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PMS: More Than Just a Medical Condition?

Updated: Oct 26, 2023


As a therapist, I've borne witness to many women grappling with the challenges of premenstrual syndrome (PMS), the menstrual cycle, and its profound impact on their mental and physical well-being. What troubles me the most though, is the startling lack of compassion, understanding, communication, support, and education that is widely available and accessible today. As a result, I've developed an approach that's inclusive of PMS and the Menstrual-Cycle in Counselling and Psychotherapy.


Although we have experienced recent shifts in societal attitudes towards women's issues, such as menopause, experiences with PMS and menstruation are still shrouded in shame and silence, creating a sense of isolation and despair. As somebody with a menstrual cycle, I've often felt frustrated by the medical and scientific communities' limited understanding of premenstrual syndrome (PMS) and the complex interplay between the female reproductive system and our mental well-being. It's as if we're only just scratching the surface of this crucial issue.


I believe It's time for us to break down these barriers and foster a culture of empathy and connection. By acknowledging the struggles and needs of women, we can help navigate the complexities of our bodies and emotions, empowering women to live in tune with their menstrual cycles.


And so, in the face of these challenges, I felt called to take action. I launched a research study that aimed to delve deeper into the lived experiences of women and their menstrual cycles through a therapeutic support group for PMS.


It was heartening for me to see these women come together, to feel heard, understood, and empowered in their shared struggles, some of them for the first time in their lives. Through this process, I learned that women need a safe and supportive space to explore the complexities of their bodies and emotions, free from shame and stigma. By creating such spaces, we can begin to transform the way we approach women's health, recognising the profound impact of PMS and the menstrual cycle on our lives and well-being.


Today, I want to share the results of this powerful study, challenging the conventional wisdom on PMS as a condition that needs treating - and instead offering hope for change through coming together.



What is PMS?

Premenstrual Syndrome (PMS) is labelled as a fixed female pathology determined by bio-medical and psychological factors, and Premenstrual Dysphoric Disorder (PMDD) is currently identified in the Diagnostic and Statistical Manual (DSM-IV) as a severe form of premenstrual distress.


What's shocking, is although there have been over 60 years of research into PMS, there is little agreement on the etiological roots of this 'disorder', and a lack of consistency on effective preventions and interventions. Consequently, there are two centuries worth of scientific setbacks and comprehension within the research of understanding women’s reproductive health, which continues to be underdeveloped and dismissed within the analysis of the human lifespan.


Today, Premenstrual distress is of the same magnitude as major depressive disorders in reducing women’s quality of life and economic functioning. Recent research has underscored the historical link between female distress and the reproductive system in Western society, leading to the medicalisation of women's natural experiences and emotions surrounding menstruation. By labeling premenstrual syndrome (PMS) as an "illness" or "syndrome," we risk overlooking the deeper roots of women's struggles, and instead prioritise medical interventions and pharmaceutical solutions.


This pathologisation of women's experiences has real-world consequences, creating a culture that invalidates and silences women's voices and perpetuates a cycle of shame and self-blame.


By medicalising PMS, we risk disregarding the unique and valid experiences of women and perpetuating the cultural shame attached to menstruation. As a result, women are left feeling ostracised, unheard, and ashamed of their premenstrual struggles.


What's more, this medicalisation has tended to overlook the many positive changes that women experience during the various phases of their menstrual cycle, such as increased libido, creativity, physical energy, emotional clarity, and a deep desire for restoration and reflection. These are powerful and important experiences that deserve to be honoured and valued, rather than dismissed or ignored.


In our fast-paced and productivity-driven culture, there is a tendency to dismiss some aspects of the menstrual cycle as a distraction or an inconvenience, failing to recognise the deep wisdom and power that comes with understanding our cyclical nature. By embracing a more holistic and compassionate approach to the menstrual cycle, one that values all aspects of our experience, we can begin to transform the way we view and relate to our reproductive bodies and tap into the power and potential that lies within.



Breaking the PMS Taboo:

Embracing Our Cycles Together


Is it possible to acknowledge the regulating powers of medical and cultural attitudes and their role in women’s experiences... and at the same time recognise the existence of pre-menstrual distress?


Can we develop non-pathologising means of support and treatment, understand and be aware of the social and political context in which PMS occurs, and work towards changing that context?


Acknowledging women’s distress does not mean we accept it as madness, instead, we can reframe their suffering as a reasonable response to the material circumstances of an individual’s life and the intersubjective context within which women negotiate their pre-menstrual changes.


PMS support groups have the potential to alleviate distressful experiences and reduce feelings of shame, an essential and powerful first step.


Through the powerful sharings and discussions in the therapeutic support group, four key themes began to emerge:


1. Experiencing PMS as a separate self: As we listened to the stories shared, a common thread emerged: many participants felt deeply disconnected from their 'PMS self'. It was as if these experiences belonged to a separate, alien self - one that they could not or did not want to recognise as part of their own identity. This internal struggle often led to feelings of chaos and loss during menstruation, exacerbating the already challenging experience.

Interestingly, as we explored these experiences together, participants began to recognise these same struggles in each other. This realisation opened up a conversation about self-compassion and the importance of treating our bodies and vulnerabilities with kindness and respect, especially during times of heightened emotional and physical stress. Through this shared experience, we were able to connect more deeply with ourselves and each other, ultimately finding a greater sense of self- acceptance, understanding, and community.


2. The lack of knowledge surrounding PMS: Participants spoke of the constant need to fight and prove themselves to a dismissive system that offered little in the way of effective treatment or basic empathy. In particular, the over-reliance on hormonal pills as a quick fix for PMS was a source of deep concern and a sense of helplessness. Many participants had been prescribed the pill at a young age without a clear understanding of its potential effects on their bodies or the choice they were making. This lack of education and agency left them feeling frustrated and angry, with a sense that their younger selves had been denied the support, care, and education they deserved.

Despite these challenges, the group remained hopeful and committed to raising awareness and advocating for better understanding and care around PMS. Through their shared experiences and developing resiliency, they demonstrated the power of community and connection in the face of systemic adversity.

3. The desire to be "in sync" with their cycles: Many of the participants expressed a desire to explore natural remedies and found themselves self-educating on their menstrual cycles. For some, this came as a result of negative experiences with hormonal contraception which left them feeling disconnected from their bodies and searching for alternative solutions. Despite their efforts to take control of their menstrual cycles, participants also shared the challenges of doing this alone, feeling isolated and overwhelmed during these times, highlighting the need for more compassionate and supportive spaces.


4. Growth through sharing: The PMS support group created a space of belonging where participants felt seen, heard, and understood. Witnessing their willingness to be vulnerable, open, and supportive of each other filled me with admiration and hope. By creating a safe and nurturing environment where women can connect and share their experiences, we can cultivate resilience, share coping strategies and knowledge, and foster a sense of community that embraces the menstrual cycle as a natural part of life.




As a therapist, I am deeply committed to shifting the socio-cultural narrative around PMS and the menstrual cycle, reframing it as a natural and vital aspect of our lives rather than a shameful burden or a medical condition to be solely treated by pharmaceutical interventions. Through PMS therapy support groups, women have the opportunity to come together, support each other, and grow in ways that offer a more holistic alternative to traditional medical interventions that can carry harmful side effects. By fostering a more empathetic and open dialogue around PMS, we can cultivate living in harmony with the menstrual cycle and dismantle the culture of shame and isolation that has long plagued women's experiences.


If this post resonates with you and how you're feeling, you can book a free therapy consultation with Tender Hearts @ tenderheartstherapy.co.uk


For further information on PMS therapy support groups, email olivia.tenderhearts@gmail.com





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