Psychology: Eighth Edition by Carole Wade and Carol Tavris. 2006.
Controversy has also raged about another long-term rhythm, the female menstrual cycle, which occurs, on average, every 28 days. During the first half of the cycle, an increase in hormone estrogen causes the lining of the uterus to thicken in preparation for a possible pregnancy. At mid-cycle, the ovaries releases a mature egg, or ovum. Afterward, the ovarian sac that contained the egg begins to produce progesterone which helps prepare the uterine lining to receive the egg. Then, if conception does not occur, estrogen and progesterone levels fall, the uterine lining sloughs off as the menstrual flow, and the cycle begins again.
The interesting question for psychologists is whether these physical changes are correlated with emotional or intellectual changes, as folklore and tradition would have us believe. Most people seem to think so. In the 1970s, a vague cluster of physical and emotional symptoms associated with the days preceding menstruation- including fatigue, headache, irritability, depression- came to be thought of as an illness and was given a label: "premenstrual syndrome" ("PMS"). Several popular books have asserted, without any evidence whatsoever, that most women suffer from it.
What does the evidence actually show? Many women do have physical symptoms associated with menstruation, including cramps, breast tenderness, and water retention, although women vary tremendously in this regard. And of course these physical symptoms can make some women feel grumpy or unhappy, just as pain can make men feel grumpy or unhappy. But emotional symptoms associated with menstruation- notably, irritability and depression- are rare, which is why we put "PMS" in quotation marks. In fact, fewer than 5 percent of all women have such symptoms predictable over their cycles (Brooks-Gunn, 1986; Reid, 1991; Walker, 1994). Just as with "SAD," more people claim to have symptoms than actually do.
If true PMS is so uncommon, then why do so many women think they have it? One possibility is that they tend to notice feelings of depression or irritability when these moods happen to occur premenstrually but overlook times which such moods are absent premenstrually. Or they may label symptoms that occur before a period as "PMS" and attribute the same symptoms at other times of the month to a stressful day or a low grade on an English paper. A women's perceptions of her own emotional ups and downs can also be influenced by cultural attitudes and myths about menstruation. Some studies have made biases in the reporting of premenstrual and menstrual symptoms more likely by using the questionnaires with titles such as "Menstrual Distress Questionnaire."
To get around these problems, psychologists have polled women ab out their psychological and physical well-being without revealing the true purpose of the study (e.g., AuBuchon & Calhoun, 1985; Chrisler, 2000; Englander-Golden, Whitmore & Dienstbier, 1978; Gallant et al., 1991; Hardie, 1997; Parlee, 1982; Rapkin, Chang & Reading, 1988; Slade, 1984; Vila & Beech, 1980; Walker, 1994). Using double-blind procedures, they have had women report symptoms for a single day and have then gone back to see what phase of the menstrual cycle the women were in; or they have had women keep daily records over an extended period of time. Some studies have included a control group that is usually excluded from research on hormones and moods: men! Here are the major findings:
* No gender differences exist in mood. Overall, women and men do not differ significantly in the emotional symptoms they report or the number of mood swings they experience over the course of a month, as you can see in Figure 5.1 (McFarlane, Martin & Williams, 198
* No relationship exists between stage of the menstrual cycle and emotional symptoms. Most women do not have the typical "PMS" symptoms even when they firmly believe they do (Hardie, 1997; McFarlane & Williams, 1994). They may recall their moods as having been more unpleasant before or during menstruation, but, as you can also see in Figure 5.1, their own daily reports fail to bear them out.
* No consistent "PMS" pattern exists across successive menstrual cycles. Even when women know that menstruation is being studies, most do not consistently report negative (or positive) psychological changes from one cycle to the next. Their moods and emotions vary far more in degree an direction than one would expect if predictable hormone fluctuations were the main reason for these changes (Walker, 1994).
* No connection exists between "PMS" and behavior. There is no relationship between stage of the menstrual cycle and work efficiency, problem solving, motor performance, memory, college exam scores, creativity, or any other behavior that matters in real life. (Golub, 1992; Richardson, 1992). In the workplace, men, premenstrual women, postmenstrual women, and nonmenstrual women all report similar levels of stress, wellness, and work performance (Hardie, 1997).
These results are unknown to most people and have usually been ignored by doctors, therapists, and the media. As a result, since the 1970s, premenstrual symptoms have come to be defined almost solely in medical and psychiatric terms (Parlee, 1994). In 1994, over the objections of many psychologists, the American Psychiatric Association included "premenstrual dysphoric disorder" (PMDD) in an appendix of the Diagnostic and Statistical Manual of Mental Disorders, the official guide to psychiatric diagnosis. The label is supposed to describe a rare and debilitating disorder, but its description includes the same hodgepodge of physical and emotional symptoms as "PMS" does. A few years ago, the antidepressant Prozac was repackaged and marketed as Sarafem, a medication supposedly just for PMDD.




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