Blog of the Society for Menstrual Cycle Research

Putting the ‘Men’ in Menstruation

September 12th, 2014 by David Linton

re-blogging re:Cycling

In celebration of our fifth anniversary, we are republishing some of our favorite posts. This post by David Linton originally appeared October 8, 2009.

pms_buddyA lot of ideas get hatched in a bar over drinks with friends. Most don’t make it past the sober morning after.  But a conversation in a Denver bistro in 2008 led to the creation of a new Internet service that aims to address Rodney King’s eternal question, “Can’t we all just get along?”  In this case the “getting along” applies to men and women who feel afflicted by the scourge of Pre-Menstrual Syndrome – PMS – and its presumed negative impact on otherwise harmonious relationships.

Despite the sound research and persuasive arguments of writers such as Carol Tavris (The Mismeasure of Woman), Anne Fausto-Sterling (Myths of Gender), Joan C. Chrisler (Charting a New Course for Feminist Psychology) and Paula Caplan (Fighting the Pathologizing of PMS), to name just a few who have labored to dispel the pernicious misconceptions and stigma surrounding the menstrual cycle, stereotypes and myths have been tenacious.  Thus, in the digital age it was probably inevitable that PMS Lore would find new outlets for dissemination.  Which brings us back to Denver.

One of the participants in the fateful exchange over Coors and coolers in the Mile High City was Jordan Eisenberg, a self-described entrepreneur.  He and a group of friends had somehow gotten into a spirited conversation about PMS.  The women expressed annoyance that men sometimes asked, “Are you getting your period?” as a way to discredit feelings women had about real concerns.  It was so bad, they said, that even if they actually were menstruating, they could never acknowledge it because they’d be dismissed out of hand.

Opinions bounced around until one of the men mentioned that he put the date of his girl friend’s expected period in his Palm Pilot so he could anticipate her mood swings and avoid topics that might provoke conflict on “those days.”  The men thought that this was a sensible idea, and the women were outraged that anyone would track their biology so mechanically.

For all but one of the participants the evening’s outing yielded no more than another story to share with friends at some future bar gathering.  But for Jordan Eisenberg it was an inspiration.  And so was born the Web site PMSBuddy.com.

In no time at all, the site has become an Internet hit.  It can be found as an iPhone application and comes up under a number of Google search terms. Within a year of its launch, the site claimed to have 150,000 registered users and that it was currently tracking (as of 10/5/09) 33,192  menstrual cycles.  According to the daily tally 1,366 women whose cycles were being tracked began to have PMS that day.   Another 6,437 would begin within five days and the “Overall Threat Index” was “1-4:1,” whatever that means.

One might view the site as just a “guy joke,” another way for men to make light of something they don’t understand and to cope with their menstrual fears.  The PMSBuddy web site uses fairly benign language and claims to have good intentions.  It even has what it calls an “altruistic” aim with a slogan that boasts, “Saving relationships, one month at a time!” yet it reflects an underlying anxiety.  It addresses male subscribers in a chummy voice: “PMSBuddy.com is a free service . . .to keep you aware of when . . . things can get intense for what may seem to be no reason at all. . . .there is no reason to ever be blindsided by PMS again.”

In addition to tracking the cycles of women in the lives of its subscribers and sending warning announcements about the impending periods of one’s wife, girlfriend, daughters, etc., it has a section called “PMS Stories,” submissions from subscribers about their PMS encounters and opinions.   On the first day I first looked at the site there were nearly 150 stories posted from both men and women, but by the time these pages are being read there are surely many more.

My first reaction on discovering PMSbuddy.com was a combination of wonder and amusement.

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

Lookin’ for them reds everywhere – on menstrual leave

January 14th, 2014 by Holly Grigg-Spall

By MichaelBueker (Own work) [CC-BY-3.0],
via Wikimedia Commons

Last year Russian lawmaker and LDPR party member Mikhail Degtyaryov proposed that women have two days paid leave from their work when they are menstruating.

“During that period [of menstruation], most women experience psychological and physiological discomfort,” said Degtyaryov.

He also argued that pain from menstruation causes heightened fatigue, reduced memory and efficiency at work, and emotional discomfort.

NBC, amongst other sources, reported this news as a sign of Russia’s move towards more conservative social politics.

“Scientists and gynecologists look on difficult menstruation not only as a medical, but also a social problem,” Degtyaryov explained.

Responses to this across feminist media and others ranged from shocked to outraged.

I argue in my book ‘Sweetening the Pill’ that the emphasis on constant and consistent productivity and on quantity over quality of work is hard on everyone, not just women, and not just when they’re menstruating. As technology makes it so we can be available at all times, we therefore have to be available at all times. Dave Eggers’ novel ‘The Circle’ satirizes this pressure to be “on” brilliantly, making for an exhausting read in itself.

