premenstrual syndrome ( pms) biological/psychosocial???
TRANSCRIPT
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 SxBloating Irritability
Breast tenderness Anxiety
Cramps Depression
GnRH
FSH LH
EstrogenProgesterone
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