Is PMS real? It’s every bit as real as erectile dysfunction.

59766856 - hysteria disorder grunge concept

Let’s try a thought experiment.

Imagine if I asked if erectile dysfunction is real or is it socially constructed. I might write something like this:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Bures exemplifies a culturally mediated response that has existed since time out of mind: ignoring women’s symptoms.[/pullquote]

Erectile dysfunction is widely accepted to be a real disorder and there is an entire industry devoted to treating it with everything from medications to mechanical devices. But does erectile dysfunction reflect biological causes or is it figment of our sex ambivalent culture and men’s embrace of traditional gender roles?

You’d probably think I was nuts. Then you’d have some idea how I (and many other women) feel about author Frank Bures’ piece in Slate Is PMS real? Or is it a figment of our menstruation fearing culture?

Bures was researching culture specific syndromes:

Eventually this path led me back to my own culture, and to our own syndromes that don’t occur in other cultures. Premenstrual syndrome was near the top of this list. And much of what I read suggested that PMS was not caused by a tide of hormones wreaking havoc on a woman’s psyche, as I’d always believed…

He claims that PMS is social constructed:

… meaning it’s an imaginary condition foisted on women by society, which is another way of saying PMS is “not real.” Yet just because something is a social construction does not mean we don’t experience it—it simply means that our “real” physiological symptoms can have roots in our mind as well as our body.

Bures is wrong.

Part of the problem is that Bures conflates “culturally constructed” and “culturally mediated.” For example, Bures quotes several studies to support his contention.

Others have elaborated on PMS’s problematic nature as an evidence-based biological condition. Researchers Lisa Cosgrove and Bethany Riddle found that women who endorsed traditional gender roles experienced more menstrual distress. “One of the most striking results,” they wrote, “was that PMS discourse has gained such cultural currency that women often expect to have PMS.” Another study found that patients “firmly believed that PMS is biologically based, and they rejected situational attributions for their distress.” In another experiment, women who were misled to believe they were premenstrual experienced more symptoms of PMS than those who were actually premenstrual but who were misled to believe they were not.

But these studies don’t demonstrate that PMS is culturally constructed, merely that the way women experience and talk about their symptoms can be culturally mediated. The fact that the response varies among cultures is not proof that the syndrome itself exists only in the minds of its sufferers.

Indeed, the response to any condition, be it premenstural syndrome or erectile dysfunction is inevitably culturally mediated. A striking example occurs in the case of leprosy. The term “leper” originally meant someone who was suffering from leprosy (Hansen’s disease), a disfiguring condition that has long been met with social rejection. The term has come to mean a person who is avoided or rejected for moral or social reasons and that’s particularly apt when you consider that Hansen’s disease is not particularly contagious. Nonetheless, it was culturally perceived as punishment and in many ways people feared it more than an illness like tuberculous, which is far more common, more contagious and more deadly.

Yes, the response to leprosy has been culturally mediated, but that doesn’t mean that leprosy itself isn’t an organic syndrome. Similarly, while the response to PMS may be culturally mediated, it doesn’t mean that it is any less an organic syndrome than leprosy itself.

Ironically, in arguing that PMS is culturally constructed as opposed to culturally mediated, Bures exemplifies a different culturally mediated response that has existed since time out of mind, the culturally mediated response of men in discounting women’s symptoms, especially pain.

Bures alludes to this history before unwittingly adding to it. Bures explains:

In our own culture, the underlying idea behind PMS can be traced back 2,500 years to Hippocrates, the father of Western medicine, who believed that certain moods and physical disorders in women were caused by “hysteria” or the “wandering uterus,” meaning the organ literally drifted around the body, pulled by the moon, lodging in wrong places, blocking passages, causing pressures. Cures included marriage and intercourse, which supposedly worked. This notion endured for eons. But by the early 1900s, medical theories around “hysteria” were beginning to crumble. In 1908, at the meeting of the Societé de Neurologie in Paris, Joseph Babinski argued that hysteria was “the consequence of suggestion, sometimes directly from a doctor, and more often culturally absorbed.”

Hyster is the Latin word for uterus. Women’s ailments were traditionally classed as hysteria and thought to be caused by the uterus. But the fact that hysteria does not exist does NOT mean that the symptoms they were meant to describe did not exist. Hysteria provided a scientific sounding nomenclature by which to dismiss women’s real physical and psychiatric symptoms.

