On Wednesday, the Royal College of Obstetricians and Gynecologists (RCOG) issued new guidelines on Premenstrual Syndrome. And, contrary to a theory recently put forth in Frank Bures' book The Geography of Madness that PMS is "a figment of our menstruation-fearing culture," they call on medical professionals to take it more seriously.
According to their paper, published in BJOG, 40 percent of women experience PMS. Between five and eight percent have a severe form of it—and not all of them get the help they need. Those who suffer from bad PMS "may benefit from being managed by a multidisciplinary team comprising a general practitioner, a general gynecologist, or a gynecologist with a special interest in PMS, a mental health professional (psychiatrist, clinical psychologist or counsellor), and a dietician," the authors write. "When treating women with severe PMS, CBT [cognitive behavioral therapy] should be considered routinely as a treatment option."
In an excerpt republished in Slate, Bures called into question PMS's status "as an evidence-based biological condition," suggesting that expecting to be unhappy before your period is a self-fulfilling prophecy. But the RCOG would beg to differ.
A recent BBC survey showed that 52 percent of women experienced such bad menstrual pains that they got in the way of their ability to work. Yet most haven't even told their bosses, let alone called in sick. In addition, many women with severe discomfort or emotional distress around their periods have serious health conditions like endometriosis or premenstrual dysphoric disorder, making the trivialization of PMS symptoms even more dangerous.
“PMS can be a serious condition which can dramatically impact on the quality of a woman’s life affecting her personal and professional life," said Shaughn O’Brien, a Keele University Professor of Obstetrics and Gynecology and lead author of the guidelines, said in a press release. “We hope that these guidelines go some way in raising awareness of the seriousness of the condition and available treatment options, not only in women but also among healthcare professionals.”
So, in case women's own accounts were not evidence enough, I think we can safely say that PMS is not just in our heads.