Friday, May 8, 2009

PMS is a Social Construction

A couple of people have questioned me about my comments suggesting that PMS is a social construction. So I'm reposting this. I posted this on Feministing a few months ago, so if you're interested in the responses, check out the comments there.



I know from previous posts that this is a sensitive issue, so I want to clarify a couple of things right up front. To say that PMS is a social construction does not mean that women don’t experience it. It does not mean that “it’s all in your head.” It does not mean that your experience doesn’t exist, or is invalid in some way. Rather, the claim is that the explanatory framework surrounding this set of experiences is faulty, and that it would be more constructive to look for and attempt to address the true causes behind this phenomenon.

So, what does it mean to say that PMS is a social construction? A social construction is any contingent phenomenon that is created by a society. Social constructs exist only because the members of a society implicitly agree to behave as if they do. Generally speaking, there are conventions around social constructs that guide our behavior regarding them. The most common example used to illustrate this is paper money. Paper money would be worthless if it weren’t for our practices and conventions.

What evidence is there that PMS is a social construction? First, there’s a great deal of cultural mythology surrounding the concept of PMS that has no grounding in science. There is no identifiable hormonal cause for the symptoms of PMS. This is particularly significant when you consider how much research has been done. There is no consensus within the medical community on how to diagnose PMS, on which symptoms must be displayed, or on when in the menstrual cycle they should occur. Over 150 symptoms are attributed to PMS, many of which are experienced by men and post-menopausal women with the same frequency as menstruating women. In countries which don’t have a construct corresponding to the Western idea of PMS, women don’t report experiencing the symptoms in any pattern tied to menstruation.

Add to this the benefit a patriarchal culture derives from any mechanism which serves to marginalize women and explain away their behavior and cognition as merely the result of some bio-chemical event. When women voice legitimate complaints or concerns, it is common to suggest that they are “feeling hormonal.” This serves to delegitimize their claims and cast them as irrational, overemotional creatures. Further, PMS has historically been used as a mechanism to keep women out of the work force when jobs were scarce for men due to the Depression and the end of wars. Of course, in times when women were in demand in the workforce, research was used to demonstrate that PMS was not an issue and would not prevent women from being productive members of the workforce (for a fascinating history of this topic read Emily Martin, The woman in the body: A cultural analysis of reproduction ). In addition, the economic motives of the medical and pharmaceutical industries are solidly at play here. PMS and PMDD have been useful in allowing pharmaceutical companies to extend their patents and thus retain a monopoly on revenues. Although the underlying causes of the symptoms of PMS have not been identified, the pharmaceutical companies continue to offer remedies.

Finally, reports of PMS symptoms are far more severe in women who are in or have a history of abusive relationships , are experiencing high levels of stress, feel overwhelmed by their workload, or are unhappy with their lives in general. This correlation suggests that women who are unhappy with their lives subconsciously utilize the construct of PMS as a socially acceptable outlet for the suppressed frustration and rage they feel, since expression of these emotions is widely viewed as “unfeminine.”

All of these things suggest that PMS is a social construction. If PMS was a disease or a syndrome there would be some underlying bio-medical cause, as well as some consensus among women who are diagnosed as to what the symptoms are and when they are experienced in the menstrual cycle. But there isn’t. Retaining PMS as a medical and cultural fact does not benefit women. Researching PMS with an open mind regarding other possible causes and related phenomenon would benefit women far more than clinging to the notion that women are fundamentally flawed by the normal functions of their reproductive systems. Finally, simply prescribing antidepressants to help women deal with the hardships in their lives is one way to avoid addressing the more challenging and important issues regarding the societal causes of their depression and unhappiness.

26 comments:

  1. Anonymous5/10/2009

    I think that saying that PMS is a "social construct" is over complicating the issue by use of academic jargon. Research has shown that female primates in Kenya udergo a similar process to PMS. I've heard that the medical establishment "treats" PMS with Seratonin injections. So, I don't think we can completely take this out of the realm of the scientific and into the social. What we can say is that the language that we humans use to describe PMS is not well understood.
    -Ben

    ReplyDelete
    Replies
    1. CaroLuna10/24/2013

      It is precisely in language use that we can agree there is no agreement as to what is PMS. However, the fact that it is real (at least in it's own created category) is obvious.

      Conceptualizing PMS as a social construct does not "over complicate" the issue. On the contrary, it brings the debate back to where it started: society and culture signification. If it were a simple biological process, why is it included in the DSM as a psychological disorder?

      Ascribing it's psychological dimension, one has to admit the fact it is a social construct since not every culture signifies the same way. Hormonal changes do happen, but the way a particular society signifies it is very diverse and relative.

      By going farther and making it a 'gendered issue', real profound problems arise especially taking into account patriarchal scientific occidental view of women in a capitalist context.

      Delete
    2. Anonymous3/03/2015

      Too many buzzwords in that post.