Our desire to miss out on the time when we might be pre-disposed to slow down – our period – by taking drugs that let us keep up the consistency in all ways is symptomatic of a wider cultural emphasis on inhuman work expectations.

SMCR’s own Margaret Stubbs pointed out in an interview with Yahoo! Shine – why can’t women just take sick days when they’re menstruating, if they want?

However, most US employers do not provide paid sick days, and those that do limit the number significantly. A sick day often needs to be used for a doctor’s appointment, a family emergency, or just to catch up on myriad other duties. A policy that attributes additional sick days (and if we’re talking two days per month that means A LOT of additional sick days) doesn’t seem such a bad idea to me at this point.

There was something of an echo of the Cold War in the reaction to this news. It was partly America’s faith in work as a cure-all that positioned it in opposition to the communists.

Yes, menstrual leave is not entirely unproblematic as a proposal, within the context. Apparently, according to Wikipedia at least, the LDPR party is worryingly nationalistic (any Russian readers please feel free to correct me on this). But some of the reactions suggested a pride in the American way of long hours and little vacation time. As I find myself saying at least once a week as a British person living in Los Angeles – take a look at the economically solid, recession-surviving countries like Germany and Australia for some good reasons why that pride is misplaced.

Sometimes it seems many women are so busy establishing the lack of difference between themselves and men that they find it hard to be truly honest about the experience – possibly painful, possibly tiring – that they are going through when they get their period. See Chris Bobel’s great post about suffering in silence for more on this. She suggests that discomfort during menstruation should indeed be a “social problem” of a kind.

If we are only valued for our productive output then menstrual leave will always be seen as dead time. It will then be more about getting women out of the office when their productivity is low and they may become a burden, than it is about valuing the potential benefits of the leave for the woman.

I admit that this is old news, and well-discussed elsewhere, but what prompted me to write a post is the desire to share more widely this great piece of writing over at the Irish Feminist Network by Barbara Scully. She discusses a BBC documentary that showed a British woman’s experience of a menstrual hut in a tribal community. Just as the capitalists saw the communists as backward, we sometimes too willingly believe our way of organizing things is the most progressive, most modern, most sophisticated. Perhaps we’re not always right.

Silent Suffering: In 3 Scenes

December 23rd, 2013 by Chris Bobel

In PMS jokes the punchline is often a bitchy, out of control woman // someecards.com

Scene 1 10: 45 am:

A quiet Sunday morning, sunny and bright. Brunch on the patio.  I sat with my daughter, my partner, and my niece. Over pastries and coffee, I experienced waves of menstrual contractions, coming steadily every 15 minutes. And I winced, swallowing my moans.

While my niece spoke of her back pain, and my partner lamented his brief but powerful bout of the flu, I offered no comment about the vice grip around my uterus, the attention-grabbing cramping that hit me again and again. Through these cramping spells, I coached myself to  “tough it out” though I noticed that when I was alone, I audibly groaned. I hurt, but I said nothing.

And interestingly, later, while chatting with my stepson and his boyfriend, I kept the cramps entirely to myself. I chose to suffer in silence.

Why?

I hurt and yet, it seemed, my menstrual pain was not worth mentioning. It was mundane, even nearly universal. It was not the type of thing you sit around and whine about. I was aware, at some level, that an occasional mention of my pain would garner some sympathy, but beyond that, let the eye rolling begin. And in some company, it might be too-much-information, too private, too gross, even, to mention.

Scene 2  4:30 pm: Returning home after a 10-day road trip. The house, showing the wear of a place overrun by two cats with little human intervention, needed to be restored to order. Piles of mail. Bags to unpack.

But the very first thing I did when I walked through the door was take a shower and then do laundry. I had leaked badly during the last leg of the trip and I was a mess. My partner and daughter, alternatively, immediately settled on the (cat hair-encrusted) couch and reconnected to their wired worlds. While I, 21st century pioneer wife, scrubbed blood stains out of my clothes and hung another pair of “ruined” panties on the clothesline.

I walked past my family several times during my emergency clean up operation. With each glance, I felt envy rise up, and if i am honest,  resentment, too. But I did not complain. My body, my period, my mess. My problem.

But is it? Should it?

During menstrual moments like these,  (and now I will generalize) we often experience an acute embodied awareness that arrests our attention. At times, the experiences are painful or messy or both. Sometimes these ‘invasions’ are significant ,and we could benefit from some company. And yet, it is the rare menstruator who is NOT  socialized to  ‘buck up’ and ‘just deal with it.’ There is a persistent voice in our heads:  ‘No body wants to hear about your period…. Cramps are boring. And stain stories? Nobody wants to hear about THAT!”

I’ve argued this point before;  it seems the only acceptable menstrual discourse is PMS jokes (in which the punchline is a bitchy, out of control woman [see image above].

