PMS gets in the way of life. The symptoms are bad enough on their own, but when they affect others—friends, coworkers, family, and significant others—PMS can have a ripple effect that reverberates throughout work, family, and social life.
This makes it especially unfortunate when doctors, the media, and even family and friends minimize PMS and its symptoms. What woman with PMS symptoms hasn’t been told to “buck up,” or “it’s all in your imagination,” or “you just have to learn to live with it”?
This attitude has made the PMS ripple effect the butt of jokes and a source of eyeball-rolling, rather than receiving the serious attention it deserves. As much as our focus on this site is on the relief of PMS symptoms, and on helping women overcome PMS so they can get back to living their lives, it’s worth taking a moment to look at how PMS effects others as well.
The problem in discussing this is that we don’t want to give more ammunition to those who will use any reason to attack the very existence of PMS, and to question the legitimacy of the suffering experienced by women with PMS. We have no sympathy for that point of view. But it is important to recognize that PMS has a financial and morale cost to employers and the health care system. While its main effect is on the women who suffer from PMS, its ripple effect exists and interferes with work and home productivity, work morale, relationships, and it does cost money.
Several studies back this up. One, from 2003, found that PMS negatively impacted women’s work productivity and work attendance, their ability to pursue hobbies and interests, and that women with PMS had more doctor’s visits and health care costs. Another study, from 2008, found that 25% of women have such severe PMS that it interferes with work, family, and social life! A 2009 paper reached similar conclusions: PMS affects not only the women with the condition, but also their employers and insurers: women with PMS have more health care visits, higher health care costs, are less productive while at work, and miss more workdays than women without PMS, resulting in a decreased quality of life.
Our point is, a decreased quality of life for a woman with PMS means a decreased quality of life for her co-workers, her family, her friends, and her significant others. The PMS ripple effect!
Even though PMS has now been proven to decrease productivity at work, increase work absenteeism, increase health care visits so that employers lose a tremendous amount of money to PMS—still, none that we know of provide any support, counseling, or awareness programs.
The most direct effects of PMS are on the woman who suffers, and this suffering interferes with living and enjoying life. But the indirect effects at work, at home, and in relationships are both significant and costly. We believe PMS and its impact on everyone it touches is under-recognized, and that effective natural treatment can make a huge impact on women’s lives, as well as on the lives of those who experience PMS’s ripple effect.
What symptoms really mean you have PMS? Many reliable sources suggest there are over 150 PMS symptoms. Academic studies typically rely on a mere 17 symptoms that are often considered to be the true PMS symptoms. Most women have some idea of what most of those 17 are, including cramping, bloating, irritability, anger, headaches, crying easily, and the like.
A 2011 paper published in the Journal of Women's Health followed 1,081 women who were seeking conventional medical treatment for PMS and attempted to determine which of their symptoms were the most accurate predictors of PMS. That is, which symptoms really distinguished PMS from "not-PMS"? Keep reading and you'll find out what they discovered!
This might seem like a waste of time. After all, if you get crabby and crampy every month a week before your period, you have PMS, right? The problem is two-fold: it turns out that when people have to remember and record symptoms, their memory and accuracy are less than perfect. Apparently, we all have trouble comparing how we feel now to how we felt before; and our criteria for what a symptom is, or what its severity is or was, shifts continuously. So, it's important for researchers to be able to distinguish true PMS from "not-PMS."
An illustration might be in order: let's say our patient "Chantal" has actual clinical depression. It makes her lose interest in her usual activities and she has a tendency to withdraw from others when she's feeling down. And, like almost everyone with some depression, some days are better than others. Let's also say that, for cultural reasons, it's difficult for Chantal to admit depression (many cultures have a social taboo against psychological illness) but easier to admit to a condition that tends to be considered physical, like PMS. Since Chantal's symptoms are worse on some days than others, it's fairly easy to pay closer attention before the period and conclude that that is when the symptoms are occurring the most. Chantal probably isn't aware of her own cultural bias either, so she does not have an objective view of her own symptoms.
A doctor or researcher, who wants to help other doctors and researchers treat and investigate PMS, needs to have a way to distinguish PMS from clinical depression that could be mistaken for PMS. In conventional medicine, most treatments are drugs that have side effects and have the potential to cause bigger problems than they solve, so it's important to get the right fit between the diagnosis and the treatment. And, suggesting therapy or counseling to someone who has PMS—a biochemical disorder—rather than depression might end up being pretty frustrating for everyone!
So, back to the study. These researchers found that just six symptoms worked as well as the full 17 symptoms to distinguish PMS from "not PMS."
Those six symptoms: food cravings; cramps; anxiety/tension; mood swings; decreased interest in usual activities; and aches. These symptoms probably sound very familiar to anyone who has, or has had, PMS. Interestingly, this study found that food cravings were the most reliable indicator of PMS.
Does this mean that if your symptoms aren't on this list, you don't have PMS? Not at all. If you have (to pick a few symptoms that were not part of the six) premenstrual headaches, fatigue, irritability, and sadness most months, and these symptoms interfere with your life, you almost certainly do have PMS. What this research tells us is that those six symptoms, when they occur before the period, are very accurate predictors of PMS.
You might have read all this, and still think: "This is silly. What does it matter which six or nine or 18 symptoms I have? They happen every month before my period, so it must be PMS. Duh!" To that, we can only say, this is how medical research works. It's not perfect. It never correctly predicts anything with 100% accuracy. Over time, though, if enough studies can look at a similar set of circumstances from several different angles, we end up with a very accurate sense of what is going on.