      Delete
  2. Ben,

    I'm not saying that hormones never cause discomfort or anything like that. However, the huge cultural mythology that's built up around PMS is almost completely unfounded scientifically and serves to marginalize and deligitimate the real concerns and experiences of women in our culture. Men also have a monthly hormone flux, which can also lead to differences in the way men experience the world and interact with it. However, their voices are never, ever dismissed because they're simply "feeling hormonal." Further, much of the fruitful research that could be done on hormones in general, and their effect on both male and female behavior and experiences, and stress hormones, and the changes in how the body responds to hormones when the person is stressed or has experienced trauma, is not being done because so much of the research is informed by our cultural mythology surrounding PMS. That's a huge problem.

    ReplyDelete
  3. Meg'n5/11/2009

    I think you're totally right about this.

    ReplyDelete
  4. This is a great post! There's nothing I hate more than the whole "you're just PMSing" thing. It's so dismissive and, as you say, deligitimizing.

    ReplyDelete
  5. Lyndsay5/14/2009

    I have a couple questions that maybe could give you ideas for an entry. Or maybe you've already written an entry on gender essentialism. I'm wondering if there's a term for what is the opposite, believing men and women are different only because of society. I know someone who believes behavioural differences in gender have nothing at all to do with biology. Now, that makes me think if someone believes that, do they believe NO behaviours come from biology? That we are a blank slate when we're born? Because if a Y instead of an X and different hormones in utero don't have any effect why would any other genes or hormones have an effect on how we act? If men, on average, aren't more aggressive than women because of biology, does that mean anyone who's very aggressive has only their family, friends, society and him or herself to blame? So maybe you could write a post about not just gender essentialism but on thinking some part of gender differences is caused by biology. I think you'd have interesting things to say. And also, what is wrong with acknowledging some gender differences?

    ReplyDelete
  6. Lyndsay,

    Usually social constructionists are portrayed as the polar opposite of essentialists, although this isn't always, or even usually, accurate. A social constructionist view of gender is explained here. Many social constructionists acknowledge that there are differences between men and women, but maintain that they are very small but are magnified by our culture, given a huge amount of significance, and don't justify the huge edifice of gender that's built up around these small biological differences. So they wouldn't agree that any part of gender is caused by biology, but rather that some sex differences are.

    I'm not sure if that helps or not.

    ReplyDelete
  7. Anonymous6/25/2009

    Lyndsay,

    To build on what Rachel said (I think), social constructionists can also note that even when differences between men and womyn due to biology might exist on average, there can still be a lot of overlap. For example, men are taller than womyn on average. Are you going to bet very much on the gender of someone you are told is 5'6"? If there is a statistically significant effect of biological sex on some variable but there's a huge amount of variation among both populations, it is strange to consider sex to be so important.

    John

    ReplyDelete
  8. I love this post. There was in interesting episode of "This American Life" where Ira Glass tested Testosterone levels of all the men in a particular office. Though you would have thought that the "manliest" man in the place would have tested highest, there results were surprising. Earlier in that episode, Ira interviewed a man whose body no longer manufactured testosterone; he described his interpretation of the world, post hormones, similar to how I imagine enlightenment might be; suddenly, he was able to pay attention to things without the underlying feeling of drive that he had previously experienced. I marveled at the role human hormones play in our experience of life. Add to that social constructs that allow us to interpret our normal ebb and flow as a disease, and I wonder how much free will humans have without hormonal influence....

    ReplyDelete
  9. TClaire12/13/2010

    Just wondering, are you counting cramps as part of PMS? Because I can only speak for myself, but I'm not sure how they would be socially constructed. I realize they could be psychosomatic, but my own experiences with [pre]menstrual cramps make me dubious for various reasons.

    ReplyDelete
    Replies
    1. Anonymous12/03/2014

      Right! I'm wondering it waking up at 5am to cramps so bad that I can't even get out of bed and make it to the bathtub, are they socially constructed? It hurt so bad that I vomited. It's not like I could control it or make it go away, because if that were the case then I would have. How can that be psychological? I think it's just easier to brush these symptoms off as psychological rather that evaluate the gender-related biological differences. Female research is more complicated; researchers need to complete less standardized studies. Hormonal shifts and the symptoms that come with these shifts are not a physical or psychological disorder. It is natural and due to lack of proper research we don't understand how it all works. The DSM pathologies PMS. Research only really began in the 80's.

      Delete
    2. See my earlier comment below on physiological symptoms.

      Delete
  10. TClaire,

    The physiological symptoms that accompany menstruation aren't generally considered PMS, although it depends on whose definition you're talking about. There was a fairly robust discussion of this in the comment thread of the orginal post at Feministing.

    I do think it's significant that women in cultures that don't have the PMS construct experience the physical symptoms but not the emotional/mental health symptoms that we attribute to female hormones. Once again, of course, I'm not saying women don't experience these things, but that the explanatory framework of PMS is counterproductive, not scientifically founded, and often misogynistic.

    ReplyDelete
    Replies
    1. Anonymous8/15/2012

      >women in cultures that don't have the PMS construct

      ... are usually highly patriarchical and surpress women so far, that they dont even get to "express" themselves in any aggressive ways.