When it comes to expressing the reality of our menstrual lives—wherever our experiences fall on the continuum from menstrual joy to menstrual misery—we do so in a veritable sound chamber that CAN hurt us. For many of us, our menstrual experiences are uneventful, at least most of the time. But for the rest, they can be catastrophic. Or they may be normal, ho-hum, TODAY until they are NOT, a day later. Things change. Needs change. But the silence persists.

My concern is this: if we don’t open spaces for menstrual discourse, how can we find the support to discern the normal from the NOT normal? How can we get the info and support we need when we need it?

Scene: 3 3:24 am. I slowly came to consciousness and as I did, I instinctively reached between my legs. Yes. I was wet. Yes. My pad had shifted. And yes, so had the “insurance towel” I placed beneath me to protect the sheets. Damn. I didn’t want to get up and change my pad and underwear, but if I did not, I would have an even bigger stain on my sheet, maybe one that would  soak through the mattress pad and onto my mattress. Ugh.

Essentialism and experience

August 26th, 2013 by Holly Grigg-Spall

My forthcoming book ‘Sweetening the Pill or How We Got Hooked on Hormonal Birth Control’ began to take shape on the pages of this blog and much of the process of its development was spurred on by the work of members of SMCR. As such, it seems only fitting, with the release date of September 7th soon here, to share for my post this month an excerpt and to say thank you for the support of this community. I hope to have added something of interest and value to this on-going conversation.

……

Women often discuss menstruation and birth as happening to them, rather than as part of them and their experience. Emily Martin remarks in ‘The Woman in the Body’ that women often see their self as separate to their body. Women’s central image is that “your body is something your self has to adjust to or cope with” and therefore, Martin concludes,“your body needs to be controlled by your self.”

Martin explores the idea that women did not fit into the structure of the jobs that were open to them in industrialized society. These jobs most often required monotony, routine and repetition. Although in reality no more suited to men than they were women, it was women that were judged as innately unable to succeed in such positions due on the constantly changing and supposedly unpredictable nature of their physical state.

As Martin states, “Women were perceived as malfunctioning and their hormones out of balance,” especially when experiencing PMS and menstruation, “rather than the organization of society and work perceived as in need of transformation to demand less constant discipline and productivity.”

The rigidity of society was forcefully imposed on women as it was on men. For all, both men and women, it is inhumane but it was women that were required to adapt in a more dramatic and overt way. Men are viewed as naturally given to the industrious and disciplined way of life demanded of them and the structure of society is built on these assumed capabilities.

If we admit that women do change through the month, that we do menstruate, experience PMS, have differing moods week to week, we fear that this admission will be used as justification for negative judgment.

Martin counters the feminist refrain of “biology is not destiny”; “I think the way out of this bind is to focus on women’s experiential statements – that they function differently during certain days. We could then perhaps hear these statements not as warnings of the flaws inside women that need to be fixed, but as insights into flaws in society that need to be addressed.”

The idea that men are otherwise unchanging is falsified. Men also experience hormonal changes with studies suggesting they experience a cycle daily that is equivalent to the monthly cycle of women as well as changes in hormone levels across their lifetimes.

Women’s “experiential statements” as Martin describes them are often silenced in the discourse surrounding hormonal contraceptives. It is a betrayal of the feminist cause to speak out with openness about the side effects of the pill.

When Yaz and Yasmin were released the marketing strategy co-opted the idea of word of mouth. In a commercial women were seen passing along the “secret” of these new drugs with their host of beneficial yet superficial side effects. Receiving messages of increased physical attractiveness as the result of a drug that many women were using anyway, only a different brand, increased the transference of this experience from one woman to the next.

In the face of such powerful manipulation, what place does a skillfully worded informational insert have in women’s decision making process? The time of the Nelson Pill Hearings was a very different to today.

Naomi Wolf mentions the pill briefly in ‘The Beauty Myth.’ She remarks that it was originally marketed as a drug to keep women “young, beautiful and sexy,” concepts parallel to those promoted by Bayer through its contemporary advertising. Wolf quotes, in the context of the beauty industry, John Galbraith, “Behavior that is essential for economic reasons is transformed into social virtue.”

I’ve got Aunt Irma visiting

August 7th, 2013 by Saniya Lee Ghanoui

The IT Crowd is a British sitcom that centers on three IT workers and their daily misadventures. Maurice Moss, an intelligent but geeky technician who is quite socially awkward; his friend, Roy, who goes to lengths to avoid working; and Jen, the “Relationship Manager,” serve as the core team of the IT Department.

