I’ve recently finished reading the thought-provoking Mismeasure of Woman by Carol Tavris. Although the book was published in the early 1990s, it is still eerily current. I keep wondering what Tavris might think of the Palin pick… But I don’t want to speculate on this here. There are many, many interesting things Tavris talks about in her book, I would like to focus on how normal bodily processes are turned into diseases. How women are pathologized simply for being women.

Take the Premenstrual Syndrome, for example. When women started to fight for their right to get an education, they were confronted with arguments that supposedly made it physiologically dangerous for them to study. Men (and most women) believed that girls required one week per month of “remission, if not abstinence” because of menstruation – or as they called it, “the organism’s periodical function” (source and hat tip). Dr. Edward Clark wrote that in 1873, implying that girls just shouldn’t go to school because their body’s energies would be needed for reproduction. As late as 1970, the idea that women are less capable to think before their period pervaded the public discourse (132). And then, lots of research burst onto the scene that showed

that women were just as able as men to work, play, think, sing, pass exams, and otherwise carry on, even when they were menstruating, premenstruating, postmenstruating, and nonmenstruating. (132)

This research created cognitive dissonance – a topic Tavris addresses in her most recent book. The dissonance might have been caused by thoughts like this: Research shows there is no impact but I – as a smart researcher – know there is an impact. So, either I am not that smart or the research is wrong. Well, fortunately, there are changes that happen premenstrually:

It is clear that some physical changes normally occur: breast tenderness, water retention, and increased metabolism being the most common. The key word here is normally. It is normal for premenstrual women to have some aches and pains, to gain a few pounds (because of temporary water retention), or to crave food (because of increased metabolism). (144)

Instead of viewing these changes as normal, then, we can resolve our cognitive dissonance by claiming that they are abnormal, that we need to do something about them, pop a bill to make them go away, rather than accepting them as normal processes of our bodily changes. (I realize that sometimes the pains can get rather intense but that’s generally not because there’s something wrong with our body. It is simply reacting more strongly. And, of course, pain relievers can help then.) By repacking these normal changes into PMS, the most important finding of recent research is masked: Women are perfectly capable of doing what they need to do no matter where they are in their menstrual cycle (134).

Okay, you say, PMS is mostly not about the physical stuff. It’s about the emotional changes, which is what most of us think of when we hear PMS: We know that women change – often dramatically – in the period before their period. Or do we? Well, first of, look at a list of symptoms. Have you ever realized how vague and unspecific they are? You could be coming down with a cold and have aches and pains… Similarly, the emotional impacts of PMS: It is easy to attribute mood changes to PMS in retrospect. And that’s what studies have actually found:

Yet a large percentage of women claiming to experience PMS fail to demonstrate a cyclic pattern of negative moods when they actually keep daily records. (145)

A lot of the “PMS,” then, that we experience turns out to be a self-fulfilling prophecy:

The belief in PMS and the expectation of negative symptoms, apparently, influence a woman’s likelihood of noticing some symptoms and ignoring others at different times of the month. (146)

We fill in the blanks with what comes to mind, remember the many times you started your period and realize that all those feelings of the blues where “just PMS.” I’ve done this way too many times. This also makes the daily record keeping troublesome. However, there is a group of people who could function as a control group: men. And, get this:

When men are included as a comparison group in menstrual-cycle research, it turns out that their moods also change over the course of a month, just as much as women’s moods do. Among men, as among women, individuals vary enormously in their moodiness, frequency of mood swings, and general levels of grumpiness. It’s just that men can’t blame their mood changes on a menstrual cycle, and their mood changes are more unpredictable and idiosyncratic. (148)

In fact, studies have found that knowing the day of the week is more predictive of a person’s mood than knowing the day of the menstrual cycle (147). Additionally, it seems that women in the rest of the world do not experience the mood swings summarized as PMS, at least according to a World Health Organization survey: It’s a Western phenomenon (153).

How can that be? As a woman, I have experienced PMS. Or at least I thought. Tavris brings in context at this point: Our moods change and sometimes those changes coincide with the period before our menstruation. Because our societal context suggests that PMS happens, we attribute our mood changes to that, rather than to the fact that it is, say, Monday or we just had a fight with our boyfriend (or worse, we attribute the reason for the fight to PMS rather than his infidelity…). And this is where the danger of pathologizing the natural changes comes in: We tend to dismiss whatever comes up during the period before our period as “just PMS,” rather than looking at the underlying issues that might be affecting our moods.

All the talk about the biochemical origins of women’s moods, therefore, overlooks the content of those moods. (156)

And as if PMS wasn’t enough to keep us women down, menopause – another natural process – has been turned into something that requires treatment. The pathologizing of menopause does not accidentally coincide with the aging baby boomers… As a woman who will be reaching menopause in the next ten years or so, I’ve been scared to get there. It didn’t click that my Mom cannot remember when she reached menopause (it obviously wasn’t a life-altering experience). As with PMS, we are constantly exposed to the myth that menopause is a horrible experience that will affect our life dramatically and for a really long time. Well, again, reality is different. Yes, there are

“temporarily bothersome symptoms,” such as hot flashes, sweating, and menstrual irregularity, [but] most of these [2,500 randomly chosen menopausal] women said that menopause was simply “no big deal.” (157)

But “no big deal” doesn’t sell anything, so let’s create another syndrome! No, I don’t mean PMF (Post-Menstrual Freedom). I mean Estrogen Deficiency Disease. During menopause, estrogen levels drop naturally. It’s not a disease. Yet, we got a label slapped on it and all the sudden a natural process becomes something to be treated, preferably with something that costs money (and, no, it’s not just the pharmaceutical industry that benefits here, just go into a health food store and look around…).

We are left with a dilemma: We experience changes before our periods and during menopause; they are real. This is probably why, as women, we have embraced the idea of PMS and EDD: Somehow that legitimizes our experience. Yet, it goes beyond acknowledging it; it pathologizes it as “experiences [that are] deficient and diseased” (169). We need to find ways to claim our experience without turning it into a disease. One way Carol Tavris suggests of doing that is to stop using the male body as the standard of comparison.

Ultimately, the belief that menstruation and menopause are problems for women is part of a larger assumption that female physiology itself is abnormal, deficient, and diseased. Because this view is so pervasive, it is easy to forget that it is not the only one possible. (158)

What to do? Simply accept PMS and menopause as the natural processes they are. It’s as normal as a guy growing a beard when he hasn’t shaved for a while. To learn more about that process, I can highly recommend another wonderful book: Natalie Angier’s Woman. It’s a fascinating read and it takes the mystery out of the process.

Update: Here is an interesting article on the recent pathologizing of PMS.