The diagnosis of hysteria may have disappeared but the cultural impulse to ignore women’s symptoms persists to this day. It is well established that women’s symptoms, particularly pain, are notoriously undertreated when compared to men’s symptoms. Women in agony are deemed to be “hysterical” while men are simply treated with the relevant medication or procedure.

Sadly, Bures is committing the same error in questioning the existence of PMS.

81 Responses to “Is PMS real? It’s every bit as real as erectile dysfunction.”

  1. Steph858
    November 29, 2016 at 9:36 am #

    And on the other hand, you get men who dismiss women’s emotions – no matter how justified by the circumstances they may be – as “It must be that time of the month.” What’s the betting there are men out there who simultaneously believe that PMS isn’t real and is just used by women as an excuse for brusqueness yet attribute women’s anger to hormones.

    • Empress of the Iguana People
      November 29, 2016 at 9:40 am #

      You’ve met stepfather #1?

  2. Melaniexxxx
    November 28, 2016 at 11:03 pm #

    He also later conflates “ovaries” and “uterus” as being the same thing. Dude. DON’T WRITE THIS SHIT WHEN YOU CAN’T GET THE BASICS RIGHT

    • AnnaPDE
      November 29, 2016 at 1:36 am #

      He should have just called the lot by the proper scientific name, which, I believe, is “icky girly inside bits”?

    • Heidi
      November 29, 2016 at 8:36 am #

      A few years ago I read the Joy of Sex, or at least I think that was the book. Anyway, he claimed that you could accidentally hit the ovaries and cause the woman pain during intercourse! I’m pretty sure what he meant was cervix.

      • Tigger_the_Wing
        December 2, 2016 at 4:44 pm #

        Actually, if you have a retroverted or partially-prolapsed uterus (not uncommon in women with EDS), the ovaries do get pulled into a position where they can be bumped during sex.

        I’m actually very grateful for that fact, because it quite probably saved my life.

        When the ‘bumping’ became painful, I went to the doctor.

        Long story short, I had pre-cancerous tumours on both ovaries and had a total hysterectomy in my thirties.

        I lost an aunt and a great-aunt to ovarian cancer; more than two decades on, I’m very much still here.

        • FallsAngel
          December 2, 2016 at 5:18 pm #

          Sorry for your problems; glad you’re still here to talk with us!

  3. BeatriceC
    November 28, 2016 at 9:34 pm #

    I’m late to the party today, but MrC caught this:

    “Sally, Bures is committing the same error in questioning the existence of PMS.”

    Should the first word be “Sadly”?

  4. Marie Gregg
    November 28, 2016 at 4:54 pm #

    What is this idiocy? PMS is definitely real. I’m 3 months post partial hysterectomy and I can still tell you when my “time of the month” is happening.

  5. critter8875
    November 28, 2016 at 3:57 pm #

    I’m a counter example: I’m a hetero white female raised in the USA, and I didn’t have any period problems beyond very minor cramps.

    • Sean Jungian
      November 28, 2016 at 4:02 pm #

      I’ve only had mild symptoms, generally of the diarrhea variety once my period starts, some achiness, I get a little easily-weepy sometimes. Nothing too terrible. I’m due for menopause soon but so far just more of the same, it’s mostly just a hassle for me now, rather than painful.

      But I’ve known women who have had terrible pain, too.

    • Emilie Bishop
      November 28, 2016 at 4:26 pm #

      Cherish this!!! My best friend is that way. As we’ve been friends since before puberty, I’m pretty sure I somehow stole her PMS symptoms and half of her blood flow through childhood sleepover osmosis, because I have enough symptoms for both of us.

      • BeatriceC
        November 28, 2016 at 9:24 pm #

        Childhood sleepover osmosis. I feel this explains so much, not just about this topic, but so much else.

    • Erin
      November 28, 2016 at 4:33 pm #

      I think I’m pretty fortunate too. My biggest period problem is the whole ickiness factor. I hate blood. I feel I can constantly smell it and so can everyone else in a 5 mile radius.

      Really hope they take longer to come back post baby this time around.