In the last episode of season one, titled “Aunt Irma Visits,” Jen explains to the men that she is on her period. I enjoyed the list of euphemisms she rattles off in an attempt to describe what’s happening, including “its high tide,” “closed for maintenance,” and “fallen to the communists,” with Moss noting that the communists do, indeed, “have some strong arguments.” It finally takes Roy shouting “first scene in Carrie” as a means of elucidation before Moss catches on. The men subsequently begin to experience sympathy premenstrual syndrome (I’ll leave the discussion regarding the validity of “sympathy PMS” for another post). Moss, in an attempt to get a variety of opinions on the idea, sends out an email to everyone—signed by both Moss and Roy—in his address book asking, “Do we have PMT [premenstrual tension]?” He also includes a list of symptoms the guys have: headachy, weight gain, irritability, anxiety, and breast tenderness. Moss remarks that the last symptom is particular to him. In an hour, after learning of Moss’s and Roy’s problems, the staff create a mocking website depicting the men as women (the website—www.ladyproblems.com—doesn’t actually exist, for better or worse). Roy and Moss decide to try to calm Jen down in hopes that doing so will also calm their own symptoms, and the three have a Girls Night Out.

The show is overtheatrical and this episode is no exception. There is the standard play on PMS stereotypes, most notably the way Jen turns into a she-devil when bothered or irritated by the men. But the humor comes from each character’s specific traits and how they react as IT people to their sympathy PMS. There is a funny bit about how IT men all across the world are suffering from PMS at the same moment, thanks to Moss’s well-distributed email. Furthermore, it is the melodramatic nature of the show that allows the storyline to work. The plausibility of this show is nonexistent, and thus the plausibility of the PMS plot is intentionally frivolous. That’s the point.

This perhaps also illustrates a larger difference in American and British humor, or at least slightly different humorous approaches to menstruation. The episode is full of irony; my favorite is when Jen, as a she-devil, talks about ordinary activities such as using a different hair conditioner or trying to keep slim. I’m sure there are many out there who find this episode to be another jaded interpretation of menstruation, but I don’t. The fact that the emphasis is not on the perceived negative stereotypes of menstruation, but rather on how a certain group of men react to having PMS takes away the insulting references about menstruation (and places them on IT men—if there any IT men out there offended by this episode I’m here to listen to your grievances).

Note: This episode is available on Hulu Plus in its entirety, but you can also find it on Vimeo or in separate clips on YouTube.

Let’s Celebrate!

June 6th, 2013 by Alice Dan

Public domain photo by Jim Henderson // Creative Commons 1.0
http://commons.wikimedia.org/wiki/File:Marymount_dorm_door_231_E55_jeh.jpg

Today marks the start of Making Menstruation Matter, the 20th conference focusing on menstrual cycle research and women’s health. For 36 years, these conferences have been open to those interested in the latest information on menstrual aspects of women’s lives, from menarche to menopause. Not only scientists, but clinicians, educators, artists, writers, and interested members of the general public have contributed to our discussions and debates.

Since the first conference in 1977, the Society for Menstrual Cycle Research has been working to bring menstruation out of the shadows and to legitimize our concern with how our culture, medical and pharmaceutical industries, advertising, and educational efforts, have served women’s needs (or not).

Over the years, the disciplines involved in our work have broadened to include participants from around the world in fields including nursing and medicine, psychology and sociology, anthropology and communication studies, as well as the arts. The menstrual cycle is entangled in so many aspects of our lives—the personal is truly political!

It is especially appropriate to celebrate today, because we will be awarding the very first “Menstruation Matters Award” to our beloved feminist hero, Gloria Steinem! Her early article, “If Men Could Menstruate“, pointed out the entitlement that men would feel to honor their bodies. Somehow, this normal female experience has been shamed, devalued, and medicalized—girls learn at an early age not to value our amazing bodies. Recent research shows how empowering it can be for girls to get to know their bodies, to chart their cycles, and to trust their own experience.

Pediatricians have begun to recognize that menstruation can been seen as a “vital sign” or indicator of healthy functioning. Absence of menstruation can be related to dietary or exercise practices that will harm bone development in young women, or to other problems of our reproductive systems. Recognizing these problems early is important to preventing future disease or disability.

Menstrual myths are rampant in our social discourse, and it is often difficult for girls and women to know what’s really true about our menstrual cycles:

Questions like these have inspired our research over the years, and discussions of them can be found at conferences like the one beginning this evening. We are always pleased to nurture the research of our students, and we award prizes for student research in memory of some of our founding mothers.

Members of the Society have contributed greatly to healthy practices for women:

  • through advocacy with tampon manufacturers and the FDA to standardize tampon absorbancy labeling;
  • through supporting and participating in the Women’s Health Initiative, research that showed the harmful effects of longterm hormonal therapies for postmenopausal women;
  • through questioning all the negative views of hormonal changes, as if a biological rhythm is somehow unusual in our lives.

More information about positions that the Society has taken on issues such as terminology used for the menopausal transition or use of cycle-stopping hormonal drugs by young women, see the Society’s website, where you can also find information about past conferences, publications, and members of the Society.

And join us, either online, or tonight at Marymount Manhattan College, for the celebration!

