Premenstrual Syndrome - Alternative Views

Alternative Views

Some medical professionals and other people believe that PMS might be a socially constructed disorder rather than a physical illness.

In women with PMDD—which supporters of the medical model of PMS say is a severe form of PMS, and critics say is unrelated—studies have shown a correlation between self-reported emotional distress and levels of a serotonin precursor as measured by positron emission tomography (PET). PMDD also has a consistent treatment record with SSRIs, when compared with placebos. The decision to call PMDD an illness has been criticized as inappropriate medicalization.

Most supporters of PMS as a social construct believe PMDD and PMS to be unrelated issues: according to them, PMDD is a product of brain chemistry, and PMS is a product of a hypochondriatic culture. Most studies on PMS and PMDD rely solely on self-reporting. According to sociologist Carol Tavris, Western women are socially conditioned to expect PMS or to at least know of its existence, and they therefore report their symptoms accordingly.

Another view holds that PMS is too frequently or wrongly diagnosed in many cases. A variety of problems, such as chronic depression, infections, and outbursts of frustration can be mis-diagnosed as PMS if they happen to coincide with the premenstrual period. Tavris says that PMS is blamed as an explanation for rage or sadness.

The use of multiple SSRI's to treat PMS has caused some controversy. The makers of Prozac began marketing the generic form, fluoxetine, under the name Sarafem to treat PMS. This coincided with their loss of patent on Prozac, which has led to one suggestion that their motives are not completely benign. An oral contraceptive named drospirenone (Yaz) was approved to treat PMDD. The marketing of Yaz centers on this aspect of the drug.