In all the controversy over the new DSM-5, it was inevitable that a long-standing fight over premenstrual syndrome would be revived. Eighty-five percent of women claim to have suffered from this disorder, but repeated research shows there’s actually no relationship between daily moods and shifting monthly hormone levels. The debate is nothing new. In her classic 1993 feminist text The Mismeasure of Woman, Carol Tavris argued that the idea of PMS persists because it gives women an excuse to express anger and irritation in a culture that expects them to be unendingly cheerful and pleasant. (It also panders to the belief that women are irrational victims of their own hormones.) Being able to blame your socially incorrect emotions on chemical shifts is intoxicating: Tavris showed that even when confronted with evidence that menstruation doesn’t affect mood, “Many women are highly resistant to the evidence that their beliefs and expectations about PMS might be influencing their symptoms.”
But PMS is increasingly understood as a “culture-bound syndrome,” a disease of societal expectations, not biological influences. Psychologist Joan Chrisler spelled it out bluntly in 2002: “It’s convenient for women to use this … . The discourse is me, not me, my real self, my PMS self. It allows you to hold onto a view of yourself as a good mother who doesn’t lose her temper.”
Culture-bound syndromes can vary wildly, and some of them are really weird to outsiders. Parts of West and Central Africa have epidemics of men who believe that their penises have been stolen. As with PMS, the distress to the sufferer is entirely real, even though the empirical evidence demonstrates that there isn’t a biological source for the suffering. Other examples include the dhat syndrome in India, the Native American “ghost sickness” and the Korean “fire illness.”
Of course, referring to problems like penis-stealing or PMS as culture-bound syndromes may well convince sufferers that they are being dismissed. But research shows that women who self-identify as suffering from PMS and who take active steps to reduce stress, avoid unnecessary conflict, and set aside time for themselves start to feel better. Hot baths and minimizing your contact with difficult people is a good idea, it seems, regardless of whether you blame your bad mood on impending menses or a lousy day at work.