Is it true that PMS does not exist?

There is a widespread belief among both men and women that premenstrual syndrome does not exist, and those who complain about it are hysterics and malingerers. We decided to check what science knows about PMS.

IN Media And blogs authors regularly are given question, does PMS exist at all or is it just for women? whims. Articles trying to figure out whether PMS actually exists were published in the publications “Gazeta.ru» (“Pain, depression, tantrums: myths and truth about PMS”), “Arguments and facts» (“Yes, I’m freaking out!” Premenstrual syndrome: a woman’s whim or reality?), “VkPress» (“Katya is on fire: Is PMS a woman’s whim or reality?”). In January 2022, the satirical publication “Panorama” published comic news: “Russian scientists have proven that PMS does not exist.” Women themselves do not believe in the existence of PMS, according to data survey of VTsIOM and pharmaceutical company "Gideon Richter» 37% of men and 61% of women consider PMS an excuse for incontinence and bad mood, and not a real disorder.

PMS, or premenstrual syndrome, is state, which can occur in women seven to ten days before menstruation and include one or more manifestations. The most common symptoms of PMS are anxiety, anger, insomnia, problems concentrating, lethargy and fatigue. Fluid retention can lead to edema, temporary weight gain, and tenderness of the mammary glands. There may be heaviness and a feeling of pressure in the lower abdomen and back, as well as skin rashes.

By data According to the Office of Women's Health at the US Department of Health and Human Services, up to 90% of all American women experience PMS during their lifetime. In 2014, a group of researchers let me down results of a meta-analysis of the prevalence of PMS in different countries. In the world as a whole, according to their data, 47.8% of women suffer from this pathology: the least in France (only 12%), and the most in Iran (98%). By different data, from 5% to 20% women experience symptoms so severe that they interfere with work or school. This condition is no longer called PMS, but PMDD - premenstrual dysphoric disorder. 

Both PMS and PMDD were coded the same way in ICD-10 - N94.3 (section “Diseases of the genitourinary system”). But in ICD-11, the transition to which in Russia started January 1, 2022, pathologies were divided: now a code is provided for PMS GA34.40, and for PMDD - GA34.41. The fact that PMS is in the ICD means that doctors agree on the symptoms and manifestations of diseases and can distinguish PMS from other pathologies. However, there is no consensus among the medical community regarding the causes of PMS. Bye No.

Researchers notethat hormones may play a significant role. At the same time, the development of PMS is also facilitated by mental state—women with a high level of stress, having V family and personal history depressive disorders. Age also acts as an additional risk factor - symptoms are most pronounced in women after 30 years of age and before menopause. In 2016, scientists also notedthat more severe PMS symptoms correlate with higher levels of CRP, an indicator of tissue damage from inflammation as well as necrosis or injury. That is, presumably, a latent inflammatory reaction may also play a role.

Also researchers notethat the severity of symptoms can be affected by cycle-related fluctuations in calcium levels in the body. Another hypothesis connects PMS with fluctuations in serotonin levels. Progesterone, a hormone that prepares a woman's body for pregnancy and rises after ovulation, reduces levels of serotonin, also known as the happy hormone, so a woman may experience symptoms similar to depression. In such cases, for the treatment of PMS appoint SSRI antidepressants are selective serotonin reuptake inhibitors that help prevent fluctuations in its levels in the body. In addition to antidepressants, non-steroidal anti-inflammatory drugs and diuretics, as well as hormonal contraceptives that stop ovulation, can help. In rare cases, when symptoms are so severe that they interfere with normal life and drug treatment does not help, doctors accept the decision to undergo a hysterectomy, that is, removal of the uterus. 

However, PMS research is underfunded. Psychologist Carolyn Janda counted, that on the ResearchGate website, one of the largest libraries of scientific publications, there are five times fewer articles on PMS than articles on erectile dysfunction. However, only 19% of men experience erectile dysfunction, and the prevalence of PMS can reach 90%. For example, University of Washington psychologist Kathleen Lastyk refused in funding research work on PMS on the basis that, according to the reviewers, "PMS is simply a product of our society or culture that portrays a natural process in a negative light and which, given its monthly predictability, leads to suffering through waiting." 

The self-fulfilling prophecy effect may indeed play a role in increasing PMS symptoms. In 1977, Diana Rubble from Princeton University, using hormonal drugs "untied» the cycle of women volunteers from their ideas about when it should happen. As a result, when women filled out questionnaires, those who were told they were about to get their period complained more about symptoms, including physical ones (such as fluid retention and swelling), than those who were told they were mid-period. 

Thus, the nature of the occurrence of PMS has not yet been scientifically clarified, but the fact that this condition actually exists, and is not invented by women to justify their whims, does not raise questions among the scientific community. Perhaps, if grant givers become more active in funding research on this complex condition of the female body, science will sooner receive an answer to the question of why it still occurs.

Cover image: Bionorics

Not true

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