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Overview
A completely revised edition of the classic guide to PMS-the first book on this pressing health issue ever published in the United States
Soon after Self-Help for Premenstrual Syndrome came out more than fifteen years ago, it was established as the definitive resource. In this third edition, you'll find accurate, up-to-date information on
Symptoms and causes of PMS
PMS and perimenopause
Premenstrual magnification (PMM)
Diagnosing PMS
Treating PMS through diet, exercise, and stress management
Vitamins, minerals, oil of evening primrose, and other nonprescription remedies
Progesterone
Antiprostaglandins, antidepressants, and diuretics
Acupuncture and alternative therapies
Psychotherapy
PMS and its effect on sexuality, the family, and creativity
Support groups
Social and political implications of PMS
Other resources, including information on using the Internet for further research
With its practical advice, friendly approach, and comprehensive resource section, you'll find Self-Help for Premenstrual Syndrome an invaluable guide to the answers you need.
Product Details
| ISBN-13: | 9780307559579 |
|---|---|
| Publisher: | Random House Publishing Group |
| Publication date: | 07/08/2009 |
| Sold by: | Random House |
| Format: | eBook |
| Pages: | 208 |
| File size: | 5 MB |
About the Author
Marla Ahlgrimm, R.Ph., a registered pharmacist, is the cofounder of PMS Access (www.womenshealth.com) and the founder of Women's Health America. She was one of the first health professionals in the United States to recognize, define, and develop PMS options for consumers.
Read an Excerpt
Chapter 1
How Do I Know That PMS Exists?
Medically, PMS is a striking phenomenon. In my medical practice, at lectures, and through the mail, thousands of women have told me such things as: “I'm not me that time of the month”; “My body swells up, and I look like I'm pregnant. My rings and shoes get tight”; “When I'm premenstrual the least little things make me cry”; “I just want to be alone and hide until I get my period”; “I can't go back to school because when I'm premenstrual I can't focus on the page”; “Getting my period is a bother, but being premenstrual is a nightmare.”
As a child, I remember women sitting around a neighbor's kitchen table talking about irritability at that time of month, eating ice cream and potato chips at that time of month, and dealing with husbands and children at that time of month. They weren't talking about menstrual bleeding, for that had other expressions, like “having my friend” or “getting” it, said with a raising of one or both eyebrows that let everyone know what was meant.
It is clear that PMS exists, because among the thousands of women I have listened to, I have never had one say that each month, after her period, she loses self-esteem or fights with her husband or wants to kill herself. I've never heard a woman say that she wanted to feel postmenstrually as well as she does each month premenstrually. I've never heard a woman say, “You know, I get irritated easily, but premenstrually nothing could bother me.” Whatever this phenomenon is, it appears to occur only premenstrually. Yes, women have difficulties at other times of the month, but those who have problems in relation to their menstrual cycles always report them as occurring premenstrually.
I'm struck by the diversity of the women I see: women in positions of power, who hold responsible jobs, but for whom PMS is a private agony; women living in poverty with three children still in diapers, who premenstrually struggle against their bodies and their living conditions to maintain a sense of order and hope. PMS has been reported around the world.
In 1982 I wrote of my feelings about PMS:
How do I feel about PMS? I am conflicted. The feminist in me wishes that our biology were irrelevant. The doctor in me sees the need for recognizing and treating premenstrual symptoms. The woman in me recognizes the power of the biological forces within me and wishes I lived in a society in which my menstrual cycle was seen as an asset, not a liability. The writer in me keeps hoping that if you can get it all down on paper, you will not be alone in your dilemma or your conflict.
It is possible that there are lessons for women and men in PMS. Is the greater sensitivity experienced by women premenstrually something we all, as a society, need to learn about? Without wanting to glorify or romanticize their pain, I wonder what growth will come to women as they confront PMS. What would the world be like if men sometimes seemed to cry without reason? What would we then believe about vulnerability or sensitivity?
Are there lessons to be learned from PMS regarding responsibility, anger, or violence, lessons applicable to both men and women? I wonder how we will look at PMS in twenty years. What will we have learned, and most important, how will we deal responsibly and compassionately with that knowledge?
Our strength as women must lie in our honesty and in our commitment to help each other, to concentrate on the ways we are more like each other than different. To these ends, we must continue to explore the cyclic nature of our lives, while remembering that our expressions and aspirations are still limited by a society in which we have not yet achieved equality.
This book examines the physical and emotional symptoms of PMS, their origins, and ways to deal with them. To provide this information, I have drawn on my work as a physician, on available research, and on traditional as well as nontraditional treatments found to be effective.
Much work remains to be done on PMS, and that process is well under way.
