An Examination of the Symptoms of Premenstrual Syndrome

Abstract

Formal research into the physiological and psychological effects of menstruation was inaugurated in the second half of the 19th Century, and 1ed to the development of the theory of the Menstrual Wave, the hypothesis that a woman's physical, mental, and emotional processes were determined by an all-encompassing menstrual rhythm. Continued investigation into the supposed infirmities of the menstrual phase found no association between it and the various cardiovascular, and other sensory variables measured, and the menstrual wave theory 1ost favour. The discovery and description, in 1931, of premenstrual tension (PMT), later called premenstrual syndrome (PMS), focused attention upon the physical and psychological symptoms of the premenstrual phase, in an attempt to find a cause and cure for the new symptom complex. During the approximately 60 years since then, a variety of biological, and psychological causes of PMS were suggested, but all, finally, suffered from a lack of evidential support. Paralleling the PMS research endeavour was a considerable growth in symptom numbers. Whereas Frank (1931) gathered some 12, Moos (1958a) described 150 different, PMS symptoms. Of all the attempts to organise these symptoms, the most influential was the notion that they represented the symptoms of, not one syndrome, but several different syndromes with different underlying causes. The large amount of symptom overlap however, made this approach difficult to sustain. A field study of, 55 of the most-often ascribed PMS symptoms was carried out. This found that they may be organised around a group of, 'core' PMS symptoms consisting entirely of physiological symptoms relevant to women' reproductive functions and apparently comprising a core, or essential, PMS. At, mild to moderate PMS severities, irrespective of any other, more peripheral, symptoms in the syndrome, essential PMS comprised varying numbers of the core PMS symptoms. In extremely severe PMS, the core, or essential PMS appeared to have undergone not only quantitative, but qualitative, changes in that the original five or six symptoms had been augmented by not only additional physiological symptoms but, psychological symptoms as well. A measure of PMS severity was developed. This measure suggested that the PMS of the research, and popular, literature may be the extreme end of a range of PMS severities, affecting only some 7% of reproductively cycling women.