MENSTRUATION MATTERS

A new study published in a recent issue of Women & Therapy finds problems with the diagnostic criteria for PMDD. No surprise – feminist psychologists, researchers within the Society for Menstrual Cycle Research, and many others have repeatedly criticized the concept of PMDD as a mental illness related to menstruation for these and other reasons.

Supposedly, PMDD occurs in 3% to 8% of menstruating women. There is a host of problems with how this is determined, including varying means of defining and applying the DSM-IV criteria for PMDD across studies, but I’ll spare you that litany here. If PMDD is truly an illness related to the menstrual cycle, the criteria should be sex-specific; that is, only those capable of menstruating should meet the diagnosic criteria (the research implicitly assumes everyone is cissexual and that all non-pregnant women of reproductive age menstruate and no men do – let’s set that aside for now).

To test the sex-specificity of the criteria for PMDD, the researchers created two versions of the assessment tools they used to determine its presence: one version included sex-specific terms like menstruation, menstrual cycle, and premenstrual symptoms, while the other version substituted sex-neutral terms such as experiences and symptoms.

Lo and behold, women who completed the sex-specific diagnostic tools met the provisional criteria for PMDD at a significantly higher rate (20%) than women who completed the sex-neutral diagnostic assessment (8%). And 4.1% of men completing the sex-neutral assessment also met the criteria for PMDD. There was no statistically significant difference in the number of women and number of men meeting the criteria when sex-neutral language was used. The researchers tentatively conclude,

Therefore, these data suggest that PMDD may not be a premenstrual disorder per se. PMDD may instead reflect general cyclical changes in mood, and in women sometimes these changes occur during or near menstruation.

So this little study is far from being the last nail in the coffin PMDD deserves. But it’s a start.

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