      • N
        November 29, 2016 at 12:23 am #

        Yes, I don’t like all that blood either. I hate it and can smell it too all the time. And it is so much of it. And what makes it worse for me is the fact that since my second child was born, I can’t wear normal disposable pads anymore. They make me all itchy. I don’t know why. Probably related to the fact that I can’t wear new cloths until washed several times. And as I just don’t like tampons, make it washable pads for me. It feels better, is a bit less smelly, but I don’t feel really save with them – too much blood. And I have to wash all that blood out. No not cool. I wish myself beyond menopause…

        • Inmara
          November 29, 2016 at 4:01 am #

          I hate that most of disposable pads nowadays come with strong aromas, which means they are more likely to irritate skin (and combination of blood and artificial scent is, well, not pleasant anyway). I have tried several “eco” and “organic” pads but none of them have figured out how to make a pad which actually stays in place safely, so I’m back to Always and Libresse.

          • Gatita
            November 29, 2016 at 11:21 pm #

            Have you tried store brands? More utilitarian, less likely to be scented.

          • Inmara
            November 30, 2016 at 3:03 am #

            We don’t have store brands for feminine hygiene items at all (though it’s a question of time, there are already some store brand diapers available). Small market, no big worldwide chains here.

          • Dr Kitty
            December 2, 2016 at 5:03 am #

            Menstrual cup.
            Game changer.
            Several online stores with worldwide shipping.

          • N
            December 2, 2016 at 6:25 am #

            Yes I have those too. It is just,… I don’t like to insert things there, I don’t like the feeling of permanently having something in there, although cups are more comfortable than tampons. And, I am always a bit afraid, that if the cup is full before I have time to change it, what will happen? So, very often I choose a cup combined with a cloth pad for going out, a tampon for swimming and a cloth pad while at home, and disposable pads (always Always) while traveling.

            @Inmara, oh yes, organic pads are really crap. They don’t stay in place and they can’t deal with a great amount of blood. And for scented pads, well as a teenager back at my parents house, they liked their scented toilet paper. And even back than I didn’t like the smell of it at all and that paper irritated my skin too. So I don’t even dare try scented disposable pads.

          • Inmara
            December 2, 2016 at 7:07 am #

            I haven’t tried cups for the same reason – don’t like even tampon going in there. Anyway, it’s still better than using just piece of cotton or cloth as it was the case for only 2 decades ago (don’t know when proper pads were available in Western countries but in Soviet Union there were none).

    • LaMont
      November 28, 2016 at 5:07 pm #

      Yeah, I was told that every month I’d go batshit crazy and want to die, and pretty much believed it, but ended up only with 24h/month of draining, slightly painful cramps and (more recently) exacerbated IBS symptoms. Pre-menstrual symptoms? Pretty much zilch. Mine’s super irregular, so I’d love a warning beyond “increased abdominal pain” which, having IBS, isn’t much of a help. And I’m a rolling ball of hair-on-fire craziness *most* of the time, so…

    • AnnaPDE
      November 29, 2016 at 1:35 am #

      I used to be like that, too, and was wondering what people meant with PMS. And then endometriosis started and suddenly it was massive cramping and AAAAARGH I HATE EVERYONE AND I’LL KILL ANYONE WHO COMES CLOSE and icky stupid amounts of blood clots at the worst moments. I guess awful pain in the lower abdomen, coupled with a loss of full control over bodily excretions, doesn’t exactly make anyone happy and easy to get along with.
      Though I guess PMS does get mixed up with this kind of horrible during-menstruation-mood.
      Anyway, I’m glad my period isn’t back yet.

    • StephanieJR
      November 29, 2016 at 11:09 am #

      I’m usually not too bad; more fatigue than bad cramping. Sometimes a touch of the runs. But every now and again I have a real bad ‘episode’; I’ve actually vomited a couple of times, and stripped naked to hold a tub of ice cream against my tummy, or lain on a tiled floor. I feel feverish and generally icky. But they only seem to happen every few years, and it’s been a while.

      What was weird was skipping a couple (not in a row), as a virgin. And a couple years back I switched dates.

      • critter8875
        November 29, 2016 at 6:21 pm #

        When I went away to college at 18, I went 4 months without a period. Didn’t miss it and wasn’t worried because I was a virgin.

  6. OttawaAlison
    November 28, 2016 at 3:48 pm #

    I have PMDD, only when I finally got my depression treated did I realize how bad it was. I would suddenly start to get really dark thoughts each month. Having been diagnosed with PMDD has been great, when I have a dark thought, I can look at my cycle and know my period is coming up which helps me cope. I guess it’s in my head, but it is not a social construct – it’s my brain reacting to the changes in my body.