Is PMS Overblown? That’s What Research Shows

October 24th, 2012 by Elizabeth Kissling

If PMS is a myth, then what on earth can we blame for all the lady-rage?

Photo by Flickr user dearbarbie // CC 2.0

You may have seen the article in The Star or The Globe and Mail or The Atlantic about the recently published research review by a team of medical researchers who assert that “clear evidence for a specific premenstrual phase-related mood occurring in the general population is lacking.” Judging from the headlines and the online comments, this proposition is surprisingly controversial–probably because the headlines were frequently misleading, suggesting the findings are much broader than they are. Some online commenters are especially angry, insulting the intelligence and methods of the researchers, proclaiming that of course hormones affect moods, as does menstrual pain, citing examples of their own or their wives’ experience.

But Sarah Romans, MB, M.D.; Rose Clarkson, M.D.; Gillian Einstein, Ph.D.; Michele Petrovic, BSc and Donna Stewart, M.D., DPsych–the five medical scholars who reviewed all the extant studies of PMS based on prospective data–did not claim in the now-infamous Gender Medicine review study that PMS does not exist, or that hormones do not affect emotion or mood. The variety of research methods used in other studies prevented them from conducting a meta-analysis–a statistical technique that allows researchers to pool results of several studies, thus suggesting greater impact–so the authors instead looked at such study characteristics as sample size, whether the data was collected prospectively or retrospectively (that is, at the time of occurrence or recalled from memory), whether participants knew menstruation was the focus of the study and whether the study looked at only negative aspects of the menstrual cycle. Although their initial database searches yielded 646 research articles dealing with the menstrual cycle, PMS, emotions, mood and related keywords, only 47 studies met their criteria of daily prospective data collection for at least one full cycle.

When the authors scrutinized these studies, they found that, taken together, there is no basis for the widespread assumption in the U.S. that all (or even most) menstruating women experience PMS. In fact, only seven studies found “the classic premenstrual pattern” with negative mood symptoms experienced in the premenstrual phase only. Eighteen studies found no negative mood associations with any phase of the menstrual cycle at all, while another 18 found negative moods premenstrually and during another phase of the menstrual cycle. In other words, the symptoms these women experienced were not exclusively premenstrual, making the label inaccurate. Four other studies found negative moods only in the non-premenstrual phase of the cycle.

So let’s be fair, angry online commenters (and careless journalists): The researchers aren’t telling you menstrual pain is all in your head, or that your very real period pain won’t affect your mood. Sarah Romans did tell James Hamblin of The Atlantic,

The idea that any emotionality in women can be firstly attributed to their reproductive function—we’re skeptical about that.

Rightly so–feminists have been saying this for decades. Feminist critiques of PMS as a construct point to both the ever-increasing medicalization of women’s lives and the dismissal of women’s emotions, especially anger, by attributing them to biology.

Part of what makes PMS difficult to study, and difficult to talk about, is the multiple meanings of the term. In the research literature, there are more than 150 symptoms–ranging from psychological, cognitive and neurological to physical and behavioral–attributed to PMS. There is no medical or scientific consensus on its definition or its etiology, which also means there is no consensus on its treatment.

In everyday language, its meaning is even more amorphous. Some women and girls use PMS to mean any kind of menstrual pain or discomfort, as well as premenstrual moodiness. Some men and boys, as well as some girls and women, use it to diminish a woman’s or girl’s emotions when they disagree with her, or want to dismiss her opinions, or are embarrassed by her feelings.

Even researchers are influenced by entrenched cultural meanings. Romans and her colleagues observed that none of the 47 studies analyzed variability in positive mood changes, which they attribute to biases of the researchers. Many women have reported anecdotally that they feel more energetic, more inspired or other positive feelings during their premenstrual phase, but this is seldom studied or regarded as a “syndrome.” Romans and colleagues note that most measures of menstrual mood changes only assess negative changes, so even if positive changes are occurring, researchers are missing them. They also cite research indicating that both women and men tend to attribute negative experiences to the menstrual cycle, especially the premenstrual phase, and positive experiences during the premenstrual phase to external sources.

Romans and her colleagues do not deny the existence of menstrual pain, or even the existence of PMS. What their study shows is that very few women experience cyclic negative mood changes associated with the premenstrual phase of their ovulatory cycle. PMS is not widespread, and the authors are careful to distinguish it from premenstrual dysphoric disorder (PMDD), which is rarer still. As Gillian Einstein, one of the researchers, told the Toronto Star, “We have a menstrual cycle and we have moods, but they don’t necessarily correlate.” She did not add, but I will, that it it is unfair and unreasonable to assume that every woman’s moods should be attributed to her menstrual cycle and to refuse to take her feelings seriously.

Cross-posted at Ms. blog.

An Apple A Day . . .

August 24th, 2012 by Heather Dillaway

My most recent apple!

