THE PRE-MENSTRUAL SYNDROME

WHAT ARE THE OBSTACLES?

The attitude of some drug companies, doctors and psychiatrists is not always conducive to the active participation of women in their health dilemmas.
Some doctors may prefer to keep control by fostering dependent relationships with their patients and keep them "in the dark". Other doctors may be reluctant to accept the biological causes of psychological disorders and there is an urgent need for more interspecialty collaborative research to assess the role of hormones, nutritional supplements and drugs in various types of depression. Some psychiatrists, (usually males), still see women through the teachings of Sigmund Freud who believed that women were inherently more neurotic than men with their inability to resolve subconscious conflicts shown in the typical neuroses of depression, anxiety, hysteria or hypochondriasis. This narrow perspective leads to the stereotyping of women, reinforcing their inferiority and dependence upon mind-altering drugs.
In reality, today's women is psychologically, if not hormonally, just as liberated and aware as today's man. She is increasingly reluctant to accept psychotropic drugs (sedatives, tranquillisers and anti-depressants) for fear that they may take the edge off performance and blunt feelings and self expression.
It is interesting that often it is not only psychiatrists, but also some feminists who are cynical towards the idea that hormone fluctuations affect female psychology and behaviour. Such feminists also have a narrow perspective, preferring to say that the higher incidence of depression and suicide attempts in women is entirely due to environmental and psycho-social issues. They may feel it demeaning or trivialising to admit that one's hormones could wreak mental havoc, fearing that this will give women a handicapping vulnerability or a uniquely female "Achilles heel". This nihilistic attitude of denial is no longer appropriate and hormone therapy will enable us to compete and share with our male counterparts in a world where we need to keep our wits about us not for two, but for four weeks every month.
Another obstacle to overcome is the sometimes confused and crossed messages about our hormones that are given to us by the media, lay press and "pseudo experts" who have never had any clinical experience with women. We read negative and patronising articles with no clear strategies or hopes of cure offered. For example, we are told that PMS women should avoid giving dinner parties at that time of the month as if the most serious implication was a collapsed souffle or lumpy sauce! This is ineffectual advice for the many professional women of today who are surgeons, airline pilots or politicians.
Another common obstacle is our self-image. Many women have very low self-esteem, and are unable to love and admire themselves as unique individuals and find it uncomfortable to be assertive with their doctors. This lack of confidence makes it difficult for them to express their needs, anger, aggression or resentment especially in front of a professional.
To overcome these limitations, the establishment of support groups for women with such problems as PMS, postnatal depression, drug dependence or midlife depression can be invaluable. Support groups provide an environment where women can begin to express themselves, building skills in confidence, creativity and self-assertiveness. For women who feel they have "lost it", support groups can act as a stepping stone back into the real world. Support groups can really open other avenues and take on many roles such as sending a spokesperson for a radio interview, writing newspaper articles, inviting an expert speaker on women's health to your area, raising money for the local women's refuge, etc. They also provide psychological support for those women unable to afford expensive counselling from a professional.
At the end of the day we need to keep our sense of humour which can be hard when the struggle for mental and physical harmony seems elusive, so the little cartoons in this chapter will help us to laugh at ourselves. Yes, it's true now, as ever, laughter is a great form of medicine!
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