    • Megan
      November 29, 2016 at 9:26 pm #

      I hear you! I developed this after delivering my second child. It finally started to ease up about 7 months postpartum but it was a real shock at the time for someone who never had any PMS at all prior to that. It was like clockwork too; horrible anger and irritability for about 24 hours exactly 10 days before my period and increasing sadness for the rest of my cycle. As soon as my period arrived it was like a literal cloud lifted. I’m so glad it’s improving because I feared it would be my new normal. It’s horrible and it’s very real (and I think associated with stopping breastfeeding for me),

    • Taysha
      December 1, 2016 at 9:38 am #

      This.

      I have a few friends that seriously ask to check how close I am to my period sometimes because of this exact same behavior. At this point, my bestie (and sounding board for those types of feelings) will literally ask “should I worry about you, or will this pass in three days?”

  7. StephanieA
    November 28, 2016 at 2:27 pm #

    So just like labor pain is a social construct as well? I guess us silly women are imagining intense pain during labor and epidurals aren’t really needed. I just love hearing that everything I experience is ‘all in my head.’

    Sort of related, we have an anesthesiologist who was in a case and wouldn’t be able to place an epidural for a patient. Understandable, but he then tried to refuse calling his backup in because ‘epidurals aren’t necessary.’ I don’t see them ever making that argument for emergency surgeries.

    • Charybdis
      November 29, 2016 at 11:10 am #

      A good wallop upside a man’s head with whatever object is nearest is clearly in order. Then we can “tut-tut” and “tsk-tsk” over their whiny response and tell them that the pain “is all in their head. Maybe your hormones are out of whack, too”. Because the pain would really BE in their heads, what with being walloped with a chair.

      Then, kick them in the crotch. Tell them that THAT pain is also “just in their head” and not really real/happening. Ask them if they can see the difference.

      • StephanieJR
        November 29, 2016 at 11:16 am #

        I may have actually done that to my brother once.

  8. Emilie Bishop
    November 28, 2016 at 2:24 pm #

    This is why endometriosis takes an AVERAGE OF 9 YEARS to correctly diagnose and why our treatment options are so inadequate. If men had constant pelvic pain, let alone my severe PMS symptoms, there would be a cure for all of it last week. But women just have to suck it up because that’s life. Can’t even tell you the number of times and ways my gynecological pain and hormonal symptoms have been minimized, and I’m sure there’s a next time because it’s so ingrained in our culture we don’t realize we do it.

    • Dr Kitty
      November 28, 2016 at 5:43 pm #

      Yup.

      Hyperemesis too.

      Apparently it is somatising an unconscious fear of pregnancy or rejection of the baby…or so one (older, male) psychiatrist of my acquaintance believes. He got quite het up about the fact women were getting TPN, anti-emetics and steroids instead of some psychodynamic psychotherapy to help them better accept impending motherhood.

      Because people often somatise themselves into renal failure and Wernicke’s encephalopathy *eyeroll*.

      The thing about somatising is that it is unconscious and *protective* because you feel physical distress instead of emotional distress. Your unconscious doesn’t generally try to kill you outright.

      • Emilie Bishop
        November 28, 2016 at 6:11 pm #

        Oh, that’s terrible! Women can’t even throw up without someone mansplaining it away with psychobabble.

      • fiftyfifty1
        November 28, 2016 at 6:20 pm #

        Probably he has had good success with psychodynamic therapy for hyperemesis…although he has found it takes about 12 weeks of sessions for most women.

      • N
        November 29, 2016 at 12:29 am #

        Yeah, and somehow I know already in the first weeks of pregnancy that it will be a boy. And I only reject boys. As my 24h/day for 20 weeks morning sickness was ways more horrible with my first and third boy, than with my second girl…

        • Kelly
          November 30, 2016 at 8:11 pm #

          Oh no. I thought it was the other way around. I have only had girls and each time I get sicker. I am hoping that if I ever have a boy that it will be easier.

          • Tigger_the_Wing
            December 2, 2016 at 4:56 pm #

            I missed a fair bit of work when pregnant with my eldest son, from being to sick to stray too far from a loo. The second wasn’t nearly as bad, but I don’t think that it had anything to do with my then being a SAHM.

            My worst times for vomiting were with my twin pregnancies; for the girls and the boys. But the first one, with my daughter (her twin died during pregnancy) was definitely the worst. I lost so much weight that by five months I was 16lbs lighter than I had been before pregnancy, and I was 40lbs underweight to start with.

