Bad mood not specific to PMS, but is linked to menstrual cycle: experts

TORONTO – PMS may no longer be an explanation for a woman’s bad mood, to the surprise of women and men alike.

A review led by University of Toronto researchers says there’s no clear link between women’s negative moods and the pre-menstrual phase of their cycles.

But before you shake your head (or fist) in disbelief, the research needs some clarifying.

Published online in Gender Medicine, the findings were based on 41 research studies tracking women’s daily moods through their menstrual cycles.

Six of the 41 papers (13.5 per cent) showed an association between negative moods and PMS, which is not considered clear evidence that pre-menstrual syndrome (PMS) exists.

“There is so much cultural baggage around women’s menstrual cycles, and entire industries built around the idea that women are moody, irrational – even unstable – in the phase leading up to menstruation,” said Dr. Gillian Einstein, one of several University of Toronto experts who reviewed the literature. “Our review – which shows no clear evidence that PMS exists – will be surprising to many people, including health professionals.”

Surprising, indeed. But the key is “in the phase leading up to menstruation.” While there may be no link between bad moods and pre-MS only, there is a link with plain old menstruation.

Out of the 41 studies (which all had a sample size of at least 15 participants), 36.6 per cent had no bad mood link with any menstrual (MC) phase, but 42.5 per cent experienced bad mood in the premenstrum plus another MC phase. Fourteen-point-six per cent reported the “classic premenstrual pattern.”

So with a range of times when the ladies felt worse than usual-some directly linked with menstrual cycle-calling PMS a myth is not accurate.

“To be correct, this is a review paper of the literature and what it shows is that the literature, as it is out there now, does not support the idea that there is something called pre-menstrual syndrome,” Einstein told Globalnews.ca. “On the simplest level, you could say it’s misnamed.”

Notably, the review didn’t discount the existence of physical symptoms like bloating and cramping related to the pre-menstrual phase, but wouldn’t that be likely to put people in a bad mood? Einstein says it depends.

“In some people they might, in some people they might make them really sleepy,” she said. “I think the point is really more that women’s moods aren’t just fluctuating depending on hormones… That in fact, neither negative nor positive moods are correlated statistically with ovarian hormones like estrogen and progesterone.”

Einstein says that the notion of PMS was a positive thing when it first became popular, since menstruation used to be “taboo” to talk about.

“It was the first time that women were given permission to talk about menstruation in public…given permission to say, ‘hey I have this natural thing that’s happening to me, and I don’t like this or I don’t like that,’” she said.

“I think one step further now…let’s say it’s okay to talk about menstruation, but if you’ve got feelings about something, take yourself seriously. Don’t just wait until before you menstruate to tell somebody in your life you don’t like the way you’ve been treated.”

Dr. Gillian Einstein is the director of University of Toronto’s collaborative program in women’s health. She is an associate professor in the Department of Psychology and the Dalla Lana School of Public Health, a senior scientist with Women’s College Hospital and a scientific associate with Sunnybrook Health Sciences Centre. She notes that the review paper described above did not address the existence of premenstrual dysphoric disorder (PMDD), a clinical mood disorder linked with menstruation characterized by severe physical and behavioural symptoms in the latter half of the menstrual cycle.