Is PMS A Myth? This Researcher Says Yes, And That It's Holding Women Back

If you were to believe the countless YouTube skits of "what girls say on their period," or every stereotypical portrayal of the "crazed hormonal woman," you'd think women who menstruate were mentally incapable of basic day-to-day functioning — never mind being trusted with positions of power. And beyond menstruation, hormones apparently turn us into depressed and dangerous women after giving birth, and make us unhappy and unhinged when we hit menopause.

But looking at the studies done since the 1990s, there's little hard evidence that hormones have any major bearing on a woman's emotions during menstruation. New York–based psychologist and professor Robyn Stein DeLuca has been researching and writing about postpartum depression and women's health for over a decade. In her new book, The Hormone Myth, she challenges how our culture dismisses women's legitimate personal frustrations as "just hormones" and brush off actual depression as "mood swings." (She's even given a TED talk on PMS.)

We talked to DeLuca about what she believes is a stereotype that has for a long time been harmful to women, and asked her how she understands those anxious or weepy or irritable emotions that many women do experience before their periods.

Why did you write this book?

I want to encourage people to be skeptical when they read about PMS. I want them to know that research doesn’t support the existence of widespread mental disorders when women’s hormones change, and I want women to be generous with themselves and other women when they express negative emotions.

For many women who experience these feelings at regular intervals that coincide with their period, PMS does feel very real. So what's the danger in saying "I'm feeling hormonal" or blaming PMS for your feelings?

It makes me sad that women feel like their bodies are betraying them, or that they can’t trust themselves. It keeps you from figuring out what’s really going on and it gives other people an easy way to dismiss any kind of anger or disagreement that you have with them. For example, some women feel tearful or moody after giving birth. Usually it goes away on its own, but when it's a full depressive episode that lasts over at least two weeks where they feel hopeless, sad, exhausted and they find no pleasure in anything — it's postpartum depression. Hormones alone don’t play a role in that.

So what do you think is really going on when women get postpartum depression?

It's much more significant to look at whether she was depressed before she had the baby. You have to look at what her situation is like when she comes home. Does she have a good marital relationship? Does she have good support from family and friends? Things like that are much more powerful.

Why don't we challenge this notion that "women are overly emotional because of their hormones" more?

Because that explanation is everywhere, and women have come to internalize it. From the fifth grade, girls are given packets from companies that make tampons and pads that say, "you may experience an emotional roller-coaster when you get your period." They’re told that mood swings are a normal thing they should expect from a young age. Then this idea of the irrational, crazy, hormonal woman picks up in movies, TV shows and the Internet. There was an episode of New Girl where Zooey's character goes nuts because she’s about to get her period. And there’s that show with Allison Janney where she does crazy things like throwing a phone out the window because she’s menopausal.

There's also a whole industry of physicians and psychologists who claim to give PMS treatment and workshops. They'll say you need to exercise, have a specific kind of diet or you need to pay someone. For so long, the medical field has imagined women’s reproductive processes in terms of illness. As if menopause is not a normal decrease in hormones, but a deficiency that needs to be treated.

When Hillary Clinton was running for president, there was a column in TIME magazine where the author said it’s just so great that Hillary is post-menopausal because she can be president and we don’t have to worry about all those awful mood things. That’s an awful thing to say! First of all, Hillary Clinton has been high-functioning throughout her whole life. But to say that a woman can’t be counted on to have a lot of power until she’s post-menopausal? That’s ridiculous.

When I’m suddenly feeling sad or angry before my period, that’s not all hormones?

Reproductive hormones can cause physical or emotional symptoms, but not mental disorders. There’s no widespread PMS; there’s not a huge amount of women becoming depressed because of their hormones.

What do you mean by widespread? Are you saying PMS is not real?

PMS has so many possible symptoms that the label has become meaningless. There's no standard definition of PMS, so studies estimated between five and 97 percent of women have PMS. Which meant almost no one, and almost everyone, gets PMS. It wasn't scientific, so psychologists really pulled it together and narrowed it down to 11 symptoms that would mean you could have premenstrual dysphoric disorder (PMDD) Diagnostic and Statistical Manual of Mental Disorders>. There were very specific guidelines as to who can be diagnosed. It has to be at least two to three cycles in a row, and the dysfunction has to threaten your functioning in terms of your relationship or your work. Psychologists also have to be sure it’s not just part of another disorder going on. When they used all of those limiting guidelines, the numbers we saw are much smaller. Three to eight percent. So that does appear to be happening for a small minority of people.

So what are hormones responsible for?

They certainly have some influence psychologically; people who are gender-transitioning are given hormones and often report feeling different when they are given the hormones of the gender they were not born with. Polycystic ovarian syndrome (PCOS) is definitely exacerbated by changes in hormones that cause women a lot of pain and they certainly need treatment for that.

What do you make of places that legislate having a "menstrual leave"?

There are women who have such severe cramps that they need the day off, but it’s not a lot. It’s a very controversial thing. You want to validate what some people are going through, but what’s the cost of that when it’s applied to women as a whole? I think putting information out there that you are so affected by your menstrual cycle that there are days where you shouldn’t schedule a meeting or you shouldn’t make a big decision really undermines women. Women are capable all the time; time of the month or time of their life really has very little to do with that level of functioning.