    • Caylynn
      November 28, 2016 at 6:03 pm #

      Yes. Took an enormous amount of time for my 4th degree endometriosis to be diagnosed, and only because I ended up writhing in pain and vomiting in the ER. I was told that my pain was ‘normal’ – sure, it’s ‘normal’ to be curled up for 3-4 days, once a month, in the fetal position, unable to function, due to severe pain. I just needed to ‘deal with it.’ It is not like my pain tolerance is low – after fracturing my L2 vertebra falling off a horse while jumping, I finished the lesson, untacked and groomed the horse, cleaned the tack, and drove myself home (30 min drive). Then drew myself a bath when I got home, and only thought something was wrong when I had trouble getting out of the tub.

      • Emilie Bishop
        November 28, 2016 at 6:13 pm #

        I’m sorry for your pain and suffering. I was diagnosed very quickly (a couple of months after noticing symptoms following a miscarriage), but doctors all throw up their hands when I say their pet treatment doesn’t make a dent in my pain. Like I’m sabotaging their efforts because I like feeling this bad. Endo needs to die! PMS along with it!

      • Caylynn
        November 28, 2016 at 8:01 pm #

        Sorry that you are dealing with this horrible disease too. At least I was a good student in high school, so when I missed class, it wasn’t questioned. Currently dealing with constant low level pain, which is not fun. At least it’s not incapacitating. Wondering if my age (early 40s) is having an effect (previously my pain was only during my period, but continuous BCPs and Mirena did not work for me).

        • Inmara
          November 29, 2016 at 4:08 am #

          My late grandmother claimed that she haven’t lived several years of her life, just due to being completely incapacitated by menstruation several days a month. I seem to have inherited some traits of it, fortunately once I quit toughing it up and started to take Ibuprofen for 1-2 days a month I can live through it. No serious PMS, though, just mild ache in lower back that reminds to put some pads in my purse.

  9. November 28, 2016 at 2:24 pm #

    If they can now simulate labour for men, why not let them have a go with “simulated” menstruation. Seriously, men would be out-of-their-minds if they had to deal with an average woman’s period. Just look at how splendidly they handled a trial run of male birth control, which was discontinued because the “side-effects” were unacceptable. So those were real, but a woman’s PMS is all in her head?

    • J.B.
      November 28, 2016 at 2:52 pm #

      The male birth control study called off due to hormonal wackiness…yeah…

      • Sean Jungian
        November 28, 2016 at 3:28 pm #

        Main side-effect? Acne and mood swings.

        http://www.npr.org/sections/health-shots/2016/11/03/500549503/male-birth-control-study-killed-after-men-complain-about-side-effects

        From the NPR article, this speaks volumes:
        “But there’s a little bit of a different risk-benefit analysis when it comes to men using a contraceptive. When women use a contraceptive, they’re balancing the risks of the drug against the risks of getting pregnant. And pregnancy itself carries risks. But these are healthy men — they’re not going to suffer any risks if they get somebody else pregnant.”

        Riiiiiiight, a man has no risks when getting a woman pregnant – that’s a pretty widespread belief, too.

        • fiftyfifty1
          November 28, 2016 at 6:23 pm #

          “Main side-effect? Acne and mood swings.”

          Well that and a death from suicide and a case of permanent infertility. This trial was not stopped because “men couldn’t hack it”. The safety profile simply was unacceptable and it would have been unethical to continue.

          • Melaniexxxx
            November 28, 2016 at 11:10 pm #

            Suicide is also listed as vaccine side effects too? Just because something happens in a clinical trial doesn’t mean it’s RELATED to the trial

          • fiftyfifty1
            November 29, 2016 at 8:31 am #

            “Just because something happens in a clinical trial doesn’t mean it’s RELATED to the trial”

            But when it happens to a person without any prior history of mental illness or depression, it needs to give us pause, no? Or should the ethics board just blow it off?

          • indigosky
            November 29, 2016 at 5:06 pm #

            They do for female birth control. My friend had zero prior depression, and the Pill made her suicidal. Yet it has been brushed off by multiple doctors. And she’s not the only one. So no, its hard when it happens to men and they immediately pull the drug and it happens to women and no one gives a shit. Sexism at its finest.

          • fiftyfifty1
            November 29, 2016 at 5:21 pm #

            So to make it “fair” in your eyes the trial should have continued?

