research."

Now here's some hot fucking social science for ya. From "Transformations: Women, Gender, and Psychology" by Dr. Mary Crawford, in reference to the psychiatric article Arlenna mentioned and its focus on "Premenstrual Dysphoric Disorder" (PMDD):

"PMDD currently appears in the DSM-IV appendix of potential categories needing further study. It does not appear as an official category because of insufficient support; however, it can still be used by psychiatrists and other doctors as a diagnosis. Contraversy continues to rage regarding the inclusion of PMDD in the DSM. Supporters claim it is an identifiable clinical syndrome and its inclusion in the DSM is important to legitimize some women's cyclical suffering. Some critics agree that the validation of women's experiences is important, but assert that women should not require a mental illness diagnosis to receive medication for physical and emotional symptoms commonly associated with menstruation. Also, the existence of this diagnostic category may reinforce the stereotype of premenstrual women as emotionally unstable. " Page 456. 

So here's the deal, folks. No one has quality experimental research demonstrating that hormones CAUSE the symptoms known as PMS. Most researchers don't even know what PMS IS in a well-defined, testable way. 

Obviously this issue is incredibly important to me, because I just spent the last fucking 2 hours writing this post. Saying that your behavior is due to hormonal changes you experience because you are a WOMAN is short-sighted and the fact of the matter is that we cannot separate expectations from biology. Not yet, anyway. 

Refer to the debate that was going on at Dr. Isis' blog on the effects of different alcohols. My argument over there was that we have no idea what's really going on when I drink tequila versus vodka as far as the physiology goes, and so I and a few others used anecdotal data in support of our conclusion that tequila is an evil substance. If we consider these two issues to be fundamentally the same, I was arguing on the opposite side for the alcohol issue. 

But the fact of the matter is that whether or not tequila causes physiological things to happen in my brain that make me a raging lunatic speaks to whether or not I should drink tequila. 

My tequila issues will not prevent me from getting a certain job in the military unless I make it a problem. But PMS and hormones causing "brain dysfunction" because I am a WOMAN can and DOES prevent women from doing certain things in this world. 

I refuse to accept that my behavior is "abnormal" because it's "that time of the month."