ChapTER 5 Body Rhythms and Mental States 157(Parlee, 1994). Since then, most laypeople, doctors,
and psychiatrists have assumed, uncritically, that
many women “suffer” from PMS. What does the
evidence actually show?
The answer illustrates the close connection
between bodily changes and cultural norms, which
help determine how people label and interpret
their physical symptoms (Chrisler & Caplan,
2001). PMS symptoms have been reported most
often in North America, Western Europe, and
Australia. But with the rise of globalization and
worldwide drug marketing, reports of such symp-
toms are increasing in places where they were
previously not reported, such as Mexico (Marvan,
Diaz-Erosa, & Montesinos, 1998) and Saudi
Arabia (Rasheed & Al-Sowielem, 2003). In con-
trast, in most tribal cultures, PMS is virtually
unknown; the concern has been with menstrua-
tion itself, which is often considered “unclean.”
And in some cultures, women report physical
symptoms but not emotional ones: In research
done in the 1990s, women in China reported
fatigue, water retention, pain, and cold (American
women rarely report cold), but not depression or
irritability (Yu et al., 1996).
In Western societies, many women report
physical symptoms associated with menstruation,
including cramps, breast tenderness, and water
retention. Naturally, these symptoms can make
some women feel grumpy, just as pain or discom-
fort can make men feel grumpy. But emotional
symptoms associated with menstruation—notably,
irritability and depression—are pretty rare, affect-
ing fewer than 5 percent of women predictably
over their cycles (Brooks-Gunn, 1986; Reid, 1991;
Walker, 1994).
Then why do so many women think they have
a predictable “syndrome,” PMS? One possibility
is that they tend to notice feelings of depression
or irritability when these moods happen to occur
premenstrually but overlook times when such
moods are absent premenstrually. Or, because of
cultural attitudes about menstruation, they may
label symptoms that occur before a period as
PMS (“I am irritable and cranky; I must be get-
ting my period”) and attribute the same symptoms
at other times of the month to a stressful day or
a low grade on an English paper (“No wonder
I’m irritable and cranky; I worked really hard on
that paper and only got a C”). Some studies have
encouraged biases in the reporting of premen-
strual and menstrual symptoms by using ques-
tionnaires with gloomy titles such as “Menstrual
Distress Questionnaire.”
To get around these problems, some psycholo-
gists have polled women about their psychological
and physical well-being without revealing the trueproduce or respond to melatonin: They may pro-
duce too much daytime melatonin in the winter,
or their morning levels may not fall as quickly as
other people’s (Wehr et al., 2001). However, it is
not clear why light therapy also appears to help
some people with nonseasonal depression. True
cases of SAD may have a biological basis, but if so,
the mechanism remains uncertain. Keep in mind,
too, that many people who get the winter blues
might do so because they hate cold weather, are
physically inactive, do not get outside much, or
feel lonely during the winter holidays.
Does the Menstrual Cycle Affect Moods?
Another long-term rhythm, the female menstrual
cycle, occurs, on average, every 28 days. During
the first half of this cycle, an increase in the hor-
mone estrogen causes the lining of the uterus to
thicken in preparation for a possible pregnancy.
At mid-cycle, the ovaries release a mature egg, or
ovum. Afterward, the ovarian sac that contained
the egg begins to produce progesterone, which
helps prepare the uterine lining to receive the egg.
Then, if conception does not occur, estrogen and
progesterone levels fall, the uterine lining sloughs
off as the menstrual flow, and the cycle begins
again. The interesting question for psychologists
is whether these physical changes cause emotional
or intellectual changes, as folklore and tradition
would have us believe.
Most people nowadays think so. They are
often surprised to learn that it was not until the
1970s that a vague cluster of physical and emo-
tional symptoms associated with the days preced-
ing menstruation—including fatigue, headache,
irritability, and depression—was packaged together
and given a label: premenstrual syndrome (“PMS”)
Many women say they become more irritable or de-
pressed premenstrually, and PMS remedies line the
shelves of drugstores. But what does the evidence show
about PMS? How might attitudes and expectations affect
reports of emotional symptoms? What happens when
women report their daily moods and feelings to research-
ers without knowing that menstruation is being studied?