          • Taysha
            December 1, 2016 at 9:48 am #

            http://press.endocrine.org/doi/pdf/10.1210/jc.2016-2141

            Actual study

            The suicide was confirmed as unrelated and related via family to grades/school during follow up phase.

            And I quote, from the paper: “The AEs of
            concern to the RP2 were reports of mood changes, depression, pain at the injection site, and increased libido.”

            Is it ethical to continue a study or approve a drug with increased side effects? No. But apparently those ethics only apply if the drug applies to men. I have zero issue with a study being ended for ethical reasons such as increased AEs. I have all the issues with this not triggering an immediate review of all female BC on the market with even worse AEs than those reported in this study.

            Of note: none of the participant suffered any cardiac or hematological events. Blood clots and stroke, potentially deadly, are a high incidence side effect in female bc.

          • fiftyfifty1
            December 1, 2016 at 11:49 am #

            “The suicide was confirmed as unrelated and related via family to grades/school during follow up phase.”

            The authors can say that, but clinical trials don’t work that way. Deaths are taken very seriously, and rightly so, if there is any plausible mechanism at all to the death. The family can say “it was life stress, not the meds” but how do we know this is true? The med might be the straw that broke the camel’s back,no?

            Pulling this trial is very similar to another trial I have seen pulled. The medical school where I trained was doing an early trial of a antidepressant. A young woman killed herself shortly into the trial. Some claimed that she had had prior emotional disturbances, and that it wasn’t the drug’s fault. The drug got pulled anyway.

          • Taysha
            December 1, 2016 at 11:56 am #

            I would agree with you if the RP2 had pulled the study due to the suicide. The suicide was not the reason it was pulled.

            Re: infertility – the threshold for return to fertility for the study was 15 million sperm per ml. The subject who remained infertile failed to reach that threshold. The problem here being that even low sperm counts can be fertile. Not knowing what the final sperm counts were make me wonder.

            Again, I’m not saying the trial should have not been pulled. I’m saying I expect the same metric to now be applied to female bc.

          • Taysha
            December 1, 2016 at 9:56 am #

            For contrast, I offer you the NDA for Yasmin. This is documentation APPROVED by the FDA, based on studies that were NOT stopped.

            There is no mention in any of the AEs of depression. It was not followed as a potential AE. So, what you don’t know, apparently doesn’t exist.

            http://www.accessdata.fda.gov/drugsatfda_docs/nda/2001/21-098_Yasmin_medr_P1.pdf

            Please look at page 9 and 21, if nothing else. 14-25% of women had to be REMOVED FROM STUDY due to AEs. If I remember it was just 1 in the men’s study.

            Yet Yasmin was approved.

          • fiftyfifty1
            December 1, 2016 at 11:04 am #

            Hmm..that link’s not working for me.

          • fiftyfifty1
            December 1, 2016 at 11:39 am #

            Ok, now the link is working for me. Here are my thoughts:

            “There is no mention in any of the AEs of depression. It was not followed as a potential AE. So, what you don’t know, apparently doesn’t exist.”

            Actually it was followed. It’s there in your link.

            “Please look at page 9 ”

            I’m not impressed. A number of women were removed from the study, but it was because the trial design was very cautious. 28.7% of women on the drug were classified as having “severe” AEs, but it turns out that these AEs were overwhelmingly nausea, breast pain and headache. Nausea and breast pain on OCPs are well known side effects. They also occur with hormonal fluctuations in nature (e.g. luteal phase and pregnancy) and typically go away within 3 months of pill use. For headache/migraine, it doesn’t tend to go away with time, and women with migraine with aura should not be on estrogen-containing OCPs at all. That’s why standard of care is to screen for these disorders in clinic and recommend another type of BC if a woman has them. A final note: 14.6% of women on PLACEBO also qualified as having a “severe” AE. What is more important is that there were no “Serious” AE’s and no deaths with the med (the terminology is confusing to the uninitiated, but a “serious” AE is actually serious, whereas a “severe” AE is something that no regular person would tend to see as “severe”…I mean breast tenderness…come on). The men’s trial, in contrast, had a number of “serious” AE’s including 1 death, 1 other attempted suicide, a number of temporary infertilities (~ 2 years) and 1 permanent infertility. If Yasmin had had these, the trial would have been yanked too.

