Premenstrual Syndrome ( PMS) Biological/Psychosocial???

General Definition A cyclic recurrence of physical, , and behavioral Sx 5-10 days before the onset of menses (Marvàn & Cotes-Iniestra, 2001). Biological Sx Affective Sx Bloating Irritability Breast tenderness Anxiety Cramps Depression

GnRH FSH LH Estrogen Progesterone Anterior Pituitary Ovaries Hypothalamus

Results in… Sx’s

Premenstrual Syndrome Over 70 years of research! Controversial concept Known etiology? You tell me!!!

Etiological Hypotheses Linkage of Sx with a specific phase of menstrual cycle Biological etiology Proposed mechanisms Thyroid dysfunction, serotonin dysregulation, endocrine dysfunction

Biological Basis… Sx related to hormone levels Abnormal High Low FSH, LH Estrogen Progesterone

Biological Basis cont… Seippel & Bäckström Hormone levels and Sx severity in PMS patients ( Daily sampling and questionnaires ) High levels of luteal phase estrogen related to severity of negative premenstrual Sx’s

Biological Basis cont… Hammerback, Damber, & Bäckström Hormone levels and Sx severity in PMS patients More (-) Sx associated with higher luteal phase levels of E & P, More specifically, lowest scores for (+) mood with higher E

Biological Basis cont… These findings suggests… A strong a link between PMS and circulating hormone levels

Question If ovarian hormones are the culprits, then removing them or decreasing their levels should be beneficial

Biological Basis cont… Mortola, Girton, & Fischer Treatment of PMS with GnRH agonist Negative consequences (hypoestrogenism) associated with GnRH agonist treatment alone Exogenous E & P replacement 75 % improvement in Sx reporting

Conclusion Ovarian hormones and perhaps LH as determining factors in premenstrual symptomology Abnormal levels E, P, or combination of the two remains unclear…

Psychosocial Etiologies Learned Expectancies surrounding menstruation acquired through socialization Ruble  who thought they were PM report more Sx Marván & Cortés-Iniestra Prevalence estimates affect retrospective ratings PMS as a Culture-specific disorder

Conclusions Learned expectancies play an important role in determining premenstrual experiences Reflecting cultural stereotypes rather than actual premenstrual experiences

In the end… Problems with both approaches to studying PMS Inclusion criteria Inconsistencies Retrospective nature of studies Ss know that study is about PMS therefore expectations come into play May account for placebo effects

Is it Bio or  ? Probably both…. Ovarian hormones are required for Sx to occur (Schmidt et al., 1998) Expectations play an important role A premenstrual Experiential State-Change occurs that affects women’s perception of events surrounding normal cyclic changes Colored by  psychological traits, social contexts, and learned expectancies (Anson, 1999; Woods, Mitchell & Lentz, 1995).

Simply Put…. Fluctuations in hormones set the stage The extent to which events are perceived as negative is largely dependent upon learned expectancies