Everybody knows “an apple a day keeps the doctor away.” Or at least we teach our kids this saying.
It turns out now “an apple a day keeps menopause woes away,” at least according to the Red Hot Mamas’ website, and some other recent news posts. Apples (along with many other fruits and vegetables) apparently help us fight (lessen) menopausal symptoms, and other websites advocate apple cider vinegar to help with menopausal symptoms. Not to mention these things help with weight gain and other chronic health conditions as we age.

 

Apples help alleviate PMS symptoms too, apparently. A “PMS Comfort” Website even has a Cinnamon Baked Apple recipe for women to make when they need to relieve PMS symptoms. From a perusal of these websites, it seems one of the things apples can do is reduce bloating and swelling.

 

To some extent I’m skeptical: what makes an apple better than a blueberry or a nice cold glass of water? I guess this simply reminds us that diet definitely matters at all stages of our reproductive life cycles. This also harks back to Paula Derry’s recent post about how the environment affects our bodies and what we put our bodies through matters, and Kati Bicknell’s latest post about the impacts of eating meat on fertility. What we put into our bodies matters too.

I guess it’s true that an apple a day is a good thing. But, how did the apple get some much hype anyway? Seriously, if there is one fruit that has become part of our daily lexicon it is the apple. . . . Adam and Eve’s apple, Johny Appleseed, Mom and Apple Pie, the Big Apple, the poison apples from from Snow White, you’re the apple of my eye, you’re sweet as apple pie, an apple for the teacher, an apple a day keeps the doctor away …. I guess it was a matter of time before apples made it to PMS and menopause.

Cosmo’s Menstrual Politics

August 14th, 2012 by David Linton

Saniya Ghanoui and David Linton

How peculiar are the sexual politics of Cosmopolitan magazine?!?! We previously noted the editorial avoidance of menstrual sex, but let’s take a look at their most recent ride on the menstrual cycle.

On one hand, Cosmo aspires to liberate women from sexual repression into a world of ever better orgasms and perpetual youth and beauty. On the other hand, it ceaselessly stokes anxiety and insecurity with its constant twin emphasis on pleasing “him” and urging the purchase of the latest Big Thing. Occasionally, in an effort to demonstrate concern for women’s health there appears a reference to some aspect of the menstrual cycle.

The most recent example occurs in the June 2012 issue whose cover, under a hot photo of the rock star Pink, announces that inside you can learn, “Why your Period Makes You Cra-a-zy”. Off the bat, the cover recirculates the tired notion that the period is responsible for some kind of transformation, turning a woman into a crazy person. The use of an extra “a” emphasizes the word in a way that enhances its meaning, thus the period causes almost an abnormal form of craziness. There’s also a lovely irony to this cover. Pink is dressed in a vibrant solid-red dress that counters her pale skin and hair. She pulls up one side of outfit as she claws her dress and her expression is meant to show a “tough girl” side to her personality. It’s as if the cover alludes to notions of craziness, as caused by the period, via the image of Pink.

The article does seem to contain practical advice for those who experience some level of discomfort prior to getting their period. The five suggestions include topics such as diet, exercise, orgasms, coffee, and laughter. Unfortunately, embedded in the nuggets of advice one finds relentless reinforcements of age-old prejudices, stereotypes, and negative perspectives. Even the opening page, which sets up the piece, is titled “Beat the PMS Brain Haze” and shows a woman whose head is slightly out of focus and fading into a cloud. In case you miss the point, a sentence beside her head states, “It’s hard to function when your head is in the clouds”. In larger type under the title the message is reinforced, “It’s when you feel so foggy, you can barely choose between a lemon and a lime for your diet soda”.

The next two pages of suggestions comprise a litany of ways to cope with the “annoying symptom”, “hormonal cloud”, “haze”, and “PMS coma” that leave women “easily overwhelmed, stressed out, forgetful and indecisive”, Women are told to “cancel everything that’s optional”, “snack on yummy oatmeal” to “make up for the PMS brain drain”, “ask your guy to rub your back”, and have “a dose of caffeine”.

As published in June 2012 issue of Cosmopolitan

What is obvious about the article and the tips that are meant to keep women “sane”, insinuating that one may be insane while PMSing, is the way in which each bit of advice is meant to fix some frustrating characteristic that is either caused or heightened by PMS. Thus, the message is that women have an extra hindrance they must overcome in order to have a peaceful week leading up to their period. In order to solve the problem Cosmo advises some simple changes, such as having a cup of coffee, to more radical ones like changing or canceling items on your schedule. What the latter puts forward is the idea that PMS is such a hindrance that one must change one’s weekly agenda in order to function normally. While it is true that some may have discomfort during PMS and desire extra time to relax, to completely cancel or modify a weekly schedule suggests a level of wealth or leisure that is in the realm of fantasy.