            “Please look at page…[…]…21”

            I’m confused as to why this is relevant. If I’m interpreting it right, it seems to be a short study of the different components of the drug given at all sorts of different concentrations (including unopposed estrogen) just to make sure nothing is obviously poisonous at these doses? It was not designed to reflect real life prescribing.

          • Taysha
            December 1, 2016 at 9:40 am #

            There was one suicide reported, and the family of the individual verified it was related to his grades/life circumstances.

            Source: I read the actual paper. It’s listed under AEs

          • indigosky
            November 29, 2016 at 1:52 am #

            Yet women’s birth control does all that and more and except for Yaz, its all still allowed to be on the market. So excuse me for not caring that men get side effects and a product is pulled, yet they allow meds with the same side effects because us silly wimmenz are just making it up. Been through several birth control methods and have had various doctors that told me just to deal with it, its better than pregnacy. So fuck them and their bullshit that I’m hysterical or that I should suck it up.

          • SporkParade
            November 29, 2016 at 7:10 am #

            The men were reporting serious side effects at about 15x the rate of women, and the medication was only 96% effeective.

          • indigosky
            November 29, 2016 at 5:01 pm #

            So? Women have more side effects than thye should with birth control as well and those are ignored because we bear 100% responsibility for not getting pregnant. But when it’s men its OK. So no, zero sympathy.

          • Taysha
            December 1, 2016 at 9:42 am #

            Actually, they were not.

            Effectiveness, per the authors, was similar to female birth control and the percentage of men reporting an adverse event was low, and the vast majority were mild (there were 2 reports, if I remember, of moderate acne).

            When the DSM reviewed it, they were concerned that men were actually experiencing acne and mild mood depression and stopped the study.

            The paper is rather rage-inducing when you compare it with the percentage and listing of side effects for women.

          • fiftyfifty1
            November 29, 2016 at 8:27 am #

            Hormonal birth control does not cause permanent infertility in women, while exogenous testosterone has been documented multiple times to do so in men. And you may think that a death in a previously healthy person falls into the “excuse me for not caring” category, but most people don’t.

          • indigosky
            November 29, 2016 at 5:04 pm #

            Bullshit. The depo shot has caused infertility in women.

            And that death was not fully linked to the meidcation, so I am still calling bullshit. Correlation does not equal causation. – why is that used here all he time but suddenly forgotten when it comes to this study?

          • fiftyfifty1
            November 29, 2016 at 5:35 pm #

            Studies show Depo does NOT cause permanent infertility in women. If you disagree, cite some evidence. In contrast, exogenous testosterone has been shown multiple times to cause permanent infertility in men.

            I get it that you don’t like hormonal contraception for women. You yourself didn’t like it, and you have friends that didn’t like it either. But the vast majority of women don’t have side effects and do like it. It was life changing for me.
            Here’s the thing: you don’t have to take hormonal contraception, and neither do your friends. Nobody is forcing you. To be so angry at hormonal contraception for women that you feel that men’s experimental hormonal treatments should be forced to continue to “make it fair” is immature. There is a reason there are ethics boards overseeing clinical trials.

          • SporkParade
            November 30, 2016 at 4:12 am #

            For biological reasons that are unfair but not the fault of sexism, it is easier to develop hormonal contraception for women than it is for men. If you have problems with hormonal contraception, there are quite a few fairly reliable options that still distribute the responsibility, including condoms and (assuming you have a very regular cycle) natural family planning. The fact remains that the overwhelming majority of women who use hormonal contraception are pleased with it. By the way, one could also argue that women benefit from being in charge of contraception because it means that women in abusive relationships don’t lose control over their fertility.

          • fiftyfifty1
            November 30, 2016 at 9:26 am #

            “For biological reasons that are unfair but not the fault of sexism, it is easier to develop hormonal contraception for women than it is for men. ”

            Exactly. Women only ovulate one day per month. It’s easy to recreate the hormonal milieu of the luteal phase and then the body reads this as “I’ve already ovulated” and won’t produce an egg. Men, in contrast, make sperm every day. You have to keep them in an entirely not-found-in-nature hormonal state for them to turn off sperm production.

        • Steph858
          November 29, 2016 at 8:42 am #

          In fairness, female BC can have beneficial side-effects too which would factor in to the risk-benefit analysis in a way that the (all negative, IIRC) male BC side-effects don’t.