Chapter 2
The PMS Dilemma
“YOU KNOW YOU'LL FEEL BETTER when your period starts.” Hours later, Alex's words still reverberated in Sally's head, making clear thought or action impossible. Behind the closed door of her office, she sat at her desk, twisting paper clips and crumpling tiny pieces of tissue paper.
In the minutes before leaving home that morning, Sally had said she was ending her marriage. She felt that she was at the end of caring, the end of giving, and had screamed at Alex that it was all over, that she wanted him to leave, that she couldn't stand living with him anymore. With a sinking feeling she realized that Amanda, their three-year-old, had heard the entire battle. She clutched the child and quickly left the house with her. Stopping briefly at the day-care center, she told the teachers that Amanda might be upset and then guiltily went on to work.
Driving along the river, gliding in and out of slow and faster lanes, she experienced confusion, despair, and anger. She wasn't sure who she was, what she was feeling, or why. The driving helped her, creating the distance she needed now in her struggle for inner clarity.
Mornings were always the worst, when she woke to find herself between the fading darkness and dreams. Sally needed to be alone when she awakened, to gather slowly the strength for the demands that seemed to drain her. That need seemed especially strong this morning. She had awakened feeling bloated, wanting to hold on to the darkness that hid the distortions of her body, kept her from the mirror and skirt snaps that were the enemies of her self-esteem. Her skin had crawled, and she had thought that if only the world would leave her alone, she might just make it through.
Work was a different world. Here, where she managed the production department of a major trade publication, she competently made decisions, negotiated, managed people and policies. Here her life with Alex seemed unreal. Shuffling papers, trying to overcome her despair, she fought the intruding thought: Was her marriage over?
Had Alex been right? That question, one she sometimes asked herself and sometimes fled, now left her feeling sick, vulnerable, and naked. If this were a week from now, would she feel better? After her period arrived, would she simply smile and say she must have been tired? Would the rage, confusion, and desperate need to be alone have vanished?
Does Sally have premenstrual syndrome? Will she be all right when her period starts? Which is the “real” Sally? Is she out of control premenstrually, or is she simply suppressing her real feelings the rest of the month? Does Sally have an illness, as is implied by the word syndrome, or is she experiencing the mood shifts that are a normal part of everyone's life?
What about other women? What about women who have a day of blues premenstrually? What about women who are premenstrually suicidal or unable to function? Are those states all separate conditions, or are they points on a continuum, and at what point is it “illness”?
In the past fifty years we have seen the increased medicalization of women's normal functions. Childbirth has become a technological event, often a surgical procedure. Menopause is often seen as a disease to be treated, frequently in the face of the woman's protest that she feels fine and doesn't need or want medication.
In looking at illness, Western culture traditionally tends to split the body from the mind, to see the two as distinct entities, often unrelated. If we define a disease as physical, then we are not responsible for it. If it is emotional, then we not only assign blame for its development (parents have done it to us, et cetera) but are also held responsible for overcoming it. We tend to believe that physical disease happens to us and that mental disease we bring on ourselves.
In recent years medicine has given more attention to the intricate interplay between body and mind. Heart disease and cancer are physical diseases that have been shown to be strongly influenced by environment, diet, stress, and personality dynamics. Depression, an emotional disorder, also has physical manifestations, including at times biochemical changes now measurable with laboratory testing. Whether the biochemical change is a cause or a result of the depression remains unanswered. Women living together in dormitories unknowingly begin to synchronize their menstrual cycles. Testosterone levels in males are altered by their positions of dominance. Hormones can produce emotional changes. And social interactions can elicit hormonal changes.
Premenstrual syndrome is usually described as a disorder either of body (advocates of that theory believe there is a basic biological flaw in a large percentage of women of reproductive age) or of mind (a woman with PMS has not “accepted her role as a woman”). The issue of whether PMS is physical or mental becomes further polarized because of the significance we place on whether we can define an illness as physical or emotional. But in fact, all diseases raise this issue. PMS is just one more example.
Physicians said for years that dysmenorrhea, severe menstrual cramps, were due to a woman's ambivalence about womanhood. When prosta-glandins were discovered to be related to the cramping, this theory lost favor, but in the meantime generations of women were treated as though this belief were fact. Women were told they had cramps because they didn't like being women, that they were “rejecting the feminine role.”
Our culture has a negative attitude toward menstruation. Little notice has been made of women who report increased efficiency, creativity, and sensitivity during their premenstrual times, sometimes even in the presence of uncomfortable physical or emotional states. Professionals often have difficulty hearing what women are really saying, and thus even the research can be tainted by personal biases. For example, attempts are made to separate what women “really” feel from what they “think” they feel, a distinction that implies an inability to hear what is being said and an assumption that there is a difference between the two.
The situation continues to improve. The dramatic changes in women's health over the past twenty years have mostly been in the willingness of the health care community to take seriously the concerns of women. Women's health care services abound, as do books and information. Women have options today, for information and for care.