Despite the appearance that the article is simply a pleasant set of suggestions, it turns out that the three pages are actually a lead into a fourth page on the right side so the connection can’t be missed, consisting of the latest ad for Tampax Radiant tampons. In design and placement the ad blends perfectly with the article so as to flow, as it were, directly from the pre-menstrual days into the period itself with Tampax waiting there to fill the need.

There has been a lot written in recent years about the blurring of lines between editorial content and advertising but the only blurring in this case is the unintentional design of the first page of the piece which is purposely shot out of focus to visually illustrate how women must feel as their hormones debilitate them.

Furthermore, the ad purposely counters all the frustrations exhibited in the previous three pages. The ad promotes the “invisible” period, thanks to this specific tampon, that has “leakguard technology” and a “discreet resealable wrapper.” All of these characteristics are meant to ease irritations associated with the period. And why wouldn’t a woman want to have her aggravations eliminated, especially after reading three pages of problems associated with PMS? It seems the message is that since there isn’t a menstrual product (outside of drugs) that can ease PMS, at least the period can be eased by this tampon.

PMDD: No News Is News, for the APA

July 11th, 2012 by Elizabeth Kissling

Guest Post by Joan Chrisler, Connecticut College

I have to admit that I have not been closely following the news about the forthcoming edition (5th) of the Diagnostic and Statistical Manual of Mental Disorders, which is expected to be published by the American Psychiatric Association in May 2013.  So, when our blog editor Elizabeth Kissling asked me to take a look at a recent update on PMDD in Psychiatric News, I was intrigued.  As I read the article I found myself becoming irritable, very irritable, even angry – but, don’t worry about me; I couldn’t possibly have PMDD, as I no longer menstruate.  No, my emotional lability has more to do with the psychiatrists’ tendency to play fast and loose with facts than it does with my physiology.

Photo by Ben Husmann // CC 2.0

The “news” begins with a statement that PMDD has been “proposed” to be included in the section on depressive disorders rather than in the appendix, which is reserved for disorders that need more study and shouldn’t yet be used clinically.  This is a canard.  PMDD appears in both the appendix and the depressive disorders section of the current edition – the DSM-IV-TR, which was published in 2000.  As a result, it is already being used clinically.  Perhaps what they really mean to say is that it is being removed from the appendix because we already know enough about it.  Hmmm.

Next, we are told that there has been an “explosion” of research on PMDD in the “past 20 years.”  Why 20 years?  PMDD was originally named Late Luteal Phase Dysphoric Disorder and proposed for listing in the DSM-II-R (1987); early research that was intended to support the new diagnosis was not convincing, which probably factored into the decision to change its name. The current edition of the DSM was published 12 years ago, and the original DSM-IV in 1995 (17 years ago).  According to PsycINFO, the largest psychology database, there have only been 259 articles published since the most recent edition of the DSM appeared, which hardly seems like an explosion, especially if we consider that many of them are about PMS, not PMDD.  Others are not empirical reports of studies about PMDD; they are literature reviews, critiques of the diagnosis, and articles about psychotherapy for women with the diagnosis. The 259 even include random studies of migraines, schizophrenia, bipolar disorder, and menopause.  The psychiatrists believe that these studies provide “greater legitimacy” for the diagnosis.  Sorry, but I am not convinced.

The news report indicates that the criteria have been sharpened to require the presence of at least five of eleven symptoms during “most” menstrual cycles of the previous year.  Prospective daily ratings are recommended, but it seems unlikely to me that most patients would be willing to wait or that most doctors would really insist that women rate themselves daily for a year before prescribing medication for PMDD.  Another change is that the symptoms must produce “clinically significant distress” and “interference” with work, school, relationships, or social activities. These require judgment calls: “clinical significance” is the doctor’s call, and “interference” is the patient’s call.

I predict that these “sharper” descriptions are still vague enough to be overused. Example: A student in one of my classes told me in all seriousness that her menstrual cramps interfered with her daily life because she had to take an aspirin occasionally.  Did she have to skip class and lay down with a heating pad?  No, she took her pill and went about her business.  “Then, how is that interference?”, I asked. “I don’t usually have to take an aspirin!”, she insisted. Now, I hope that that young woman is unusual, but I ask you to consider that the youth culture seems to value anything “extreme” and consider much of their experience to be unusual. My students think that (almost) everything is “awesome”, “incredible”, and “amazing”. If they were asked if their irritability is “extreme”, I suspect they would be much more likely than I would be to say “yes”.

Perhaps the most interesting (well, in a bad way) part of the news is that symptoms have been reordered to give priority to emotional lability, irritability, and anger and to deemphasize depressed mood. Why? “The work group agreed that clinically depressed mood is not the first thing you think of when you think of PMDD”.  Perhaps the work group is thinking about cultural stereotypes of premenstrual women!  If depressed mood is no longer a key criterion for PMDD, why is it still called PMDD?  Shouldn’t the work group have proposed a name change that would drop “dysphoric disorder”?  Why will it be continue to be classified with depressive disorders if it isn’t one?

