In 1931, a condition called “premenstrual tension” was described for the first time in a scientific study by gynecologist Robert Frank. His advice for women with severe cases of premenstrual tension? Radiate the ovaries, or completely remove them. Fast forward 80 years and the treatment of premenstrual syndrome hasn’t progressed far from this drastic approach. Yes, as a last resort, women with extreme PMS still opt to have their ovaries taken out. If removing an entire organ sounds archaic, it is, but there’s a reason why this still happens in the 21st century.
For decades, PMS, its causes, and the question whether it is actually a medical condition have been shrouded in mystery. PMS is a complicated health problem as symptoms and severity differ in every woman and, even in individuals, often vary from month to month. This makes it difficult to study and has led to a vicious cycle developing in PMS research – scientists don’t understand what causes PMS, meaning there is little scientific research into it, and, in turn, less funding for new studies.
What’s known is that PMS has to do with hormone changes during the luteal phase of the menstrual cycle. Chemical changes in the brain – a reduction of serotonin triggered by these hormone change – may also play a role in PMS. So may lifestyle factors like stress and diet. Others may have a genetic predisposition to PMS, psychologist Carolyn Janda says.
To put how little research has been done into PMS into context, a search of titles and abstracts on ResearchGate found there are over five times more studies into erectile dysfunction than into premenstrual syndrome. That’s despite the fact that approximately 19 percent of men experience erectile dysfunction over the course of their lifetime, while over 90 percent of women report some symptoms of PMS.
Over 40% of women who have PMS do not respond to treatments currently available
Defining the symptoms is where the problem of researching PMS starts. Researchers still don’t agree on what the symptoms of PMS are – over 150 are commonly listed, from the predictable bloating and mood swings, to headaches, sleep disorders, and even clumsiness.
This lack of consensus means women are often unsure which symptoms they can actually attribute to their period, and which are unrelated. This also makes treatment – let alone finding a cure apart from hysterectomy – difficult. Treatment currently includes taking a class of antidepressants, selective serotonin reuptake inhibitors, to easy emotional imbalances. Hormonal contraception is commonly used too. There’s also evidence that certain alternative treatments help alleviate symptoms, including chasteberry. However, over 40% of women who have PMS do not respond to treatments currently available, and five percent have premenstrual dysphoric disorder (PMDD), a condition so severe that 15 percent of sufferers attempt suicide at some point in their lives.