Saturday, October 3, 2009

Diagnoses

In 1950 the book 'Once A Month: The Premenstrual Syndrome Handbook' by Dr Katharina Dalton was released. In this, she claims, that PMS 'threatens the very foundations of society.' For half of every month, the two weeks before a woman's period, she can not be trusted with anything but the simplest of tasks, not even in taking care of her own children. Her irrational state of mind makes her a danger to her family, her colleagues, and society at large.

Karen Houppert speculates that the assumed 'weakness' of women was played down during World War II when they were needed to take on the jobs left behind by enlisted men; but once those men returned, women needed to hustled quickly back into the kitchen - and so the mental disorder PMS was born. Women's wombs and ovaries had been linked to their emotional states long before, but PMS proved far more pliable than its ancestor, hysteria.

The existence of PMS has never been proven scientifically, yet in 1950 40% of women were believed to suffer from it for half of every year of their life. Presently, the term PMS is thrown about quite casually, with most women claiming to have experienced it at one time or another. There are over 200 symptoms under this banner - irritability, nervousness, anxiety, anger, stress. A whole range of emotions that fluctuate above a baseline of complete calm can be attributed to a PMS episode. It is often described as 'moodiness' - a word I find odd as all it seems to suggest is that the person is experiencing moods, and all people are always experiencing moods - but 'moodiness' is apparently a uniquely feminine problem. And in 1950, according to Dr Dalton, women's moods were costing American society 8% of the total wage bill.

Of course the 1950s saw an explosion in the invention of all kinds of disorders where normal, healthy, human life experience had been before. Diagnosis was helpful in some cases, and certainly brought a slow halt to the terrible treatment of people truly suffering and previously incarcerated in asylums; but this new enthusiasm for psychotherapy also ushered in some more dubious labelling, and lots of emotional problems that patients were told could only be treated with drugs.

It could be argued that PMS was a convenient way of containing the anger of women who had shown themselves to be very capable in men's jobs during the war, and now resented how they were being boxed back in to the role of housewife. I usually have a tendancy to doubt the organisational skills of those in power to orchestrate the kind of conspiracies that sometimes appear so obvious in hindsight. However, the book I read by Bernard Asbell on the history of the pill suggested its invention was an accident, that various scientists across the world just happened to come together in their research over twenty years, which sounded sort of suspicious to me - and so I read Barbara Seaman's 'Exploding The Estrogen Myth' and discovered that Mr Asbell left out a whole chunk of the pill's history - the part in which synthetic hormones were developed in Nazi Germany, and not just synthetic hormones generally, but the synthetic estrogen that is now used in nearly all birth control pill brands.

Bayer Schering, the company behind Yasmin and Yaz, was previously the Schering Corporation and during World War II they worked on creating the synthetic hormone ethinyl estradiol for experimental use on Jewish prisoners in concentration camps. The Nazis were trying to create a sterilization drug and so would feed liquid synthetic estrogen to men and women and monitor the results. The women stopped menstruating, but were not made permanently infertile. Bayer Schering later went on to introduce the birth control to Europe in the early 1960s.

So, sometimes it's healthy to hold some suspicion. PMS medicalised the emotions experienced by women. It's true that women do feel more this, or more that at certain times in a month, but none of these feelings should be considered 'threats' to anything other than that woman's good day. And, it can be seen as positive that these changes, and as such the broad effect of the menstrual cycle, was being acknowledged by doctors. But as Paula Caplan argues, those doctors were effectively saying: "We'll believe what you women tell us about how you're feeling - but you've got to let us call you mentally ill."

The suggestion that PMS effected other people - even if it was only the husbands and children of the woman - also conveniently made menstruation the public's business. And when periods are made a public problem, we get adverts for pills that stop them entirely in men's magazines. There are many women prescribed the pill for PMS symptoms - Yasmin promoted itself as a unique cure for that moodiness in the beginning - and many women advocate the pill for helping them to feel less angry and upset for the last week of the month. The pill was one of the first medications to be distributed widely to healthy people. Now, there are hundreds of medicines taken by the essentially healthy. Anti-depressants are prescribed with casual frequency, particularly in the US, where they are advertised heavily, and often taken for years and years with little regulation by doctors.

As I've been saying, the pill can produce an endlessly flat, nothingness feeling, as well as causing anxiety, nervousness, anger, depression - all the issues discussed previously. It is natural to feel happy or sad and all that's inbetween. But I know from my experience using the pill that the feelings of PMS are more grounded in real circumstances, less violent and more manageable than the feelings that can be brought on by the birth control pill. With PMS, by which I really mean normal fluctuations in mood brought on by hormonal changes, you know it's coming, you understand why, and you know that it will go away. You also know that there are times when you have every right to be angry.

On the pill, the anxiety can build and build, can go on for months. When you are taking the pill you feel detached from your body, which only makes it harder to handle a rush of anxiety or paranoia. I'm not blaming all the ups and downs of my life, or anyone else's, on taking the pill. I think most women who have felt the pill's effects know the difference between legitimate reactions and pill-related problems. When the pill was first launched the high levels of estrogen produced depression, which I think is related to the flatness women experience today, and which was clearly effective in ridding them of the perils of PMS. Now, new progestogens seem to play a large, and different, part in the emotional side effects of the pill.

"Pills are to sell, not to take. If we put horse manure in a capsule we could sell it to 95% of these doctors."
Harry Loynd, former president of Parke-Davis, a subsidery company of Pfizer.

1 comment:

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