      Delete
  11. I don't think the problem itself is a social construct although a lot of things that get attributed to it possibly are.

    If the symptoms were purely emotional, the social construct idea would be more plausible. However, 2 things...I get physical symptoms such as tiredness, physical weakness and increased tendency to hypoglycemia along with mine. How does social teaching cause that? I am also irregular a lot which makes knowing when I am about to have one difficult and yet when my cycle does come back it's usually after suffering all the symptoms described. If it were socially constructed you'd think I'd 'forget' to develop the symptoms since I wouldn't know I was about to menstruate.

    ReplyDelete
  12. Rachel9/27/2011

    Right. The physiological symptoms aren't usually considered to be PMS (see comment above). But even with physical symptoms, the way we experience them has a lot to do with our expectations and our perception of mentruation. For instance, in cultures (like ours) where childbirth is thought to be terribly painful and dangerous, women report experiencing more pain, and the physiological measures of pain are heightened during childbirth. But in cultures where this isn't the case, women don't report experiencing the same levels of pain, and the stress signs in their bodies that are generally associated with pain show up at a much lower level. So there's a complex interplay there.

    ReplyDelete
  13. Hello all. I find this subject to be fascinating! I'm not sure what to think yet but I definitely see a combination of social construct, psychosomatic, physiological and psychological factors at play. I'm actually so fascinated by this debate that I'm doing a paper on it for school and I was wondering if any of the statements made here could be referenced? I would appreciate it!

    ReplyDelete
  14. As someone who suffers from PMS, I just find it insensitive that you would suggest it is socially constructed. There are a lot of factors that go into someone having PMS (which is sooo broad), that is true. But to say it is socially constructed is a whole different story. PMS can be compounded by industrial chemicals as well as someones emotional life. I do think a small minority suffers from the actual symptoms of PMS. There is not enough science on PMS! Science can come up with many contradictory studies on nearly ALL TOPICS that are hard to study. Just because there is a lack of science does not mean it exist. I understand your point about how PMS is used so trivially to make subjugate women, but to say that it is socially constructed just makes those who actually suffer from it feel even more out of marginalized.

    ReplyDelete
    Replies
    1. I understand your point and I do take it seriously. I suspect I would word some of this differently if I were writing it today.
      However, the point remains that to say that something is a social construction is not to say that it isn't real. Money is a social construction, but it's very very real. Each and every one of us went to school at some point in our lives - for years, and it's a social construction. Our experiences of things that are socially constructed are very real - they impact our lives deeply and daily. The point is simply that when something has been built up in this way and used to delegitimize women, it bears some scrutiny and rethinking.

      Delete
  15. A social construction of menstruation is also what people are expected to react when they hear about tampons and periods. Periods are believed to be gross and women are taught to be shameful of it and keep it hidden. Men refuse to buy tampons for their ladies because its gross. Also women and men believe it is gross to have sex during menstruation when it's not. It is just a natural occurrence. In reality it is not gross nor does it prevent women from doing anything in their lives. It should be welcomed with open arms and a part of womanhood rather than shunned and kept secret. Conventional products and pharmacies play on this shame and reinforce it. Such as needing menstrual wipes to be kept "clean" but menstrual blood is not actually dirty (unless the woman has STD's or something) but that's another story. Women don't want to leak because it is shameful to have a period. They say "its that time of the month" because it is so shameful that they can't even call it by its proper name. Pharamacies and drug companies attempt to help women no longer having periods with the use of certain birth control pills such as Seasonique where their slogan sells fewer periods and "more possibilities" as if menstruation is so debilitating. We have to remember that once upon a time while developing in mothers uterus, we were exclusively surrounded by her menstrual blood uterine lining for months. Nothing gross about it. Also fun story: in my first semester of college, my backpack was wide open and I had a little tampon purse in there. Some guy asked what it was. I told him "I put my tampons in it." He immediately went quiet and embarrassed. LOL.

    ReplyDelete
  16. Anonymous3/02/2014

    I wrote a comment and it wasn't published :-(

    ReplyDelete
    Replies
    1. I'm not sure what happened to it - I don't see a comment on this post in the Spam folder.

      Delete
  17. Anonymous5/28/2015

    Actually, there are many hormonal problems that can contribute to premenstrual dysfunction, including thyroid disease, Cushing's disease, Addison's disease, pituitary tumors, PCOS, etc. There are so many possible explanations that you need a battery of endocrine tests to narrow it down to just one per patient. PMS is something that is seldom adequately addressed from an endocrine viewpoint (and endocrinology is already a terribly under-researched field) and needs to be. This may sound harsh, but my opinion is that this article was poorly researched and poorly written from a medical point of view and will enable even more doctors to write off women with severe premenstrual problems, whether emotional or physical, as silly hysterics who are giving in to a social construct. In an age where many people may be impacted by the presence of endocrine-disrupting chemicals such as xenoestrogens in the environment, this is dangerous.

    ReplyDelete
  18. BTW the link to your original article on Feministing is broken. I did not find your article on that site by searching for it either. Have they removed it for some reason?

    ReplyDelete