          To use myself as a personal anecdote, my periods were debilitatingly painful when they started when I was 14. I was ‘too young’ to use BC (read: my GP didn’t want to be seen as encouraging underage sex. Don’t know why; [i]Gillick v West Norfolk and Wisbech Area Health Authority[/i] would protect him from any such accusations). Over the years I tried many non-BC medicines from Naproxen through Mefenamic Acid up to Nurofen Plus. They helped, but not nearly enough.

          Years later, when I needed BC for its main purpose (as opposed to its beneficial side-effects), I searched for the kind that would help the most. Depo Provera was the best – no periods at all – but trekking 5 miles each way to my nearest Family Planning clinic every 3 months was a pain in the arse both literally and figuratively. So I went with Implanon and it was brilliant. I have 2 or 3 periods a year and they are very light in terms of both flow and cramp levels. I’ve had no negative side-effects from it.

          TL;DR: Side-effects from female BC aren’t all bad.

      • Azuran
        November 29, 2016 at 10:12 am #

        It wasn’t actually this simple.
        Here’s another OB who does a good vulgarisation of why the study was cancelled: https://drjengunter.wordpress.com/2016/11/01/new-study-doesnt-show-men-are-wimps-about-contraception-side-effects-low-vasectomy-rate-might/

    • An Actual Attorney
      November 28, 2016 at 9:21 pm #

      Years ago, in a cash strapped phase, I went with my then-BF to sell our bone marrow. It was something like $300 each for something we made anyway, and seemed worth it. I went first. I said it hurt, but no worse than a normal period cramp and only took a few minutes. BF went next. He said it hurt like unimaginable hell. He and the male doctor agree that they were both really damn glad that they weren’t women.

    • Charybdis
      November 29, 2016 at 11:18 am #

      Google The Try Guys and find their YouTube videos of experiencing periods and labor pain simulations. They are hysterical.

  10. Empress of the Iguana People
    November 28, 2016 at 1:50 pm #

    It doesn’t help when PMS isn’t all that well understood by us lay people. I remember my roommate and I having an argument (in the philosophical sense rather than in the getting angry sense) over whether PMS was the usual pre-period symptoms or if it’s unusual ones.

  11. Krista
    November 28, 2016 at 1:41 pm #

    I love a good mansplain to start off my week. Please, Frank, tell me more about myself and my body.

    • Sean Jungian
      November 28, 2016 at 1:54 pm #

      Thank goodness we have men to do the heavy thinking for us.

      *insert most-over-the-top-eyeroll here*

      • Empress of the Iguana People
        November 28, 2016 at 2:10 pm #

        I tell my husband that next time he can be the girl.

  12. Zornorph
    November 28, 2016 at 1:01 pm #

    Why on earth would a man even attempt this subject? I mean, at least if it was a woman, she’d have her own experience to draw on. Either way, I’m going to take the word of Dolly Parton over this guy:

    Eve you wicked woman, you done put your curse on me
    Why didn’t you just leave that apple hangin’ in the tree
    You make us hate our husbands, our lovers and our boss
    Why I can’t even count the good friends I’ve already lost
    Cause of PMS blues

  13. Taysha
    November 28, 2016 at 12:39 pm #

    Societal constructs do not give me suicidal ideations every roughly 4 weeks.

    It’s commentaries like this one that makes me want to go on the feminist warpath and makes me wish men a few rounds of PMS and cramps and a particularly gleeful proctologist.

  14. AirPlant
    November 28, 2016 at 12:29 pm #

    Fun fact: as a teenager my (female!) doctor told me that cramps were purely psychological.
    .
    Five years later my IUD was installed. I was shocked to discover that the pain was the exact same feeling as my cramps. the OBGYN looked at me like I was nuts and basically said no shit Sherlock, cramps are caused by your cervix dilating.

  15. mighty_aphrodite
    November 28, 2016 at 12:26 pm #

    I’m sure that the fact that the reason it feels like my nipples are going to fall off, and I gain at LEAST 5 pounds before my period it totally cultural in origin. *eyeroll*

  16. J.B.
    November 28, 2016 at 12:16 pm #

    Thank you for this. I think there may also be some parallels between “PMS doesn’t exist” and “childbirth isn’t really painful”.

    • MaineJen
      November 28, 2016 at 12:20 pm #

      Yes, this “the pain is all in your head” argument is eerily similar.

      Those cramps sure felt real to me.

    • StephanieA
      November 28, 2016 at 2:30 pm #

      Oops, read your comment after I commented. This was the first thing I thought of as well.

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