Finally, the news report notes that how much distress and/or interference premenstrual symptoms produce depends on women’s personality, coping style, and life circumstances. Well, of course. There are many studies in the literature that show this. Stress, trauma, and even frequency of perceived discrimination (Pilver et al., 2011) predict severity of premenstrual complaints. There is much that psychotherapists can do to help women to manage their symptoms, but all the DSM suggests is drug treatment: SSRIs (selective serotonin reuptake inhibitors — the most commonly prescribed anti-depressants in the U.S.).

In conclusion, I refer readers to the SMCR’s resolution dated June 2001.  Women should continue to be cautious about whether their premenstrual symptoms constitute a mental illness and whether they want to take a strong anti-depressant medication for the rest of their menstrual lives. Other types of help, without potentially serious side effects and the stigma of a psychiatric diagnosis, might be effective.

For more information about PMDD and the DSM, see:

Caplan, P. J. (1995).  They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal.  Reading, MA: Addison Wesley.

Chrisler, J. C., & Caplan, P. (2003).  The strange case of Dr. Jekyll and Ms. Hyde: How PMS became a cultural phenomenon and a psychiatric disorderAnnual Review of Sex Research, 13, 274-306.

 

Understanding Research: Buyer Beware

April 2nd, 2012 by Paula Derry

xkcd.com // CC 2.5

I certainly believe that scientific research is important.  Research uncovers new knowledge and prunes away facts that are not accurate.  However, in our society, research is also a coinage to justify views of reality. A Biblical scholar might invoke a sentence from the Bible before holding forth on his own interpretation or opinions. In a similar manner, a scientific study might be cited or a scientist quoted to justify that something is real before jumping off into one’s own thoughts, opinions, theories, or justifications.  If a scientific result can be invoked, we can believe that something is true. Is there an unconscious?  Freud said so, but he’s out of date.  Are we intrinsically social beings?  Evolutionary theorists argue. Does meditation really result in an altered state of consciousness?  If I present results from research, preferably using a high tech measurement like a brain scan, or if I can come up with a theory that uses words like “neural nets” or “neurotransmitters,” then I can believe all of these things.

What’s wrong with this? Isn’t this science doing its job of uncovering truth?  There are two things wrong with this. One is that not all knowledge is scientific knowledge.  The second is that scientific results are often portrayed inaccurately in our society.

With regard to the first point, I’ll just give a few examples.  von Bertalanffy, a systems theory scientist, wrote that even a physicist will chase his (sic) hat when the wind blows it without knowing the mathematics determining which way the hat will blow.   Einstein famously said that not everything that was important could be measured, and not everything that could be measured was important.

But what I really want to talk about here is the second point.  We are inundated with scientific results in newspapers, websites, and other places. Most often, a brief summary of research is followed by broad generalizations about what the research means.   However, the outcome of research is not simple facts. Experiments are complicated things that must be evaluated by readers and understood in context.  When I was a graduate student in psychology, every class included practice in critiquing research.

To understand research, certain mathematical ideas are important.  “Statistical significance” is important to both accurate interpretation of research and to inaccurate or misleading reports. If you’ll bear with me, I’ll run through what I mean. Suppose you have a coin. If you toss the coin 100 times, it will come up heads about 50 times, not exactly 50 but close. Why?  That’s just the way the world we live in works, there are laws of probability. Since there are two possible outcomes—heads or tails—each will come up about half the time. If I toss my coin 100 times and it always comes up heads, I’ll probably conclude the coin is biased.  Why?  Because it just doesn’t happen; it’s extremely improbable, in the world we live in, that an honest coin would do this.

What if the coin came up heads 60 times? Is the coin honest or not?   The question is this: When is an outcome still “what you would expect by chance even though the numbers are not exactly alike (since we expect approximately 50 heads, not exactly 50)”?  On the other hand, when is the difference big enough that you would conclude that the coin is probably biased?   Sometimes it’s hard to tell.  In research, very often results are in the “hard to tell” category.   For example, if 55 percent of the women in my research prefer chocolate ice cream, while 65 percent of the men prefer chocolate, is there a real sex difference (it’s so improbable there’s a real difference) or is there not (the numbers seem different, but I’m not sure whether this is just because there is a range due to chance and not a real difference). Sometimes numbers that seem very different are actually what you could commonly get by chance, and sometimes numbers that don’t seem very different are very improbable.  In addition, what I’m studying may produce a weak rather than a larger, obvious effect because among us humans, for all kinds of psychological, social, and biological research, what is being studied is only one factor contributing to a situation and not the only thing going on.  In the example, even if men and women do have different likelihoods of preferring chocolate, there are many possible reasons for a person’s choices—diabetes, city you grew up in, getting rejected by a date while you were eating chocolate ice cream, etc.

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.